Why stayin’ alive?
• Students come here to earn a degree, learn skills and grow for the future
• Many variables must align to make that possible:
• Need to understand various sides of the retention issue in order to understand retention
• Focus and concentrate• Attend classes regularly• Think critically
• Complete work on time• Organize and process
information
Overview of Presentation
• Overview of Campus Health - services offered• Student health and wellness needs • CHS’ contribution to student retention– Challenges to measuring retention– Data overview and what we see on the ground
• A deeper look at retention, health and mental health issues
Campus Health Service is…• Medical Services, Counseling
and Psych Services, Oasis Program Against Sexual Assault and Relationship Violence and Health Promotion and Preventive Services
• Integration of services on several fronts
Health Services• Full service outpatient medical clinic – See a range of patients, from very mild to more severe (case
example)
• Staffed by licensed medical practitioners • Students seen by appointment and walk-in• On site X-ray, laboratory• Full service pharmacy• After hours phone line
General Medicine (cont’d)
• Urgent Care • Women’s Health • Sports Medicine • Physical Therapy• Acupuncture • Massage Therapy• Immunization & Travel Clinic
Counseling and Psych Services (CAPS)• Treatment of depression, anxiety, eating & body image
issues, substance abuse, sleep issues, grief, trauma, family & other relationship issues, ADHD management, etc.)
• Staffed by licensed mental health practitioners • Same-day walk-in Triage• Solution focused counseling for individuals and couples• Psychiatric services• Support groups and other psychoeducational groups
Counseling and Psych Services (CAPS) cont’d• Consultation with faculty, staff, families and
friends about students of concern • Education and training around college mental
health issues• Suicide prevention • Risk assessment, mental health screenings• Assistance with developing coping skills and
strategies (case example)
Oasis Program Against Sexual Assault & Relationship Violence
• Team staffed by licensed Psychologist and violence prevention specialist
• Counseling for individuals impacted by:– Sexual Assault– Relationship Violence– Stalking
• Consultation • Education and Outreach• Community advocacy and decision making
Health Promotion and Preventive Services
• Alcohol & other drug awareness and counseling (case example)
• Sexual health• Nutrition and fitness • Stress management• Violence prevention and bystander intervention• Body issues • Suicide prevention
Some HPPS programs• Brief Alcohol Screening and Intervention for College
Students (BASICS)• The Buzz• Student Health Alcohol and Drug Education (SHADE)• Step Up! Bystander intervention program• Question, Persuade, Refer suicide prevention training• Individual consultation and referral for alcohol and
other drug issues and nutrition
How do the services at CHS relate to retention?
Students’ ability to succeed in college
Anxiety
Sleep
Physical Illness
Chronic pain
Family concerns
Depression
Substance use
Attention/ concentration
Eating disorders
Grief
Relationship conflict
Intrusive thoughts
Identity Issues
It’s hard to succeed academically if…
• Too impacted by personal issues to complete coursework
• Mental or physical illness interferes with cognitive skills or energy levels
What do we know about student retention?• Reasons for leaving are varied – from finding
another school to dealing with personal issues (Rummel, 1999)
• The needs of students and our ability to meet them is related to retention
• “Institutional efforts to ensure a healthy campus environment can have an impact on student success and potentially affect retention.” (NASPA, 2004)
ACHA top impediments to academic performance
AI-1.1 Reduce the proportion of students who report that their academic performance was adversely affected by stress in the past
12 months.
AI-1.2 Reduce the proportion of students who report that their academic performance was adversely affected by sleep difficulties in the past
12 months.
AI-1.3 Reduce the proportion of students who report that their academic performance was adversely affected by anxiety in the past
12 months.
AI-1.4 Reduce the proportion of students who report that their academic performance was adversely affected by cold/flu/sore throat in the
past 12 months.
AI-1.5 Reduce the proportion of students who report that their academic performance was adversely affected by work in the past
12 months.
Mental health of UA students*• 27% said depression or anxiety made it difficult to
work, study, or go to class• 51% experience more than average stress• 6.6% have seriously considered suicide in the last
year• 19% had experienced violence in last 3 months• 10% have been diagnosed with depression, and
11% have been diagnosed with anxiety
*2012 Health and Wellness Survey, n=2,406
Concerns presented at CAPS Triage
Top 10 concerns presented (n=1,974)
70% Anxiety/Panic63% Depression/sadness44% Sleep problems40% Low energy36% Academic concerns
31% Isolation/withdrawal30% Impaired concentration30% Mood swings28% Low self-esteem24% Romantic relationship issues
Intuitively, we know that wellness has an effect on retention. But what are some challenges to measuring student retention?
