MENTALMHEALTH PROMOTION AND SUICIDE PREVENTION AT MIT

Mental Health Promotion and Suicide Prevention at the Massachusetts

Institute of Technology

Cassady Collins

University of Kentucky

CPH 440-001
MENTAL HEALTH PROMOTION AND SUICIDE PREVENTION AT MIT 2

Mental Health Promotion and Suicide Prevention at the Massachusetts

Institute of Technology

Mental health issues such as anxiety and depression in United States citizens

have been a growing problem for decades. Currently in the United States, suicide is the

10th leading cause of death and nearly 90% of all people who die by suicide have a

diagnosable psychiatric disorder (American Foundation for Suicide Prevention, 2017).

In 2014, 469,096 people in the United States visited a hospital for injuries due to self-

harm behavior (American Foundation for Suicide Prevention, 2017). These numbers

have caused an increase in awareness of mental health and suicide prevention. While

mental health services have become more accessible across the country, young adults

receiving secondary education are still having problems with mental health treatment

on campus. This proposal is aims to create a program for mental health issues among

college students and determining what can be done to help them lead a healthier life.

Mental health problems such as depression and anxiety have been associated

with not only poorer life quality, but also lower academic success (Hunt and Eisenberg,

2010). Secondary education can be challenging, research conducted by the American

College Health Association has shown that more than 80% of college students felt

buried by the levels of stress they had been facing at school and 45% of students felt as

if things were hopeless. Currently on college campuses, suicide is the third leading

cause of death (Pedrelli et. al, 2014). Anxiety is most commonly diagnosed mental

heath problem diagnosed among young adults ages 18-24, coincidentally this is also the

average onset age for many medical health conditions (Tartakovsky, 2016). In the past

fifteen years, mental health problems among college students have increased, with
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depression doubling and anxiety tripling (Tartakovsky, 2016). The mental health of

today’s college students is extremely important to keep track of. Not only can poor

mental health can be linked to even more serious issues such as suicide, but also due to

the increasing number of students who are forced to drop out of school due to a mental

health issue that they feel their own school cannot help them with. In fact, it was

reported that more than 45% of young adults who did not return to finish their degrees

due to mental health issues, did not request accommodations (National Alliance on

Mental Illness). Common risk factors for mental health issues include stress and

drugs/alcohol usage while health disparities for mental health issues in college students

can include but are not limited to family history of mental illness, gender, race,

substance abuse and socioeconomic status. (Mrazek and Haggerty 1994). Consequences

such as suicide that could be considered a result of poor mental health and even poorer

access to treatments across college campuses are what make this a public health

problem that is in need of an intervention.

Various interventions have been performed on many college campuses across the

country (Alvarez, 2014). In 2008, the shootings at Virginia Tech created a dialogue

surrounding the topic of mental health in college students by showing what can happen

when mental health issues are not discussed. In 2014, The Jed Foundation and The

Clinton Foundation partnered up to create The Jed and Clinton Health Matters Campus

Program (JCHMCP), a mental health promotion program that aims towards suicide

prevention and fifty-five colleges and universities across the country have signed on to

the program since its introduction (Alvarez, 2014).

However, many university mental health programs still come with flaws such as
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never ending wait times to see a counselor (Alters, 2015). Prestigious universities such

as Ivy League schools and the Massachusetts Institute of Technology (MIT) are well

known for their challenging curriculums, but many of these institutions lack effective

mental health programs causing these universities to have students with high levels of

stress with nowhere on campus to go for help. This program is going to propose the

implementation of a greater mental health assessment and the addition of suicide

prevention programs for those enrolled at MIT. This project would need the help of the

institution’s president, employees and current stakeholders at the university health

services, and the campus counseling centers in order to implement the program

successfully. The purpose of this program is to help lower the number of those at risk

for suicide and mental health problems and create a safe, welcoming space for students

to go when they are feeling at risk or overwhelmed.

The population of MIT students was chosen not only because of the institutions

known history with suicides, but because the institution’s rates of suicide is currently

higher than the national average and has been for decades (Rocheleau, 2015). According to

a study conducted between the years 1964-2000, 47 students died by suicide on MIT’s

campus. This roughly translates to 14.6 deaths per 100,000 students; nearly double the

national average of 7.6 per 100,000 students (Reappropriate, 2015). Within the last five

years, the university’s suicide rate has decreased to 12.5 deaths per 100,000 students.

