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Navigating College Life

Among the keys to enhanced student success has been a heightened focus on students’ mental health.
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By Tom Woolf

Paul Dosal, USF’s vice president for Student Affairs and Student Success, empathizes with students who struggle academically because of anxiety and depression.

He knows all too well what that feels like.

After graduating high school, the Tampa native elected to pursue his bachelor’s degree at a large university out of state. As a first-year student, he struggled with English composition. He was uncomfortable in his residence hall. He was homesick, and he was depressed.

“Nobody reached out to me,” he recalls. “The university didn’t care. When I left, who noticed? Nobody. And even if somebody had noticed, what might they have said? ‘He was a minority first-generation student. He wasn’t ready.’”

Dosal left that university after his freshman year, enrolling at a 600-student college in North Carolina. It was the perfect fit. And, after earning his bachelor’s degree – as if to prove a point – he returned to the large institution he first attended for his advanced degrees.

Dosal’s personal experience helps inspire his commitment to ensuring students’ needs are being addressed holistically – a commitment that is shared throughout the university and that has earned national recognition. Since 2013, student success has been the university’s No. 1 strategic goal. The results have been striking: USF has raised the six-year graduation rate from 51 percent to 73 percent, and it has eliminated the achievement gap by race, ethnicity and income.

Among the keys to the enhanced student success has been a heightened focus on students’ mental health needs, which have grown in recent years at USF and nationally.

According to Dosal, a variety of issues can impact student success that are not directly related to academics.

“Telling a student to go see their academic adviser may not be the answer,” he says.

“That may be part of it, but what’s underlying the problem may be something very different and that means the treatment may need to be different. That understanding plays into the development of our case management approach to ensure multiple offices are sharing information about a particular student.”

Various national studies reflect students’ main mental health concerns as well as the increasing demand for services:

  • The Center for Collegiate Mental Health’s 2018 annual report found that college students seeking treatment (and the professionals who treat them) continue to identify anxiety and depression as the most common concerns for seeking treatment, among dozens of other concerns. The report incorporates data provided by 152 college and counseling centers, describing 173,964 unique college students seeking mental health treatment.

  • In the 2018 American College Health Association’s National College Health Assessment, more than 60 percent of undergraduates reported feeling overwhelming anxiety any time within the previous 12 months.

  • A 2019 study by the University of California, Berkeley, reported that nationally, the percentage of students who reported being diagnosed or treated for anxiety disorder in the last 12 months doubled between 2008 and 2016 from 10 percent to 20 percent.

Some studies and media reports have characterized the situation as a “crisis” or “epidemic.”

Scott Strader sitting on a couch smiling.

Counseling Center Director Scott Strader says anxiety and depression are the most prevalent issues among students. (photo: Ryan Noone, USF News)

Scott Strader, director of USF’s Counseling Center, disagrees.

“In college mental health generally, I think the crisis is a lack of resources,” he says. “Here, we are better resourced than a lot of universities our size.”

Ben Locke, senior director of Counseling and Psychological Services at Penn State University, leads the Center for Collegiate Mental Health, which is housed at Penn State. The center, which has been producing its annual report for 10 years, is an international practice-research network of nearly 500 colleges and universities, including USF.

“One of my areas of frustration in the coverage of mental health in college is it being framed as an epidemic or a crisis,” Locke says. “I really take issue with that.”

For the past 15-20 years, a great deal of money has been spent throughout the country on reducing the stigma attached to mental health. Those efforts, Locke believes, have helped students become more comfortable with seeking help.

“We have been decreasing negative judgments of people around mental health and we’ve been actively training all ages of people to refer themselves and their friends for help,” Locke says. “Secondary school systems, even middle schools, have student referral programs. The students who are coming to college grew up in an era where talking about distress is normal.”

According to the American Psychological Association’s 2018 “Stress in America – Generation Z” report, more than a third of both Generation Z and Millennials reported receiving treatment or therapy from a psychologist or other mental health professional at some point in their lives.

Locke says that on university campuses, “No one planned ahead for the receiving systems, which have just been flooded. The mantra that this is a crisis is a reaction to the scarcity principle. When something becomes scarce, people freak out.

“More students than ever are coming forward with a genuine need for help, and they can benefit from receiving that help,” he adds. “Institutions have to grow their mental health services to respond to this new demand. Most institutions have been doing that, but not all of them.”

Strader also points to the fact that more students are enrolled in college compared to 20 years ago.

“For them to be successful, the supports have to be there,” he says. “Just the sheer number of 18-to-25-year-olds now in college is going to affect demand for services. We’ve done a really good job at reducing stigma, talking with students about seeking help. Parents are more willing to recommend that, as are students’ friends.”