Measurement challenges
• Causal link between support services and retention is hard to quantify
• Students themselves may not realize impact of a problem (or its solution) on remaining in school
• Multiple, complex factors at play• Multiple and varied support services to support
struggling students can be synergistic
Measurement challenges (cont’d)
• Unique challenges for CHS:– Confidentiality and data collection– Broad reaching services may support students in
subtle ways – Can’t measure how a crisis averted (prevention)
affects retention
• All data presented here is self report
Health services and retention
• There is very little research about the link between physical health and retention
• Aitkin (1982) found that number of sick days was significantly associated with GPA
• Findings from a Rutgers disease prevention program found a correlation between use of health services and GPA, retention and classroom attendance (Conciatore, 1991)
• Can hypothesize that:– Illness (including chronic and severe episodes) may have a negative
impact on academic performance– Health services which assist the student with these issues may positively
impact retention (Case Examples)
49% of UA students indicated that using CHS helped them remain a student* - equivalent to 1,178 students in sample
*2012 Health and Wellness Survey – n=2,406
44% - 1,058
19% - 457
8% - 192
% students who said any of the following services helped them remain a UA student (n=2,406)
Medical Services CAPS HPPS
Counseling services and retention• 63% of counseling centers nationally asked students
about retention– 56% indicated that counseling helped them remain a student
and 61% said it helped their academic performance (AUCCCD, 2011)
• Range of severity in patients, but either end may have an impact on retention (suicidality vs. grief – case examples)
• Substantial literature to support Counseling advantage:– Iowa state – 14% retention advantage against control group– University of Western Illinois – followed freshman for 2 years
and found 70% retention rate in counseling group vs. 68% in general student population
Mental health and retention
• Depression, anxiety, and eating disorders are linked with lower GPA and higher risk of dropping out (Eisenberg, Golberstein and Hunt, 2009)
• In one study, 1/5 students attending counseling were considering dropping out (Turner and Berry, 2000)
• Socio-emotional adjustment problems are better predictors of retention than academic difficulties (Bray, Braxton and Sullivan, 1999)
CAPS Triage usersStudents surveyed after triage appointments between Feb-March 2012 (n=71) indicated that their visit to caps:
Increased sense of hope
Increased comfort in help seeking
Improved outlook on the future
Increased awareness of options
64%
82%
59%
79%
CAPS patient satisfaction survey 2012• Collected April 2-12, 2012• Administered to students after their counseling
appointment• N=246 (20 triage only and 226 returning students)• Sessions at CAPS– 29% 1-3 sessions– 13% 4-5 sessions– 51% more than 5 sessions
CAPS patient satisfaction survey (cont’d)
Anxiety/Panic Depression Family Issues Low self esteem Hopelessness
91% 93%78%
91% 85%
45%53% 53%
60%
43%
Problems treated and impact on academic success/decision to stay enrolled
Impacted academic performance Impacted decision to stay
CAPS patient satisfaction survey (cont’d)
Life decisions Relationship Suicidal thoughts AOD issues Physical health
80% 81% 83% 84% 80%
57%
34%
56% 52%44%
Problems treated and impact on academic success/decision to stay enrolled
Impacted academic performance Impacted decision to stay
Stayin’ alive
• Retention cannot be the sole focus of the CHS mission (case example)
• Sometimes, we must recognize the greater need to withdraw, for reasons of health and safety – …and some get help too late– Temporary separation does not always equal failure to complete
college
• Direct service to students with health and mental health issues may position others in student affairs to assist students with retention in other ways
Retention challenges for today’s students
• Students may be more difficult to retain if they have:– Reduced tolerance for discomfort and unwanted feelings – Belief in immediacy of solutions– Delay in self-responsibility – Increase prevalence of bipolar disorder due to widespread
use of ADMS in undiagnosed bipolar– Increase in severity and multiplicity of symptoms– Treatment making college a possibility for those with
marginal skills and coping (greater use of medications)
Remaining questions
• How can we better examine the causal link between CHS services and retention? (measurement difficulties)
• How do different types of services impact retention differently?
• What is the relationship between severity of presenting problem and retention? (Achter, 2008)
• For CAPS, how is number of visits related to retention?
Next steps in data collection
• Looking at more creative ways to collect retention data– Where can we incorporate into evaluation? Support
groups, educational outreach, diversion programs, etc.
– How can we work with other departments?– How can we measure actual retention among those
using our services, as opposed to only self report? (many complications!)
Summary
• Retention is a complex variable• Hard to define causal relationships definitively• Hard to get hard evidence for the specific role of
any single intervention• Health and mental health issues clearly impact a
student’s ability to succeed and possibly remain in college
You have to be alive and functional to be retained!
Top Related