Cura in Mind: University Counseling Center Innovates to Help Students Heal, Thrive
09/21/2020
For many students, adapting to college life can be a challenge – from navigating a new class schedule to adjusting to life with roommates to coping with new experiences away from home and loved ones.
Although many students make the transition smoothly, for some students, struggles with mental health and wellness issues can make grappling with the changes that come with college painful, isolating and in urgent need of help.
Today a rising number of students arrive on college campuses with histories of pre-existing psychiatric disorders that require ongoing treatment while on campus. The stress of adjusting to college can cause these conditions to quickly escalate into serious struggles with mental health and wellness.
For the counselors and staff at Saint Louis University’s Counseling Center, expanding the resources available to help students not only cope, but thrive, has been a critical focus of a holistic approach to care and healing, one that has drawn in partners across the University and encompasses innovative new approaches to removing the barriers that might keep Billikens from seeking help when they need it.
“The Ignatian concept of cura personalis, or healthy mind, body and spirit, applies most directly to supporting mental health,” Steve Byrnes, Psy.D., director of SLU’s University Counseling Center, said.
“A primary outcome of a Jesuit education is to use what has been learned to bring God’s glory to our world and make it a better place,” he continued. “Supporting mental health means more students will manage their mental health, graduate, go on to live healthier lives and bring good to the world. That is how our work carries out the Jesuit mission.”
Tackling a Need Challenging the Nation’s Campuses
Nationally, the incidence and awareness of mental health and wellness issues has increased on college campuses. The Chronicle of Higher Education, among others, has highlighted the rise in student mental health needs in recent years.
More students are experiencing depression, trauma, anxiety and stress management issues. Students in the “GenZ” or “iGen” age range report higher rates of psychiatric conditions, such as depression, autism, anxiety, substance abuse, suicidal thoughts and self-harming behaviors than previous cohorts.
According to U.S. national health surveys, roughly one in four young adults reports a history that includes trauma such as experiencing physical, emotional or sexual abuse, combat-related violence or living through a natural disaster.
Today’s students also spend an average of six to eight hours per day online, which leading researchers like Jean Twenge, Ph.D., professor of psychology at San Diego State University, have cited as negatively impacting interpersonal skills and social development.
These conditions have been tied in part to the rising self-harm and suicide rate among young adults around the country. Substance abuse and the impact of the opioid epidemic have also contributed to the stressors young people face, impacting their physical, mental and emotional well-being. Suicide is now the second leading cause of death nationally among the young adult population.
Adapting to Meet the Challenges of a 'New Normal'
As students’ mental health and wellness concerns have dramatically reshaped the landscape of higher education, universities like SLU have responded with re-assessing how they care for and support students who may have complex needs.
“This picture is the ‘new normal’ for students pursuing higher education,” Byrnes explained, “and it is expected to be the case for many more years.”
With this altered landscape in mind, Byrnes and his staff, together with University leaders and partners across SLU’s campus, have been working to improve and innovate on the ways the SLU community cares for students in need. The 2019 Novel Coronavirus (COVID-19) pandemic and the precautions put in place to protect the campus have also shaped changes in how the UCC has been caring for students.
“COVID-19 has certainly necessitated adapting how we serve students,” Byrnes said.
All counselors engaged in specialized training to provide care virtually when the campus community dispersed and, since April, most of the UCC’s appointments have shifted online. Byrnes and his staff plan to continue doing so for the duration of the pandemic.
Supporting mental health means more students will manage their mental health, graduate, go on to live healthier lives and bring good to the world. That is how our work carries out the Jesuit mission.”
Steven Byrnes, Psy.D., director of the University Counseling Center
Other planned initiatives have included an enhanced after-hours medical and behavioral health nurses triage phone service to help with symptom management, primary care and counseling telehealth appointments on evenings and weekends, promoting the use of an on-demand texting crisis line, an initiative spearheaded by SLU's Student Government Association (SGA), and expanding community training to help a peer or student in crisis.
Pivoting to a New Approach to Better to Care for Students
As wellness – mental, physical, emotional and spiritual – becomes an increasingly visible issue on campuses across the country, the SLU community has stepped in and stepped up to care for their fellow students with new programs, resources and opportunities to connect in the spirit of cura personalis.
Since 2015, Byrnes and his staff have made significant changes to student care on campus. The UCC shifted from referring students to off campus providers for care, to positioning SLU’s counseling center as a place where definitive care is provided on campus efficiently and quickly by adding staff and programs.
“We are able to take care of most of, the majority of the student population right here on campus and only rely on our community partners for more intensive treatment needs,” Byrnes explained.
Off-campus referrals, he continued, imposed too many barriers that prevented students from getting help because they required transportation and their deductibles and co-pays were often cost prohibitive to students seeking care.
