UNC project helps students with mental illnesses, support services prepare for 'what if' scenarios

September 25, 2008

Nationally, an estimated 15 percent of students experience some form of mental illness such as major depression while in college. Many often struggle with where to get support.

But a new study at the University of North Carolina at Chapel Hill could close this gap by encouraging students to consider their needs and treatment options well in advance.

The research project, which began this year, explores whether students with mental illnesses will document their mental health issues, outline the care they prefer and provide copies of this information to people and agencies that students agree could assist if a crisis occurred.

Known as "advanced directives for mental health," these legal documents enable someone to communicate their wishes while they are capable of making decisions on their own. The study is being funded by the UNC School of Social Work's Armfield-Reeves Innovations Fund, which was established by Billy and Janie Armfield and Sam and Betsy Reeves.

The project is believed to be the first of its kind involving college students and could help ensure that young people get the help they need sooner, said Anna Scheyett, the project's lead investigator and associate dean for academic affairs at the School of Social Work.

"It's almost like a living will," Scheyett said. "It gives you a chance up front when you're healthy to speak for yourself and your needs – to keep your autonomy when the illness might be trying to take that away from you."

Scheyett said because of confidentiality laws, administrators often struggle with the legal and ethical dilemmas of how to respond when a student shows symptoms of a mental illness. An advanced directive could help the University to act more responsively for students.

The document can include as much information as a student is comfortable sharing. For example, it may explain "how a student looks" during a crisis or what signs to watch for, what medicines he or she prefers to take, the name of a therapist and hospital instructions.

"It could even include things like, 'Call my brother and tell him to pay my rent so I don't lose my place,'" Scheyett noted.

Information on the study is being distributed through UNC's Disability Services, the Office of the Dean of Students and Counseling and Wellness Services. Students must be 18 to participate. Staff members have been trained to assist students with creating the advanced directives documents and selecting what agencies should receive copies, such as campus police, an emergency room or a local police social work unit. Students can also choose to give copies to resident advisers, faculty or any other friends, relatives or people they trust.

"I think the preparation just says a lot," said Jim Kessler, director of Disability Services. "I think many students do have ownership of their mental health issues and are compliant with their medication, but sometimes that doesn't work."

For families, just preparing for college can be stressful. When it involves a child with a mental illness, there are additional anxieties. Knowing that the University has an advanced directive on file may help alleviate family fears, Scheyett said.

It also ensures that the University has up-to-date information in case of an emergency, said Melinda Manning, assistant dean of students. "Our ultimate goal is we want to retain all of our students," she said. "And anything we can do to accomplish that goal is worth it to us."

Source: University of North Carolina at Chapel Hill

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