Factors that distinguish college students with depressive symptoms with and without suicidal thoughts.

BACKGROUND: Suicide among college students is a significant public health concern. Although suicidality is linked to depression, not all depressed college students experience suicidal ideation (SI). The primary aim of this study was to determine potential factors that may distinguish college students with depressive symptoms with and without SI. METHODS: A total of 287 undergraduate college students with substantial depressive symptoms (Beck Depression Inventory [BDI] total score >13) with and without SI were compared across psychiatric and functional outcome variables. Independent sample t tests were conducted for each outcome variable using the suicide item of the BDI as a dichotomous (ie, zero vs nonzero score) grouping variable. RESULTS: Relative to students with substantial depressive symptoms without SI, those with SI were more symptomatic overall, having significantly higher levels of depressive symptoms, hopelessness, and anxiety. However, contrary to our expectations, nonsuicidal and suicidal students did not differ on measures of everyday functioning (ie, cognitive and physical functioning and grade point average). CONCLUSIONS: Our findings suggest that SI among college students is associated with increased subjective distress but may not adversely impact physical or cognitive functioning or academic performance.

Peer Academic Supports for Success (PASS) for College Students with Mental Illness: Open Trial.

Increasing numbers of college students have serious mental health conditions, but their dropout rates are high and debt accrual is common. A well-specified intervention that colleges can directly offer their undergraduates with serious mental health conditions that sustains their academic persistence is greatly needed. The Peer Academic Supports for Success (PASS) coaching model was developed to address this need. This study's goal was to conduct an open trial of the initial PASS model to test the feasibility of the model and research methods in preparation for more rigorous testing. Ten college juniors and seniors, with and without lived mental health experience, were hired, trained, and supervised to be PASS peer coaches. Twelve undergraduate students with academically impairing mental health conditions served as study participants and received PASS. Student data were collected at baseline and two semesters post baseline. Intervention feasibility data were assessed through coach report. Results indicate PASS can be delivered with fidelity by peer coaches, can attract and retain students, and is safe. Results also suggest that PASS has significant effects on most of the targeted proximal outcomes. The PASS findings are promising as a college-based intervention to support young adult students with mental health conditions.

The recovery education center: an integrated health promotion and wellness program.

TOPIC: This brief report describes a recovery education program that is designed to develop health as a foundation for recovery from psychiatric illnesses. PURPOSE: Using readiness to change theory, health promotion, and psychiatric rehabilitation processes that are bundled in an adult education model of service, participants learn the knowledge, skills, and supports they want and need to increase their domains of wellness that will support their recovery. SOURCES USED: Author's relevant knowledge and citations of health and behavioral health evidence. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Health promotion that is delivered in a healthy environment enhances people's quality of life, promotes readiness for role change and in the end, works to ensure that people with mental illnesses have a right to optimal health. To support rehabilitation and recovery, practitioners are encouraged to review this program model and select elements described to replicate in various mental health settings.

Evaluation of a combined supported computer education and employment training program for persons with psychiatric disabilities.

Meaningful work is described as one of the functional indicators of healing and growth beyond the disability and is seen as critical in recovering a personal sense of worth and value. We describe a supported education-supported employment program which focused on teaching computer, recovery and work skills. A program evaluation was implemented on four consecutive classes of this program. Four classes with a convenience sample of sixty-one students were involved in the evaluation over years. The program utilized a one group pretest, posttest design, with repeated measures over time. Following the 10-month classroom training phase, students entered a 2-month internship to give them computer office work experience. Students were interviewed quarterly using standardized assessments involving work and other subjective outcomes. Results suggest that overall the students experienced a positive change in work status and income and a decrease in mental health services utilization. In addition, non-vocational outcomes, specifically self-esteem and empowerment improved. The program represents a successful integration of supported education and supported employment program models.

A Calming Cushion as a Therapeutic Wellness Tool for Youths with Disabilities and History of Trauma.

Seclusion and restraint are commonly used by residential staff to control unsafe behaviors of youths with disabilities and complex trauma histories. This pilot study examined the effect of a nonrestraining cushion as a calming device and wellness tool in a setting that prohibits supportive physical contact, to see to what extent the cushion might help these youths to better regulate their emotional distress and unwanted behaviors. Volunteers used the cushion for 15 minutes over 24 sessions. Nine students completed the study and reported reduction in anxiety and agitation, and a soothing feeling with residual effects to their daily routines. This pilot study suggests that the use of a nonrestraining, deep-pressure cushion may simulate a secure holding effect for young people with emotional dysregulation. The cushion is a safe and healing wellness tool that empowers youths and provides programs with an alternative to seclusion and restraint.