University Counseling eliminated all insurance billing, co-pays and deductibles for on-campus appointments in 2015 to address student concerns about being able to pay for care. The UCC now provides care at no cost to students.
A move to a larger space in Wuller Hall expanded the center’s capacity to meet with students. Clinical specialists were hired to create specialty services for emerging needs in the areas related to substance abuse, identity and orientation, students of color, sexual assault and trauma, international student care and how multicultural backgrounds intersect with the counseling process.
In recent years, the center has nearly doubled its staff to keep wait times for new appointments to around seven business days or less for non-emergency visits, meaning students seeking help see a counselor much faster than national norms. The average wait nationally for a non-emergency counseling services new client appointment at colleges and universities is around 15 business days, according to the Association for University and College Counseling Center Directors Annual Survey Report.
Need Help or Information About Mental Health and Wellness?
- Resources for Students in Immediate Need
- Mental Health Resources for Students of Color
- Mental Health Resources for LGBTQIA+ Students
- Learn More About the Collegiate Recovery Community
A Cross-Campus Network to Care for Students
In addition to innovating on-campus treatment, the University Counseling and Student Health Centers, along with student organizations including the SGA, have partnered to launch a new effort to create a SLU community that is more aware of student mental health needs.
Together with University leaders including President Fred P. Pestello, Ph.D., and partners from across all corners of campus, new programs, ranging from study break de-stress fests to programs advancing openness about mental health issues on campus, have been put in place or are underway.
Student organizations are mobilizing to create support groups and community-wide peer interventions, Byrnes explained. Other campus groups are creating additional recommendations for University leaders to consider, and faculty members are starting to weave mental health content into course curriculums.
“We are starting to see the larger community embrace this change, and the energy it is creating has only just begun. There is so much more potential for change when the whole community takes on this issue. I am excited to see what becomes of it.” Byrnes said.
In August 2018, Byrnes presented a day-long Campus Mental Health Summit to discuss ways to better address campus mental health needs, including a new model for suicide prevention at the University. Those participating in the summit reviewed national data that pointed to issues with traditional approaches to suicide prevention and to other mental health issues.
While traditional approaches have emphasized helping students improve their coping skills or on resiliency training, research has shown that a more effective model is training community members to quickly recognize when someone is facing a mental health issue and to quickly refer that person to resources and help.
“The only community intervention that showed a lasting reduction in suicidal behavior was treatment combined with training a community to quickly refer members in crisis to care,” Byrnes said.
The summit has sparked a push to train staff, faculty and students in Mental Health First Aid, a training for communities that educates people about recognizing the signs of emotional and mental distress and how to provide a basic intervention and connection to treatment resources.
Spearheaded by Renee Jonas, director of SLU’s Student Health Center, staff members, including officers from the Department of Public Safety (DPS), have already undergone the training. Approximately 100 SLU staff members have been trained to date, and more training and outreach is planned.
“The long-term goal is to train most of the SLU community to pick up on the subtle and overt signs of psychological distress like suicidal thoughts, and to create a community ready to help someone in a crisis moment,” Byrnes said.
The SLU community will also be looking at ways to leverage available health care technologies and advances in health care to supplement what is being provided in SLU’s health clinics, to better serve students, Byrnes said.
As part of the partners’ efforts, staff members in the Division of Student Development have also organized new Health and Wellness Coalitions to focus on creating a healthier community. New fronts in the campaign may include outreach to students who traditionally have not sought mental health and wellness support, students studying abroad and international students who may be struggling with cultural stigmas associated with mental health issues and treatment.
“My hope is that we can create a community of people who are confident enough to have a conversation with a student in a moment of need, and who can connect that person to a robust and capable treatment team to reduce symptoms and optimize a student’s ability to function academically and socially,” Byrnes said.
In Dr. Byrnes’s Words
The rising rate of mental health needs calls for an approach that emphasizes a large-scale community response to manage, especially when talking about suicide. Only about one-third of suicides are committed by someone who had recent contact with a health care provider. For the other roughly two-thirds, we must rely on those who “rub elbows” often with the distressed person to detect one is in crisis.
Therefore, we must train the community to get better at detecting signs of distress in its members to prevent suicidal behavior.
The next improvement in suicide prevention will only come with training the community to identify those who are in distress and quickly connect them to life-saving care. This is no longer a University Counseling Center problem to fix, but one the entire community must embrace.
Nationally and at home here at SLU, mental health and wellness issues have become increasingly visible. In the spirit of cura personalis, the University community's call to “care for the individual person” and to respect the dignity of each person as a child of God, Cura in Mind, a limited series, is shining a light on the ways that Billikens are helping students cope, manage and thrive mentally and emotionally on campus.
The series aims to give those working on mental health issues on campus a chance to reach out to let Billikens know that there are friends, faculty and staff members who are here to help.
Story by Amelia Flood, University Marketing and Communications.