What could we have provided or done differently?

1. What could we have provided or done differently? A closer look at students’ suggestions for campus services. Ashley Boynton Sarah Christman Elizabeth Hentschel Stuart Irvin Erika Jonietz with Dr. Chris Brownson

2. Founded in 1991 at The University of Texas at Austin • Six completed studies to date • Membership in Consortium is determined study-by-study, and all are welcome and encouraged to participate • In the process of developing two more studies

3. Overview of Presentation • The Intervention Continuum • Basics of 2011 study • Themes of student responses • Break into small groups • Q&A

4. c

5. Basics of the 2011 Study • Anonymous, web-based survey • Random sample at each school • 73 colleges and universities participated • Over 26,000 undergraduate and graduate student responses (≈101,000 surveys sent)

6. Basics of the 2011 Study We looked at: • Risk Factors and Protective Factors • Stressors • Distress and Suicidality • Coping Behaviors • Connectedness (family, friends, university) • Sense of Coherence • Help Seeking

7. We asked students… “Please reflect on the most stressful period of time that you have experienced in the past 12 months, including the present day. While it may be difficult to choose just one time, please think back on your experiences over the past 12 months and identify a single period when you were most upset, distressed, or overwhelmed.”

8. We then asked… “What could your college or university have provided you or done differently to better help you manage during this stressful time?”

9. First, some numbers: Blank — 9,229 + “Nothing” — 4,851 + “Not much” — xxx + “N/A” — xxx + “Not sure” or “Don’t know” — xxx _______________________ = 16,000 uninformative responses ≈10,000 suggestions!!

10. Themes we will not be covering: • “Less schoolwork.” • “More financial aid.” • Spreading out exams/finals. • Requests for specific groups. • Practicum student concerns.

11. A Matter of Balance: • Students, Professionals, and Services • Just because a suggestion is made, does not mean it is appropriate, possible, realistic, or within the scope of services that we could or should provide. • In order for an intervention to work to the best of its capability, it has to work for us as well.

12. Availability of Counseling Services

13. Availability of Counseling Services • Themes: • Session Limits • Frequency of Sessions • Eligibility for Services • Accessibility • Non-Traditional Services • Following Up

14. Session Limits • “If they had offered more than 6 sessions with a counselor.” • “They could have offered more than 10 sessions. I was afraid to go if I didn’t really need it that day for fear of wasting sessions.”

15. Session Limits • “More free sessions provided by the college.” • “We are only allowed a particular number of visits during our academic career... I reached my limit my first semester. I feel that if a student is serious about visiting the center to get help, that help should be available.”

16. Session Limits • “I wish there wasn’t a session limit per student per year. My counselor went above and beyond to request a few extra sessions so that I wouldn’t feel so much like I was kicked out the door. It just would have been nice to not have a limit on your recovery.”

17. Frequency of Sessions • “The ability to see my counselor more often (instead of every 2–3 weeks).” • “To be able to talk to a professional for more than an hour or more than once a week.”

18. Frequency of Sessions • “The counseling center was difficult to use because the counselors were very busy and were available only once every three weeks on average. It would be more helpful if I could see them once a week.”

19. Eligibility for Services • “My college, [XXX], requires that student take 12 credit hours in order to be eligible for counseling. As a student who takes 10 credit hours, I was seriously distressed and felt like I had nowhere to turn to. Finally, they saw me on a one-time, crisis basis.” • “Allow students who were enrolled in the spring and fall semesters to utilize the counseling services in the summer if need be.”

20. Eligibility for Services • “They denied me counseling services because I was not currently enrolled in any classes, even though I was enrolled in a program. If a student is enrolled in a program at the University, they should be able to receive services, whether or not they are currently taking classes. For example, during the summer.”

21. Eligibility for Services • “I dropped a class when my father died. When I called to get grief counseling, they said I was ineligible because I wasn’t full time. I explained the situation, and they refused.”

22. Accessibility • “Have quicker access to appointments. I found it difficult to get an appointment when I was feeling in crisis.” • “Having therapists or psychiatrists available after business hours.” • “Walk-in counseling. Emphasis on walk-in.”

23. Accessibility • “People aren’t 8–5, M–F. Be open when people need help.” • “Open up the counseling hours for students who are only on the campus in the evenings.” • “Weekend counseling!! And more than five free sessions. That’d make it much more usable.” • “Weekend and/or evening opportunities for counseling on campus.”

24. Accessibility • “Help outside of counseling center hours. There were many times when I needed help when the counseling center was not open, and I did not know who to turn to.” • “Being able to have a counseling session over the phone, maybe.” • “Online appointment scheduling.”

25. Non-Traditional Services • “So many students live off campus and participate in online learning. I think that the university counseling service should have online services [for] students.” • “Provide some type of counseling service to non-traditional students who do not live on or near main campus.”

