Victor Schwartz

The Importance of Hopelessness Among University Students Seeking Psychiatric Counseling

Hopelessness is a clinically important state relative to morbidity and suicide risk among university students. We examined its role in relation to presenting concerns, diagnosis, psychopharmacologic treatment and spiritual orientation among students seeking treatment at a university counseling center. The most commonly identified concern was anxiety, followed by stress and depression. Eighty-two percent were given a DSM IV diagnosis. Hopelessness was higher among students dually diagnosed with anxiety and depressive disorders and those who were started on psychiatric medication. Spirituality was inversely correlated with hopelessness and constitutes a personal characteristic warranting further investigation. The concerns bringing students to counseling, the rates of DSM IV diagnosis and the use of psychiatric medication suggest a preponderance of psychopathology over developmental or situational concerns that may be more prominent than has been noted in the counseling literature. In this regard, hopelessness appears to be an important feature even beyond its relationship to suicidality and merits attention and evaluation in student counseling.

College Mental Health at the Cutting Edge

Victor Schwartz was previously University Dean of Students for 6 years and Director of Counseling for 1 year at Yeshiva University and was Medical Director at New York University Counseling Center for 14 years.

Increasing Counseling Center Utilization: Yeshiva University's Experience

Yeshiva University established a counseling center during the 2004–2005 academic year. As a religiously based institution, the administration recognized that there would likely be significant impediments to utilization of on-campus mental health services as a result of negative attitudes about mental illness and its treatment—stigma. To combat these anticipated attitudes, the university put in place a number of assertive programs. Subsequently, rates of utilization increased to national norms within a relatively brief time, suggesting that a multifaceted outreach and referral campaign was as effective on this campus as at a secular institution. Of note, however, although utilization increased to national norms, levels of reported stigma remained significantly above national college norms, raising the intriguing possibility that stigma may not represent an absolute impediment to help-seeking.

Commentary on “Contrasting Case Studies of Frequent Internet Use:”

Abstract Leon and Rotunda are right to call attention to the problems associated with excessive computer and Internet use and to the computers potential for both adaptive and maladaptive consequences. To decide when computer use is a problem, it makes sense to adapt criteria used for pathological gambling and substance abuse. Although excessive computer use is a new problem on the college psychotherapy scene, the psychological issues underlying this problem are familiar ones: the struggles for intimacy, self-understanding, identity and self-worth.

Psychiatry Resident Rotations in University and College Counseling Centers: A Pilot Study of Rotation Types and Challenges

With an increased demand for mental health services, perceived increased severity of students presenting for services, and increased number of students prescribed psychotropic medications, university and college counseling center directors have had to increasingly identify psychiatric service options. Psychiatry residents can potentially help fill these needs. To better understand the role of psychiatry residents in university and college counseling programs, we conducted a web-based survey of United States psychiatry residency program directors. This study describes clinical activities and rotation characteristics of psychiatric residents working in counseling centers. Of the 48 residency programs that responded, 27 provide rotations at university or college counseling centers, and of those with rotations, 100% report that the residents rate these as very good or excellent. Expanding psychiatry residency rotations at college counseling centers may be mutually beneficial both to the centers and to psychiatric residents.