Presence/incidence of students with mental health concerns within University



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Presence/incidence of students with mental health concerns within University

  • Presence/incidence of students with mental health concerns within University

  • Education at University

  • Triggers for students with Mental Health concerns in general & within the university environment

  • Other issues around mental wellbeing that may impact upon their success at university

  • PhD research into success for postgraduate students at UniSA

  • Strategies to facilitate success



Around 1 in 5 adults in the general community (Aust Bureau of Stats)

  • Around 1 in 5 adults in the general community (Aust Bureau of Stats)

  • Individuals with mental illnesses have educational potential (Collins & Mowbray 2005) and are supported with their studies through various legislation worldwide (McLean & Andrews 1999)

  • In Australia students are supported through legislation, standards and policies on disability, education and mental health (Martin 2010). This includes the UN convention on the Rights of Persons with Disabilities – ratified 17 July 2008. http://www.ag.gov.au/www/agd/agd.nsf/Page/Humanrightsandanti-discrimination_UnitedNationsConventionontheRightsofPersonswithDisabilities

  • Students entering further education rather than university do not have fewer incidence than those at university (Warwick et al 2008)

  • Estimated between 10 & 20% of university students have mental illnesses – research in USA (Collins & Mowbray 2005), despite earlier research indicating that young people are unlikely to enrol in higher education (Megivern et al. 2003)



Out of those, some students have pre-existing mental health concerns, where as others may have their first episodes during their time at university (Martin 2010) – especially if they are school leavers as...

  • Out of those, some students have pre-existing mental health concerns, where as others may have their first episodes during their time at university (Martin 2010) – especially if they are school leavers as...

  • ¾ of initial onset of mental illnesses is between 16 & 25 years old (Mcgivern et al 2003 & McLean & Andrews 1999)

  • UniSA: Number who made contact with me through my online survey – 120 students – therefore there are students at this university studying with mental health concerns – it is around you!



Major change in delivery and focus of your learning (Lu 1994; Biggs 2003)

  • Major change in delivery and focus of your learning (Lu 1994; Biggs 2003)

    • Adult learning
    • Responsibility for learning shifts to the individual student
    • Few contact hours
    • Attendance is usually not compulsory
    • This becomes even more prevalent with post-graduate studies and research only studies


Other areas that can also change in conjunction with change to university studies (particularly if you are a school leaver entering university)

  • Other areas that can also change in conjunction with change to university studies (particularly if you are a school leaver entering university)

    • Housing
    • Employment
  • Also, international students have to contend with a different culture and for some a new/different language as well as being away from familial & other supports (Biggs 2003)

  • In general, transition to university is a major life change & fits within stressful life events research (Lu 1994; Thoits 1982)



CHANGE & UNI EDUCATION OFTEN LEADS TO.....

  • CHANGE & UNI EDUCATION OFTEN LEADS TO.....

  • STRESS

  • impacts on any individual, both home and international, with a strong link to psychological distress and also links to risk & resiliency theory (Lu 1994; Collins 2001; Halamandaris & Power 1999)

  • for students with a predisposition to mental health concerns or those who already have mental health concerns, this can lead to attrition (Martin 2010; Tennant 2002; Surtees et al 2002; McLaren & Andrews 1999)

  • Appropriate supports are required to reduce that attrition



Thinking, behaviour, perception of reality, affects and judgement & insight

  • Thinking, behaviour, perception of reality, affects and judgement & insight

  • Effects of medication impact learning and increased around change/withdrawal of medication

  • This impaired functioning includes the areas of cognition, emotions, psychological and social.

  • Grief & Loss of their mental illness experience – future oriented loss (Baker, Procter & Gibbons 2009) UniSA research



Benefits of university education

  • Benefits of university education

    • increasing self-esteem (Coleman & Hagell 2007)
    • community engagement (Martin 2010, Humphrey 2004 & Kohn 1994)
      • In the University community: through meaningful and purposeful engagement in order to achieve study goals, and
      • In the wider community: through employment and other engagement to achieve life goals
      • Decreased hospitalisations, increased self-confidence & empowerment - if appropriate support is utilised
  • My research explored ways to maximise student potential within higher education and its flow on into the wider community despite the hurdles that present



Definition:

  • Definition:

    • a multi-theoretical approach to understanding how people maintain well-being despite adversity, which is learnt (nurture) rather than something you are born with (nature) (Greene 2009; Fergus & Zimmerman 2005)
    • Ability to bounce back from or overcome adversity & stressors
    • See table 12.2 in reading from Greene (2009)


How it relates to students with mental health concerns

  • How it relates to students with mental health concerns

    • As mentioned changes to learning at university and assessments can be significant stressors, particularly for students with mental health concerns
    • Dealing with the stress is necessary to provide an environment where success is possible


How it can facilitate student success and engagement within the university and wider community.

