Increasing Online Support for Mental Wellness
According to survey research conducted from May to July 2020, about one-third of students screened were found to have depression or anxiety or both at higher rates than seen in the past. According to the authors, this change is largely attributable to COVID-19 and was higher among students who did not adapt well to remote instruction (Chirikov et al., 2020). At campus counseling centers nationwide, students present anxiety (60.7 percent) as the most frequent concern, with depression (48.6 percent) and stress (47 percent) close behind, and the demand for counseling services is increasing (LeViness et al., 2020). It is not unusual for college students to use drugs and alcohol as an unhealthy coping strategy for mental health concerns.
Western Kentucky University (WKU) has three regional campuses and over 80 online degree programs. As student demand for mental health services grew between 2016 and 2019, a gap in service provision became evident. Students struggle with depression, anxiety, and substance use on all campuses and online, but the counseling center provides most services face-to-face only on the Bowling Green campus. While the counseling center offered training at the regional campuses, no ongoing counseling was scheduled at those locations. Further, no virtual and minimal phone counseling services were available for students there. This is typical across the US, where only about 20 percent of centers have counselors embedded in locations other than the counseling center and less than half provide telehealth services (LeViness et al., 2020). As a result, WKU staff and faculty recognized the need for easily accessible mental health services, which led to the development of a wellness portal available to all students. This collaborative approach can serve as a guide for other universities with similar experiences on their campuses for creating a mental health resource accessible to all students, not limited by spatial and temporal restrictions.
The social work department faculty teaching at multiple regional locations and online were the first to recognize the lack of mental health resources for distance student populations. After conducting several focus groups with social work students to determine specific needs, the social work department head brought these concerns to the attention of—and ultimately partnered with—both Counseling Center and Division of Extended Learning and Outreach (DELO) staff. Collaborating with key departments such as counseling and distance learning as well as students is essential to brainstorming effective ways to meet the mental health needs of regional campus and online students. This platform needed to be universal in design, offering an interactive experience for all students who might be struggling with mental health concerns, even those who are unsure of their readiness to seek professional help. The platform needed to allow for self-enrollment to protect student anonymity and encourage student users to complete a brief screening tool, review individual results, and seek other services in cases of high complexity or need (i.e., hotlines, websites, and local service providers who could further assess client needs when indicated). Lastly, it was important that students leave with some concrete strategies to cope effectively with their immediate concerns in mild and moderate cases.
To create such a platform requires many types of expertise, and the initial group identified four crucial team members: one subject matter expert (SME) for each of the three selected initial problem areas—depression, anxiety, and substance abuse—and an instructional designer. The counseling center’s associate director and counselor created the depression portal, and social work faculty contributed the anxiety and substance abuse SMEs for portal creation. DELO provided the instructional designer.
The instructional designer worked closely with SMEs to design and develop content in clear and engaging ways. Having the same instructional designer allowed each section to share structure with the others while having each SME’s unique and creative contributions shine. The platform is situated within the WKU learning management system to ensure that students have easy access to the platform and can self=enroll at will. To differentiate the platform from an online course, we took care to use technologies such as Articulate Rise and Storyline so that it felt more personal and less academic. Instead of providing a list of national online resources, the content contextualizes those resources and shows students how to use them. The three initial topics chosen were the most common issues facing our student population.
For many students, college is the first opportunity for independence. But adjusting to a new environment, meeting new people, participating in activities, and balancing schoolwork may increase the risk of substance misuse. The rate of drug and alcohol use among college students has risen steadily in recent years (Center for Behavioral Health Statistics and Quality, 2020, Table 6.16B). With evidence-informed best practices in mind, the creators designed the substance use platform to guide students through a journey of discovery by using standardized tools to assess their level of substance use risk. In a nonjudgmental tone, using principles of motivational interviewing and stages of change, students may assess harmful behaviors and consequences that are related to their substance use. Depending on their level of risk and readiness to change, they are led to develop a plan to reduce harmful substance use.
Anxiety symptoms are the most common mental health concern of college students (LeViness et al., 2020) and may range from mildly annoying to severely debilitating. Left unrecognized and untreated, they can have various negative impacts. Worries about academic performance, test-taking, and public speaking are common among college students; however, severe signs and symptoms include panic attacks, using substances to cope, and suicidal ideation. The anxiety platform begins with a WKU student video sharing firsthand experience with anxiety and information about what anxiety actually means. A self-assessment that indicates levels of anxiety follows. No matter how they score, students can continue to explore several specific evidence informed strategies likely to immediately reduce their anxiety levels. The strategies are presented in an engaging manner whereby scrolling over pictures brings up text describing the strategy. There is also guidance on developing an action plan to cope with anxiety; developing body, spirit, and mind self-care strategies; and building a supportive people list.