26. Non-Traditional Services • “Provided online communities for distance students working on their graduate degrees. It is helpful to know that others are going through the same process.” • “Random e-mail center where you could ask questions and receive anonymous responses.”

27. Non-Traditional Services • “Online counseling. I am an online student.” • “Perhaps outreach services of some kind for students who are off-campus. I am a distance education student so am unable to take advantage of the support on campus. Perhaps cohort or online groups for people struggling with similar problems.”

28. Non-Traditional Services • “Live one-on-one online chat that did not have to be scheduled ahead of time.” • “I am currently taking online classes. Internet resources would have been helpful.” • “Anonymous chats or online counseling.”

29. Non-Traditional Services • “It would have been nice to be on a online forum with people who were experiencing similar signs of depression, so I could have a community I could connect with at all times of the day.”

30. Following Up • “The university referred me to a nutrition counselor when I came in at a low BMI... but then did nothing to follow up.” • “The mental health department could follow up better when someone misses appointments because they may be missing the appointment because they are not functioning very well.”

31. Following Up • “Provided more attentive medical staff. Checked up on me after my initial visit—rather than me coming to them.” • “Asked me to come back for a follow-up appointment at the counseling center.”

32. Provider Options • “Give me the option of [choosing] my psychiatrist, because I would have rather had a female than a male.”

33. Summary of Themes • Session Limits - More free sessions, offering longer-term services • Frequency of Sessions - Allowing students to schedule with clinicians on a more regular basis • Eligibility for Services - Part-time and summer enrollment

34. Summary of Themes • Accessibility - Quicker access to appointments - Services available after business hours - Evening/weekend counseling • Non-Traditional Services - Offer online counseling - Offer anonymous help services - Building online communities for distance learning students

35. Summary of Themes • Following Up - Checking in with students post-treatment/ contact • Provider Options - Ability to request a male or female clinician

36. Miscellaneous (Not so helpful responses)

37. “Puppies and kittens. Best destressors ever.” • “A mass e-mail that told me that I am cool.” • “Save me from the pirates.” • “Um, added days to the calendar?” • “Free beer would be very helpful.” • “A better meal plan. The food is disgusting.”

38. Visibility of Counseling Services

39. Visibility of Counseling Services • Themes: - Raising Awareness - Cost and Availability of Services - Advertising - Campus Policy Changes

40. Raising Awareness • “Let me know it existed! Let me know it was available—in all 3 years as a student I did not know there was counseling services available.” • “Make the students aware of the counseling services. I have been in school for two years and did not know about that. More awareness…”

41. Cost and Availability of Services • “Students need more accessible information about what kind of help is available. I had no idea where to turn. I hadn’t even known about our counseling center. They need better publicity.” • “Until this survey I had no idea there was any help available on campus, or if there was a fee to utilize this resource.”

42. Cost and Availability of Services • “Make the cost of the counseling services better known to students.... Didn’t go because I didn’t think I could afford it and I do not have health insurance.” • “I think the university could better publicize counseling options, particularly around exam weeks.”

43. Advertising • “Well, they could have posters about counseling and where to go for it. I honestly don’t know if we have on-campus counseling.” • “More increased visibility with flyers, e-blasts, posters, a Facebook page, advertising in the [campus paper], could really help.”

44. Advertising • “I wish I would have been tipped to helpful resources, such as free counseling, by seeing a poster, or flyer, or even a couple bulletin boards solely dedicated to providing helpful resources concerning mental health problems, life stressors, and traumatic experiences. This way students who are having trouble with something in their lives, they immediately know where to go for help. Not only that, the students won’t see getting help as ‘only for crazy people.’”

45. Advertising • “Not everyone knows about the free counseling. Facebook page maybe?” • “Advertise on campus... target grad school students... we aren’t on campus in the same way as other students. I didn’t even remember that [XXX] had a counseling center.”

46. Advertising • “I think that advertisements in bathrooms are pretty effective when it comes to displaying counseling because it is a private place and going to counseling is a private activity.” • “More increased visibility with flyers, e-blasts, posters, a Facebook page, advertising in the [campus paper], could really help.”

47. Campus Policy Changes • “Have this information in each syllabus for every course. Graduate students are disconnected from the university & don’t use as many resources.” • “I wish I knew of counselors on campus sooner. Maybe letting it be known during orientation.”

48. Summary of Themes • Raising Awareness - Many students are not aware counseling services exist • Cost and Availability of Services - Inform students of cost of services - Inform students of type of services provided

49. Summary of Themes • Advertising - Facebook page - e-blasts - Flyers • Campus Policy Changes - Inform students of counseling services at orientation - Information on counseling services included in course syllabi

50. Miscellaneous II (Not so helpful responses)