  • How it can facilitate student success and engagement within the university and wider community.

    • It promotes the development of protective factors to reduce the risk of stressors
    • Protective factors can be either internal (personal) or viable support networks that modify the risk from life events stress including uni education(Greene p, 321; Thoits 1982; Warwick et al 2008).
    • Assistance through LTU and other means, both inside and outside the university, are important in the provision of support services/networks


Positive psychology is focused on the wellbeing of individuals and mental wellness rather than just the absence of mental illness.

  • Positive psychology is focused on the wellbeing of individuals and mental wellness rather than just the absence of mental illness.

  • It links to resilience and strengths based approaches in working to achieve goals.

  • Often referred to as the wellness model

  • Originated as an opposing viewpoint to learned helplessness as put forward by Martin Seligman. (Seligman 2011a; Seligman 2011b; ; Seligman 1992; Seligman & Csikszentmihalyi 2000)



Positive Emotion

  • Positive Emotion

  • Engagement

  • Relationships

  • Meaning

  • Accomplishment



The positive impact of help seeking behaviour

  • The positive impact of help seeking behaviour

    • Increased success (as mentioned earlier)
  • Reasons those with mental health concerns may avoid seeking help and the impact of this on their university educational success and university experience (Martin 2010)

    • Stigma ( & link to empowerment)
    • Hidden nature of the disability
    • Nature of the disability being a fluctuating condition
    • Nature of the illness – characterised by withdrawal
    • Need people they can connect with when they are in need
  • However, to aid students in the pursuit of their studies, universities need to ensure that their support provision is responsive and effective (Surtees et al 2002; Thoits 1982)



  • Success for University Students with Mental Illness: Building Resilience and Positive Emotion, Engagement, Relationships, Meaning and Accomplishment

  • [Conferred August 2014]

  • (Blake 2014)





Self-initiated strategies, but the focus is on University initiated strategies here

  • Self-initiated strategies, but the focus is on University initiated strategies here

  • Resilience focused strategies will be first discussed and then those around Positive Psychology’s PERMA



Workshops on self-esteem and positive outlooks for students

  • Workshops on self-esteem and positive outlooks for students

  • Student participation in campus programs such as mentoring

  • Provision of flexibility and assistance

  • LTU staff being available

  • More encouragement given

  • More assignment feedback

  • LTU staff having more time to provide services

  • Provision of information to students about services such as information packs pointing out that mental illness is part of disability services



Support Group

  • Support Group

  • Consolidated Student Information Packs or staff guiding them through options

  • Case Management (Higher Degree supervisors could help manage this or provide some brochures to help direct to appropriate services)

  • Staff trained in MHFA (Mental Health First Aid)



Allowing resubmissions within reason

  • Allowing resubmissions within reason

  • Understanding that Academics have a lot of pressures and providing more administrative support to free them up to respond more speedily to emails and help-seeking

  • Being willing to explain information a number or times, possibly in a number of different ways



Understanding, approaching and treating mental illnesses as physical illnesses

  • Understanding, approaching and treating mental illnesses as physical illnesses

  • Promoting, confidence to even out the self-doubt, particularly in the first 6 months around the research proposal as this grounds the student in an experience and understanding that they can and are achieving

  • Engaging in the provided postgraduate gatherings either for academic or social reasons



Access to information and provision of information about services to access outside of university, including alternative approaches

  • Access to information and provision of information about services to access outside of university, including alternative approaches

  • Holistic approaches

  • Enshrining bio-psycho-social approaches – not just reliant on referrals to doctors for medication



Only around ½ students disclose to staff and then only ½ of those seek help through DAPs

  • Only around ½ students disclose to staff and then only ½ of those seek help through DAPs

  • Students are often confused around the terminology and could be assisted further by staff, particularly those undertaking higher degrees

  • Not all students have a positive experience of disclosure and perceptions of students with mental illnesses going into professions can be negative



Australian Bureau of Statistics (2007) National Survey of Mental Health and Wellbeing: Summary of Results. Vol. 4326.0 Canberra: Australian Bureau of Statistics.

