What do final exams and the holidays have in common?  They are both major stressors for many students during the last two months of the year.  Yet students seem to feel stressed throughout the entire year, not just this traditionally busy time according to CDC and WHO data.  According to the CDC suicide rates are on the rise, and depression, according to The World Health Organization (WHO) has become one of the top disabilities in the world.  For young adults those number are even higher than the average for adults.  UCLA has been surveying incoming college freshman for nearly fifty years, and findings from a 2016 survey that questioned 137,456 incoming freshman at 184 colleges uncovered some startling results. The survey found “students’ self-rated emotional health dropped to 47.3%,” the lowest level ever.  This indicates that most students thought they were worse off than the average student regarding their emotional health and well-being.  As 2018 just ended and 2019 New Year’s Resolutions begin to form, I’d like to highlight a very valuable resource on the University of Nevada, Reno campus that is doing its part to fight rising mental health issues: The Take 5 program.

Counseling Service’s  Take 5 Program is partially funded by a Berger North Foundation grant, and provides students with a variety of opportunities and activities to learn to better manage their stress. It also gives students the chance to interact and meet with mental health professionals in a convenient and less formal manner during the semester.  Thanks to their successful grant application, Take 5 “provides a host of interesting and fun interactive activities that help reduce stress and build confidence and self-esteem” throughout the year. The name “Take 5” comes from the suggestion to take a quick five-minute break from normal activities to relax or do something that will better one’s mental health. One of the more popular Take 5 activities is a bi-weekly session of “pawsitive” therapy with local therapy dogs in collaboration with the Paws 4 Love organization. During this activity students get the chance to pet and play with local therapy dogs during traditional school hours. Besides bringing a smile to many faces, research from UCLA has shown that “interacting with an animal can reduce blood pressure, diminish pain, lower anxiety, reduce loneliness and generally improve your mood.” Another healthy alternative Take 5 offers is free weekly yoga classes that take place on the Quad. While special events may bring Take 5 to various spots throughout campus, the Knowledge Center (library) is its primary home. During lunchtime on Tuesdays, Wednesdays, and Thursdays throughout the semester students and staff can take a few minutes to color, solve puzzles, meditate, or read articles on stress management tips and other informative health topics.

“Be it more pressure from parents and society, technology, or the general struggle of leaving home, this semester the students seemed even worse than last semester, and last semester was the most challenging semester I can remember.” From the research gathered above and observations from those working with students daily, there is a huge need for a program that helps students handle the unique stressors of college.  According to Ms. Cooper, the goal for Take 5 is not only to help struggling students succeed, but also “to reduce the stigma of mental health on campus.” For Ms. Cooper, getting students interested and asking questions is a win in and of itself. While the therapy dogs are the major hit with the students and bring the most smiles and positive reviews, other benefits are available once a student stops to talk with staff.  Marcia adds, “having a certified counselor available and open for consultation at each event allows students to take the crucial next step, thus combating the fear and stigma associated with visiting the counseling center.”

Results: Does Take 5 work?

The program has grown greatly since its beginning as a one-time tabling event during Suicide Prevention Week.  Ms. Cooper provided some basic testimonials to share students’ takes on the benefits of the program. One student said, “The dogs are my favorite.  Petting them makes my day!”  Another student added, “I love the coloring options; they are incredibly relaxing and therapeutic.” A third student showed how a simple event left a lasting impact. The student said “Tom the Pomeranian made my day.  He reminded me of my own dog who passed away last year. He was with me since I was 5 years-old so his death was very hard for me. Seeing Tom brightened my day and made me feel way less stressed. Thank you so much!” Marcia Cooper concluded our conversation by stating, “The students love it (Take 5) and we hope it continues to grow and helps students be successful.”

While this article highlights Take 5 at the University of Nevada, Reno, other universities and colleges in Nevada that don’t have the benefit of additional grant funds have still begun having similar stress reduction activities for their students, especially during finals weeks.  The University of Nevada, Las Vegas, for example, brought therapy dogs and held special yoga sessions, art therapy, and guided meditation during their 2018 finals week. Great Basin College (GBC) also has online workshops and other valuable tools to help students succeed. Ms. Cooper and many UNR students believe in the Take 5 program and the benefits it can deliver for students on a college campus.  Various colleges in Nevada and colleges and universities nationwide already implement programs to help students face increased levels of stress and mental health issues. However, does the research indicate that these programs make a difference?

