Launching Cornell’s Comprehensive Review of Student Mental Health

In the six years that I’ve been at Cornell University, we have seen an unprecedented growth in the need for campus mental health services. While the Cornell administration has been extremely generous in increasing our clinical resources in recent years, it remains a challenge to keep pace with the growing need for care. And we’re not alone: universities across the country are struggling with similar challenges.

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Michael Hogan, leader of External Review Team

Beginning in 2018, I was part of many campus conversations—with students, colleagues, and campus leaders, including President Martha E. Pollack and Vice President Ryan Lombardi—about the need to find new ways to engage our community in addressing the environmental factors contributing to student distress, and to seek new perspectives on the services and resources available to students on campus.

In September 2018, these conversations and others led President Pollack to commit the university to a Comprehensive Review of Student Mental Health, to begin in 2019.

The Campus Health Executive Committee (CHEC) oversaw the development of the review’s scope and planning during the Fall 2018 semester. Feedback was solicited from a wide range of student, staff, and faculty stakeholders, including members of the university-wide Coalition on Mental Health. The consensus was that the comprehensive review should focus on two themes: how to meet the growing clinical needs of students facing mental health problems, and how to improve the campus environment and culture to better support student mental health.

In Spring 2019, CHEC announced the members of the two groups charged with conducting the review: an internal university Mental Health Review Committee tasked with examining Cornell’s academic and social environment, climate, and culture related to mental health, and an External Review Team responsible for reviewing the university’s clinical services and campus-based strategies.

The internal committee, made up of 13 students, faculty, and staff, is led by Marla Love, senior associate dean of students in the Office of the Dean of Students, and Miranda Swanson, associate dean for Student Services in the College of Engineering.  Love and Swanson are seasoned student affairs professionals who are relatively new to Cornell, bringing a fresh perspective to the review process. Love joined Cornell in October 2017 after serving for 15 years at various institutions across the country including Scripps College and Phillips (Andover) Academy, and most recently at Azusa Pacific University. Swanson came to Cornell in December 2017 from the University of Chicago, where she spent 16 years as dean of students in the Physical Sciences Division and working with graduate students in the Humanities Division.

Members of the internal team include Catherine Thrasher-Carroll, mental health promotion program director for Cornell Health’s Skorton Center for Health Initiatives; among the four students in the group is Chelsea Kiely ‘20, of the College of Arts and Sciences, who is president of Cornell Minds Matter, a student mental health promotion organization.

The External Review Team, comprised of three highly respected leaders in the field of mental health, is led by Michael Hogan, who served as mental health commissioner in New York, Connecticut, and Ohio over a span of 25 years. He is a member of the National Action Alliance for Suicide Prevention’s executive committee, and was a developer of the Zero Suicide Model for healthcare. Hogan chaired President George W. Bush’s New Freedom Commission on Mental Health and has served on the board of the Joint Commission, an independent organization that accredits healthcare organizations and programs in the United States.

The other members of the external team are Karen Singleton, associate medical director and chief of Mental Health and Counseling Services at the Massachusetts Institute of Technology’s MIT Medical; and Henry Chung, senior medical director of Behavioral Health Integration Strategy at the Care Management Organization of Montefiore Health System, and professor of psychiatry at the Albert Einstein College of Medicine.

Listening tours and focus groups will be held through the Fall 2019 semester, and the final report of findings and recommendations will be submitted in Spring 2020. Updates about the reviewers’ process and progress—in addition to the final report—will be posted on the Mental Health Review website.

I have also asked the members of both review teams to provide ongoing feedback to Cornell’s leadership as the review proceeds, including recommendations specific to our work at Cornell Health.

It is important for the Cornell community to note that we will not be waiting for the completion of the review to begin implementing important changes to our clinical services. A new counseling appointment model—which will include brief same-day appointments, and more options for follow-up care—will begin in Fall 2019. We look forward to the opportunity to gain valuable feedback and to identify opportunities for improvement.

I am grateful to President Pollack and Vice President Lombardi for prioritizing this university-wide review in support of student campus health. And I am confident that the review will result in a healthier and more supportive campus environment with improved support resources and clinical services for our students.

