A HYBRID APPROACH: TEAM-BASED LEARNING AND TRADITIONAL LEARNING

TO MENTAL ILLNESSES AT A HBCU

® Roosevelt Faulkner, EdD., LCP, BCPC, NCC

University Counseling Center, Tennessee State University

TCA, November 19, 2012

AGENDA

Introduction

Definitions of Mental Illness

Earlier Beliefs about Mental Illnesses

Mental Health Statistics

AGENDA (CONT.)

Vignettes

Common Pitfalls and Obstacles

References

INTRODUCTION Provides individuals with conceptual and

procedural knowledge .

Members of the team gain knowledge and skills necessary in assessing and evaluating students.

Provides for accountability, feedback and team learning.

( Michealsen, 1994 )

DEFINITIONS OF MENTAL ILLNESS

Any of various conditions characterized by impairment of an individual ‘s normal cognitive, emotional, or behavioral functioning (American Heritage Dictionary,4th edition, 2003).

Any disorders in which a person’s thoughts, emotions, or behavior are abnormal as to cause suffering to him/herself or others (Collins Essential English Dictionary, 2nd edition,2006).

DEFINITIONS OF MENTAL ILLNESS (CONT.)

Any psychiatric disorders or diseases, that are characterized by impairment of thought, mood, or behavior (American Heritage Science Dictionary, 2005).

Any disease of the mind, where the psychological state of someone who has emotional or behavioral problems that serious enough to require psychiatric intervention ( Thesaurus, 2003).

EARLIER BELIEFS ABOUT MENTAL ILLNESS

Plato believed that when the irrational soul becomes disturbed, it falls out of the rational soul ‘s control, resulting into madness as either being melancholia, mania, or dementia.

Socrates believed that mental illnesses was the results of demons.

EARLIER BELIEFS ABOUT MENTAL ILLNESS (CONT.)

Aristotle believed that mental illness has an organic etiologies and that no affliction was entirely psychological.

Hippocrates believed that mental illness was a diseased that results from an imbalance of humors (yellow bile, black bile, phlegm and blood).

MENTAL HEALTH STATISTICS One in three students report having

experienced prolonged periods of depression.

One in four students report having suicidal thoughts or feeling.

One in seven students report engaging in abnormally reckless behavior.

American College Health Association, 2006

MENTAL HEALTH STATISTICS (CONT.)

In 1994, nine percent of college students were seen at the counseling center and were taken psychiatric medications (Gallagher, 1994).

In 2006, a little over twenty-three percent of college students were seen at the counseling center and were taken psychiatric medications (Gallagher,2006).

In 2009, twenty-five percent of college students were seen at the counseling center and were taken psychiatric medications (Gallagher, 2010).

MENTAL HEALTH STATISTICS (CONT.)

One in seven students report difficult functioning at school due to mental illness.

Suicide is the second leading cause of death among college students (Jed Foundation, 2007).

Four out of ten college students reported having felt so depressed that it was difficult to function during the prior 12 months (American College Health Association, 2005).

VIGNETTE 1

An RA reports to the campus police that she has noticed a female resident is always in her room, with the lights off, the room is completely shabby with things all over the floor. The 18 year old resident in the room tells the RA that she feels depressed, worthless, and hopeless, unable to get any sleep and has recurrent thoughts of death.

MOOD DISORDERS (MAJOR DEPRESSION AND BIPOLAR)

Difficulty thinking or making decision

Loss of interest or pleasure.

Changes in appetite or weight.

Feeling of worthlessness or guilt.

Diagnostic and Statistical Manual of Mental Disorders, (DSM-IV-TR ) 4th edition, 2000

MOOD DISORDERS (MAJOR DEPRESSION AND BIPOLAR) CONT.

Recurrent thoughts of death or suicidal ideation.

Insomnia.

Psychomotor changes.

Irritability.

Diagnostic and Statistical Manual of Mental Disorders, (DSM-IV-TR ) 4th edition, 2000

YOUR APPROACH TO A STUDENT WITH A MOOD DISORDER

Approach the student calmly.

Observe the verbal and non-verbal response.

Encourage the student to talk.

Listen to their thoughts and feelings.

Offer support

Identify options for assistance, such as the University Counseling Center.

VIGNETTE 2

The campus police is summoned to the resident housing by an agitated young woman named Tiffany. When the campus police enter resident housing, you see a 21 year old man, lying unconscious on the floor . The 21 year old tells the campus police that someone or something was after him. The 21 year old male began yelling about the devil is talking to him.

SCHIZOPHRENIA Distortions in thought content.

Delusions (persecutory, referential, somatic, religious, or grandiose).

Hallucinations (auditory, visual, olfactory, gustatory, tactile).

Grossly disorganized behavior. DSM-IV-TR, 2000

SCHIZOPHRENIA (CONT.) Disorganized thinking.

Catatonic motor behavior.

Avolition (inability to initiate and persist in goal directed activity).

Alogia ( brief, laconic, empty replies).DSM-IV-TR, 2000

YOUR APPROACH TO A STUDENT WITH SCHIZOPHRENIA

Remain calm and firm when talking with the student.

Asked the student if he/she is on medications.

Don’t be confrontational.

Avoid getting into arguments with the student.

Contact the mobile crisis unit.

VIGNETTE 3

A 17 year old male student, that live in Watson Hall. On weekends he often goes to parties with his girlfriend. Drugs are often available at the parties but he and his girlfriend rarely use them. However, at a recent party one of his friends offered him some marijuana to smoke. His girlfriend, who rarely used drugs, was reluctant to participate but finally agreed to join him. The couple lay on a bed while her boyfriend rolled a joint. The girlfriend became withdrawn, anxious, and frightened. The girlfriend had difficult in standing up and was feeling more anxious. She complains to boyfriend that her mouth was dry and that she was starving.

