By Carla Rivera
November 10, 2015
It's early in the semester of your English literature course and one of your students has already missed four classes. The student seems fatigued and out of sorts, and writing assignments are dominated by themes of hopelessness and despair.
The student may just be anxious about the start of classes or could be showing symptoms of more serious mental distress. But what to do?
Increasingly, faculty are being urged to intervene at the earliest signs a student may be in trouble. Professors are being told to refer students to counseling services or in extreme cases — in which imminent harm is suspected to themselves or others — to contact campus police.
Many campuses are adopting new tools that outline common situations and ways to respond, such as the Red Folder, a quick reference guide developed at the University of California that is being adopted by the 23-campus California State University system and many community colleges.
The idea is to distill information from more detailed training into a set of simple actions — see something, say something, do something.
This comes at a time when students are reporting unprecedented levels of stress and wait lists for counseling services are at an all-time high, colleges report.
"As a system of 23 campuses we're very diverse, but we wanted to have something that would have a common look," said Ana Aguayo-Bryant, Cal State's assistant director of student health and wellness. "No matter what campus a counselor or staff member goes to, this will be something recognizable and familiar."
The Cal State materials are available as a hard copy and an electronic version, and a mobile application was recently developed by students and faculty at Cal State San Bernardino. The basic protocols are the same for each campus, but contacts and resources are individualized.
Signs of distress could be a sudden decline in the quality of work or grades; weight gain or loss; and hangovers or smelling of alcohol. Panicked reactions and apathy could be signs of psychological issues, and unprovoked anger and direct threats could indicate an immediate safety risk.
The guidance is especially timely as violence has become all too common on colleges campuses, said Arturo Concepcion, a professor in the San Bernardino campus' School of Computer Science and Engineering whose team of students and interns developed the mobile application. On Wednesday, four people were stabbed at UC Merced by a student who was later fatally shot by police.
"When students become depressed or stressed in life, someone — a faculty member, classmate or staff — will notice something is wrong," said Concepcion, whose group is also developing a similar phone app for students.
Andrew Olson, a computer science engineering major who was an intern on the project, said the knowledge of how it would be used was daunting.
"I used to work in a coffee shop with a bunch of friends who are like family to me, so building this app was pretty insightful in the way I would want them to protect themselves or know what to do in some sort of emergency," Olson said.
The initiative is partly funded by Proposition 63, the Mental Health Services Act approved by California voters in 2004 to expand such services through a 1% tax on incomes at or above $1 million.
Subsequent shooting rampages at or near colleges, including Virginia Tech and UC Santa Barbara, have steadily focused attention on how colleges can be more proactive in detecting potential harm as well as whether institutions have the training and resources to do so.
A report last year by the Center for Collegiate Mental Health at Penn State University showed that rates of self-harm and suicidal thoughts have increased among students seeking mental health services at colleges. One out of 3 has seriously considered suicide and 1 out of 10 has attempted suicide, according to the report.
Meanwhile, a 2013 survey of UC, Cal State and community college campuses conducted by the Rand Corp. found that 19% of students reported psychological distress within the 30 days before the survey. That contrasts with a rate of 3.5% for the general population. Ten percent to 12% of students across all systems reported feeling hopeless most or all of the time, and 8% to 10% reported feeling so depressed that nothing could cheer them up.
The effect of mental health issues on academic performance varied by system. Percentages of students who reported anxiety-related performance issues ranged from 21% to 37% across the 10 UC campuses, from 33% to 43% across Cal State campuses, and from 10% to 50% across 113 community colleges. Forty-three percent of UC faculty, 59% of Cal State faculty and 71% of community college faculty reported talking to students about mental health issues at least once in the previous six months, according to the survey.
Many colleges take an important step by focusing more on preventive actions such as the Red Folder initiative, said Rusty Selix, executive director of the California Council of Community Mental Health Agencies.
"College students in particular ... are in the greatest at-risk age group in which the most severe mental illnesses show up," Selix said. "They are also at the high risk for substance abuse. Anxieties often peak at exam time."
But Selix said students sometimes don't get information about community resources for which they might qualify. And he noted that demand for counseling services on many campuses outstrips their capabilities.
Long wait lists for counseling services at UC campuses prompted the Board of Regents to approve a 5% annual increase in student service fees beginning this quarter, with a portion earmarked to pay for hiring more mental health clinicians.
The fee will increase 5% for each of the next five years and is projected to generate $3.8 million in the first year and $22 million by year 2019-20 system wide, said Taisha Caldwell-Harvey, the UC's mental health program manager and clinical coordinator.
"The growth in students coming in and seeking services is a national trend, and we haven't been immune to that at all," Caldwell-Harvey said. "As we increase outreach, these fees will allow campuses to increase staffing in all counseling centers."