—By Kent Bullis

Kent Bullis, MD, is the executive director of Cornell Health

Photo credit: Suicide Prevention Resource Center (video screenshot)

Exploring Strategies to Stop Bullying

Surveying students about the prevalence of bullying. Training teachers, coaches, parents, and young people on how to respond. Encouraging youth to be upstanders. Holding annual Bullying Prevention Day activities to spread awareness. These were a few of the ideas discussed Saturday at a two-hour Community Forum sponsored by the Tompkins County Bullying Prevention Task Force.

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Celia Clement reviewing feedback on school bullying

The Task Force held the forum to introduce its work to the public and to solicit ideas from the community on strategies to address bullying. More than two dozen government agencies, community organizations, and representatives from the county’s six school districts formed the Task Force in March.

“A lot of these conversations and diving deep into these topics can become very personal and very painful, which we want to honor,” said Nigel Gannon, a Healthy Living Program Specialist for New York State 4-H Youth Development, who moderated the forum.

“We have to develop spaces where we can have those emotions in a positive way. Remember that we are all feeling the same [about bullying], in some way, as individuals, as loved ones, as community members. We are not happy to be here, I think we are hopeful to be here. We’re going to help the Task Force get the information they need to try to move this forward.”

Scott MacLeod of The Sophie Fund kicked off presentations by Task Force working groups by reviewing basic information about bullying in national, regional, and local contexts.

He noted the federal government’s definition of bullying, and how it should be distinguished from other behaviors such as conflict, rudeness, and meanness:

“Bullying is any unwanted aggressive behavior(s) by another youth or group of youths who are not siblings or current dating partners that involves an observed or perceived power imbalance and is repeated multiple times or is highly likely to be repeated.”

MacLeod explained how bullying has psychological, physical, and academic effects, and adversely affects youth who are bullied as well as those who engage in bullying. He said that youth who are perceived as different, especially LGBTQ children, are at greater risk. Persistent bullying, he added, can lead to or worsen feelings of isolation, rejection, exclusion, and despair, as well as depression and anxiety, which can contribute to suicidal behavior. MacLeod said that while there is no federal stature that expressly outlaws bullying, New York State’s Dignity for All Students Act (DASA) came into force in 2012 to protect students from bullying, harassment, and discrimination.

Citing statistics, MacLeod’s report said 19 percent of American high school students are bullied, and 14.9 percent experience cyberbullying. He said that data for the 2017-2018 school year, most likely reflecting underreporting, showed that Tompkins County school districts had 109 incidents of discrimination, harassment, and bullying , and 20 incidents of cyberbullying.

Celia Clement, a retired school social worker and now an independent consultant, delivered a report on potential approaches for addressing bullying in schools. She identified five areas for attention:

  • Communication: Families are not always getting the information they need about bullying definition, prevention, intervention, education, district policies and the laws involved such as the Dignity for All Students Act.
  • Education: Families and school staff want help around recognizing signs that their youth are struggling with mental health challenges, social challenges, or bullying. Students need to be educated as well around what is bullying, recognizing the difference between peer conflict and bullying, knowing the warning signs when adults need to be informed, and ways to intervene effectively when they see bullying, harassment or cyber bullying, or suicide warning signs.
  • Prevention: The key to successful intervention models is to include students as the core drivers when building programs that promote positive school cultures. There are existing local programs that can serve as models: Friendship Assistance Brigade, Stars, Be the One, and Welcoming Allies and Mentors.
  • Intervention: There is a need to educate school teaching staff and administrators about best practice around intervention when situations of conflict, bullying, harassment and cyber bullying occur—such as restorative practices as a way to support the target and to help the aggressor make changes. There is a need to offer strategies and tools to work with families in a way that promotes outcomes where everyone feels good about the process of addressing conflict and bullying situations.
  • Assessment: Schools need to conduct surveys about bullying to inform decisions for addressing the problem.