At USF, the Counseling Center experienced an 11 percent increase in the number of students receiving mental health services from 2017-18 to 2018-19. During the same time period, the number of on-campus mental health appointments attended by students grew 15 percent.

The Counseling Center has between 23 and 25 full-time clinicians, several who are part time, as well as an extensive training program for master’s and doctoral students, along with post-docs. The average wait time for a non-crisis counseling appointment was 4.75 business days in 2018-19, compared to 6.35 business days the previous year. At similarly sized universities nationally, the wait time in 2018 was 8.5 days.

Walk-in students who are in crisis are seen within an hour of their request for assistance. When the Counseling Center is closed, telephone support is available immediately.

“We’re not unlike any other outpatient center,” Strader says. “Most of what we see is anxiety and depression. About half of the students we see are adjusting to a new setting, they aren’t sure what’s expected of them and their parents aren’t here, so there’s anxiety attached to that. The other half that we see involve issues students bring with them to college, such as family issues or childhood trauma. We do see some exacerbation of that once they get here.”

Other common causes of anxiety include homesickness, financial worries, pressure for grades and relationship problems. And social media.

“Social media is a big piece and it’s multi-faceted,” Strader says. “One of my concerns is what I call the comparison factor. We always put our best face out on social media. When students are feeling even typical anxiety, such as during their adjustment to college, what they see on social media is that everybody is having a great time. That leads to ‘how does my life match up?’ It’s a real thing. It’s also a real thing in terms of how much time students spend on social media. I’ll encourage my clients to try to find more balance in how they use their time. And then you see their anxiety when you suggest they cut back on social media.”

At USF St. Petersburg, the Wellness Center experienced a 30 percent increase in students utilizing its services from 2017-18 to 2018-19.

“I believe our increase is similar to other campuses, in that more students are in need of services, more students are willing to seek help and more students are getting referred for services,” says Anita Sahgal, Wellness Center director.

She adds: “We continue to see what is most common on college campuses: anxiety, depression, social concerns and identity concerns. Our campus also sees a lot of students who have experienced some sort of trauma, which can require more extensive treatment.”

Discussions are underway with health and wellness offices on the Tampa campus about collaborations in several areas starting next year, including wellness coaching and Mental Health First Aid Training.

Brett Kemker ’92, regional vice chancellor for academic and student affairs at USF Sarasota-Manatee, also says that it is “becoming less taboo” for students to ask for help when struggling with anxiety. While he hasn’t seen a dramatic increase in students seeking counseling, available at nearby New College of Florida, there’s no question that their many responsibilities do cause stress.

“The average age of our student population is 26-27, and so we have students with lots of responsibilities,” he says. “They don’t just have part-time jobs, they are working full time in a career. They have a family, and they are taking courses at night. The stress component is a big factor as students manage all the balls they have in the air.”

In an effort to better address students’ anxiety issues on the Tampa campus, the university has implemented Mental Health Well-being for Success, or MWell4Success. Rita DeBate, associate vice president of health and wellness and a professor in the College of Public Health, developed the program. It has three tiers: Increasing mental health literacy by providing training to all incoming students; extending the Counseling Center hours and establishing satellite stations for coaching, counseling and relaxation; and implementation of coordinated care management for students with the greatest mental health needs.

DeBate says that some students were seeking counseling “for things they didn’t need a therapist for, such as time management, communications, relationship skills. Those were causing anxiety, but they were sub-clinical. What we proposed in MWell4Success was health and wellness coaching. By bringing in health coaches to see those students, we could free up time for counselors to see higher-risk students.”

The three satellite wellness centers are located at USF Health, The Village residence hall complex and the Marshall Student Center. The goals are to increase access to services and to reduce stigma.

“Some students would not go to the Counseling Center,” DeBate says. “But the message we’ve been giving to students is that if you go to a satellite center that has coaches, counselors, yoga and a relaxation station, no one would know who you were seeing.”

The satellite centers remain open until 8 p.m. so students won’t miss class or work. During the last academic year, 10,000 students visited the centers.

An initiative introduced during the summer, and continuing this fall, is designed to encourage more male students to engage in what DeBate refers to as “help-seeking behaviors.” Nationally, and at USF, males are far less likely to ask for help than female students.

Posters installed in men’s restrooms in the Campus Recreation Center encourage them to take advantage of campus resources, particularly those available online, if they feel like they are struggling.

DeBate hopes that the many efforts designed to address students’ mental health needs, part of the overall student success initiative, demonstrate how much USF cares about the well-being of all students.

“When I was an undergraduate in New York, college wasn’t treated as a community,” she says. “USF is a community, and we have to take care of all aspects of our community members’ lives. That’s what brings me joy: Knowing this is a campus but we don’t walk around like that’s all it is. This is a community and we take care of each other.”

