Practitioners and a clinician join guest host Jenny Whittington, URMIA’s executive director, to review the state of student mental health and how risk managers can promote resources and services to the campus community, including those of the Jed Foundation. Mental health is one of the most pressing issues in the American Council on Education's recent pulse point survey signifying that even though this is now a public crisis, it's not new to higher education. And, it has certainly changed in complexity. Given that, what sort of mental health issues are our campuses dealing with now and how has this changed in the last few years? Let’s discuss!
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Student Mental Health: Legal Risks and Mitigation Strategies, session from regionals [member login required]
Guest Host Jenny Whittington, Executive Director- URMIA
[00:00:00] Jenny Whittington: Hello everyone. This is Jenny Whittington. Welcome to URMIA Matters. I'm gonna be your host for today's episode of URMIA Matters. We will be discussing student mental health and how risk managers can promote resources and services of the campus.
Joining me today to talk about this are Eva Frey, Dean of students at Pacific Lutheran University and Nance Roy, the Chief Clinical Officer at the Jed Foundation. And we also have a wonderful, our wonderful own Sue Liden with us URMIA's own education manager previously with Pacific Lutheran University. So welcome to all of you.
Thanks so much for being on our podcast today. And before we dive into this, uh, important topic, I'd like each of you to tell us a little bit about yourself. And I'd like to start with Eva.
[00:00:54] Eva Frey: Thanks, Jenny. Hi everybody. Eva Fry, Dean of Students at Pacific Lutheran University (PLU) and very warm and beautiful Washington state up here in the upper left.
And I've been at PLU now for 23 years and have had a variety of roles. Everything from, uh, diversity and multicultural, uh, affairs to campus life. Uh, and now serving as the Dean of students for the past, I think I'm completing my ninth year. You lose count after a little while, so I'm excited to be here to have this conversation over my time in higher education, what I've seen is, as we all have, is, How important mental health has become, both in, uh, the lives of our students and what they're bringing to us, but also in how our campuses respond to mental health and how do we support student success, and ensure that our policies and practices reflect, uh, our mission driven practices at our schools. So, thank you for having me.
[00:01:54] Jenny Whittington: Yeah. Thank you for the important work that you do day in and day out. Welcome to our podcast, and Nance, I know you've spoken on URMIA's agenda many a time, so welcome back to another URMIA production, and I know you're on our agenda for the fall, so looking forward to that. But tell, tell our podcast listeners a little bit about yourself.
[00:02:15] Nance Roy: Sure. Thanks. Thanks again for having me. I'm happy to be here today. I am, so I'm Nance Roy. I'm the Chief Clinical Officer at the Jed Foundation. Uh, the Jed Foundation, for those of you who may not be familiar, is a nonprofit whose mission is to promote mental health toward the ends of reducing suicide and substance misuse among teens and young adults.
We work quite extensively in colleges, universities, and now also high schools. We partner, I think, at last count with over 480 or so colleges and universities across the country. looking at their policies, programs, and systems that promote mental health and reduce suicide. I've been with Jed for almost nine years.
I am a psychologist by training. Spent my whole real life in college health before coming to Jed. Started as a staff psychologist at a counseling center and then. Director of health counseling disability, blah, blah. And then an assistant dean, associate dean. So, sort of been around the block in college health from both a direct service and administrative place, and then was asked by Jed to come on board and lead their JED campus initiative.
And now I mostly do things like this, which podcasts and talks and presentations and the fun stuff. So, thanks for having me.
[00:03:41] Jenny Whittington: Yeah. And a again, thank you for your good work in this space. I think we all know more than ever now it's, it's super important. I have a 22 year old son and you know, mental health has come up a lot in the last three years, so I appreciate you both, being part of the solution.
And last but not least, I'd like to give a special welcome to Sue Liden, URMIA's own education manager extraordinaire, and she is going to lead the discussions today. But Sue, just give a little summary about yourself just in case somebody out there, you know, doesn't know anything about the wonderful person you are.
[00:04:21] Sue Liden: Well, thank you, Jenny. Before I started working for URMIA in January of 2023, I worked at Pacific Lutheran University (PLU) in the beautiful Pacific Northwest for 15 years, 14 years serving as PLU's Risk Manager.
And when I retired, URMIA reached out and offered me a job as part-time jobs education manager. But while I worked at P L U, I had Eva on speed dial. We talked frequently, throughout our, my career at P L U about many things including student mental health. So, to get us started, Nance, I wanted to talk to you first.
