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Preventing Addiction and Mental Health Issues in College Students
Dr. Dawn-Elise Snipes

CEUs available at:


~ Review some of the unique triggers for co-occurring disorders in adolescents and college students
~ Identify current best practices for preventing those
~ Explore ways to enhance college student engagement in prevention and health promotion activities
College Student Issues
~ Almost half of college-age individuals had a psychiatric disorder in the past year which was not different between college-attending and their non-college attending peers.
~ Anxiety disorders 11.9% (& AUD in females)
~ Depression 9% / 6.7% Suicidal ideation / Tobacco & cannabis
~ ADHD 8%
~ ASDs 2%
~ Eating Disorders 10%
~ 35% to 45% of adolescent females report body image issues
~ Bipolar 3%
~ 47% of females and 62% of males had their first symptoms of schizophrenia before the age of 25 years
College Student Issues & Risks
~ Risk of alcohol use disorders was significantly greater for college students than their non-college attending peers
~ 20% meet criteria for alcohol use disorder
~ 44% binge drinks
~ Risk Factors for SUDs
~ Low self-efficacy
~ Lack of enjoyment in courses
~ Poor accommodation of special needs
~ Reliance on external validation
~ Having a low GPA
~ Experiencing a mental health issue
~ Sorority or fraternity involvement
College Student Issues & Risks
~ Risk of other drug misuse including opioids, benzodiazepines or stimulants 35%
~ Lack of identification or denial of mental health symptoms and/or lack of or inadequate treatment are common problems among college students
~ Students report they do not seek help because of limited time or worry about what others may think
~ The greater the depressive symptoms, the higher the risk of suicide HOWEVER there may be no difference on measures of everyday functioning
College Student Issues & Risks
~ Myths around stimulant use
~ Anecdotal evidence exists that stimulants are “performance enhancers”
~ A prevailing attitude, shared by many parents and physicians, is that the nonmedical use of prescription stimulants is benign
~ Nonmedical prescription stimulant users are more likely than other students to be heavy drinkers and users of other illicit drugs
~ Nonmedical users should be evaluated for ADHD
Issues Contributing to Distress
~ Psychosocial development
~ Separation from home/friends (homesickness)
~ Grief over family changes (room is now a den)
~ Need to establish new peers
~ Less enforced structure
~ Challenges to sleep hygiene
~ College work and “self-directedness” represent a significant change
~ Financial challenges
~ Taking on adult responsibilities (paying bills, cooking etc)
~ Breakups

Different Needs of Traditional & NonTraditional
~ Traditional students
~ Still dependent on parents
~ May have more scholarship opportunities
~ Study skills
~ Life Skills
~ Different biosocial developmental stages
~ Roommate difficulties

~ NonTraditional Students
~ May have children/families
~ May work part/full time
~ Self-confidence
~ Online Students
~ Circadian-related issues
~ Feelings of isolation
~ Difficult for Extroverts & Active learners
~ Less interactive = less instructor monitoring of comprehension
Suicide Prevention Interventions
~ Educate faculty, staff (janitors, residence life, counselors, food service, library, coaches)
~ Require students to take a health literacy / suicide prevention course
~ Reduce the stigma of seeking help
~ Make information and resources available in a culturally sensitive fashion both in person and online (posters, bathrooms, online…)
~ Promoting wellbeing in a holistic manner (individual and elements of their sociocultural environment)

~ Biopsychosocial factors conspire to limit the quantity of sleep for many adolescents resulting in a number of negative consequences
~ The suprachiasmatic nucleus of the hypothalamus is the circadian timekeeper (biological clock)
~ Melatonin levels rise just before sleep onset.
~ In adolescence, the timing of melatonin release shifts to a later time, making it much harder for teenagers to fall asleep before about 10 pm
~ Self-reported sleep duration was positively correlated with bilateral hippocampal grey matter volume in the frontal and anterior cingulate cortex.

Causes of Lack of Sleep
~ Screen time, technology use
~ Social engagement in the evening
~ Early class times
~ Noise (especially in shared living quarters)
~ Poor time management
~ Difficulty transitioning to collegiate expectations
~ Stress
~ Homesickness
Consequences of Sleep Deprivation
~ Sleepiness / Fatigue
~ Impaired learning
~ Reduced class attendance
~ Mood issues
~ Increased emotional dysregulation
~ Eating Disorders and OCD
~ Impaired immunity
~ Behavioral issues
~ Substance misuse (caffeine, nicotine, stimulants)
~ Obesity
~ Pain
~ There is no single EBP that has shown effectiveness
~ Later class starting times (8:30)
~ Limited late-night activities (Close the student union at 10 on weekdays, dim dormitory hall lights at 9 on weekdays)
~ Health Education (Prevalence, Risks, Interventions) and Stigma Reduction
~ Integrative approaches to student health
~ Motivational Interviewing approaches have been shown to increase engagement with the college student population
~ FRAMES: Feedback, Responsibility, Advice, Menu, Empathy, Support
~ Reduce peer pressure and address campus-wide negative messages
~ Information about goal setting
~ Self-esteem enhancement messages (like what??)
~ Increase self-efficacy (tutoring, extracurriculars, mentoring)
~ Improving interpersonal skills and assertiveness
~ Improving stress tolerance and coping skills
~ Encourage daily pleasant activities
~ Educate students about learning styles to enhance classroom experience
~ Increase social support (group activities in classes, RH activities, clubs, campaigns (Random acts of kindness, Smile a day) Mental health first aid
~ Peer specialist facilitated online and f2f support groups
Technology and Prevention
~ Technology-based programs for screening and treatment have provide anonymity, accessibility and cost-effectiveness
~ 74 % of students acknowledged have received health information online, and more than 40 % frequently searched the Internet for health information
~ Universal Screening & Stepped-Care Model appeared to be a more cost-effective approach to university-based psychotherapy than wait-and-treat
~ As severity increases, the need for real time interaction increases
~ How to get participation???
~ Mental Health First Aid for Mental Health, Addiction and Eating Disorders
~ An 8-week Internet-based CBT program that included a moderated online discussion group (Student Bodies)
~ No participant with an elevated baseline BMI in the treatment group developed an ED, while the rates of ED development in the comparable BMI control group were 4.7% at one year and 11.9% at two years

~ Interactive, CBT based psychoeducational programming focusing on risk factors and dispelling myths
~ 9 EB Prevention programs
~ Key Issues with Technology
~ Can be a help or a hinderance
~ Mental health apps (meditation, CBT, Mood Cow)
~ Education about disinhibition and online safety in social media
~ Sites with active moderation and peer reviewed education
~ Most college students are away from home for the first time.
~ They have to quickly learn how to live alone, develop new friends, and adjust to collegiate life
~ A step-wise approach to prevention is recommended
~ Mandatory, universal education (online) that addresses risk factors
~ Universal screening (online or f/f)
~ Mental Health First Aid trained staff and faculty for identification and early intervention
~ Development of social support, efficacy and esteem
~ Availability of blended and f2f support and treatment services