SUBSTANCE-RELATED DISORDERS

A need to increase the amounts of substance to achieve intoxication or desired effect.

An increase in appetite, dry mouth and tachycardia.

Multiple legal problems.

Recurrent social and interpersonal problems.

DSM-IV-TR,4th edition, 2000

SUBSTANCE-RELATED DISORDERS (CONT.)

Repeated absences, or poor work performance related to substance.

Arguments with friends, spouse, professors about consequences of intoxication.

Intoxication.

Impaired judgment.

DSM-IV-TR,4th edition, 2000

YOUR APPROACH TO A STUDENT WITH SUBSTANCE RELATED

DISORDER Get the student to recognize that he/she has

a substance related disorders.

Assist the student in getting treatments for the substance related disorders.

Let the student know the pros / cons of substance related disorders.

VIGNETTE 4

Mark is a 19 year old AA male, very intelligent and is in his junior year of college. Mark grew up in a tumultuous home with an alcoholic father, who could not keep a job. Mark was mildly depressed during most of his high school years. He found that playing cards and gambling would helped relieve his feelings of depression. In college he continued to gamble, spending much of his time playing pool and poker with a small group of students. Mark would skipped most of his classes during the year. He passed his courses by borrowing notes from classmates and memorizing materials a few days before the final.

IMPULSE-CONTROL DISORDERS Irritability or rage.

Racing thoughts.

Increased energy.

Intense impulses.

Recurrent failure to resist impulses to steal item (Kleptomania).

DSM-IV-TR,4th edition, 2000

IMPULSE-CONTROL DISORDERS (CONT.)

Multiple episodes of deliberate and purposeful fire setting (Pyromania).

Persistent and recurrent maladaptive gambling behavior (Pathological gambling).

Recurrent pulling out of one’s own hair (Trichotillomania) that results in noticeable hair loss.

YOUR APPROACH TO A STUDENT WITH IMPULSE CONTROL DISORDERS

Remain calm.

Indicate to the student in a direct and non-punitive manner what you have observed has your concern.

Be forthright and compassionate with the student.

Don’t get into a battle or conflict with the student.

VIGNETTE 5

A 20 year old female and her girlfriend were walking through campus one night when a man jumped out of the bushes, pointed a gun at them, and ordered them to give him their money. The friend protested and the gunman knocked her to the ground, grabbed both women’s purses and ran off. The friend was shaken but unhurt. The two women immediately went to the campus police office to report the robbery. The friend find it difficult to described what had happen. She feels numb and dazed. The entire event seemed unreal and she had difficulty remembering what the gunman looked like.

ANXIETY DISORDERS

Periods of intense fear or discomfort in the absence of danger.

Palpitations, sweating, trembling.

Shortness of breath.

Feeling of choking, chest pain.DSM-IV-TR,4th edition, 2000

ANXIETY DISORDERS (CONT.)

Fear of losing control.

Living in a restricted lifestyle.

Anxious anticipation.

Hypersensitivity to criticism.

Exposure to an extreme traumatic stressors.

YOUR APPROACH TO A STUDENT WITH ANXIETY DISORDERS

Remain calm.

Provide reassurance.

Be clear and directive.

Let the student discuss their feelings and thoughts.

Offer assistance to the student in referring him/her for counseling.

VIGNETTE 6

Michelle is a 18 year old female who has been arrested for stealing and selling stolen property to other students on campus. Michelle has a long history of rebellious behavior. As a child, Michelle would lie to her parents, stole money from her mother, and engaged in repeated shoplifting. Michelle was difficult to control as an adolescent and often stay out late at night despite her parents attempts to set a curfew.

PERSONALITY DISORDERS Enduring patterns of inner experience and

behavior that deviates from the expectation of the individual’s culture.

Patterns of being inflexible.

Impairment in social, occupational and other areas of functioning.

Stable and long duration.

DSM-IV-TR,4th edition, 2000

PERSONALITY DISORDERS (CONT.)

Excessive suspiciousness.

Hypervigilant.

Act in a guarded, secretive or devious manner.

Detachment from social relationship.

Restricted range of expression of emotions.DSM-IV-TR,4th edition, 2000

YOUR APPROACH TO A STUDENT WITH PERSONALITY DISORDERS

Remain calm.

Set firm and clear limits.

Don’t get trapped into giving advice.

Acknowledge their anger and frustration.

Rephrase what the student is saying and identify their emotions.

COMMON PITFALLS AND OBSTACLES

Failure to select, prepare and orient team members.

Failure to create a clear pathway for reporting information.

Misconceptions about mental illness on your campus.

Focusing on a single intervention or approach.

(HEMHA, 2012)

REFERENCES

Blanco, C, MD, “Mental Health of College Students and Their Non-College- Attending Peers”, Archives of General Psychiatry, vol. 65,No. 12, December, 2008.

“ Students with Symptoms of Mental Illness Often don’t Seek Help”, Science Daily, June, 2007.

Mental Health Issues and College Students: What Advisors Can Do, National Academic Advising Association Clearinghouse, 2009 .

REFERENCES

“Campus Mental Health: What College and University Administrators Need to Know”, White Paper, 2007.

Student Mental Health and the Law, The JED Foundation, 2008.

Diagnostic and Statistical Manual of Mental Disorders, (DSM-IV-TR, 4th edition ),2000

“Balancing Safety and Support on Campus : A Guide For Campus Teams”, (HEMHA, 2012)