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October 1, 2008

Mental Health & Well-Being Task Force issues report

A Stanford task force charged with assessing the mental health needs of students has recommended strengthening the support system for students who may lack the emotional maturity or psychological resilience needed to cope with the intense stresses of college life.

"Extraordinarily gifted students of promise come to Stanford to be challenged and to be stretched intellectually," the Student Mental Health and Well-Being Task Force said in a 90-page report released Tuesday.

"But they come to this environment as complex human beings, not just as students, with new and perhaps unique challenges for which higher education in general has limited experience. They are highly motivated people propelled by—and, at the same time, saddled with—extraordinary internal and external expectations for success."

Provost John Etchemendy, the university's top academic and budgetary officer, convened the task force in 2006 because Stanford was deeply concerned about "the growing prevalence and complexity of student mental health problems" on campus, a phenomenon facing colleges and universities across the country.

"Increasingly, we are seeing students struggling with mental health concerns ranging from self-esteem issues and developmental disorders to depression, anxiety, eating disorders, self-mutilation behaviors, schizophrenia and suicidal behavior," Etchemendy said in his charge to the task force.

The task force and its committees—comprising 48 faculty members, students and staff—also recommended creating programs to help reduce student stress; improving advising, mentoring and academic support within individual departments; better promoting the wide array of services already available on campus; and making it easier for students to get the help they need.

Participants included people from the schools of Education, Engineering and Medicine; the departments of Psychiatry and Athletics; the Office for Religious Life; Vaden Health Center; the Asian American Activities Center; and the Lesbian, Gay, Bisexual and Transgender Community Resources Center.

"We undertook this study because of our deep concern and commitment to students," said Dr. Ira Friedman, director of Vaden Health Center and a member of the task force.

Greg Boardman, chair of the task force, said the panel's 18 recommendations would serve as a blueprint for Stanford, which will establish an oversight committee to monitor the university's progress in carrying out the proposals.

"The publication of this report represents the beginning of a second round of dialogue within the Stanford community about this critically important issue," said Boardman, vice provost for student affairs. "The conversation will continue in coming weeks with presentations in student residence halls, in town hall meetings and in the Faculty Senate."

The university already has taken several steps recommended by the task force.

At Vaden, Stanford has achieved the benchmark therapist-to-student ratio recommended by the International Association of Counseling Services Inc., the primary accrediting agency for university and college counseling centers in non-medical settings.

The university also has expanded its efforts in early intervention and risk reduction by training faculty, students and staff in the "Question, Persuade, Refer" approach to suicide prevention. In recent months, Stanford has trained more than 250 people—including residence assistants, peer health educators and departmental staff in the School of Humanities and Sciences—how to recognize the warning signs of suicidal behavior, how to persuade troubled students to seek help and where to refer them for counseling on campus.

To better understand the sources of student stress, the task force reviewed scientific studies, conducted a web-based survey of 700 Stanford students and organized focus groups.

The panel also reviewed university policies and practices related to counseling services, crisis response, emergency contacts, leaves of absence, and education and training.

The group also identified key programs, services and staff as "significant areas of strength," including new student orientation programs, referral services for students seeking long-term psychotherapy off campus, and the professional and student staff working in dorms.

The report said there is "abundant evidence" that today's students, at Stanford and elsewhere, suffer from more emotional problems and mental illnesses than earlier generations.

The report cited a 2006 study of 95,000 students at colleges and universities across the country, including Stanford, by the American College Health Association. It revealed that:

  • 44 percent felt so depressed that it was difficult to function;
  • 28 percent reported that stress negatively affected their academic performance;
  • 15 percent reported having received a diagnosis of depression in their lifetime;
  • 12 percent reported having an anxiety disorder;
  • 9 percent reported having seriously considered suicide in the past year.
  • The report also cited a telephone survey of 2,200 Stanford students conducted in 2007 and 2008 by Dr. Maurice Ohayon, a professor of psychiatry and behavioral sciences at Stanford, who found that:

  • 33 percent experienced high levels of stress;
  • 23 percent had experienced a depressed mood, often transiently, in the previous month;
  • 12 percent had thought of suicide in their lifetime, usually transiently;
  • 3 percent met the diagnostic criteria for clinical depression in the previous month;
  • 2 percent had thought of a suicide plan, and less than 1 percent had attempted suicide.
  • To its surprise, the panel discovered that emotional distress on campus wasn't limited to students who were struggling academically. Students with stellar academic records also were susceptible.

    "We have students, who, no matter what else is going on in their lives, know how to get those grades, and know how to do very well academically, and so it masks that they may be struggling emotionally," said Rabbi Patricia Karlin-Neumann, senior associate dean for religious life and a member of the task force. "They may have no friends. They may not have a sense of belonging. They may feel that no one in the community cares about them. It's important for us to take away the blinders that keep us from seeing their distress."

    Patrick Cordova, a counselor at Bridge Peer Counseling Center at Stanford and a member of the task force's committee that studied the social climate on campus, said top university officials listened, considered his opinions and incorporated them into the final report.

    Some of them got involved in what Cordova, a senior majoring in biology, called the "emotional wellness movement" on campus.

    "Some individuals on the task force have lent themselves as allies to the peer student mental health movement on campus," he wrote in an e-mail message. "Some have joined the Bridge Peer Counseling Center Advisory Board. Others have spoken at events I've hosted, while others have become sounding boards for thoughts and ideas."

    Cordova said he hopes Stanford will nurture other students who are interested in getting involved in peer counseling, and give them the tools to improve the social climate on campus.

    -30-

    Contact

    Kathleen J. Sullivan, News Service: (650) 724-5708, kathleenjsullivan@stanford.edu


    Comment

    Greg Boardman, Student Affairs: (650) 725-1808, gboardman@stanford.edu

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