  • Australian Bureau of Statistics (2007) National Survey of Mental Health and Wellbeing: Summary of Results. Vol. 4326.0 Canberra: Australian Bureau of Statistics.

  • Aneshensel, C. (1992) “Social Stress: Theory and Research” Annual Review of Sociology 18: 15-38

  • Baker, A., Procter, N. & Gibbons, T. (2009) “Dimensions of Loss from Mental Illness” Journal of Sociology & Social Welfare 36, pp. 25-52

  • Bentley, K. (2002) Social Work Practice in Mental Health: Dontemporary Roles, Tasks, and Techniques Brooks/Cole Thomson Learning: Canada

  • Biggs, J. (2003) “Teaching for Quality Learning at University: what the student does” in Teaching International students, (2nd Ed) Society for Research in Higher Education: Buckingham, Philadelphia, Chapter 7

  • Coleman, J. & Hagell, A. (2007) Adolescence Risk and Resilience: Against the Odds John Wiley & Sons Ltd: Sussex, England



Biggs, John B. and Society for Research into Higher Education (2003) Teaching for Quality Learning at University: What the Student does. Buckingham; Philadelphia: Society for Research into Higher Education.

  • Biggs, John B. and Society for Research into Higher Education (2003) Teaching for Quality Learning at University: What the Student does. Buckingham; Philadelphia: Society for Research into Higher Education.

  • Blake, Naomi (2014) Success for University Students with Mental Illness: Building Resilience and Positive Emotion, Engagement, Relationships, Meaning and Accomplishment PhD Thesis, University of SA, Adelaide

  • Coleman, John and Ann Hagell (2007) Adolescence Risk and Resilience: Against the Odds. West Sussex, England: John Wiley & Sons Ltd.

  • Collins, M (2001) “Transition to Adulthood for Vulnerable Youth: a review of research and implications of Policy” The Social Service Review 75(2): 271-291

  • Collins, M. & Mowbray, C. (2005) “Higher Education and Psychiatric Disabilities: National Survey of Campus Disability Services” American Journal of Orthopsychiatry 75 (2): 304-315



Fergus, S. & Zimmerman, M. (2005) “Adolescent Resilience: A Framework for Understanding Healthy Development in the Face of Risk” Annual Review of Public Health Vol. 26, pp. 399-419

  • Fergus, S. & Zimmerman, M. (2005) “Adolescent Resilience: A Framework for Understanding Healthy Development in the Face of Risk” Annual Review of Public Health Vol. 26, pp. 399-419

  • Fredrickson, B. L. and Losada, M. F. (2005) Positive Affect and the Complex Dynamics of Human Flourishing. American Psychologist 60:678-86.

  • Gable, Shelly L. and Jonathan Haidt. (2005) What (and Why) is Positive Psychology? Review of General Psychology 9:103-10.

  • Grigg, Margaret, Bruce Singh and Graham Meadows. (2007) Mental Health in Australia : Collaborative Community Practice. Melbourne, Vic.: Oxford University Press.

  • Greene, R. (2009) “Risk and Resilience Theory: A Social Work Perspective” in R. Greene (ed) Human Behavior Theory & Social Work Practice (3rd Ed.) Transaction Publishers: New Jersey, Chapter 12



Halamandaris, K. & Power, K. (1999) “Individual Differences, Social Support and Coping with the Examination Stress: A study of the psychosocial and academic adjustment of first year home students” Personality and Individual Differences 26: 665-685

  • Halamandaris, K. & Power, K. (1999) “Individual Differences, Social Support and Coping with the Examination Stress: A study of the psychosocial and academic adjustment of first year home students” Personality and Individual Differences 26: 665-685

  • Humphrey, N. (2004) “The Death of the Feel-Good Factor: Self-Esteem in the Educational Context” School Psychology International Vol 25, pp. 347-360

  • Kohn, A. (1994) “The Truth About Self-Esteem” Phi Delta Kappan 76 (4)

  • Langer, E. (2002)Well-being: Mindfulness Versus Positive Emotion. Pages 214 in Handbook of Positive Psychology [Electronic Resource]. Oxford England ;New York: Oxford University Press.

  • Lazarus, Richard S. (2003a) Does the Positive Psychology Movement have Legs? Psychological Inquiry 14:93-109.



Lopez, S. J. (2008a) Positive Psychology: Exploring the Best in People - Capitalizing on Emotional Experiences. Vol. 2 USA: Praeger Publishers.