MacLeod also delivered a working group report on potential approaches for addressing bullying outside school property. He cited numerous ideas including holding an annual community forum and student leadership summit, providing training and information workshops, and launching awareness projects such as an annual Tompkins County Bullying Prevention Day.

Beth Hogan, a member of the Task Force’s Family Advisory Group, delivered a working group report on the concerns of parents surveyed by the group. She said parents experienced a significant increase in stress over bullying, and felt that they themselves were effectively being bullied. The parents believed that bullying was causing heightened levels of anxiety and depression in children, she added.

Hogan said that schools were reactive rather than proactive, and that mental health services inside and outside schools were inadequate. Hogan’s report called for frequent communication about bullying, including about the Dignity Act, to staff, families, and students. She said youth and parent involvement in bullying prevention should be a priority, and that the work should begin in the elementary grades.

Sophie Callister, a former student in the Lansing Central School District and now a student at Ithaca College, is the coordinator of the Task Force’s Student Advisory Group. “The bullying task force is something that means a huge deal to me because from third grade all through my school career it was a huge problem,” she said. “I want kids to feel like there is somebody willing to listen and help them and that they feel safe every day. I never really felt safe in school.” She said that rather than school counselors or psychologists the only person she felt she could go to for support was a math teacher. Callister said a goal of the task force is “to get the community involved—parents, students, everybody. This is not a time to be quiet.”

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Community Forum on Bullying Prevention, Tompkins County Public Library

Forum participants provided feedback and engaged in discussion in breakout sessions. On school programs, participants argued that schools under report bullying incidents and do not create safe spaces for students. They noted that teachers and coaches themselves sometimes engage in bullying by humiliating students/athletes. Participants suggested strategies including peer mentors and giving students tools for confronting bullying.

For public action, participants proposed holding local public forums within the county’s six school districts to better encourage family participation in bullying prevention initiatives. Participants supported the idea of providing training and workshop opportunities to educate the community about bullying and prevention methods, and called for a centralized resource to provide information about the Dignity Act and how to file complaints about bullying incidents. The participants also endorsed exploring synergies with existing programs and activities, such as the “Be the One” campaign.

Participants who focused on family and student involvement emphasized the need for developing a common language to understand bullying, and the importance of student-led initiatives for success. They noted that it was essential to view those who bully as people also in need of support to address the underlying causes of their behavior.

Some participants called for greater attention to students who may be experiencing suicide ideation, noting that four young people from the Lansing community have died by suicide in just the past year. Participants highlighted opportunities for students to become involved by forming chapters of organizations such as Active Minds and Sources of Strength, and participating in activities such as Mental Health First Aid for Teens.

Click here to read Becky Mehorter’s Ithaca Voice article on the Community Forum, “Task force brings community together to address bullying in local schools.”

Click here to read Matt Steecker’s article in the Ithaca Journal on the Tompkins County Bullying Prevention Task Force, “Finding solutions to bullying: Task force to hold forum at library.”

Click here to visit The Sophie Fund’s website resource page on bullying prevention.

Brief Guide to Youth Bullying Prevention

Nearly one in five American high school students experiences bullying while at school. A higher percentage of girls are bullied than boys. One in three lesbian, gay, or bisexual students is bullied. Victims of bullying may suffer serious and long-lasting physical, psychological, and academic effects. Those who bully also need help: they are more likely to drop out of school, abuse alcohol and drugs, and engage in criminal activity.

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Representatives from more than two dozen local government agencies, community organizations, and local schools have formed the Tompkins County Bullying Prevention Task Force to explore the prevalence of youth bullying and strategies to combat it.

On the occasion of a Community Forum sponsored by the Task Force on June 15, The Sophie Fund presents the Brief Guide to Bullying Prevention. The guide highlights useful facts and figures, helpful resources on bullying prevention, and information about reporting acts of bullying, harassment, or discrimination under New York’s Dignity for All Students Act (DASA).

