Colleges Add Mental-Health Awareness to Crowded Orientation Lineup

Northwestern U.

“Think back: Have you known anyone who fit any of these descriptions?”

That question appears during the first part of an online simulation designed to educate students about mental health. Half a dozen options are listed: Seemed overly anxious/stressed. Had been sad/depressed for a long time. Cut or hurt their bodies on purpose.

“These are all signs of distress that are very common on high-school and college campuses,” says “Morgan,” a virtual student who guides participants through the simulation. “When our friends feel overwhelmed, sad, or anxious, we’re usually the first ones to notice, and the first ones they come to when they need to talk.”

The 30-minute program was created by Kognito, a company based in New York that creates such simulations to encourage people to change their behavior. This one teaches students how to talk with friends when something seems amiss, and where they can turn for help.

About 300 colleges offer the simulation for students, says Ron Goldman, chief executive and a founder of Kognito. Some colleges require new students to complete it.

Colleges have long educated freshmen about alcohol and drug use. Most have also started requiring new students to participate in programs on preventing sexual assault. Now, as news of campus suicides inspires calls for colleges to do more to prevent them, an increasing number of colleges are adding yet another heavy topic to the orientation lineup: mental-health awareness.

That education takes different forms. At some colleges, members of the counseling staff give a presentation or participate in a panel discussion. Others invite speakers, put on skits, or show short films that cover symptoms of possible mental illness and where to find on-campus resources. Students might discuss the material in small groups afterward.

Many institutions also offer programs like Kognito’s simulation, though that can be more expensive. A one-year license to offer one of the company’s modules costs $3,250 for a college with about 3,000 students; the price goes up on the basis of enrollment.

Experts say new students should be educated in recognizing signs of mental distress in themselves and their peers, and in where to find help. A challenge, though, is ensuring that they retain at least some of what they’re told — particularly as the scope of orientation education continues to grow.

Retention is especially important, administrators note, because freshmen often feel overwhelmed by the research papers and examinations that pile up during their first semester.

“A lot of stuff that’s presented during orientation doesn’t get absorbed so well,” says Victor Schwartz, medical director at the Jed Foundation, a nonprofit group dedicated to promoting the emotional well-being of college students. “There’s just so much information coming students’ way.”

Spreading the Word

For years, John H. Dunkle, executive director of counseling and psychological services at Northwestern University, heard from students — including upperclassmen — that they didn’t know about the campus counseling center. In the 2013-14 academic year, at students’ urging, the university added a mental-health session to new-student orientation to try to remedy that. At the time, Northwestern was mourning the deaths of three undergraduates, including two by suicide.

The program became part of a series, called True Northwestern Dialogues, that all new students attend, Mr. Dunkle says. For the first three years, Northwestern brought in an outside speaker who talked about how he or she had coped with mental illness. Then Mr. Dunkle shared information about on-campus resources, and students split up into small groups to discuss the talk.

This fall the format was changed on the basis of feedback from participants. “One of the things we learned is that they wanted to hear from Northwestern students,” Mr. Dunkle says. The speaker component was replaced by student actors, who read out narratives written by anonymous Northwestern students about their mental-health problems.

One of the key messages Mr. Dunkle hopes to get across is that counseling services aren’t just for those with a diagnosed mental illness, but for any students. “We want them to think of mental health broadly,” he says.

Before Northwestern started requiring the program, sophomores were the most frequent users of the counseling center. Now, Mr. Dunkle says, it’s freshmen.

The University of Texas at Austin has taken a student-centered approach to its new requirement for mental-health education, says Chris Brownson, associate vice president for student affairs and director of the Counseling and Mental Health Center there. Last fall a new Texas law began requiring public colleges to show a live presentation or video to new students about suicide prevention and mental-health support.

Mr. Brownson led a task force that earlier this year created a video for all Texas colleges to use. It features students talking about difficult life events that their friends were experiencing — failing a test, not making friends quickly, relationship problems — and why they had decided to encourage their peers to get help.

The task force spent a lot of time thinking about how to make the presentation as engaging as possible, Mr. Brownson says. For one thing, the film had to be concise. After pilot showings of the video, student said 10 minutes was too long; the final version runs for about four and a half minutes.

The video takes a bystander-intervention approach, Mr. Brownson says. While the chances that students watching the video are actually suicidal are low, the chances that they know someone who has talked about suicide are “very high.”

The Massachusetts Institute of Technology and Tulane University are among the colleges that use Kognito’s online program. Tulane has asked new students to complete it since 2014, as a complement to additional information on mental health that’s offered during orientation, officials there say.

Game-Based Approach

Mr. Goldman, of Kognito, describes the company’s approach as “game based.” The simulation moves beyond awareness, he says, and allows students to actually practice participating in conversations with virtual students who seem depressed or anxious.

Traditional approaches, such as trying to get students to listen to a lecture or follow a series of slides online, are not likely to work well, he says. “We’re able to pack much more learning into a shortened period of time.”

One potential problem with programs like Kognito’s, however, is their sophistication, says Mr. Schwartz, of the Jed Foundation. “If these things actually convey too much detail and too much information, it might lead students to think that you have to have special technical knowledge to help a friend,” he says.

Mr. Schwartz has seen the Kognito simulation and says it gives participants regular feedback and specific recommendations on how to talk to troubled friends. On the one hand, he says, that’s a good thing. On the other, “I worry that it could convey a sense that it’s easy to screw this up and might, in fact, make people hesitant to act.”

Mr. Goldman says Kognito’s program focuses on giving students the confidence to approach peers, not teaching them to be mental-health counselors. “The students are not expected to diagnose or intervene in the middle of a situation when someone is considering suicide,” he says.

In the Texas video, Mr. Brownson says, the word “suicide” is used sparingly on purpose. “We’re naming a reality,” he says. “We’re not preparing them for something they’ve never seen before.”

Given how easy it is for students to forget things they learned at orientation, Mr. Schwartz says, it’s critical for campus counseling centers to remind students of their presence. Members of the counseling staff might set up a table in the student union early in the semester, or write a regular column in the student newspaper about prevention resources.

It’s not easy to measure the success of such efforts at mental-health education, Mr. Schwartz says, specifically whether students change their behavior and are more likely to approach friends they’re concerned about.

But college administrators say that if students come away from orientation programs knowing that there are resources just around the corner to help them cope with the stresses of campus life, that’s a victory.

Sarah Brown writes about a range of higher-education topics, including sexual assault, race on campus, and Greek life. Follow her on Twitter @Brown_e_Points, or email her at sarah.brown@chronicle.com.