Offering Support

Statewide Initiative Addresses Mental Health Needs of Students

December 16, 2008

By Pamela McLaren

“We're here to support the emotional well-being of students,” said Gail Pakalns Naruo, director of Counseling and Psychological Services in the Student Health and Counseling Center. “We know that a student's psychological health can be a contributor or an impediment to academic and personal success, and we want to help students be successful.”

In addition to counseling services, CAPS offers information, workshops and class presentations for faculty, staff and students on a wide range of issues related to college student mental health, including communications skills and conflict resolution, body image and healthy eating, adjusting to college, anger management, anxiety and self-esteem. CAPS also offers practicum training for qualified graduate students in counseling and psychology, as well as doctoral students from neighboring universities.

Counselors under her direction are working with students who come in with relationship or family issues, health concerns or other problems that are complicated but can benefit from the short term assistance CAPS can offer. “We help them learn more about themselves, develop new strategies for dealing with an issue, find ways to utilize their social network for support – this helps students move forward and continue their efforts to earn a degree,” said Pakalns Naruo. But more and more these days, they are also seeing students who face issues which require more intensive, ongoing assistance, she added.

“We are seeing more students, more crises and the sheer numbers are increasing,” Pakalns Naruo added. “We don't have the resources of a community mental health center, and most universities — all over the country — don't have those resources. To meet national counseling accreditation standards, we'd have to double our staffing.”

Pakalns Naruo holds a doctorate in counseling psychology from New York University. She recently addressed the Orange County Mental Health Board about the statewide Student Mental Health Initiative. Here, she explains the initiative and why it is needed.

Campus Works to Prevent Suicides

Pakalns Naruo is involved with the “CSUF Suicide Prevention Project,” a three-year program funded by a grant from the Substance Abuse and Mental Health Services Administration. The project focuses on:

Increasing the utilization of mental health services on campus and in the community
Increasing awareness of suicide on college campuses and
Reducing the stigma associated with seeking mental health services
Empowering students, staff and faculty to identify high-risk behaviors of someone needing mental health services

Q. What is the Student Mental Health Initiative?

A. In November 2004, Proposition 63 — called the Mental Health Services Act — was passed, allowing the California Department of Mental Health to provide increased funding and resources to support county mental health programs. The act imposed a one percent income tax on personal income above $1 million and established the Mental Health Services Oversight and Accountability Commission.

The commission is focused on both K-12 and higher education. In June 2007, the commission voted to approve $60 million for a Student Mental Health Initiative in response to the tragedy at Virginia Tech, $34 million of which is to support projects in higher education. The California Department of Mental Health agreed to administer the statewide projects and is waiting to receive expenditure authority from the counties.

The Orange County Mental Health Board held a public hearing at which I recently gave a statement about the importance of the Student Mental Health Initiative and my support for granting DMH this authority.

Q. Why do you think it is needed?

A: College and university counseling services statewide are seeing more students needing mental health services and for more complex issues.

Tragedies, such as at Virginia Tech, have heightened expectations that counseling services manage high risk situations and their psychological repercussions, as well as collaborate with others on campus to develop good risk management strategies. At the same time, counselors are expected to continue their traditional work of helping students with a wide range of developmental issues and life crises, and of offering mental health education to the broader campus community.

So, the mission of university counseling services has expanded while resources are limited and stretched. The challenge is that typically, when high-risk situations need to be managed — and they require significant amounts of time — other counseling and prevention work gets shortchanged. Yet, education and prevention are extremely important in meeting the psychological needs of the broad student body, particularly when resources are limited.

The key components of the projects that will be funded by the Student Mental Health Initiative are training, peer-to-peer support and suicide prevention. Helping students develop the skills and understanding to manage difficult situations can help prevent them from escalating into crises. Training and consulting with faculty, staff and students to help other students in distress expands the help available and enhances the well-being of the campus.

Q. What’s the situation at Cal State Fullerton?

A. We work increasingly with students at risk while managing with limited resources, a situation similar to that at other large CSUs. Our campus has more than 37,000 students: we have one counselor for every 3,442 students and one psychiatrist 20 hours a week. Our counselors have seen 50 percent more students for initial evaluations this September and October than last year, and I expect this trend to continue.

When students first contacted us this fall, 13 percent of them presented with suicidal ideas; 11 percent with a history of past suicide attempts, the factor most predictive of a future suicide attempt; and 27 percent have limited or absent social support — a major protective factor against suicide.

Half the students we’ve seen so far this academic year have impaired sleeping and concentration, and 33 percent have a history of taking psychotropic medications, most often for depression. These statistics give a sense of the urgency of some of the situations we assess and treat every day.

At the same time, the majority of students our counselors see have issues such as adjusting to college, managing conflicts with parents, coping with the loss of a friend or romantic relationship, identity struggles or managing the stress of multiple responsibilities at home, at school and at work. Giving students with these kinds of issues the appropriate amount of counseling time becomes a challenge when we’re faced with urgent situations. The same is true for offering the amount of mental health education that we would like to offer the campus community.

Q. How will the initiative help at Cal State Fullerton?

A. The Student Mental Health Initiative presents the hopeful possibility of funding for efforts that are crucial for the mental health of our students and the safety and emotional well-being of our campuses: training, prevention, peer-to-peer support and enhanced collaboration with local mental health and substance abuse agencies.

Some of the possible initiatives I envision that could be supported by this funding include training for faculty and staff on recognizing and responding to distressed students, training for students on resiliency and emotional self-management, staff training and protocol development to address the specific emotional needs of veterans who are coming to campus, the development of online resources such as mental health screenings and self-help tools, support for the initiation of campus chapters of peer support groups such as Active Minds and enhancement of our suicide prevention efforts to focus on the unique needs, protective factors and help-seeking behavior of the diverse ethnic and cultural groups that comprise our student body.

In addition, there is the potential for policy development and protocol sharing across the three California higher education sectors. And there is the possibility of developing close partnerships with county and community mental health and substance abuse agencies to develop ways to better meet the more serious mental health needs of our students.

For more information about Counseling and Psychological Services, go to their website.