What USF Is Doing

USF Counseling Center

Kid looking through binoculars

In addition to individual counseling sessions, the center offers a range of group counseling opportunities. They include: Men’s Group, Balancing Emotions, LGBTQ+, Total Nourishment, Our Voices (for marginalized populations), Entre Familia (Among Family) for LatinX students, and Focused Brief Group Therapy. There also are drop-in groups, such as Emotional Expression through Art and Mindfulness Meditation.

“Groups can be helpful in teaching skills and they bring together students who are struggling with similar issues,” Director Scott Strader says. “It helps reduce stress levels when students see they’re not the only ones struggling.”

Some students do make use of the center’s Therapist Assisted Online (TAO), which offers a library of interactive resources. Strader notes that online resources serve as a helpful adjunct to regular treatment.

The Counseling Center has introduced tele-health, which provides individualized treatment for students who may not be able to visit in person.

“We’re doing it to increase access, for example, for para-professional students who are in class or clinic all day,” Strader says. “It’s not necessarily for students who are living on campus. It really is designed for those who can’t get to the Counseling Center on a regular basis.”

Success and Wellness Coaching
As part of the MWell4Success initiative, all USF students have access to this service. Coaching is a personalized process that empowers students to work toward any area of improvement, including health, wellness, relationships, time management and academics.

Mental Health Literacy Training
This is an online training program for faculty, staff and students. It is designed to increase knowledge regarding signs and symptoms of psychological distress, how it impacts students, and what can be done when they identify a student of concern.

Mental Health First Aid for Higher Education
Since 2018, the Counseling Center has offered this voluntary eight-hour course for faculty and staff. First introduced in Australia in 2001 and adapted in the U.S. in 2009, the course teaches participants how to approach, support and help those in mental health distress or crisis. To date, more than 500 faculty and staff have taken the course. It typically is offered three times each semester, but the Counseling Center also will schedule departmental trainings as requested.

Center for Student Well-Being and REACH
The center offers workshops, presentations and awareness campaigns on wellness topics.
REACH – Responsible Education and Action for Campus Health – is a student-run organization sponsored by student government and the Center for Student Well-Being. REACH members promote holistic wellness through educational presentations and campus events.

Student Health Services & Psychiatry
Case management services evaluate individual mental health needs and provide assistance in accessing services. Psychiatrists are available to evaluate and treat mental health conditions such as depression, anxiety, bipolar illness or thought disorders. Post-doctoral psychologists provide counseling that utilizes brief therapy techniques to improve well-being.

Student of Concern Assistance Team/ Student Outreach & Support
The Students of Concern Assistance Team (SOCAT) is the behavioral intervention team for the USF Tampa campus. The SOCAT committee provides assistance and support to Student Outreach and Support (SOS) for students of high concern. SOS is the case management office for SOCAT that provides direct services to all active USF Tampa students who exhibit or identify difficulties related to personal, emotional or behavioral distress.

USF St. Petersburg Wellness Center

The Wellness Center offers individual, couples and group counseling for students, Therapist Assisted Online and a wellness room that has a biofeedback program for stress management. The center also provides QPR, a gatekeeper training for working with students who may have thoughts of suicide.

Staff members are licensed and experienced mental health professionals from the disciplines of counseling and clinical psychology. Psychological trainees, under the supervision of licensed professionals, also provide services.

Individual counseling can be sought for a variety of reasons including but not limited to: relationships, depression, anxiety, grief, substance abuse and eating disorders. The number of visits a student receives varies, but the center provides up to 12 counseling sessions depending on the needs of the student.

The Wellness Center also advises two student organizations: PEERS, a group focused on health promotion and building healthy lifestyles through programs and education; and Active Minds, a group focused on breaking barriers around stigma and education about mental health issues.

Student Outreach & Support (SOS)
The office is a student-first direct care coordination team that supports students in managing stress that impacts their academics and overall health and wellness. SOS case managers meet with students to:

  • Identify the student’s strengths and needs
  • Develop action plan to increase the student’s overall health and wellness
  • Coordinate linkage with appropriate support services on/off campus
  • Assess risk to self/others and threats to campus
  • Advocate for students within the university and community
  • Assist the student in navigating the university system
  • Foster self-advocacy through skill building via direct case management meetings

USF Sarasota-Manatee Resources

Students have access to a wide variety of counseling, wellness and health services through the Counseling & Wellness Center (CWC), located at nearby New College of Florida.

The following counseling services are available to current USFSM students:

  • Initial evaluation
  • Brief individual counseling
  • Brief couples counseling (both members of the relationship must be USF students)
  • Group counseling
  • Therapist Assisted Online (TAO)
  • Crisis intervention
  • Psychiatric services
  • Wellness workshops