David J. Drum

Campus suicide prevention: bridging paradigms and forging partnerships.

Colleges and universities are increasingly recognizing the need to expand suicide-prevention efforts beyond the standard, clinical-intervention paradigm of suicide prevention, which relies on referral to, and treatment by, mental health services. These services frequently struggle, however, to provide effective, comprehensive care. After reviewing findings that support the need to adopt a broader, problem-focused paradigm, the article provides a framework for bridging this paradigm with the clinical-intervention approach and for conceptualizing a full continuum of preventive interventions. For each level of intervention (ranging from the individual to the ecological), we describe the goals and methods used, and provide examples to illustrate the role of psychiatrists and other campus mental health providers in the collaborative partnerships that must form to support a comprehensive, campus-wide suicide-prevention strategy.

Expanding the Application of Group Interventions: Emergence of Groups in Health Care Settings

Changes in the health care arena and within the specialty of group work are contributing to the increased utilization of groups in health care settings. Psychoeducational, theme, and interpersonal therapy groups are highlighted for their contributions to treating challenging health conditions. An understanding of the evolution of these group modalities, distinguishing their core features, and applying the fundamentals of group development assist in the development of group interventions to treat a wide range of conditions. Theme groups appear to be emerging as a more prominent group modality across a variety of health care settings to address challenging health conditions.

Differences in Suicidal Experiences of Male and Female Undergraduate and Graduate Students

Differences in the suicidal experiences of males and females and of undergraduate and graduate students have not been thoroughly explored. Furthermore, given the changing dynamics of college student suicidality and the challenges of suicide prevention, it is important to continue updating the research in this area. This article presents findings from a 2006 national survey with responses from over 26,000 undergraduate and graduate students at 70 colleges and universities. Gender and undergraduate versus graduate student differences were found in suicidal thoughts and behaviors, related experiences such as professional and informal help-seeking during a suicidal crisis, events that precipitated and contributed to the suicidal crisis, and factors that protected against attempting suicide. Among the many findings, some are consistent with previous research, some are unexpected, and some have not previously been studied. The results of this survey have implications for targeting specific interventions to better meet the needs of undergraduate and graduate student males and females.

Psychology's self-regulation and the setting of professional standards

Abstract This article presents three certification mechanisms, providing a historical introduction and a status report on each, and then relates each as a form of assessment of competence with differences in level and scope. Key national organizations that play a major role in designation or accreditation of psychology programs or in the credentialing of individual psychologists are profiled. The article concludes with a recommendation for an international regulatory council in psychology to deal with interorganizational issues in the profession.

Distress and Suicidality in Higher Education: Implications for Population-Oriented Prevention Paradigms

ABSTRACT College students respond to stressful experiences along a continuum of distress and suicidality. This study investigated, from students’ perspectives, the contributors to stress, nature of stress, coping strategies used, and role of drugs and alcohol during stressful periods—all with particular relevance for suicidality. Undergraduate and graduate students were sampled on an online survey from 73 institutions, totaling 26,292 respondents. The pervasiveness of stressful experiences students endorse appears to be more than traditional clinical interventions can manage on their own. Recommendations are, therefore, made about how to utilize population-based prevention to reduce students’ distress and suicidality and improve their mental health.

The Influence of Suicide Prevention Gatekeeper Training on Resident Assistants' Mental Health.

This study explored the mental health influence on resident assistants associated with their training in suicide prevention and their subsequent role as campus mental health gatekeepers. Despite considerable prior personal experience with their own suicidal thinking as well as with others who have thoughts of suicide, a multiple regression analysis revealed that resident assistants in this study appear resilient to situational stress experienced with resident mental health interventions. Implications for campus gatekeeper training are discussed.

College Students’ Sense of Coherence and Connectedness as Predictors of Suicidal Thoughts and Behaviors

This study aimed to explore the relationship between college students’ sense of coherence and connectedness and their development of suicidal thoughts and behaviors. Using archival data from a larger survey with responses from 26,742 undergraduate and graduate students at 74 colleges and universities, we applied Exploratory Factor Analysis to derive these protective factors (coherence and connectedness) as well as hypothesized distal and proximal risk factors (pre-existing vulnerabilities and distress). Structural Equation Modeling was used to explore latent variable interactions among these factors with regards to outcomes on a continuum of suicidal thinking and behavior. Sense of coherence mitigated the impact of pre-existing vulnerabilities on movement along the continuum, while connectedness mitigated the impact of distress. Findings suggest that including both connectedness and coherence in suicide prevention frameworks will increase the impact of suicide prevention programming.

Suicidal Asian American College Students' Perceptions of Protective Factors: A Qualitative Study.

This study addresses the paucity of knowledge on protective factors associated with Asian American college students’ suicidal behavior. Participants were 58 Asian American college students who seriously considered suicide within the past 12 months and responded to open-ended online survey questions about what was helpful during their suicide crisis. A phenomenological analysis of participants’ narratives revealed the following protective factors: (a) a desire not to hurt or burden others, (b) social support, (c) fear, (d) self-reliance, and (e) insight. These findings can guide culturally informed clinical interventions by mental health professionals.

Essential Counseling Knowledge and Skills to Prepare Student Affairs Staff to Promote Emotional Wellbeing and to Intervene with Students in Distress.

Abstract The focus on helping students transform their lives has emerged as part of the mission of many colleges and universities. Campus-based student affairs personnel contribute to this endeavor through their efforts to create a campus ecology conducive to supporting and promoting well-being and by their engagement with students in their time of need. These two types of involvement with students necessitate that graduate studies programs in student affairs educate future student affairs professionals in the knowledge base and, at times, the skill base essential to being effective in both population-focused and individual assistance. This article delineates several aspects of the counseling and health promotion knowledge base and related competencies students should acquire during their graduate program in student affairs. It divides the knowledge and skill base into activities that are primarily growth and prevention oriented and those that are focused on helping students resolve existing challenges commonly encountered during enrollment in college.

Management of a Mental Health Clinic

Publisher Summary This chapter discusses the management of a mental health clinic. The chapter states that each year the tasks faced by the manager of a mental health clinic increase in complexity as standards of care rise, accreditation criteria expand, functions become more specialized, treatments are more differentiated, competition for resources intensifies, and the walls separating public and private sector care crumble, thereby changing the mixture of clientele agencies serve. Managers of mental health clinics must serve many masters. These are the multiple constituents to whom they are accountable for the agencys performance. Foremost are the consumers and potential consumers who hold the manager responsible for administering an agency in a way that is responsive to their needs. Mental health clinics also operate in larger host organizations, such as hospitals or universities, or have governing bodies that are additional constituents with another set of expectations. Managers of a mental health clinic need to lead their agencies through the crosscurrents of changes and the demands of the new service paradigm. Mental health clinics seek to compete with other practice groups and also face competition for their clients, and the competition is intense. Therefore this chapter concludes that successful managers are people who can balance competing demands, determining which processes must take precedence given the circumstances.