Prevalence of Youth Bullying

  • 19.0% of high school students were bullied at school in 2016-17.
  • 14.9% of high school students experienced electronic bullying.
  • More female students (22.3%) were bullied compared to male students (15.6%).
  • More female students (19.7%) were electronically bullied compared to male students (9.9%).
  • More lesbian, gay, or bisexual students (33.0%) were bullied at school than heterosexual students (17.1%) or students not sure of their sexual identity (24.3%).
  • 21.7% of New York high school students were bullied at school (higher than national average of 19.0%) in 2016-17.
  • More New York female students (24.6%) were bullied compared to male students (18.7%).
  • Nearly twice as many New York gay, lesbian, or bisexual students (34.6%) were bullied compared to heterosexual students (19.4%).
  • Tompkins County school districts reported 109 incidents of discrimination, harassment, and bullying (excluding cyberbullying), and 20 incidents of cyberbullying, in the 2017-2018 school year under the Dignity for All Students Act (DASA).
  • The 2018 Communities that Care Youth Survey of schools in Tompkins County and Seneca County found that more than a third of high school students reported feeling depressed on most days.

 

Basics of Youth Bullying

Definition: “Bullying is any unwanted aggressive behavior(s) by another youth or group of youths who are not siblings or current dating partners that involves an observed or perceived power imbalance and is repeated multiple times or is highly likely to be repeated.” Types include physical, verbal, and relational. Cyberbullying involves e-mail, instant messaging, blogs, chat rooms, gaming systems, tweeting, or social media.

Potential Psychological Effects: Depression, anxiety, low self-esteem, self- harming behavior (especially for girls), alcohol and drug use and dependence, aggression, involvement in violence or crime (especially for boys), emotional distress, hostility, and delinquency.

Potential Physical Effects: Immediate physical injury, sleep disorders, stomach aches, headaches, heart palpitations, dizziness, bedwetting, chronic pain, somatization (a syndrome of distressful, physical symptoms that cannot be explained by a medical cause), stress-related impact on the immune system and hormones, and impact on brain activity and functioning.

Potential Academic Effects: Impact on grades and standardized test scores starting as early as kindergarten and continuing through high school.

Bullying and Suicide: Persistent bullying can lead to or worsen feelings of isolation, rejection, exclusion, and despair, as well as depression and anxiety, which can contribute to suicidal behavior. Most young people who die by suicide have multiple risk factors.

Click here to read the Brief Guide to Youth Bullying Prevention, or click here to download a PDF.

Community Forum on Bullying @ TCPL

The newly formed Tompkins County Bullying Prevention Task Force announced Tuesday that it will sponsor a community forum on youth bullying and harassment at the Tompkins County Public Library (TCPL) on June 15.

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Members of the Tompkins County Bullying Prevention Task Force

The forum will feature reports from the Task Force’s Working Group on the prevalence and impact of bullying and potential school and public programs and campaigns to address the issue. The forum will also provide an opportunity for members of the public to share knowledge and suggestions for promoting bullying-free communities.

“Working together to create communities where all young people feel safe and that they belong, the Bullying Prevention Task Force is inviting members of the public to come and learn more about the work that has been done so far and to help us envision the next steps for this regional initiative,” said Jaydn McCune, a Racker program director and forum organizer. “We hope to see anybody who has been touched by the issue of bullying, whether you are a young person, family member, community member, or provider.”

Representatives from 28 government agencies, community organizations, and local schools formed the Task Force in March to explore the prevalence of youth bullying and strategies to combat it.

“The Bullying Prevention Task Force has brought together parents, students, service providers, school personnel, and community members to better understand the resources and strategies needed to take on the serious issue of bullying,” said Bridgette Nugent, Tompkins County Youth Services Department deputy director and Task Force co-coordinator. “The Task Force is energized to take real action to address a very real problem in our community.”

The forum will be held from 10 a.m.-12 Noon in the BorgWarner Community Room of the Tompkins County Public Library. Students, parents, teachers, school administrators, social workers, and all members of the public are welcome.

 

A Little Help from Your Friends

Young people are often bewildered about mental health and mental illness, and Melanie Little loves explaining the difference to them. “When I asked high school students to define mental health, some of them didn’t know what to say,” said Little, director of Youth Services at the Mental Health Association in Tompkins County (MHA). “Others said it was ‘the wellbeing of the mind.’ Being mentally healthy is the ability to make positive decisions, cope with difficult emotions and enjoy one’s life, whereas mental illness is diagnosable and disrupts a person’s ability to carry out daily activities.”

