UTHSC Adopts Innovative Model for Student Mental Health Services

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UTHSC has adopted a more holistic approach toward the mental health of its students, said Kathy Gibbs, right, director of the Office of Student Academic Support Services and Inclusion, which is leading the initiative. (Photo by Natalie Brewer/UTHSC)

When third-year medical student Hannah Ashitey was preparing for a major exam, she turned to the Office of Student Academic Support Services and Inclusion (SASSI) for help with her studies. Ashitey got more than just academic assistance, and she believes the help made a big difference in her success.

“I went to SASSI and was talking to an educational specialist, when I was planning to take my board exam,” Ashitey said. She was encouraged to talk with a mental health specialist, just to ease pretest stress. “They told me what they see is students who see a mental health specialist during this time score higher, and she referred me to go talk to somebody while going through that.”

An initial consultation, evolved into weekly visits prior to the exam. She passed the test with ease.

That’s exactly the scenario university administrators envisioned when they adopted a new initiative for focusing on the mental health of students. It promises to be a model for other academic health science institutions across the country.

Adopted after consultation and recommendations from national student mental health organizations, the initiative centers on preventive care and intervention. It involves adding counseling personnel, improving student access to mental health services, and most importantly, moving student mental health services out of the traditional health clinic setting and into the Office of Student Academic Support Services and Inclusion.

Marrying academic assistance with mental health support worked perfectly for Ashitey. “For me, having somebody helping me academically and having somebody help me focus on the mental health part and the stressors and all the extra stuff in my life, as a rational person, you understand that,” she said.

Making Mental Health Services Accessible

The idea is to take the stigma out of accessing mental health services and encourage students to view them as one more aspect of support and self-care.

SASSI offers learning resources, tutoring, inclusion services, assistance for disabled students, services for veterans, and more. SASSI is already a competitive advantage for UTHSC, according to university officials, and adding mental health counseling to it is unusual among health science centers.

National statistics are a driving factor in the university’s increased focus on student mental health, said Lori Gonzalez, PhD, vice chancellor of Academic, Faculty and Student Affairs at UTHSC. The trend of increasing numbers of students coming to campuses in need of some form of mental health counseling, prompted the university to adopt a more holistic approach to services offered.

According to the journal Academic Psychiatry, the most prevalent psychiatric problems among college students are anxiety disorders, including social phobia, panic disorder, post-traumatic stress disorder, and generalized anxiety issues.

Because students at academic health science institutions face demanding schedules, high tuition, and competition with other high-level learners, they are at even greater risk for anxiety and mental health issues. For example, the Association of American Medical Colleges reports rates of depression for medical students are 15 to 30 percent higher compared to the general population.

Now when students at UTHSC access SASSI for academic support, they will also find a care team prepared to offer counseling services and referrals if needed. “To have the counseling delivered in conjunction with the academic support on a health science campus is a really unique model,” said Kathy Gibbs, director of SASSI.

“Education is our core mission,” Dr. Gonzalez said. “Most of these students will have been on an undergraduate campus, where there is an entity called the counseling center. One of the things we were struggling with is, even if they are savvy users of a counseling center, it wasn’t always obvious how they would access services here.”

Developing the Plan

The university sought input and recommendations for improvements from The JED Foundation, a national nonprofit focused on the emotional health of the nation’s teens and young adults; the National Behavioral Intervention Team Association (NaBITA), which works with campuses to improve safety and foster intervention; and the National Center for Higher Education Risk Management (NCHERM), which conducted a counseling and psychological services program review.

In response to their recommendations, two master’s-level mental health counselors to serve astalk therapists” and a case manager will be added to the SASSI staff early this year. Kimberly Williams Collins, PhD, MS, counseling psychologist in University Health Services (UHS), the campus health care clinic, will provide clinical supervision. A care team with members from all the colleges on campus has been trained to identify students in need of intervention and offer help in accessing it.

University Health Services is using a primary care model in which evaluation of mental health status is part of the intake and conversation with any patient seen. The UHS behavioral health team includes Dr. Williams Collins, who provides counseling services to the students; a psychiatric nurse practitioner, who sees students for psychiatric medication management; and a part-time psychiatrist, who provides medication oversight and sees students. The UHS behavioral health team frequently collaborates with SASSI for cohesive behavioral health management.

“This approach ties University Health Services and SASSI together in an integrated way,” Dr. Gonzalez said.

Workshops on suicide prevention, substance abuse prevention, sexual assault prevention, wellness and resilience will be offered. Students will be educated to recognize when their classmates exhibit signs of mental distress, and to recommend SASSI for assistance.

Encouraging Student Mental Health and Self-Care

“This gives the campus an opportunity to have a preventive approach for our students, more toward mental hygiene and self-care,” Gibbs said. “Instead of being reactive, we can be preventive, and that’s going to decrease the situations where we have to react in an emergency.”

It also helps ensure that students will be successful in their studies, as well as more diligent about self-care and resilient when facing problems in their careers.

“The demands and stress factors on professional students, where high performance is required and rapid acquisition of skills is expected, creates an intense atmosphere,” said UTHSC Chancellor Steve J. Schwab, MD. “The development of coping skills for our students is essential.”

David J. Denino, LPC, NCC, a consultant from NCHERM, said UTHSC has put itself on the cutting edge of smoothing the path of success for its students. “As more students seek help from on-campus resources, UTHSC is now in the position of doing more by treating depression, anxiety, and other maladies that commonly impair student success,” he said. “Beyond additional staffing, the university is also training current staff so that everyone on campus knows to treat mental health concerns seriously – as seriously as they treat physical illness or injuries.”

NCHERM’s Brian Van Brunt, EdD, LPC, said, this approach offers “a unique model that other health science centers will want to emulate.”

Ashitey said she is glad the university is focusing on the mental health of its students. “The people behind this have the passion for it,” she said. “It makes me very proud that it (mental health) is something they are taking seriously and they are trying to get students to come on board to take advantage of these resources that are beneficial to us now and will be for the long term as well.”