Katherine G. Lucatorto, DNP, RN Thomas Jefferson University Jefferson School of Nursing

1. Evaluation of the Utilization of the Interactive Screening Program at an Urban Health Services University Katherine G. Lucatorto, DNP, RN Thomas Jefferson University Jefferson School of Nursing (The speaker has no conflicts of interest to disclose)

2. Background and Significance • The history of mental health services on college campuses in the United States spans just a century. • In 1910, Princeton University organized the first mental health service dedicated to treating students. The next decade brought about similar services in other schools. • The importance of mental health (‘mental hygiene’) was recognized at the first American Student (now College) Health Association meeting in 1920 (Kraft, 2009). • Depression is the primary reason college students report a need for mental health services. • The risk of suicide increases with clinical depression.

3. Purpose The purpose of this project was to assist with staff training, implementation and evaluation of the Interactive Screening Program (ISP) at Thomas Jefferson University, Philadelphia, PA.

4. ???? What is the Interactive Screening Program?

5. Primary Project Objectives 1. Participate in ISP training provided by AFSP. Training included all program procedures, website technology and recommended evaluation activities. 2. Design and oversee ISP implementation such that substantial data would be generated to assess the use and effectiveness of the ISP. 3. Create an evaluation plan for the ISP incorporating recommendations from the AFSP and observations made at similar university mental health services settings.

6. Clinical Questions • How many students are logging on to the website and completing the Stress and Depression Questionnaire? • What is the use and effectiveness of the ISP as determined by: a. How many students were assessed to be in need of immediate (tier 1a or tier 1b), intermediate (tier 2) or generic (tier 3) follow-up by an ISP counselor? b. How many students returned to the website to access the counselor’s response? c. How many students engaged in online dialogues with an ISP counselor? 3. How did the ISP model compare with practices at similar area university mental health services?

7. Assumptions and Limitations Assumptions: 1. The SPCC would successfully implement the ISP in roll out phases. The participants in phase one would likely be limited to the student body of one school (i.e. School of Nursing, School of Pharmacy, etc). 2. The mental health needs of the students at TJU would be accurately assessed via the ISP. 3. Student response rates would yield sufficient data to conduct a thorough evaluation of the program. Limitations: 1. Participation was voluntary and student response rates may be low. 2. The ISP cannot guarantee all students would be honest when asked about their mental health status or needs. 3. The stigma of mental illness has an effect on help-seeking behaviors.

8. Conceptual Framework • The nursing theorist Jean Watson, developed the Model of Human Care (Watson, 1979). The emphasis of Watson’s theory is placed on the interpersonal process between the caregiver and patient. Although this framework is based in nursing practice, it can readily apply to any caregiver relationship (Felgen, 2004). • Watson’s framework was chosen to guide this project as it is believed by the author that the Model of Care is applicable to the nature of implementing the ISP for college students and fits the vision, mission and values of TJU. Implementing such a program fosters a caring and healing environment.

9. A Peek at how other Academic Institutions Care… • Site Visits • Similarities and Differences • Lessons Learned • ISP utilization

10. How Does the ISP Work? • Email Invitation • Program Website • Stress and Depression Questionnaire (see: handout)

11. How Does the ISP Work?(continued) Tier Designation • Based on their answers to specific questions in the Stress and Depression Questionnaire, students are placed in one of four tiers. • Criteria Tier 1a, Tier 1b, Tier 2, Tier 3

12. How Does the ISP Work?(continued) • Counselor Responses (Templates) • Online dialogue • Face-to-Face Counseling • The ultimate goal

13. Website • Website Development and Hosting • Training of Program Staff • Student Personal Counseling Center at TJU • Data Security

14. Tier 1a 2 Tier 1b 1 Tier 2 7 Tier 3 0 Female 7 Male 3 Mean Age 28.4 yrs. History of Suicide Attempt 0 Current Suicidal Ideation 0 Currently in Counseling or Therapy 1 Currently taking Medications (Anxiety; Depression; Stress; Sleep) 1 Full-time Student 10 International Student 2 Demographic Characteristicsof Pilot Sample

15. Where are we now? Discussion of current data as of October, 2011

16. Conclusions • The ISP is one simple way to engage students in better addressing their mental health needs. • It is worthwhile to evaluate the implications of an asynchronous mental health screening tool and the long term effects it has on student mental health, wellness, and academic success. • In the future, the ISP may also prove beneficial to the growing number of online programs being offered at many universities.

17. Implications and Recommendations • It is recommended that the project continue and be expanded to the entire student body. • TJU provides the unique opportunity for the ISP to be evaluated among students specifically engaged in health profession studies. • This collection of data will help to evaluate the mental health issues and needs of health professions students in general. • The data will include students from baccalaureate to PhD programs, as well as medical students. • It is important to assess the needs of students who are engaged in what are sometimes referred to as ‘helping professions.’

18. ISP Partnership(Your academic institution and the American Foundation of Suicide Prevention) Questions and comments should be addressed to: Ann P. Haas, Ph.D. Director of Prevention Projects American Foundation for Suicide Prevention 120 Wall Street, 22nd Floor New York, NY 10005 (207)236-2475 ahaas@afsp.org