A student led program called Active Minds performed an impact study^[i]  on over 1000 students at twelve universities just to test that question.  Active Minds was formed in the early 2000s as a nonprofit organization focused on student advocacy and mental health. It has now grown to over 450 chapters and reaches 15,000 students each year.  The research found that having general knowledge of and a positive attitude toward mental health improved because of this program.  Those actively involved changed their behaviors and would more often reach out to help a friend or classmate in need. The research also found that the changes in behavior and improved knowledge of mental health occurred within a single school year. This program and others exist because of a need that universities aren’t currently meeting. Some people at the national level, including Richard Kadison M.D., Chief, Mental Health Service at Harvard University Health Services, have argued that there is a “campus mental health crisis.[ii]” As this is a newer area of study, little peer reviewed research exists; however, Kadison’s book, College of the Overwhelmed: The Campus Mental Health Crisis and What We Must Do About It, offers a foundation for research to build upon.

The 2018 American College Health Association National College Health Assessment looked at the issue of mental health on campuses. Surveying over 88,000 students from 140 different schools, researchers found that mental health issues affected individual academic performance, defined as earning a lower grade on an exam, a lower grade on project, or a lower grade in the course, for many students. The report looked at 32 different criteria ranging from drug use, finances, internet use, and sleep difficulties to anxiety and stress.  The results showed that stress affected 33.2% of students, anxiety affected 26.5%, sleep difficulties at 21.8% and depression affected 18.7% of students.  Another study looking at the change in mental health diagnosis/treatment and help-seeking behavior among college students (n 454,029) over time (Oswalt et al 2018)[iii] found significant increases between 2009-2015 in the mental health issues (anxiety, depression, bulimia, ADHD, panic attacks, insomnia and OCD). Unfortunately, the paper cited sources saying that 50-80% of students who struggled with these concerns did not seek help, often based on the lack of perceived need and belief that this type of stress is expected in college.  The results of these surveys show that many students are struggling.  Whether it is stigma, misguided beliefs, or lack of capacity at counseling centers that stops students from easily receiving the care they need, participation in programs such as Active Minds and Take 5 can help fill that void.

Where do we go from here?

The programs mentioned above find success by addressing the stigma against mental health, and seem to make it easier for students in need to find help.  Moreover, these programs are grounded in techniques and programs that research has shown help alleviate stress and anxiety and can address issues before they impact academic performance.  Awareness and acknowledgement are just the first steps for those in need of help. There are numerous other evidence-based techniques that also reduce stress and promote health that behavioral health professionals both on and off campuses can learn to utilize. Lisa Varvogli and Christina Darviri^[iv] (2011) of the Postgraduate program of Stress management at the Athens Medical school did a literature review and found the following techniques from evidence-based programs:  progressive muscle relaxation, autogenic training, relaxation response, biofeedback, emotional freedom technique, guided imagery, diaphragmatic breathing, transcendental meditation, cognitive behavioral therapy, and mindfulness-based stress reduction. The scope of the paper didn’t allow for a full explanation of each individual technique’s benefit but did provide a great place for practitioners to find additional ideas for helping clients in need. The Mental Health on College Campuses Report, also provides numerous recommendations to both Congress and The Department of Education (found on pages 15-17) to better serve the needs of students.

Testimonials from Take 5 participants and the research above show how valuable mental health resources can be for college students. As self-care and managing stress are two important steps for living a healthy and balanced life, it is encouraging to see what institutions such as UNR, UNLV, and GBC are doing with their state funds and grant resources.  These institutions provide tangible ways to help students achieve their goals and highlight what other colleges and universities can do to help students find guidance and reduce stress during their college experience.  For more information on important behavioral health topics feel free to check out CASAT OnDemand and come meet a dog during a future Take 5 event, or look for similar resources at your local community college or university.

References

[i]  Sontag-Padilla, L., Dunbar, M. S., Ye, F., Kase, C., Fein, R., Abelson, S., . . . Stein, B. D. (2018). Strengthening College Students’ Mental Health Knowledge, Awareness, and Helping Behaviors: The Impact of Active Minds, a Peer Mental Health Organization. Journal of the American Academy of Child & Adolescent Psychiatry, 57(7), 500-507. doi:10.1016/j.jaac.2018.03.019

[ii] Kadison, R., & DiGeronimo, T. F. (2005). College of the overwhelmed: The campus mental health crisis and what we must do about it. San Francisco, CA: Jossey-Bass.

[iii] Oswalt, S. B., Lederer, A. M., Chestnut-Steich, K., Day, C., Halbritter, A., & Ortiz, D. (2018). Trends in college students’ mental health diagnoses and utilization of services, 2009–2015. Journal of American College Health, 1-11. doi:10.1080/07448481.2018.1515748

[iv] Varvogli, L.; Darviri, C., (2011). Stress management techniques: Evidence-based procedures that reduce stress and promote health. Health Science Journal, 5 (2).