Depression Among College Students in the US - Implementation and Evaluation

Problem Definition: High prevalence of depression among college students in the US from the years 1985 to 2010

The primary intervention decided upon revision from the last blog entry to the outline of the final paper will be the promotion of student organize clubs and organizations along with the funding of recreational facilities on campus. The crux of this intervention relies on the fact that those who are physically active tend to exhibit better mental health, while the student organizations will be able to provide both support and community for students on campus. The plan itself focuses on stress as its key determinant, and the programs implemented would seek to reduce said stress from the college environment.

The implementation of the plan will require both a substantial amount of funding on behalf of the institutions and the support and involvement of students on campus. Ideally, the student groups would be ethnically or culturally inspired and ran by upperclassman for the incoming freshman of institution. The stakeholders in this case would be students who would join the organizations and upperclassmen needed to get the group off the ground, while the university itself would need to provide initial funding for these clubs before they can fund raise and function on their own.

The recreational center would certainly be a long term project for schools and benefits would far outweigh the initial costs, but these costs would be high. Depending on the institution, the school would need to set aside revenue or look to alumni to aid in funding this venture, and this could only be accomplished if they approved of the reasons behind creating these centers. The additions can range from a modest addition of a volleyball net of basketball hoop on campus to a full on center, however this would take several months if not years to complete.

The evaluation of these programs would most effectively be discovered via an indirect survey of student sentiments as the changes progress. Instead of sending out online surveys asking specifically about depression, these surveys would instead test for levels of stress, comfort, happiness, etc as time wore on and the changes came into effect. As these descriptions generally are not paired with the conditions of depression and students are more likely to state how they are feeling than identify themselves with a certain condition, this will definitely prove the best way to evaluate the efficacy of the intervention.

Depression Among College Students in the US - Interventions

A couple current interventions at work on college campuses are:

1. Credit limits - while these are applied to the student body as a whole, they are greatly beneficial in decreasing the amount of stress on a student by limiting how much work they can take on per semester. Even though these limits can be surpassed, students are generally strongly advised against such action.
2. On campus counseling - student counseling services like JHU's "A Place to Talk" provide an area for students under emotional duress to seek advice on how to deal with their current issues and how to move forward.  
3. Promotion of cultural and ethnic clubs on campus, providing a sense of familiarity and community in a different environment

A few possible interventions to help lower the incidence of depression on college campuses are:

1. Hosting early year and mid-year assemblies, much like the orientation events, that would educate the student body about depression and various campus resources available to deal with the issue
• Secondary intervention
2. Increase the availability of on-campus recreation areas and activities - there is a strong correlation between physical activity and good mental health.
• Secondary intervention
3. Enforce stricter guidelines for underage alcohol consumption and inebriation by students - dependency on alcohol only worsens depression and the measure would benefit not only those who are suffering from depression but the health of the student body as a whole.
• Tertiary intervention
4. Record the students who are currently prescribed antidepressants according to their mandatory student health forms submitted at the beginning of these school year and create an opt-in counseling program for which said students would be contacted.
• Secondary intervention

There are no primary interventions, as there are no actual means to "prevent" depression in people. One can only treat the onset of the condition and help people through it. 

1 = Poor

2 = Fair

3 = Good

Options Decision Criteria	Intervention 1: Early and Midyear Informational Assemblies	Intervention 2: Increase of On-campus Recreational	Intervention 3: Opt-in Counseling Program
Effectiveness	2	2	3
Feasibility	3	2	1
Sustainability	3	2	1
Cost	3	1	1
Cost effectiveness	3	2	3
Political acceptability	3	3	1
Social will	1	2	1
Potential for unintended risks	3	1	1
Potential for unintended benefits	3	3	2
Total/conclusion	24	18	14

The best/ most feasible intervention is the early and midyear assemblies for educating the student body about on campus ready - they are perhaps the most plausible methods to address the problem as they are the least invasive and least costly. 

The creation of on-campus recreational centers, while being a pro not only for the population of depressed students but the community as a whole, will be quite costly to create and will take a significant amount of time and resources to organize.

The opt-in program is premised on the fact that Hopkins officials will use medical records as a basis to contact depressed students and offer help of some sort. While this may be seen as a solid step to some, it will certainly come off as invasive to others. However, it will be the most direct means of reaching the depressed community specifically. 

Depression Among College Students - Stakeholders

The issue of depression among college students has several stakeholders. These include:

• Students
• Higher level institution
• Parents
• Student advisors

Depression itself directly affects the student body's health and well being; both the atmosphere of the school and the success of students rely on the health of the students, whether it be  physical or mental. Institutions that have high rates of depression tend to be looked at with caution during the application process; if the student is looking to spend the next four years of their life at a school, it shouldn't be somewhere that will provide enough stress to push students towards mental instability. Parents definitely beyond anything want good health for their children.

With respect to possible interventions that could be made, a major factor for depression is extreme stress and a sense of hopelessness. Certain financial and academic situation may be the major triggers for depression. As such, increasing the availability of on campus resources when under a lot of stress or other issues would be extremely beneficial to the students. However, at the same time there would be the issue of funding said programs and providing staff available to speak and provide help to the students in question. The institution itself must be willing to invest resources, both monetary and human, to curbing the rates of depression. They will not go down without options being there to help the process along. Advisors of students could help students by directing them on the proper schedules to make such that workloads aren't overwhelming and the quality of student life isn't hindered by taking too many credits. Parents can be advised not to place excessive importance on doing well in school verses enjoying the time that is spent in college. The biggest intervention would be the increased amount of on-campus counseling resources to reach out to troubled students. However, this would require the most effort on the side of the school using its budget to fund it. Colleges may be reluctant to allocate many funds to such a cause and may be against the idea in general. 

Problem Definition & Key Determinants

Problem Definition: Studies show an high prevalence of depression among college students.

Depression has several different factors that contribute to its prevalence among college students. As discussed in my previous entry, the most notable factors being social circumstances. The standard loneliness and hopelessness isn't the only issue, however. In fact, there are several issues beyond the economic factors that contribute to the prevalence of depression.

Among the environmental determinants, one factor that appeared in the Furr article was the effect on the actual type of school at which the student attended. According to the data, the social and economic determinants intertwined with the environmental. Those attending large community colleges expressed income as the major cause in their depression. From campus to campus, loneliness is a major issue because of the institution's ability to fund and maintain extracurricular on campus groups to promote a sense on belonging among students on the campus.

Other specifically social and cultural factors would be the race and genders of students at college. The prevalence of self-harm was greater among men than women. Asian Americans expressed a much greater prevalence of depression in their sample population. The differences among other races were not noted as significant. The article put forward "self-silencing" as a major factor for both genders, which is the extreme internalization of emotion and needs before those of others.  The key determinants that can be gathered from this data are the race of the college student and the gender of the student. These however, are the main two key determinants that are gathered from the given data. They can be further expressed by looking at the reasons behind why there is a difference among these sample populations. The kind of parents of these students, their culture of they come, the expectations of the families , and even the expectations of society. All of these factors play a role in depression's prevalence among students.

References:

Furr, Susan R., John S. Westefeld, Gaye N. McConnell, and J. M. Jenkins. "Suicide and Depression among College Students: A Decade Later." Professional Psychology (2000): n. pag. EBSCOhost. Web. 6 Apr. 2013.

Gratch, Linda V., Margaret E. Bassett, and Sharon L. Attra. "The Relationship Of Gender And Ethnicity To Self-Silencing And Depression Among College Students." Psychology of Women Quaterly 19.509 (1995): n. pag. SAGE. Web. 06 Apr. 2013.