2006 NACADA National Conference Code

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2006 NACADA National ConferenceCode 214
THE STUDENT YOUVE MET BUT MAY NOT
KNOWPRESENTER JEFFREY HERMAN,
M.A.jherman_at_lccc.edu610-799-1137Lehigh Carbon
Community CollegeSchnecksville, PA
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Objectives

• Increase awareness and understanding of mood
  disorders in college students
• Explain why we are seeing more students with
  mental health disorders
• Encourage an understanding of what these students
  are experiencing
• Improve our ability to help the student in crisis
  or one who is disruptive

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What do Words Say?

• Schizo
• Looney
• Psycho
• Nuts
• Kooks
• Maniac
• Loco
• Deranged
• Mad as a hatter
• Insane
• Off your rocker

• Berserk
• Cuckoo
• Cracked
• Raving mad
• Crazy
• Hysterical
• Lunatic
• Wacky
• Deviant
• Hyper
• Unbalanced

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Why are we seeing more students with mental
health problems?

• Better psychotropic medications
• Individuals with Disabilities Education Act
  (IDEA), its regulations have been modified to
  clarify it is to prepare students for further
  education
• Americans with Disabilities Act (ADA)
• Improvements in the delivery of therapeutic
  interventions
• Increased advocacy among those with a mental
  health disorders and their families
• Increased awareness of disability support
  services at colleges
• Government agencies such as OVR/VRS and the
  Veterans Administration pay for college as part
  of a persons vocational rehabilitation plan
• Community based treatment options instead of
  institutionalization
• It is a persons right to want and seek a better
  future through education

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Overview of mental health problems in the college
student population

• Suicide is the second leading cause of death
  (National Mental Health Association)
• 1 in 12 college students makes a suicide plan
  (NMHA)
• There are more than 1,000 suicides on college
  campuses every year (NMHA)
• Every 2 hours and 11 minutes, a person under 25
  completes suicide (National Center for Injury
  Prevention and Control)
• 9.5 of college students have considered suicide
  and 1.5 have made a suicide attempt (American
  College Health Association)
• A study at Kansas State Univ. found that between
  1989-2001 the proportion of students taking
  psychiatric medications rose to 25, from 10
  (Chronicle of Higher Education)

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Overview of mental health problems in the college
age population

• Highest risk for suicide are those students with
  a pre-existing mental health condition and those
  who develop a mental health condition while in
  college
• Males, Asians and Hispanics, those under age 21,
  or in treatment are more likely to have suicidal
  ideation and attempts (NMHA)
• Reasons given include a new environment, academic
  and social pressures, feelings of failure,
  alienation, family history of mental illness,
  poor coping skills, poor adjustment to the
  demands of college
• Risk factors for suicide in college students
  include depression, sadness, hopelessness, and
  stress
• Half of all lifetime cases of mental illness
  begin by age 14 and are often undiagnosed and
  untreated for decades (Archive of General
  Psychiatry)

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Features of Bipolar I Disorder

• One or more manic episodes
• Often have had one or more major depressive
  episodes
• Person can be up or euphoric for up to a week
• May think that others need to improve their
  outlook
• May believe his plans, ideas, and abilities are
  brilliant
• May feel a special communication with nature,
  God, or mankind
• Very alert and energetic despite a lack of sleep
• Racing thoughts
• Increasingly distracted by the smallest things
• Person takes on too many projects
• Uninhibited to the point of being in danger
• School truancy and failure are common

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Prevalence of Bipolar I Disorder

• 0.4 to 1.6 of the population
• Equally common in men and women
• Average onset is age 20
• 60 experience interpersonal and occupational
  problems between acute episodes
• 40 of this population are alcohol or drug
  dependent
• There is often an 8 to 10 year lag between
  symptoms and diagnosis (National Association of
  Manic Depressive Illnesses)

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Features of Bipolar II Disorder

• Presence or history of one or more depressive
  episodes
• Presence or history of at least one episode of
  hypomania
• No history of a manic episode
• Frequently diagnosed as being only depressed
• School truancy and failure are common
• Inconsistent social interactions due to mood
  changes
• Are often seen as irritable, angry, sensitive,
  grandiose and arrogant

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Prevalence of Bipolar II Disorder

• 0.5 of the population impacted by the disorder
• More common in women
• 10-15 probability of committing suicide
• Substance abuse is common

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Features of Major Depression

• Depressed mood most of the day over two week
  period
• Diminished interest or pleasure in activities
• Significant weight loss or gain
• Insomnia or hypersomnia nearly everyday
• Psychomotor agitation (inability to sit) or
  retardation (slowed speech and thinking)
• Feeling of worthlessness, excessive guilt
• Diminished ability to think or indecisive
  everyday
• Recurrent thoughts of death, suicidal ideation

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Prevalence of Major Depression

• Lifetime risk varies but about 10 to 25 for
  women and 5 to 12 for men
• Average age of onset is in the mid-20s
• Some studies suggest that an early onset of major
  depression is likely to predict a future bipolar
  disorder
• Up to 15 of individuals with severe major
  depressive disorder dies by suicide