  • Lopez, S. J. (2008a) Positive Psychology: Exploring the Best in People - Capitalizing on Emotional Experiences. Vol. 2 USA: Praeger Publishers.

  • Lopez, S. J. (2008b) Positive Psychology: Exploring the Best in People - Discovering Human Strengths. Vol. 1 USA: Praeger Publishers.

  • Lu, L. (1994) “University Transition: major and minor life stressors, personality characteristics and mental health” Psychological Medicine Vol.24, pp. 81-87

  • Maddux, J. (2005) Stopping the "Madness": Positive Psychology and the Deconstruction of the Illness Ideology and the DSM. Pages 13-25 in Handbook of Positive Psychology. Edited by C. R. Snyder and S. J. Lopez. Oxford: Oxford Univeristy Press

  • Maddux, J. (2002) Self-Efficacy: The Power of Believing You can. Handbook of Positive Psychology. Edited by Shane J. Lopez and C. R. Snyder. Vol. 2. Oxford: Oxford University Press.



Martin, J. (2010) “Sigma and Student Mental Health in Higher Education” Higher Education Research & Development 29(3): 259-274

  • Martin, J. (2010) “Sigma and Student Mental Health in Higher Education” Higher Education Research & Development 29(3): 259-274

  • Masten, Ann S. and M. Reed. 2002. Resilience in Development. Handbook of Positive Psychology. Edited by Shane J. Lopez and C. R. Snyder. Vol. 2. Oxford: Oxford University Press.

  • McLean, P. & Andrews, J. (1999) The Learning Support Needs of Students with Psychiatric Disabilities in Australian Post-Secondary Institutions Adelaide: National Centre for Vocational Education Research

  • Meadows, G., Singh, B. & Grigg, M. (2007) Mental Health in Australia Oxford University Press: Melbourne

  • Megivern, D., Pellerito, S. & Mowbray, C. (2003) “Barriers to Higher Education for Individuals with Psychiatric Disabilities” Psychiatric Rehabilitation Journal 26 (3): 217-231



Oades, L., P. Robinson, S. Green and G. Spence. (2011) Towards a Positive University. The Journal of Positive Psychology 6:432-9.

  • Oades, L., P. Robinson, S. Green and G. Spence. (2011) Towards a Positive University. The Journal of Positive Psychology 6:432-9.

  • Peterson, Christopher. (2006) A Primer in Positive Psychology. New York: Oxford University Press.

  • Seligman, Martin E. P. (2011a) Authentic Happiness. North Sydney: Random House Australia.

  • Seligman, Martin E. P.(2011b) Flourish : A Visionary New Understanding of Happiness and Well-being. London: Nicholas Brealey Publishing.

  • Seligman, Martin E. P.(1992) Learned Optimism. Milsons Point, N.S.W.: Random House Australia.

  • Seligman, Martin E. P. and Csikszentmihalyi, M. (2000) Positive Psychology: An Introduction. American Psychologist 55:5-14.



Seligman, Martin E. P., Steen, Tracy A., Park, Nansook and Peterson, Christopher. (2005) Positive Psychology Progress: Empirical Validation of Interventions. American Psychologist 60:410-21.

  • Seligman, Martin E. P., Steen, Tracy A., Park, Nansook and Peterson, Christopher. (2005) Positive Psychology Progress: Empirical Validation of Interventions. American Psychologist 60:410-21.

  • Snyder, C. R. and Lopez, S. J. (2005) Handbook of Positive Psychology. Oxford: Oxford University Press.

  • Surtees, P., Wainwright, N. & Pharoah, P. (2002) “Psychosocial Factors and Sex Differences in High Academic Attainment at Cambridge University” Oxford Review of Education 28(1): 21-38

  • Tennant, C. (2002) “Life Events, Stress and Depression: a review of recent findings” Australian and New Zealand Journal of Psychiatry Vol.36, pp. 173-182

  • Thoits, P. (1982) “Conceptual, Methodological and Theoretical Problems in Studying Social Support as a Buffer Against Life Stress” Journal of health and Social Behavior 23(2): 145-159



Warwick, I., Maxwell, C., Statham, J., Aggleton, P. & Simon, A. (2008) “Supporting Mental Health and Emotional Well-being Among Younger Students in Further Education” Journal of Further and Higher Education 32(1): 1-13

  • Warwick, I., Maxwell, C., Statham, J., Aggleton, P. & Simon, A. (2008) “Supporting Mental Health and Emotional Well-being Among Younger Students in Further Education” Journal of Further and Higher Education 32(1): 1-13




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