Creating Caring Communities Through Mental Health Awareness and Referral Training

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Creating Caring Communities Through Mental Health Awareness and Referral Training Franca Mancini, PhD., LPC Director of Counseling and Psychological Services Shannon Killeen, MA Assistant Vice President for Student Services Monmouth University West Long Branch, New Jersey

Monmouth Profile Private, moderate sized (approximately 6,000), coeducational, comprehensive University Residential population of 1,700 students Approximately 800 1,000 live off campus in the surrounding communities Located on the Jersey shore

Campus Mental Health Nationwide Utilization of mental health services has grown exponentially in recent years Presenting problems are more challenging and complex Counseling centers struggle to maintain adequate staff to student ratios

Mental Health Cont d. Post Virginia Tech, each state has called on colleges and universities to revisit both safety and student mental health and to provide training opportunities on student mental health to the campus community Mandates have shifted to include mental health awareness programming for the entire campus community as well as providing specific clinical services to individuals

The New Campus Reality Minds on Campus Video

The Problem As We See It at MU In NJ and many other states, campus community training has been mandated Prevention and early intervention in responding to students with behaviors of concern has become as important as the ability to offer clinical treatment options on campus Funding is limited or nonexistent

The Problem cont d. Clinical staff alone cannot meet the demand and generally only see students when concerns have become more evident and often more serious A great deal of observable information is readily available and can assist in early intervention

The Problem cont d. Campus community members are hesitant to communicate what they observe There is need for a procedure to follow for a structured response Existing structures can be adapted and expanded to creatively meet the need for campus wide programming

Monmouth University s Response The Interdisciplinary Training Team Utilize existing personnel Identify stakeholders with complimentary roles on (and off) campus Identify specialists on campus in relevant areas Utilize campus specialists to train members of the community to act as facilitators

MU s Response Cont d. Conduct a Training Needs Assessment Who should be trained? Who are the best trainers for the specific populations identified? How can the training team best access the specific groups?

MU s Response Cont d. Creating the Training Module What information should be presented? What resources are necessary? What about funding? When is the best time to train? Where should the trainings be held? How large should the groups be? How long should the sessions be?

Training Module cont d. What handouts are useful? Common Concerns Handout Responding to Behaviors of Concern Resources for Consultation and Referral Sheet Basic FERPA and Clery information is helpful. Check with Legal Affairs for guidelines on your campus.

COMMON MENTAL HEALTH ISSUES AMONG COLLEGE STUDENTS Depression and mood fluctuations Anxiety and stress Eating disorders, disordered eating and compulsive exercising Relationships, relationship abuse and domestic violence Responsible sexuality Drug and substance abuse Sexual orientation issues Homesickness Confusion about career issues and direction Academic concerns, time management and study skills development Anger management Acceptance of diversity Feelings of isolation and loneliness Confronting hate, discrimination and prejudice

REASONS FOR REFERRING STUDENTS Talk of suicide or of suicidal thoughts Change in appetite or sleep patterns Sudden weight loss or weight gain Unusual problems with concentration and attention Extreme fatigue Sudden lack of motivation Unusual mood swings Irrational fits of anger Unexplained bouts of crying Lack of interest in usual pursuits Increased usage of alcohol and other drugs to cope with problems Promiscuity or other high risk behaviors Self injurious behavior Unexpected change in level of academic performance Any mental health crisis

GUIDELINES FOR RESPONDING TO BEHAVIORS OF CONCERN If the behavior observed represents an immediate threat to any member of the campus community, call Monmouth University Police immediately at 732 571 3472. If you are unclear as to the safety risk, call for clarification. Step I Step II Step III Step IV Step V Identify the Behavior Speak with Student Follow-Up Appointment Formal Referral Follow Up Behavioral Classifications (adapted, Sokolow & Lewis, 2007) Disruptive: Behaviors cause concern or keep you from performing your duties. If in doubt, call for support and clarification.. Distressed: Emotionally troubled; impacted by situational stressors and/or traumatic events; may be moving to crisis; possible psychiatric symptoms. Disturbed: Unusual, bizarre; lack of touch with reality; harmful to others; lack of social norms; erratic behavior; possible substance abuse. Dysregulated: Suicidal; self-injurious; eating disordered; substance abusing; hostile and unable to self-regulate. Request an appointment with the student. Approach with a calm demeanor, nonconfrontational and nonjudgmental. Be specific regarding the observed behavior and/or writings of concern. Ask another colleague to be in the area or even in the room with you. Engage in solution-finding and formulate a plan with the student. Schedule a follow-up appointment. Unable to plan? High-risk student? Make a formal referral as per item IV and inform the student. Discuss progress or lack thereof with the student. Progress noted? Decide for one more appointment or commend the student without further follow-up. Some progress noted? Discuss areas of concern and schedule another meeting. No progress noted? On a case by case basis, and if appropriate, discuss alternate options and another possible plan. If the behavior is high risk, inform the student that you are making a referral and proceed as per Step IV. Inform your department Supervisor/Chair as soon as possible if you have not already done so. See attached chart to determine appropriate referral department: Monmouth University Police Department Counseling and Psychological Services Health Services Student Services Judicial Affairs Substance Awareness Department of Disability Services Possible options after referral: Depending on the behavior and department, the student may: Be called in to discuss the behavior. Be charged with a violation of the Student Code of Conduct in Student Services and/or referred. Please refer to online Code of Conduct: www.monmouth.edu/student_ha ndbook. Be assessed in the Department of Counseling and Psychological Services and/or referred Be assessed in Health Services and/or referred. Be assessed in the Office of Substance Awareness and/or referred. ANNOTATE YOUR OBSERVATIONS ANNOTATE YOUR OBSERVATIONS ANNOTATE YOUR OBSERVATIONS ANNOTATE YOUR OBSERVATIONS ANNOTATE YOUR OBSERVATIONS Monmouth University Police Counseling and Psychological Services Health Services Student Services Judicial Affairs Substance Awareness Department of Disability Services 732 571 3472 732 571 7517 732 571 3464 732 571 3417 732 263 5218 732 263 5804 732 571 3460 Killeen/Mancini 2009 Monmouth University

Monmouth University Resources for Consultation and Referral: Depending on the situation, you may contact one or more of the offices listed. Area of Concern Counsel. and Psych. Serv. 732-571- 7517 Student Services 732-571- 3417 Judicial Affairs 732-263- 5218 Monmouth University Police 732-571- 3472 Substance Awareness 732-263- 5408 Health Services 732-571- 3464 Disability Services 732-571-3460 Follow-Up: Talks and/or writes about homicide or suicide Poses an immediate threat to self of others Is a victim of sexual assault/harassment Is a victim of violence, stalking or intimidation Exhibits behavior that seems bizarre or out of touch with reality Angry or hostile behavior Is the subject of complaints by other students regarding behavior in class Other students express serious concern regarding the student Has emotional outbursts Appears during class to be high and/or intoxicated Continuously disrupts class Exhibits signs of an eating disorder and/or distorted body image Is having difficulty due to illness Displays poor personal hygiene / Appears disheveled Displays unwanted attention towards other students/faculty Lack of participation Exhibits signs of depression Exhibits signs of anxiety Exhibits signs that may indicate a disability Bereavement related issues

Creating Modules on Your Campus Campus Specific Questions

Conclusions Brief Summary and Suggestions Contact Information Franca Mancini, Director Counseling and Psychological Services mancini@monmouth.edu Shannon Killeen, Asst. VP for Student Services skilleen@monmouth.edu