A framework for health promotion services for people with psychiatric disabilities.

The concepts of wellness and its complement, health promotion, have popularized the notion that health itself is more than simply the absence of disease. Furthermore, the wellness concept has advanced the idea of the importance of engaging in certain health promoting behaviors within healthy environments, not simply for the purpose of preventing or better managing a disease, but also to enhance one's well-being and quality of life (Green & Kreuter, 1991; Mullen, 1986). Encouraging this emphasis on wellness is Healthy People 2010 (U.S. Department of Health and Human Services, 2000), a national ten-year plan intended to increase quality and years of life and eliminate disparities which for the now features a new area that recognizes the importance of health promotion and disease prevention in the lives of people with disabilities. Increasingly, the value of promoting wellness--including for people with disabilities--is being recognized (Rimmer & Braddock, 2002).

The personal and vocational impact of training and employing people with psychiatric disabilities as providers.

OBJECTIVE: This study examined the feasibility of a structured peer provider training program and its effect on peer providers with respect to their own personal and vocational recovery. METHODS: Sixty-six individuals participated in an evaluation of a 60-hour, 5-week long peer training program. Participants were assessed prior to and after the training on scales to measure recovery, empowerment and self-concept. Analyses of variance were used to examine subjective changes in these measures. Job acquisition and retention data were also examined at posttest. RESULTS: Participants experienced gains in perceived empowerment, attitudes toward recovery and self-concept. Trainees went on to obtain peer provider positions within the mental health agency in which they received the training and 89% of those trained retained employment at 12 months. Twenty-nine percent of the initial jobs into which the peer providers were placed were full-time; 52% were part-time and 19% were hourly. CONCLUSIONS: Findings suggest that a standardized program designed to provide peer training was used successfully and participants' recovery and employability were improved. Further studies are recommended to rigorously test peer providers' impact on their clients and to examine the advantages that accrue to the agency when mental health recipients are employed as peer providers.

Integrating physical activity into mental health services for persons with serious mental illness.

This article reviews evidence supporting the need for interventions to promote physical activity among persons with serious mental illness. Principles of designing effective physical activity interventions are discussed along with ways to adapt such interventions for this population. Individuals with serious mental illness are at high risk of chronic diseases associated with sedentary behavior, including diabetes and cardiovascular disease. The effects of lifestyle modification on chronic disease outcomes are large and consistent across multiple studies. Evidence for the psychological benefits for clinical populations comes from two meta-analyses of outcomes of depressed patients that showed that effects of exercise were similar to those of psychotherapeutic interventions. Exercise can also alleviate secondary symptoms such as low self-esteem and social withdrawal. Although structured group programs can be effective for persons with serious mental illness, especially walking programs, lifestyle changes that focus on accumulation of moderate-intensity activity throughout the day may be most appropriate. Research suggests that exercise is well accepted by people with serious mental illness and is often considered one of the most valued components of treatment. Adherence to physical activity interventions appears comparable to that in the general population. Mental health service providers can provide effective, evidence-based physical activity interventions for individuals with serious mental illness.

The role of a fitness intervention on people with serious psychiatric disabilities.

The purpose of this study was to determine the effects a health education and exercise program would have in limiting weight gain and in improving fitness and psychological parameters in adults with mood or psychotic disorders. Thirty volunteers were randomly assigned to the healthy lifestyle group (HL) or a control group. The HL group engaged in exercise for 12 weeks. Pre- and post-exercise testing was conducted to assess body fat, lipid profile, and cardiovascular fitness. Educational seminars were held weekly. The intervention group evidenced greater weight loss than the control group, although not statistically significant. Significant differences were observed in ratings of general health (p < .05) and empowerment (p < .01). Trends suggest that exercise interventions may encourage weight loss, particularly if barriers to full participation can be addressed. Additionally, such interventions may contribute to "perceived" well-being even among those with subclinical participation.

Results of an innovative university-based recovery education program for adults with psychiatric disabilities.

This study examined the effectiveness of an educational approach to psychiatric rehabilitation called the Recovery Center. Using a quasi-experimental design we recruited 97 intervention and 81 comparison participants and examined the intervention's impact on health, mental health, subjective, and role functioning outcomes. Results suggested that this intervention was effective in improving subjective outcomes, especially empowerment and recovery attitudes, both of which received primary emphasis in the intervention. The Recovery Center, which integrates a bio-psychosocial framework with psycho-educational interventions shows promise as a complement to traditional mental health services in developing readiness for rehabilitation and promoting recovery among individuals with severe psychiatric disabilities.