1. Extent of the Problem Help Seeking Are Problems getting worse? K-State 13 year study

2. Extent of the Problem Last epidemiological study of depression in college students, 1985 Center for Disease Control: Average age of onset has dropped from 28 to 20 over the last 20 years. NIMH: suicide is the third larges cause of death for 15-24 year olds.

3. 4 Campus study of depression and suicide 1455 Students Surveyed 53% reported “depression” 9% reported suicidal thoughts 1% reported having attempted suicide Furr, Westefeld, NcConnell, Jenkins, (2001).

4. Percent of students who said they were likely to consult with a mental health professional for each problem: 96%Serious mental illness 90%Suicidal feelings 77%Alcohol/drug dependency 75%Coping with serious illness 71%Eating disorders 62%Depression or anxiety 57%Divorce or marital problems 49%Death in the family 33%Problems at school 31%Stress Survey of 346 students at a large western university (sample skewed toward freshman). Turner, Quinn, (1999)

5. Yes Survey of counseling center directors 77% reported students with more severe pathology than 3 years ago. Gallagher, Gill, & Sysco, (2000) No Longitudinal studies using client distress levels at intake over 6 years. Cornish, et al. (2000) Pledge, et al. (1998)

6. 13,257 students/clients 1988-2001 13 fiscal years 13,257 students/clients over 13 fiscal years Gender: 63.9%Female 36.1%Male 75.4% Traditional college age Students of Color: 11.8% in early years, 14.7% in later years 16.1%Freshman 18.3%Sophomores 22.7%Juniors 26.8%Seniors 15.4Graduate students

7. Client problem 1 (%) 2 (%) 3 (%) Pearson   Post hoc Comparison Stress/anxiety36.2663.4262.87825.512,3>1* Depression21.1034.4940.67404.643>2>1* Medication Used8.9712.0422.22354.223>2>1* Suicidal ideation4.809.018.9870.012,3>1* Percentages of Clients Experiencing Each Problem Area Across Three Time Periods Note: 1 refers to years 1988-1992 (N=4,104), 2 refers to 1992-1996 (N = 4,019), 3 refers to 1996-2001 (N = 5,134). * p <.001

8. Pattern of change in problems over the 13 year study, Plus fiscal year 2002.

9. Public response and speculation about results Impact of depression and anxiety on student life Steps to develop a responsive campus Need for further research

10. 10. Changes attributed to the therapist Changing treatment perspectives Medications Managed care 9. Home alone generation Less family support More reliance on professionals 8. Therapy reluctance Students waiting until problems become severe

11. 7.It is cool to have a therapist More openness, less stigma about therapy 6.Campus and earlier supports Early treatment, better resources allow more students with problems to make it to college and succeed. 5.Need to succeed More pressure, competitiveness, resume building Using counseling to cope

12. 4.Impact of terrorism and uneasy world Post trauma incidents increasing in society 3.Return to college, get therapy Older students return with more problems 2.Therapy seekers not typical 10% Atypical group, not able to manage 1.More stressed/ more depressed Research on the millenial student, more stress (economic, social, technological, cultural)

13. Correlation with interference 7 factors

14. Level of Interference Score on mood/anxiety scale

15. Department Head’s Seminar http://www.k-state.edu/dh/seminar_series_2002-2003.html Campus Crisis Team Campus “mash” unit to deal with special problems Students Helping Students http://www- personal.ksu.edu/~newtonf/interests/training/helping/helping.htm Consultation and Education http://www.allaboutdepression.com/

16. Client – Intake Assess. Demographic 7 factors Critical factors Readiness Social, Academic Interference Treatment choice Client Follow-up 7 factors Critical items Social, Academic Interference Symptom reduction Goal attainment Satisfaction Therapist – Intake Assess 7 factors Client problem, severity Readiness Social, Academic Interference GAF Treatment modalities Therapist Follow-up Case description 7 factors Social, Academic Interference GAF Symptom reduction Goal attainment Treatment modalities # of sessions Problem incidence in general student population

17. 1.Develop 4 instruments 2.Establishment psychometric properties of instruments. 3.Develop normative standards across campus populations and sub- groups. 4.Expand data base by region and institution type. 5.Develop research hypotheses including: Characteristics of client problems Client- therapist congruence Changes and trends across time Impact and change during psychotherapy Efficacy and outcome of treatment options.