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Melanie Little and the Kids First Summer Camp

Little empathizes with struggling teens. She’s been there herself. Originally from Rochester, she battled mental illness during her youth.

As Little, 27, recalls her own experiences growing up, her mental health issues were not taken seriously. Adults blamed her discontent on typical teen mood swings. She didn’t fit the stereotypes around mental illness; she earned good grades and had close connections in her life. However, this did not alleviate the pain she felt or obviate her need for help. It was not until Little attended Ithaca College in 2009 that she finally reached out to receive treatment.

Little has always been interested in social justice and in striving to make positive change in the community. She yearned to provide guidance for young people in a way that she felt had been lacking in her own upbringing. She heard about MHA’s Kids First Summer Camp, a program designed for children ages 5-18 experiencing a wide range of internal or external struggles, and quickly signed up to become a camp counselor. It was a summer job, but turned out to be the first stepping stone in a career path as a community mental health educator and advocate.

At Kids First, Little learned valuable lessons about mental health and the significance of working directly with children. “Sometimes it feels like you are getting nowhere,” said Little. “Mental health can’t be fixed overnight. But, people don’t need to be ‘fixed.’ They just need to harness their strengths, which takes time. You have to trust yourself and trust the process. You don’t always get to see the progress, but you’re planting seeds.”

Over time, Little watched as the children in the summer camp began to open up and grow closer to their peers and the adult supervisors. She learned how to discipline and set limits for the children while remaining compassionate and empathetic about the kids’ variety of personalities and needs.

“A common misconception is that all children who struggle come from broken homes or have a lower socioeconomic status,” said Little. “However, some of the children had families that were perfectly stable and loving. Mental illness can be genetic or come from other external environmental factors. Mental health doesn’t exist in a vacuum.” Little finds it rewarding to work with children who she recognizes are capable of change and growth.

As the director of Youth Services, Little is responsible for a wide variety of tasks pertaining to community outreach, education and individual peer support and advocacy. Part of her community outreach involves visiting health classes in high schools and middle schools in the Ithaca City School District as a guest speaker in its mental health unit. She provides Mental Health and Wellness 101 courses for students, faculty, and parents. She also attends Parent Teacher Association meetings to educate adults. Little supervises recreational programs for young people at the MHA-affiliated Saturday Group Respite at the YMCA. She also carries out the Youth Wellness Recovery Action Plan (WRAP) that helps to decrease and prevent intrusive or troubling behaviors, increase personal empowerment, improve quality of life and help a young person take steps to achieve their goals.

In addition, Little serves MHA as a Mental Health First Aid instructor. She works to combat the stigma around mental illness and educates adults about how to recognize signs of mental illness and actively support family members, friends, colleagues, and others in a way that is non-judgmental. She informs trainees that “no one size fits all,” meaning each individual is different and must be treated with patience and care. She teaches that recovery is possible for everyone. MHA offers regular Mental Health First Aid courses for the general public. The Sophie Fund has sponsored special MHA training sessions for members of Ithaca’s food service community.

Although there tends to be more openness, progression, and awareness pertaining to mental health advocacy, Little believes that there is still an abundance of work to be done; she says that “roughly one in three Tompkins County high school students reported feeling sad or depressed most days.” Little intends to continue providing support, guidance, and mental health education for adolescents and adults. She believes that teaching about mental health and mental illness should be a crucial part of health classes in schools to have children understand their own minds from a younger age, and to grow into empathetic and aware adults. She also wants to take her advocacy work to the next level by going with a group of youth advocates to Albany to speak to legislators about providing more funding for mental health organizations and health classes in schools.

—By Nicole Kramer

Nicole Kramer, an intern at The Sophie Fund, is a Class of 2019 Writing major and Sociology minor at Ithaca College. She is a nonfiction editor for Stillwatera student-run literary magazine. She also enjoys creating mixed media image-text work and writing poetry.