From Intention to Action

Campus Exchange: Leveraging Mental Health Innovation

Centre for Innovation in Campus Mental Health

June 9,2015

Dr. John Meissner & Larry McCloskey

Overview

1. FITA’s origins in LOTF findings

2. Opportunities and difficulties in the development

of mental health services

3. Mental health, achievement /retention research

4. FITA students, interns, intake & recruitment

5. Sharing FITA (UToronto: St. George & Humber)

6. Discussion

From Intention to Action was developed with the support of

the Ontario Ministry of Training, Colleges and

Universities .

Goals of FITA

Help the most vulnerable post-secondary

students

Improve psychological well-being, grades &

retention

Train new generation of counsellors and

psychotherapists

Intervene at the earliest possible stage by

reaching out to secondary schools to recruit

students identified as at risk (transition support)

Provide cost-effective services (50%+ services

offered by graduate student interns).

What is FITA?

Began as student support / retention program developed for students

struggling academically and has evolved to focus on mental health.

FITA is based on 4 primary : Program Components

• Provides assessment, feedback, and collaborative goal

setting.(M.B.T.I., Strong II, LASSI, BASC2, Nelson-Denny Reading, WJ- writing

samples)

• 12 consecutive, weekly meetings with coordinators.

• Counselling with a goal of developing a strong therapeutic alliance

and supportive relationship.

• Emphasis on personal and emotional issues where applicable.

• Learning strategies and, when needed, tutorial support

4th Floor MacOdrum Library

FITA Team

Origins of the FITA Model

Learning Opportunities Task Force in Ontario

& 7 year longitudinal follow-up

The Nancy Factor (therapeutic alliance)

Assessment

Student commitment

Transformative impact on graduation rates of

students with disabilities

Challenges & Opportunities

• Our values in serving students

• Challenges of increasing mental health

services in the face of increasing demand

• Present financial realities – PSE’s, provinces,

nation

• Until there is public funding support for

counselling and therapy we make a case for

incremental development of services & a

vision for the future

Mental Health Funding

• Students spend most of their time on campus &

expect service to be provided where they live.

• In most PSEs there is no legal agreement

designating a contract to PSEs to provide mental

health services (i.e., core funding).

• The onus of developing a PSE mental health system

has fallen on PSE service providers whose

employers normally set a central priority on their

academic mandate.

Finance and Retention

All schools have to address the problems

of attracting and retaining students. For

every student that stops, drops, or

transfers, the institution loses significant

income. Retaining even a small number

of students can provide a major return on

equity that far exceeds student service

costs.

Mental Health and Retention

Healthy Minds research:

Mental Health and Academic Success in College. Eisenburg, Golberstein, and Hunt (2009) http://www.bepress.com/bejeap/vol9/iss1/

Depression & anxiety (and both together) have a significant negative impact on GPA

Depression is a significant predictor of drop-out

Of the 9 DSM questions regarding depression, anhedonia (“little interest or pleasure in doing things”) has the strongest impact on grades and retention (i.e., “just going through the motions”)

Mental Health and Grades

Hysenbegasi, A., Hass, S., and Rowland, J. Ment

Health Policy Econ 8, 145-151 (2005)

In depressed students, GPA = loss of 0.49 or half a letter

grade

This means that a C student will be placed on AW and

have to face the prospect of Suspension

Aspiring B+ to A- students face the prospect of a GPA not

sufficient to confidently meet requirements for graduate or

professional programs following graduation

Treatment (primarily medication) was associated with a

protective effect with a gain of 0.44

Depression Anxiety & Academics

- Anhedonia undermines brains reward system

- ( just going through the motions).

- Withdrawal / avoidance affects attendance

- Stress> cortisol < memory (< tests score).

- hippocampus< 10% with depression

- sleep loss < adaptability & learning

- poor sustained effort < academic self-

determination (correlates r = .60 with PSE grades)

- - poor concentration < effective planning & T.M.

- Memory impairment is significant in meta-analyses

(n = 95 studies) with major depressive episodes.

Mental Health and Grades

DeBerardet al. (2004) "Predictors Of Academic Achievement And Retention Among college

Freshmen: A Longitudinal Study." College Student Journal 38.1 (2004): 66-80. Academic

Search Premier. Web. 20 Apr. 2012.

SF-36 Mental Health Composite Scale indicated that overall

level of mental health was a significant independent

predictor of achievement

SF-36 Mental Health Composite, while not showing a

statistically significant Pearson correlation with cumulative

GPA, did evidence a beta value that was statistically

significant, indicating the presence of suppressor

relationship among the predictor variables

Arria et al.: Healthy Minds Network

Eisenburg’s Model: Healthy Minds

7-Yr Graduation Rates of AW

Students (non-FITA)

FITA Students 2011-12 (N=115)

FITA and Grades

n μ1 ± St. Dev.a μ2 ± St. Dev.b Mean Diff.c P

AW 76 4.23 ± 1.52 4.90 ± 1.51 .67 <.0005

OW 52 6.90 ± 2.61 6.78 ± 2.41 -.13 .417 (n.s.)

RT 38 6.16 ± 2.29 6.49 ± 2.03 .32 .024

Overall 186 5.62 ± 2.54 5.96 ± 2.24 .34 <.0005

a. Mean of pre-program Overall GPA and standard deviation.

b. Mean of post-program Overall GPA and standard deviation.

c. Difference between pre- and post-program mean Overall GPAs.

n.s.