Although lower than the rates calculated from previous studies, the rate is still much higher

than the national average for students (Rocheleau, 2015). The rate is also only slightly

lower than the national average of 13 suicides per 100,000 people in the United States

(Rocheleau, 2015).
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MIT is located in Boston, Massachusetts, a state well known for its advanced efforts

in public health (Massachusetts Department of Health, 2010). MIT currently has an

undergraduate enrollment of 4,524 undergraduate students and 6,852 graduate students all

of varying ethnicities and socioeconomic statuses (Massachusetts Institute of Technology,

2016). The university is highly diverse and has all 50 states and 128 countries currently

being represented by their student body (Massachusetts Institute of Technology, 2016).

MIT is one of the most prestigious schools in the country, as it is known for its rigorous

course load and low acceptance rates. The high levels of stress along with the lack of

resources for mental health issues could be the reason for why mental health issues and

suicides have become such a huge problem at the school. The purpose of this intervention

is to promote mental health, increase access to services, and prevent suicides.

Part 2: Theory

According to Mark Edberg, a theory is an explanatory proposal that can be tested, and

tested through falsification (Edberg, 2015). Theories are an important part of program planning

due to their ability to provide insight to program planners on the why, what, and how of their

specific programs (Glanz et al., 2005). Other applications can be derived from theories including

different hypothesis and constructs for behavior (Edberg, 2015). Theories can help build a

program by giving a planner direction (Glanz et al., 2005). Theories assist program planners by

helping explain behavior and suggesting ways to achieve a noticeable change in behavior among

the targets of a particular program (Glanz et al., 2005). The more a program planner utilizes a

theory, the greater likelihood that their program will have a more successful implementation and

outcome (Glanz et al., 2005).

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The specific theory that will be used in this program is a community level theory called

Social Cognitive Theory (SCT). Unlike individual health behavior theories, social/environmental

theories generally focus on various social and environmental factors and the way they interact

with an individual (Edberg, 2015). According to Edberg, SCT is derived from the Social

Learning Theory, which proposes that people learn from both their own experiences and through

observing the actions of others (Edberg, 2015). SCT simply expands on this idea by proposing

the concept of self-efficacy and that an individual influences their environment and relationships

around them and those in turn will influence a person’s behavior (Edberg, 2015). SCT tends to

reveal two common criticisms; its complexity and construct integration can cause the theory to

have a lack of clarity (Edberg, 2015). However, even with the theory’s critiques, SCT has

become one of the most utilized theories in the world of public health interventions, particularly

when it comes to public health interventions geared towards personality development, behavior

pathology, and health promotion (Warmin, 2009).

SCT believes that changing a behavior is a function of three factors—individual

characteristic, environmental factors, and reciprocal determinism (Edberg, 2015). Constructs

regarding individual characteristic include an individuals level of confidence or self- efficacy to

achieve something, their current level or knowledge regarding a certain health problem or

behavior, and their expectations and expectancies about the results if a change is made, self-

control in order to make a change, and an individuals ability to cope with a change (Edberg,

2015). Constructs revolving around environmental factors include the physical and social

environment an individual has, vicarious learning through others behaviors, the perception of

situation that a particular behavior occurs, and the outcomes or reinforcements given to those in

response to a behavior (Edberg, 2015). The final factor, reciprocal determinism, describes a
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cycle where an individual acts based on his or her own factors and social/environmental cues,

notes a response from the environment, and adjusts accordingly (Edberg, 2015).

A recognized study that uses SCT is the Coping with Work and Family Stress: A

Workplace Preventative Intervention developed by David L. Snow in hopes to help prevent and

reduce stress-related problems among workers (Snow, 2007). This particular program involved a

sixteen-session weekly group intervention that was designed to help employees understand the

signs of stress and how to cope with them. The study was tested with a variety of workplace

settings and included men and women from diverse groups with varying ages and socioeconomic

backgrounds (Snow, 2007). The program involves training professionals in the workplace to help

implement the program to their coworkers. Trainers were provided with the necessary materials

to help their trainees practice the stress management techniques and coping mechanisms for not

only the duration of the sixteen-session program, but once the program was completed as well.

Snow discovered a significant reduction in depression and anxiety, a 15% increase in the

use of social support systems, a 33% reduction in avoidance coping, and a 17% reduction in

social withdrawal (Snow, 2007). Snow’s results relate heavily to the constructs of SCT,

particularly the constructs regarding emotional coping and vicarious learning since participants

learned stress management techniques and coping mechanisms. This particular program is

extremely significant; Snow’s program has been carefully implemented and evaluated to further

prove its effectiveness. This program is very adaptable to many environments and can help

provide the framework for a mental health promotion and suicide prevention program on a

college campus.
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Part 3: Program Description

The first four years of college can be a very stressful time in a young adult’s life

(National Alliance on Mental Illness). Many of those who choose to receive a higher education

after high school are in a new environment—one without their primary support system of their

family and friends (New Jersey Department of the Public Advocate, 2009). With the grueling

workload and the exciting, new social scene, it easy to see how one’s mental health could

decline. According to the New Jersey Department of the Public Advocate, symptoms of mental

illnesses including depression have been known to reveal themselves in the years of early

adulthood (New Jersey Department of the Public Advocate, 2009). Due to the new environment,

it can be difficult to differentiate feelings that could be symptoms of a mental illness from

normal feelings (New Jersey Department of the Public Advocate, 2009). In order to implement a

successful program, one must create a way to reduce the stigma of mental illness and its

correlation to suicide through education focused on when to seek help and providing a safe and

comfortable environment for students to do so (Baker, 2014).

