1. T OWARDS AN I NTEGRATED A PPROACH TO C OLLEGE H EALTH AND H EALTH P ROMOTION Jenny Haubenreiser, MA, Montana State University Pat Ketcham, PhD, Oregon State University ACHA May 30, 2012

2. O BJECTIVES : FOCAL POINTS Foundational principles of the field that reflect the the value and necessity of integrated practice Terminology issues Focus on public health approaches linking substance abuse prevention and mental health promotion Consideration of a “continuum” of integration Barriers and opportunities for success

3. W HAT ARE OUR HEALTH PRIORITIES ?

4. T ERMINOLOGY OF INTEREST o Integration Incorporation as equals into society or an organization of individuals of different groups. o Alignment The proper positioning or state of adjustment of parts in relation to each other; forming a line. o Collaboration To work jointly with other, especially in an intellectual endeavor.

5. T RANSFORMING HEALTH ON CAMPUS o Multi-disciplinary nature of college health Complexity of “health” as a construct o An integrated approach expands traditional and historical perspectives of health on campus. o Approaching health as building health-supporting communities. Making the healthier choice the easier choice.

6. F UNDAMENTAL PRINCIPALS OF H EALTH P ROMOTION o Maintaining fidelity to the guiding definitions and principles for the field of health promotion WHO definition o Standards of Practice for Health Promotion in Higher Education o Establishing common goals that are inclusive of individual disciplines and priorities within college health and student success. o Health promotion professionals as instigators of integrated efforts.

7. W ORLD H EALTH O RGANIZATION O TTAWA C HARTER ON H EALTH P ROMOTION “Health Promotion is the process of enabling people to increase control over the determinants of health.” Build healthy public policy Create supportive environments Strengthen community actions Five Health Promotion Actions: Develop personal skills Reorient health services 1234512345

8. Optimal health is the dynamic balance of physical, emotional, social, spiritual and intellectual health. Lifestyle change can be facilitated through a combination of learning experiences that enhance awareness, increase motivation and build skills, and most importantly, through the creation of opportunities that open access to environments that make positive health practices the easiest choice. Michael P. O’Donnell, American Journal of Health Promotion

9. S PHERES OF INFLUENCE SOCIETY COMMUNITY CAMPUS INTER- PERSONAL INDIVIDUAL

10. S PHERES OF INFLUENCE

11. W HY U SE A P UBLIC H EALTH A PPROACH TO ADDRESS MENTAL HEALTH ? o Suicide declared a public health problem by the Surgeon General in 1999. o Mental health is a complex issue associated with multiple factors: Individual (biological, psychological) Environmental (physical, interpersonal, community, societal) o Interventions require multidimensional approaches: Social-ecological approach Comprehensive and collaborative approach Continuum of prevention

12. P UBLIC H EALTH APPROACH TO MENTAL HEALTH : G UIDING P RINCIPLES o Success requires a comprehensive network of support. o Problem is the responsibility of the entire campus and community o mental health is a shared responsibility: creating a “Caring Community” o Integrated strategies include prevention and treatment: addresses problems at multiple levels. o clinical services are necessary but not sufficient. o Requires strategic thinking and planning. o Utilizes best practices, incorporating the most current theory and data.

13. M ENTAL H EALTH P ROMOTION C ONTINUUM o Enhancing and promoting health o Primary prevention o Early recognition and intervention o Treatment o Maintenance o Postvention

14. TJF/SPRC C OMPREHENSIVE A PPROACH

15. SAMHSA: “ W E ’ RE ON AN INTEGRATION R OLL ” o August 2011: “ An Integrated response to Public Health Issues on College Campuses: Mental Health Promotion, Alcohol and Other Drug Abuse Prevention and Suicide Prevention.” How campuses are integrating the public health issues of mental health promotion, AOD prevention and suicide prevention. Examination of current data linking substance abuse and mental health. o Barriers to integration: Campus readiness for change, including leadership roadblocks (e.g., fear of negative attention to a problem) “Turf” issues – fear that integration will mean losing status, identity, influence, resources Increasing complexity of student behavioral health issues Ongoing “culture” that supports problem behaviors “Strategy of the week” approach

16. SAMHSA: “ W E ’ RE ON AN INTEGRATION R OLL ” o Strategies for success Tie efforts into broader academic outcomes, i.e., student success, retention, long term health outcomes (making the “business case”). Incorporate a coalition approach. Consider shift focus from “health” to well-being – consideration of students as whole beings. Expand work to assume the role of instigator to encourage collaboration and sharing of expertise. Start small – cultural change is complex, incremental, opportunistic, and will include inevitable failures.

17. C ONTINUUM OF INTEGRATION … FROM TO

18. C ONTINUUM OF INTEGRATION Parallel Largely operating in silos “Token” agreements to work together Little recognition of what others are doing Collaborative Some efforts shared among different departments Unidirectional understanding of the relationship Complexity of the issue often misunderstood Integrated Goals shared and developed by a coalition Key stakeholder and leadership buy-in Understanding of the complexity and long-view aspects of change

19. K EY QUOTES “…the nation is now well positioned to equip young people with the skills, interests, assets, and health habits needed to live happy, healthy and productive lives in caring relationships that strengthen the social fabric.” Kathryn Power, Director of the Center for Mental Health Services, SAMHSA “…it is no longer possible to separate individual from environmental approaches. You don’t have the luxury of doing only one type of intervention. That’s why we talk about comprehensive programming.” Fran Harding, Director of the Center for Substance Abuse Prevention, SAMHSA

20. In the confrontation between the stream and the rock, the stream always wins; not through strength, but through persistence. Author Unknown T HERE IS NO SUBSTITUTION FOR PERSISTENCE

21. R ESOURCES SAMHSA http://www.samhsa.gov/ http://www.samhsa.gov/ “Behavioral Health is Essential to Health, Prevention Works, People Recover, Treatment is Effective” Suicide Prevention Resource Center http://www.sprc.org/ http://www.sprc.org/ The Jed Foundation www.jedfoundation.org/ www.jedfoundation.org/ Higher Education Center for Alcohol, Drug Abuse and Violence Prevention http://www.higheredcenter.org/ http://www.higheredcenter.org/ Standards of Practice for Health Promotion in Higher Education, Third Edition, May 2012 http://www.acha.org/ http://www.acha.org/