At campus counseling centers nationwide, about half of all student clients (48.6 percent) present with depression (LeViness et al., 2020). Those experiencing depression are at risk for poor academic performance, self-isolation, and in the worst cases suicidal thoughts or attempts. The depression platform begins with a video of a college student sharing their story of overcoming depression and then the student is directed to an online depression screening tool. Following an explanation of the screening results, students are offered several potential strategies for preventing and managing depression, and then there is a discussion of when medication should be considered. Lastly, the depression portal provides WKU-specific and national resources for student follow-up related to their unique symptoms.
The entire development process took around 18 months. In spring 2019, pertinent stakeholders—including faculty, staff, and administrators—met to focus on the platform goals, initial content, and issues regarding duty of care and privacy. Throughout fall 2019 and spring 2020, the SMEs worked with an instructional designer one-on-one and with the whole group to create and review the platform content. The pilot of the platform, scheduled for spring 2020, was delayed by the pandemic. Despite this delay, a pilot commenced in summer 2020, and a soft launch of the platform occurred in October 2020. To date, more than 60 student users have been active in the site. The feedback has again been extremely positive, and students have provided the developers with a list of topics from which to choose moving forward. Recruitment of SMEs to create additional content areas and expand the project scope is possible due to the easily expandable portal design.
An institution’s investment in student mental health is important for the social, educational, and economic well-being of students, their campuses, and broader society. Investing time and resources in student mental health can result in academic and economic benefits for an institution and society (Ketchen et al., 2019). Prioritizing mental health outreach efforts requires developing complementary mental health resources that are accessible to all student learners. WKU’s mental health resource portal is a prime example of where cross-institutional stakeholders and resources come together. To further the well-being and prosperity of WKU’s student populations, no matter their location, the portal development continues.
Center for Behavioral Health Statistics and Quality. (2020). Results from the 2019 national survey on drug use and health: Detailed tables. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/sites/default/files/reports/rpt29394/NSDUHDetailedTabs2019/NSDUHDetailedTabs2019.pdf
Chirikov, I., Soria, K. M., Horgos, B., & Jones-White, D. (2020). Undergraduate and graduate students’ mental health during the COVID-19 pandemic. SERU Consortium, University of California–Berkeley and University of Minnesota. https://escholarship.org/uc/item/80k5d5hw
Ketchen Lipson, S., Abelson, S., Ceglarek, P., Phillips, M., & Eisenberg, D. (2019). Investing in student mental health: Opportunities & benefits for college leadership. American Council on Education. https://www.acenet.edu/Documents/Investing-in-Student-Mental-Health.pdf
LeViness, P., Gorman, K., Braun, L., Koenig, L., & Bershad, C. (2020). Association for University and College Counseling Center Directors annual survey: 2019 monograph. https://www.aucccd.org/assets/documents/Survey/2019%20AUCCCD%20Survey-2020-05-31-PUBLIC.pdf
Patricia Desrosiers, PhD, MSW, LCSW, worked as a clinical social worker in the mental health field for over 20 years. She is currently department head of Social Work at Western Kentucky University. Areas of research interest include leadership, supervision, online teaching, and interprofessional teams.
Whitney Harper, PhD, MSW, LCSW, worked as a clinical addiction specialist for over 15 years. She is currently an assistant professor at Western Kentucky University. She serves as the WKU-Owensboro regional liaison. Areas of research include adolescent substance use, aging out foster care youth, and first-generation college students.
Beth Laves, PhD, serves as associate vice president of the Division of Extended Learning and Outreach at Western Kentucky University. Dr. Laves takes advantage of the talents and interests of faculty and other WKU resources and matches those with the needs of constituents locally, nationally, and internationally.
Hannah Digges Elliott, EdD, is currently a senior instructional designer with the Center for Innovative Teaching and Learning at Western Kentucky University. Hannah collaborates with faculty on quality course design, and she provides experience and expertise regarding effective instructional methods, technology usage, and assessments to meet and measure objectives and competencies.