As stated earlier, evidence shows that symptoms of mental health issues arise during the

years of young adulthood (New Jersey Department of the Public Advocate, 2009). Due to this,

the program being implemented will target at risk students. Coping with Work and Family

Stress: A Workplace Preventative Intervention conducted by David L. Snow, could be

considered a suitable choice to base a mental health awareness and prevention program for

students off of (Snow, 2007). This program would be adapted for a college environment by

creating a peer education awareness and prevention program. Peer educators would be trained in

order to gain skills and knowledge on how to promote mental health awareness among campus.

Differentiating from Snow’s program where trainers simply help trainees deal with stress
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management and coping mechanisms, this program will not only aim to help students deal with

the stressors that come with college and adulthood, but in addition will provide students a safe

place to turn to during the school year. The goal of this adaptation is to encourage students and

improve their self-efficacy when it comes to reaching out for help in times of stress. It is

expected that with the outcomes of Snow’s research along with the adaptations for the specific

population, this program will have a positive outcome.

As stated previously, Snow’s research saw a significant reduction in depression and

anxiety and a 15% increase in the use of social support systems in and out of the workplace. It is

believed that with focus on implementing a safe environment for students at risk for mental

health issues during the school year, one would see a larger percentage of students utilizing

social support systems on campus.

This program would be implemented at MIT, a prestigious institution known for its

challenging admissions and curriculum. In the past, the institution has been criticized for causing

high levels of stress in students, leading many to question if the school’s academic expectations

along with their ineffective mental health services for students to utilize are to blame for their

reputation as a ‘suicide school’ (Scelfo, 2015). The program would consist of a two-month

training program for educators prior to the beginning of the school year. The peer educators will

consist of licensed psychiatrists, physiologists, nurse specialists, and student volunteers. During

this time, educators will learn how help students cope with the stressors of students’ academic

and social lives. They will learn to how to determine if an individual is at risk for suicide or

suicidal ideations and take the necessary steps to help the individual. Educators will provide

students with the necessary materials and resources such as checklists and online therapy

sessions to perform their own mental health checks for when they are not on campus or the
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program is not available to them, such as holiday and summer breaks.

Educators should be respectful, sympathetic, and encouraging to students coming in for

help as this will hopefully help increase the student’s own self-efficacy when it comes to

returning to the educators for help or performing self care on their own. Students on campus with

previously diagnosed mental health conditions will be encouraged to utilize services more and

would have the opportunity to work with the program to conduct one on one wellness checks

with educators. This is something that will be done on a weekly basis, or more depending on the

severity of the student’s mental health at the given time.

The success of this program will be measured by frequency of use from the student body.

If students use their student ID numbers to check into the program, statistics will be calculated to

determine the use of the program. The program will be located on the east side of campus at the

MIT Medical Mental Health Service center and will be opened seven days a week, Monday

through Thursday from 8:00AM to 7:00PM. The center will also be opened from Friday through

Sunday from 8:00AM to 4:00PM. Walk-ins will be accepted seven days a week from 2:00PM to

4:00PM for urgent concerns. The staff will be comprised of 4 full-time and 10 part-time

psychiatrists, 3 clinical nurse specialists, 4 part time psychologists, and student volunteers to

ensure that students will always have someone to turn to. Performance surveys will also be done

regarding how the student body feels the program is running. Additions to the program will also

be made in the future given further funding and acceptable success of improved mental health

and lower rates of suicide among students.

It is predicted that the mental health of students enrolled at MIT would improve given the

implementation of the program. With the improved student mental health it would also be

predicted that the rates of suicide and suicidal ideations would also decrease. This information
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would be gathered using information obtained during appointments at the center, student

emergency room records, and surveys taken by students who utilize the program.

The constructs addressed by this program include the individual level of self-efficacy by

providing students with the necessary resources and encouragement to help them maintain

improved mental health and the idea of vicarious learning through the use of peer educators.

Also the construct of emotional coping as students who utilize the services will learn stress

management techniques and coping mechanisms. The construct of reciprocal determinism plays

a large role in this program as it is expected that at the end of the program, students will act

based on what they have learned from their educators and their own social and environmental

cues (Edberg, 2015).

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