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Features of Dysthymia

• Depressed mood for most of the day for at least
  two years
• Often goes undiagnosed and frequently seen as a
  personality problem
• Increased dependency needs
• May complain frequently about stress
• May want to run away when overwhelmed
• Sensitive to criticism
• Low self-esteem
• Take everything seriously, seems to have no fun
• Poor concentration and indecisive
• Pessimistic

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Features of Cyclothymia

• The presence of numerous periods of hypomanic and
  depressive symptoms for two years
• Probably underreported
• Thrill seeking
• Poor judgment
• Unstable school and work history
• Can be energetic, upbeat and friendly but easily
  irritated, critical, unpredictable, or hostile
  when frustrated or crossed
• May interfere and give unsolicited opinions
• May tells others the best way to do things due to
  inflated self-esteem and disregard that anything
  is wrong
• Talkative and has difficulty getting to the point
• May be ambitious but lacks a history of
  accomplishments

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Psychiatric Illnesses Linked to Mood Disorders

• Substance abuse
• Eating disorders
• Anxiety disorders
• Panic disorders
• Obsessive compulsive disorders

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Treatment Options for Mood Disorders

• The problem is often not with treatment but
  getting people into treatment and having them
  follow through with the recommendations.

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Treatment Options

• Inpatient therapy
• Outpatient therapy
• Electroconvulsive therapy
• Psychopharmacology (depakote, effexor, paxil,
  lithium, prozac, tofranil wellbutrin, zoloft)
• -effective if taken for sufficient length of
  time and as prescribed
• -side effects sometimes result in
  noncompliance

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Potential Side Effects

• Insomnia
• Daytime sedation
• Memory impairment
• Weight gain
• Acne
• Nausea
• Sexual inhibitions
• Tremors
• Hair loss
• Need for dietary restrictions
• Dry mouth
• Constipation and bladder problems

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What can you do to support a student with a
mental health disorder?

• Spend time and be available for the person
• Listen carefully
• Use I statements and share your concerns
• Avoid you statements which sound critical and
  giving simple solutions
• Dont assume anything and watch for stereotypes
• Remember that relationships make a difference in
  peoples lives
• Give choices, not ultimatums
• Talk in a calm, quiet manner
• Be non-judgmental
• Acknowledge what the person is feeling

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What can you do to support a student with a
mental health disorder?

• Adhere to professional boundaries and set limits
• Remember students have the right to refuse or not
  seek out services (if not a danger to themselves
  or others)
• Know your colleges code of conduct
• Know the resources available at your college
• Know community resources
• Be aware of internet resources such as
  campusblues.com and jedfoundation.org
• Keep on doing what you do well
• Be good to yourself

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Addressing the Disruptive Student

• Invite the student into a private area. It may be
  helpful to ask the student where theyd like to
  meet.
• Mirror the emotion of the student. John I notice
  you seem to be frustrated when I asked how you
  are doing in your biology class.
• Briefly state your concern. Jennifer, Im
  concerned that you missed your algebra class five
  times this month.
• Let the student talk. If they dont want to speak
  or refuse tell them the door is open and you are
  always willing to meet.
• If you dont understand what they are saying, ask
  for clarification.
• Paraphrase what has been said to you. So its my
  understanding that you have been late because
  your mother has been ill.
• Focus on behaviors and state your expectations.
  I understand that its hard to make your 800 AM
  class but the college policy is that missing more
  than four classes is.

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Addressing the Disruptive Student

• Ask the student for comments
• Thank them for their time
• Source Hernandez, T. J., Fister, D. L., (2001)
  Dealing with disruptive and emotional college
  students A systems approach. Journal of College
  Counseling, 4, 49-62.

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Reducing Classroom Conflict

• Communicate warmth and sensitivity through eye
  contact, body posture, respectful listening,
  smiling, and expressions of interest.
• Communicate enthusiasm for your subject.
• Set your pace to match students level of
  understanding
• Be available to students after class and during
  office hours.
• Limit disparaging remarks.
• Establish a shared course framework by
  determining course objectives and seeking student
  input. You are more likely to be seen as caring
  and responsive.

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Reducing Classroom Conflict

• Build a sense of community among the students
  through ice breakers and introductions. Make use
  of peer learning and group interactions.
• Acknowledge student feelings.
• Help students look at alternatives when dealing
  with problems.
• Source Meyers, S. A., Strategies to prevent and
  reduce conflict in college classrooms. College
  Teaching.

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REMEMBER THESE PEOPLE ALL HAD A MENTAL HEALTH
DISORDER

• Abraham Lincoln
• Ludwig Beethoven
• Leo Tolstoy
• Edgar Allen Poe
• Winston Churchill
• Patty Duke
• Charles Dickens
• Isaac Newton
• Jane Pauley
• Buzz Aldrin
• Eugene ONeill
• Tennessee Williams
• Vincent van Gogh
• Brian Wilson

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