Increasing Student Engagement Outreach to Marginalized Populations on

Increasing Student Engagement: Outreach to Marginalized Populations on Campus JUANITA K. MARTIN, PHD EXECUTIVE DIRECTOR COUNSELING & ACCESSIBILITY COUNSELING AND TESTING CENTER UNIVERSITY OF AKRON

College student mental health College student mental health, service demand a diverse campus population Addressing mental health needs for African American college students University of Akron Counseling & Testing Center and some national recommendation strategies

A time of transition Exciting, new life journey Transitional - We expect developmental concerns Academic , interpersonal, financial

College student mental health Significant increase in college student emotional distress American College Health Association – National College Health Assessment (ACHA) National Longitudinal Survey of Youth Center for Collegiate Mental Health (CCMH) World Health Organization Additional online national and international research

College student mental health Depression, suicidal thoughts & attempts, use of substances increased Reports of students experiencing anxiety doubled within past 10 years – 10% to 20% Number of students considering suicide between 2009 -2018 doubled 6% to 12% Students are distressed such that report an inability to function 31% to 42% International – 1/3 college freshman mental health concerns just prior to college 20 year trend Students currently flooding college and university counseling services

College student mental health Crisis Societal changes Generation Z & loneliness Social media Academic performance pressure Financial U. S. Adults “ miserable” New normal (Locke 2019)

College population increasingly diverse Race, ethnicity, gender, sexual orientation, immigration, citizenship Marginalized communities Less research regarding mental health concerns for these students Emotional distress increasing for students from marginalized communities and not uncommon for students from these groups to exhibit distress at higher rates than white students At least one study found African American, Latinx and transgender students anxiety rates were high and increased closer to graduation (Kane, 2019).

African American college students 40% of 20 million college students are people of color (POC) 14% of college students African American 34% of traditional college age African Americans in college African American women one of highest enrolled groups 40 years more are enrolled in predominately white institutions (PWI) 20% more likely to report psychological distress compared to non-Hispanic white population Lack of research – suicide rates increase Women low - rates of suicide

African American college student mental health Research partnership – Harris Poll, Drug Free Kids Steve Fund Mental health and well-being for students of color Encourages higher ed program development Encourages campus mental health services Jed Foundation – comprehensive public health approach to address mental health concerns within colleges and universities Conducted a study on college students of color

Steve Fund

Steve Fund African American & White students Feel academically prepared AA 36%/W 50%/H 39% Emotionally prepared AA 23% / W 35% Perception of environment Good AA 48% / W 62% Overwhelmed AA 51% / W 40% Angry AA 14% / W 8% Control AA & W 36% /H 21% College not living up to my expectations – AA greater W Considered transferring first semester – AA greater than W

Steve Fund African American vs White students African American students received less mental health treatment Anxiety AA 12% / W 27% Depression 16% / 25% Self harm AA 5% / W 11% African Americans less likely to disclose concerns African Americans more likely to use spirituality/religion to cope AA 61% / W 75% AA 18%/ W 8%/H 5% African American students less likely to use alcohol compared to white students Pressured to use, college expectations, drink, illegal drug use

African American vs White students research Poor racial climate Overwhelmed Isolation Discouraged by a one size fits all approach to concerns on campus

African American students-retention and mental health services Attrition rate may be due to more emotional and non- cognitive factors Graduation rate is lower ACHA-NCHA 2015 ; Chen et 2019; Healthy Minds 2015 REM - Less likely to receive services with similar rates of psychological illnesses Disparities in service utilization Vibrant engaged campus community, campus culture of caring, positive impact of campus mental health services on retention What might we do to encourage mental services use

Addressing mental health needs of African American college students- Challenges Attitudes Less positive attitudes regarding psychological services 80% of W students knew a person who received professional help compared to 46% of AA students. (Kam et al 2018) Less favorable attitudes, less willing to disclose, less confidence in mental health professionals Favorable attitudes predict recognizing the need for help and usage

Addressing mental health needs of African American college students- Challenges African American students say they are less likely to have received a psychiatric diagnosis Behaviors however are similar to W student peers (e. g. Suicide attempts) Potential reasons Difference in prevalence? Less mental illness? Disparities in types and/or access to treatment? Different symptom expression? Attitudes, stigma Clinicians misinterpret or miss signs?

Addressing mental health needs of African American college students- Challenges AA, H, As. PI report fewer symptoms and diagnoses but behaviors are similar or greater than W students; complexities of race/ethnicity and symptoms Research (Eisenberg, Chung) suggests more likely that clinicians miss signs Balancing over and under Addressing negative attitudes, stigma One way to address this is through more mental health literacy Anti stigma campaigns AA students more likely than W to express stigma regarding person with a mental illness Basic information about services and how to access - outreach Provide psycho-education that doesn't require much personal disclosure Explore impact of cultural specific variables

Addressing mental health needs of African American college students. Challenges

Addressing mental health needs of African American college students- Challenges Cultural mistrust Apprehension based upon beliefs/experiences with inequitable systems; CMI – impacts AA expectation and satisfaction with services Faculty beliefs - 2018 study rated AA lower than W, Asian students ; (25% of faculty are people of color) College student beliefs (2011) – stereotypes AA women loud, domineering , angry, less educated Mental health professionals - long history of bias; over pathology

Addressing mental health needs of African American college students- Challenges Addressing cultural mistrust Culturally responsive video by trusted AA experts for students, 10 minutes Explore it in therapy; messages? Talking about private matters? Discrimination Concerns about potential unfair treatment – history Since 2014 -Increase in hate crimes, AA targeted in almost half of incidents Some incidents have occurred on our campuses