We know student mental health has been identified as an emerging risk in higher education, and it's been cited most frequently by presidents. Most pressing issues in American Council on Education's pulse point survey. It’s also one of the top risks on many college and universities risk registers.
So, what sort of mental health issues are our campuses dealing with now and. How has this changed in the last few years? We know it's not new to higher ed, but how has it changed?
[00:05:39] Nance Roy: Yeah, so you're right in that it's not new. and thank you for making that point because we have heard a lot in the media with the pandemic that seemingly all of a sudden, have a mental health issue on, you know, on our campuses. And we know for those of us who've been. In this space for a long time, that, that, that simply is not the case.
That in fact, we've been seeing this trend of increasing mental health concerns among our young people for 10, 15 years. And, still the majority of, uh, students’ struggles, uh, involve anxiety and depression that really hasn't changed much over the years. The acuity, I think, has increased, uh, for many.
And, and you know, as I, as we were talking the other day, and I mentioned it doesn't really surprise me insofar as, uh, look at what our young people are facing today, right? They're growing up in a very uncertain, scary world that certainly must not feel safe to them.
There's school shootings that they are immersed in. There's climate change, there's racial hate crimes. Political divisiveness. The pandemic, I mean the, for most of us, in at least my generation, we have some ability to put these traumas in a context. But for young people, this is, this is their world. This is all they know. And so, I often say if we weren't seeing increasing rates of anxiety, I might be more worried because in many cases, this is actually almost a natural reaction to their lived experience right now.
Doesn't mean to say it's not a huge issue, but it, I think we need to remember the context in which, these students, these young people are struggling. So, and, and yes, of course the pandemic did impact, uh, all of us, in fact, especially around, uh, increasing issues of loneliness and isolation, which we know are huge predictors of mental health concerns. and again, especially for young people given where they are developmentally, where their whole sort of identity is wrapped around their friendships, their connections with peers, and losing that and losing their place at on campus, for many of those who, who went remote, did a tremendous, uh, made a tremendous dent in being able to stay connected and feel belonging.
So, so those issues compounded the anxiety and depression that we're also seeing.
[00:08:31] Eva Frey: Yeah, I, you know, I concur with everything Nance said. And so, you know, on the application side of this, on a college campus right now, what we're seeing is this increased acuity, but the increased acuity includes previous hospitalizations.
Students are coming to us with long-term mental health, uh, partners in their communities. They come with a psychiatrist, they come with a therapist. They're active with their parents, working with their health teams. And so, they come much more complex, uh, on a college campus. And sometimes they tell us, and sometimes they don't.
And I think that that place right there, that pinch point is for me and for many of my colleagues across the United States, is where we find the greatest opportunities to, uh, work with students and families around mental health is destigmatizing it, but then also saying, we're here and how can we work together to ensure that you persist and graduate?
[00:09:36] Sue Liden: Great. Thank you. So, Eva, what are our institutions, what is PLU doing to support students during these challenging times?
[00:09:49] Eva Frey: Well, PLU, much like other, uh, schools across the United States started to say, well, how do you respond to increased numbers of students who walk in the door with mental health challenges and, and concerns? And you can't just hire more psychologists and therapists and you just can't staff up counseling centers. That's, that's just not going to do it.
So many schools have moved to case management systems, so parallel to a conduct system. We now have case managers and case managers then spend quite a bit of time, uh, proactively responding to what we at PLU, we call them care forms. We have the student care network and that builds off our mission, of being an institution that thinks about care intentionally.
And how do we do that, uh, across the inside and outside of the classroom. So, we have case managers. We do anywhere from 1100 to 1300 care forms a year, and it has been for the past six years, our primary way of proactively reaching out to students and helping them and their families. respond to health and wellbeing issues.
We also have crisis lines that have become really the norm. Uh, we contract out with a crisis line that provides crisis lines for counties in the area in different states, and our students have access to that 24 7. We now use it even more and more as we connect with a clinician outside of regular business hours.
So, on a… middle of the night on a Saturday, and we have a student who's experiencing a, uh, a crisis. So, we reach out to that crisis line and that clinician provides us with an immediate kind of triaging of the situation and, and, uh, informed next steps. And then we also have telehealth. And telehealth has become, A primary partner for many schools since the pandemic.
How do you work, you know, contracting with a telehealth provider so that you not only have psych on psychiatrists on demand, you also have therapists on demand. You have Talk Now so that you can just have a quick 30-minute conversation with someone. And what we've seen is our tele, our telehealth provider has expanded into wellbeing, and so we're able to offer health coaching to our students and things around mindfulness and just their general wellbeing.