Academic Functioning

Questionnaire: 2014-15

* p < .005 ** p < .05 *** n.s.

Mental Health of FITA Students

In 2013/2014 and 2014/2015 FITA students saw

improvements in SF-36 over time, indicating a

positive treatment effect (p<.002)

Last years students Students who had 10+

sessions improved to within a single percentile

point of the average range.

Students with the lowest SF-36 scores showed the

greatest improvements

Mental Health 2013-2014

Plot of SF36 Mental Health composite scores across

administration times between the amount of total

sessions.

Plot of SF36 Mental Health composite scores

across administration times between genders.

FITA and Mental Health

Composite Scores 2014-2015

Therapeutic Alliance in the 2013-14

FITA Program

1. Task Alliance

moderates increases in grades:

b = .14, t(60) = 2.32, p

< .02

2. Increases in grades moderate increases in mental health:

b = 1.06, t(60) = 2.09,

p < .04

Program Continuity: Trust, Respect,

awareness, program, & engagement

Self-reports: Comparison to previous years

2011-2012 2012-2013 2013-2014 2014-2015

Interactions with Coordinators:

“I was treated with respect by the FIT: Action

members.”

4.72 4.72 4.92 4.90

Quality of Information Received:

“I trusted the information I received.” 4.61 4.60 4.66 4.59

Academic Self-Awareness:

“I am more aware of my strengths and

weaknesses.”

4.2 4.12 4.41 4.44

Program Involvement

“I have attended meetings with my counselor.” 4.11 4.72 4.68 4.75

Appropriateness of Academic Courses

“I am taking appropriate courses for my major.” 3.79 3.62 4.41 4.51

Recruitment

Recruitment

Twice weekly email newsletters sent to all Carleton students

Cross-campus posters and flat-screens

Departmental administrators (emails and visits)

Ads in the student paper

High schools

Email letter from VP Student Services and Registrar to AW students

Campus offices: SASC, HCS, PMC, ISSO, 1st Year Experience,

Registrar’s Office, Residence

Monthly display table in high traffic area

Classroom presentations

Social media

Parent newsletter

Graduate student newsletter

FITA Students Present With…

Depression

Anxiety

Perfectionism

Stressful living situations (roommates, Res, commute)

Shame and low self-esteem

Bereavement

Break-ups

Complicated family of origin (continuing conflict)

Medical conditions

Extreme pressure to succeed (e.g. international students)

Undiagnosed or ‘dormant’ LD/ADHD

Financial issues

Lack of motivation (program, career)

Social stressors and isolation

Intake

Referrals: flow-through model throughout the academic year

• Self

• Campus staff/faculty (HCS, PMC, SASC)

• High school guidance counsellors/teachers

• Friends and family

Requirements:

• Distress

• Commitment

Process:

1. 1-hour interview including MBTI if no, student receives formal referral letter

2. Application (demonstrates commitment)

3. Coordinator matching and sessions begin

4. Assessment and feedback

Intake is a Continual Process

Referral – call/email chat with Team Leader

Referral letter

Interview

• MBTI

• Application

Coordinator matching

Sessions 2-12

1st session

Feedback

Online Testing

• Continue, or

• Cut back, or

• Exit

Testing Session

If No If Yes

Counselling Interns

Master’s in Counselling

Approx. 7 per term

Over half of our students matched with interns

2nd Year students | Have completed courses in counselling theories, ethics, tests

& measurements, ASIST, and begun ‘microcounselling’

3 days/week, 2 semesters | Approx. 12 hours client contact/wk

| 1 hour individual clinical supervision each

| 1 hour group/wk

Benefits of Using Interns

Cost-efficient

Balance b/w expertise and student relatability

New energy each year | Keeps us fresh and up-to-date in practices, regulations, and

current climate of counsellors and students

Diverse areas of expertise

| Training future counsellors/psychotherapists (CCPA and CRPO requirements)

Universities selecting interns from their own grad programs may increase quality (and enrolment) in these counselling programs | Quality internship

| Job marketability (our interns’employment)

Staffing options

Conclusions

We can change the environment for distressed

students allowing for greater educational access.

These changes are cost effective and can be

provided by graduate students.

These changes take place as a result of developing a

therapeutic relationship over time with one individual

Regardless of whether a diagnosed disorder is

present, we can improve the functioning of distressed

students, resulting in greater psychological well-being

and academic success

Sharing this Program

We would like to share this program in the

hopes of having a provincial model to

address mental health needs.

The FITA model makes the best use of

research on assessment, therapeutic

alliance, and support that taps into a

network of offices and programs to support

students.

The following manual is our attempt to

capture our program in a very practical

manner than can be useful on other

campuses

FITA Manual

Might FITA be a program for your college or

university?

As part of our agreement with the Ontario Ministry of Training

Colleges and Universities we will collaborate with other

colleges and universities to share this program on a not-for-

profit basis. From Intention To Action (FITA) :

Is scalable (has worked with 30, 100, and 250 students)

Consistently results in significant improvements in grades,

psychological wellbeing and study skills, and is well-liked

Is transferable – same results with different supervisors,

coordinators, and students in different departments

john.meissner@carleton.ca

www.carleton.ca/fita

Engagement: a different paradigm