Addressing mental health needs of African American college students- Challenges Race related stressors Stress associated with racism – holistic negative impact Impact present, afterwards, can be vicarious Most AA report frequent Health care disparities, negative campus environment, legal system, housing Often not addressed in therapy Significant threat to mental and physical health Anxiety, depression, decreased academic performance Potential Means to address discrimination & race related stressors Acknowledge , self-care, help them respond Counseling services brochure – race related stressor U. of Illinois Champaign/Brown U

Addressing mental health needs of African American college students- Challenges Racial Socialization AA socialized in preparatory manner about the impact of race Impact of their identity, how to handle racial interactions, trauma 4 steps – pride, prepare for discrimination, wariness, egalitarianism Particularly salient at adolescence Independent, spend time away from parents , AA seen as older, “adultified” Education and protection AA males – saliency for male college students Research: Poor racial climate, isolated, one size fits all

Addressing mental health needs of African American college students- Challenges Racial Socialization continued AA males – saliency for male college students “The Talk “- videos; PBS

Addressing mental health needs of African American college students- Challenges Stereotype Threat Awareness of stereotypes about a group to which one belongs can impact performance (Steele; Aronson) Cues about identity (race, gender); stereotypes, can impact performance Imposter Syndrome The belief that one is incompetent/fraud regardless of true ability or other evidence Research AA college students - IP has been associated with additional layers including survivor guilt from having “made it “ , having to prove oneself despite stereotypes Cycle – some AA high achievers (IP) repeat success, anxious, IP resumes Addressing IP – introduce the concept

Protective Factors Racial Identity The degree to which one identifies with one’s race (Cross classic model) Research – higher levels of RI (identifying as African American) generally associated with more positive mental health Particularly salient for persons from marginalized groups Helpful to have some awareness of models The student’s identity level may impact willingness to work with therapists of varying racial groups Explore what your identity means to you

African Centered Coping Styles Worldview differences African – cooperation, inclusion, spirituality, survival of the group – “I am because we are” European – exclusiveness, individualism, competition, supremacy 0 “survival of the fittest” African American coping style strategies (Utsey et al) Cognitive emotional debriefing Collective centered – support through communal resources Ritual centered – calm focus strength Spiritual – connection with creator/ancestors; promotes problem solving Research - often associated with better mental health for those who align with these values (spiritual; collective)

Afrocentric Worldview Optimal Psychology – Dr. Linda James Myers – The Ohio State University video Spirituality Group orientation/social support Culturally specific

University of Akron Counseling and Testing Center – African American student engagement Cultural competence/responsiveness Awareness, knowledge, skills Heterogeneous community Acknowledge rather than color blind Cultural humility Interpersonally open to accepting one’s identity and aware that one’s experience limits awareness of other’s cultural experiences Challenge our biases Respectful of other cultures, avoid assumptions Collaboration to move toward positive counseling outcomes Clinician is a humble, life long learner

Multicultural/Social Justice Constantine et. al. 2007 Multicultural – skills to work with people of different backgrounds – world views, oppression histories, culturally specific mental health interventions for marginalized populations Social Justice – valuing equity, rights, treatment for marginalized groups, understanding the impact of systems on a larger level, often involves action Goodman -2004 Micro-individuals and families; meso – communities organizations; macro – ideologies social structures policies Vera and Speight - resources

University of Akron Counseling and Testing Center – African American student engagement Percentage of students of color using the Counseling and Testing Center mirror or exceed their proportion within the UA population. CTC UA AA 16. 3 9. 5 AIN . 3 . 1 As 6. 1 3. 0 Hi 2. 4 2. 8 MR 4. 7 2. 1 W 67. 4 74. 1

University of Akron Counseling and Testing Center – African American student engagement Heterogeneous community Acknowledge differences/ not color blind African American student negative reaction to one size fits all Encourage student strengths, coping For some AA students this might result in leadership or political activism (may exacerbate stress associated with micro-aggressions) Groups – taps into communal , black male support, international, intersectionality of identities Culturally specific workshops – black women, identities Diverse staffing – word of mouth, raise up trainees, national connections, research

University of Akron Counseling and Testing Center – African American student engagement Diversity dialogues – among staff, trainees Getting out of the office - connecting Diversity training – for campus community race, LGBTQ ally Outreach and prevention – topics help to tell the story, an introduction Community town/gown connections

CTC - Social Justice UA CTC – Caminos Latino community, career counseling techniques importance of college to persons at a church across the street from campus participants were high school students but whole family was involved included some Latino UA students, included role models president community leaders; Recruitment tool included admissions special tour – Latino students calling CTC for info about admissions.

Steve Fund Equity in Mental Health Framework 10 Recommendations with each having 3 to 7 implementation strategies to systemically enhance the mental health of students of color. Identify/promote the mental health of students of color as a campus priority Engage students to provide feedback on student mental health and well being Address barriers to retention, tenure, build incentives for professionals of color Create opportunities to engage around national and international events Assess the climate, track data Recruit and retain a diverse and culturally competent faculty/staff Campus mission statement should reflect this commitment Create forums to discuss current events, promote social justice leadership Create roles to support students of color Top level staff reporting to the president; ombudsperson

Steve Fund Equity in Mental Health Framework Promote accessible safe communication with campus administration and an effective response system Offer supportive programs and services in varied formats Flyers, web, collaborate with student leaders, campus groups Offer culturally relevant programs/practice and collect data on efficacy Programs that address challenges (e. g. race related stress); campus & community partnerships Promote programs/services through multiple advertising channels Policies for reporting concerns; sharing information with administrators Evaluation, link data to academic outcomes Share resources/information within and between schools Student peer leaders, professional organizations (e. g. APA, ACCA, NASPA); collaborations with other schools

Increasing Student Engagement: Outreach to Marginalized Populations on Campus