That's what we're finding is, is the way to respond to what isn't going to go away and how do we partner better with our students and their families, to not solve it, but to be in partnership with, with them as they go through school.
[00:12:43] Nance Roy: You know, I just wanna follow up on what one of the points you made Eva, about not hiring your way out of this problem by, you know, increasing counseling center staff, which we find is often the first reaction that many administrators think is going to be the solution.
As much as they don't necessarily have the funding to do so they think that that's, you know, what they need to be doing. And we know, and certainly. Certainly, our approach at Jed is very not to say that health and counseling centers don't have a very important role to play. They certainly do, but they are only one very small cog in a very large wheel.
And if we really wanna move the needle on supporting mental health and reducing suicide, we need to take a much more upstream approach. Right? So where, in our work on campuses, we're working to help schools produce a culture of caring and compassion, where a student feels a sense of belonging and caring and that they can walk through any door on campus for support.
Not again, not for therapy, but for a warm hand, for someone who takes an interest in them. So, our guiding principles really are twofold that in order to, again, move the needle on this issue. We need to take a public health approach. Where everyone on campus has a role to play from faculty to athletics, to co, you know, coaches, academic advisors, you name it, security, everyone across the board, and that you need to have support from senior leadership.
And we have found with all the schools we work with, that if you don't have those two sorts of foundational principles, under your belt, you really won't be able to move the needle on this issue in any kind of long-term systemic way. And that we really need a comprehensive approach.
So, for us it's about the following, sort of, uh, if you will, domains, and they include helping students develop life skills. Helping students develop a sense of connection and belonging, increasing help seeking on your campus, educating everyone on campus on how to identify if a student is struggling, and how to reach out yourself and certainly know when to refer and where if a student reveals an acute issue, looking at crisis management policies and procedures, direct services, and Means Safety. Means Safety is something that I can't stress enough, in encouraging schools to do environmental scans, for example, to identify places on campus where students can bring harm to themselves. There’s there's many things to look at there, so, so again, you know, back to your point, Eva, and, and, uh, reinforcing that it takes a village and there's many components to this work in addition to direct clinical care.
[00:15:47] Eva Frey: And we also, it would, it would be remiss me, Nance, if I didn't say that PLU didn't get to this place without our initial, I think springboard for the conversation to make change at P L U was because we became a JED campus. And so, you know, so often, you're right, that first response is, can we hire our way out of this?
And once you have the realization that one, you may don't, you probably don't have the financial resources, there probably isn't the population to hire anyway, is then you go looking for those. Those really awesome, great national partners and Jed, for us, was that partner, which then allowed us as an institution to say, okay, now we've partnered, we see what the best practices are, how do we move forward? And to use Jed then as a, a voice, as that expert back onto our campus to say, here are the different things we need to do.
[00:16:41] Nance Roy: Yeah. And the work we see on campuses like yours is just tremendous. So, it, the, it's, uh, very rewarding partnerships for Jed as well.
[00:16:53] Sue Liden: And I remember when we b started that process of becoming a Jed campus, being part of the group that met and helped figure out how we were gonna get from point A to point B and keep moving.
What else? How else can a risk manager provide additional resources in response to student mental health concerns? Or what other roles do risk managers have to play? Eva, can you share anything?
[00:17:23] Eva Frey: Oh gosh. You know, I've been thinking about this since our conversation, uh, earlier this week, and one of the things that.
This morning really stuck out for me was risk managers should know who their campus partners are before a crisis occurs of any kind. And so, if you're, you know, and oftentimes the risk manager on a college campus is a solo person who sits someplace away from students. And to seek out who are your campus partners, whether it's in facilities, but don't forget student life, you know, and, and come have that cup of coffee and, and just start getting to know who those people are cuz you're the, you're gonna work together in some really yucky things and to be able to do that well and understand each other and speak each other's languages would be helpful. I think also be a part of campus trainings of how we respond to mental health, uh, crises and, and concerns and incidents. Understand you know, Sue. Remember when we used to do the, the FEMA trainings and those sorts of things in case Lahar or Mount St. Helen's erupted? Well, that's one part of this, but more likely than not, we're gonna have a mental health crisis before Mount St. Helen's takes us out. And so having your risk manager be a part and understand how the university chooses to respond. Then also be a part of policy review and our, and our return to campus and understanding and helping us as student affairs people understand where are our boundaries as an institution? Uh, what types of students should come back and live on campus? What types of students should just come back to campus and perhaps not live on campus? And, helping to - sometimes student affairs-y people, while they're my people, they can sometimes be really heartfelt and not make the, and it's hard to hold that balance between what an individual student needs and what a community needs, and our risk managers can bring that perspective of holding both what our individual students need in a response and what our community needs and our response. So, those would be my takeaways this morning on how can risk managers get involved in, in response to mental health crises.
And if you wanna carry a duty phone, we always have an extra spare phone for somebody who wants to carry the duty phone.
[00:19:51] Nance Roy: You know, when I was on campuses before I came to Jed, our risk manager, for some reason it fell to me to do the health insurance, uh, bidding, you know, going out to bid and developing the plan with the broker and all of that stuff.
And we, we had a committee, but our risk manager was on the committee, which was. Wonderful, because then that person got to hear, okay, this is why we need this particular plan and these particular benefits because these are the issues we're seeing among our students. And same with tuition insurance, which is, you know, again, another thing that I think risk managers could have a voice in supporting, as we know that it makes a tremendous difference for a young person who may be struggling if they know that they can actually take some time out when they need it and not lose all the money that they, or their parents or whomever that's sponsoring them, have invested in the semester or the year. So, in terms of policies, I think those are two places where risk managers can play a significant role.
[00:21:06] Sue Liden: Yeah, I agree. And I would also say in addition to making sure the student health insurance policies that our institutions have cover the mental have provide the coverage for mental healthcare also in ensuring that international travel insurance has that coverage also in making sure because Eva, I remember a few times we've dealt with, uh, student issues and setting up resources. Our international study abroad. folks were really great at setting up resources in the local areas. Where our students would study and making sure that our insurance would provide the coverage for that and the telehealth if you have it, if that can include coverage out of state and out of country.
One other thing I thought about that a risk as risk managers you can do is share resources with your student affairs folks and folks on campus. There's all kinds of training up there. Share URMIA webinars that we have …and podcasts.
Send an email, “Thought you might find this of interest.” Set up a time to all sit and watch a webinar together and be able to ask questions. And it's not just URMIA that has those, although I believe our resources are top of the line. But your brokers and your insurance underwriters also have those resources that you can share.
And sometimes it's a newsletter, a blog post. But but share those. And like Eva said, as a risk manager, you need to get out and know. Your, uh, student affairs folks before a crisis happens. Get out and have coffee with them. Get out and meet with them. And as a risk manager, I would also have students who, student workers, so those you might come face to face with this when a student worker shares either a situation they're having or one of their colleagues.
So, know the policies and procedures and know where to direct them to get the help they need.
Any other last-minute thoughts? Information to share?
[00:23:18] Jenny Whittington: Well, gosh, it's been such a treat listening to you all and all the good advice. As I mentioned at the beginning of the podcast, I do have a 22-year-old son who you know, who I worry about his own mental health and his friends' mental health. It's, it's been an extraordinary time in all of our lives the last few years.
Sue already already touched on the international topic, but we do have, we have two really great sessions at our annual conference that are coming up. One is an extended session on international travel and mental health, and our good friend Bill Hoy, who used to be the journal council at Notre Dame now is with IES. He's gonna be part of that session with a, with a medical doctor, colleague of his, the Forum for Education Abroad and a clinician. So that, that is gonna be a great session.
And Nance Roy is joining us to do a session on trends in reducing risk in student mental health. So, I, I mentioned that one at the top of the podcast. That's gonna be a good one to attend for those doing the annual conference.
And then, Sue alluded to it, we have several re, we have several resources in the URMIA library. We will, we will point to those in the show notes. From our regionals, we did a session on student mental health, legal risks, and mitigation strategies. We did that at a couple of the regionals, and it was really well received I know I, I took several tips from that myself.
And then the best of URMIA series, Engaging Risk Management and Student Mental Health. It's a video recording that you should watch if you haven't checked it out already, you should definitely check it out.
I really wanna thank you guys for spending your Friday morning with me today. Great to talk about this important topic. What I heard you say is that we're all in this together. I mean, if you see something, say something. I think that we're at a very vulnerable time for, for a lot of these, these kids and, you know, they really just wanna be heard and seen and listened to.
So, I think we can all be part of that solution. So again, thank you for doing such important work in all the space. Uh, thanks for bringing this to the URMIA membership, and that'll be a wrap on URMIA Matters.