Month: September 2024

Character and Leadership

Posted on by Dana Humphrey

Jason Weber was particularly attuned to the quiet student who sat in the very back row of the class he was leading. The student didn’t speak out, and rarely engaged. He was, as Weber recalls, very, very, shy. But this classroom wasn’t meant to be a spectator-sport environment. It was Texas Tech’s inaugural cohort of its new leader development program, designed to help students build confidence and purpose through active participation. Weber didn’t stop trying to draw him out, and slowly a relationship formed. 

About three-quarters through the semester, the student, Octavio Garza IV, approached him with surprising news.

“He said, ‘I just want to let you know that when I started this program, I didn’t really want to be here. But I just thought, maybe this would be good for me,’” recalls Weber, who in addition to being facilitator of the leader development program, is Associate Vice Chancellor-Leader and Culture Development of the Texas Tech University System. Octavio told him that his experience in this program made him decide to stick his neck out and apply for a student ambassador position, and that he had been selected.  

The following year, Weber would see Octavio in public roles around campus, staffing tables and handing out root-beer floats to new students. “This is someone who engaged with students doing things I never thought he would do,” Weber says. “Once I saw him in the hall, and I pulled him into my classroom to speak to a group about his experience with the program. He ended up standing in front of a whole room of people talking for five minutes on his experience and how beneficial it was. He had just completely come out of his shell.”              

Octavio has since graduated, and instead of following a career in law enforcement as planned, he decided to pursue a master’s degree in education while working in the admissions office for Angelo State University, part of the Texas Tech University system. “The school and that program had a huge impact on me,” he says, “and now I’d like to work in a career where I can help students make choices that will change their education, and their life.”

Texas Tech’s program for juniors, Lead Like A Ram, is now in its third year, and has become so popular that the two cohorts fill quickly. Participants meet twice a month for a two-hour learning session, with both groups overlapping over a shared dinner. The program is being piloted in different forms at other locations within the Texas Tech University System, and Weber hopes 2026 will see the launch of a version for graduate students in medicine.

Texas Tech is one of many institutions taking seriously the question, What kind of leaders does the world of tomorrow need, and how do we cultivate them? A 2021 study published by the Harvard Business School identified the top 10 leadership skills in demand for the future of work, including inclusive leadership, engaging and inspiring leadership, and leadership without formal authority. Meanwhile, a 2023 study by the National Society of Leadership and Success concluded that students today aren’t developing three essential skills most needed for the modern workplace: communication, decision-making, and leadership.

Academics and administrators interested in developing leaders through higher education have a new ally in the Carnegie Foundation for the Advancement of Teaching. Known for a broad range of transformative advancements in education, the foundation expanded its classifications of institutions in higher education to include programs focusing on Leadership for Public Purpose. The foundation defines its interest in university leadership development in this way: “Effective leadership for public purpose transcends functional or instrumental leadership (i.e., personal career or political gain; or narrow business or organization outcomes), in pursuit of collective public good, including justice, equity, diversity, and liberty.”

This year marks the first cycle of the evaluations for the Carnegie Elective Classification for Leadership for Public Purpose, with 25 U.S. institutions of higher education held up as pioneers on the national landscape of leadership development, including Rice University.

In 2015, renown venture capitalists and tech executives John and Ann Doerr—both Rice alums with bachelor’s and master’s degrees in electrical engineering—decided to make a major investment in leadership at their alma mater. Earlier contributions established their investment in engineering leadership, and they wanted to make it available to students throughout the university.

The Doerr Institute for New Leaders is the result of their $50 million gift designed to empower students with the skills, training, and confidence to make a true difference in the world, through a combination of hands-on, real-world experience, and guidance from personal coaches. The institute has a wide range of programming for Rice students at no added charge: Using a combination of classroom-based learning, excursions to watch leaders in action, one-on-one leadership coaching, and group coaching, the university practices its belief that leaders aren’t born or made, they are grown.

The focus on the word leader over leadership at Rice and many other schools is a conscious one, says Ryan Brown, Managing Director for Measurement at the institute.

“Leader development is about developing the person as a leader and their capacity as a leader, their identity as a leader. When you say leadership development, you could mean the dynamic between a leader and a follower. You could mean that broader social system in place within which leadership is happening and potential leaders are being identified. But you’re getting into more organizational or system dynamics, and that’s not what we do,” he said. “Because we don’t operate within an organization where that leadership is happening in a corporate structure, for example, elevating a person. What we’re focusing on is developing each student as a leader, then we actually want our leaders to leave, want them to graduate and go out into the world and then lead there.”

“If we only helped students to see themselves as leaders, but we had actually turned them into narcissists, then that would not be a good outcome.” 

The common set of measures Doerr Institute uses in its coaching program includes leader identity—the extent to which you see yourself as a leader, feel capable of leading, competent to lead, and willing to lead. “We also include sense of purpose, self-awareness, a couple of measures of psychological wellbeing, and an intellectual humility measure, which I really like,” Brown said. Contrary to what some might think, leadership is not about decisiveness and persuasion. “If we only helped students to see themselves as leaders, but we had actually turned them into narcissists, then that would not be a good outcome.”

Intellectual humility is a concept and measurement coined by Mark Leary at Duke University, and references the degree to which people are willing to admit that they’re wrong when they’re presented with good evidence, being open to new ideas, and finding out things that they don’t already believe are, in fact, true.

“That has a lot of application just in life and leaders that seems so important today. It’s intricately combined with active listening skills and empathy and all these kinds of things, so it makes for a healthy combination of outcomes,” he says. “We measure those things before and after students go through that coaching program, and we see consistently significant increases in leader identity and self-awareness, sense of purpose, intellectual humility and reductions in psychological distress. So we have this boost in wellbeing that is kind of a good secondary effect.”

Gavin Daves is a junior at Rice, and when he joined his first program at the Doerr Institute, he was fairly certain about what he was looking for. As someone who studies operations research and statistics, he functions in the world of applied mathematics. And he is aware of the social shortcomings within STEM.

“I’d say there is a little bit more of a vacuum or like a hole in leadership within STEM. They certainly have the leadership titles available, but not as much like the soft skills, emotional intelligence skills,” he said. “Some things that we don’t get taught in our classes are areas like how to work with the group, or how to deal with conflicts, you know, issues that are dealing with people. But I think those things are also really important when we talk about STEM jobs and careers.”

In high school, Gavin actively considered what he needed to improve on as he transitioned into college. He held some leadership positions in the band and as head of the music honor society, and belonged to a small team of students engaged in an AI competition for MIT. But he suspected that he needed to better develop elements of his personality to shine in order to have impact in his roles.

“I struggled with seeming maybe a little bit robotic to some people, unrelatable, because I came across as someone who was only focusing on the job they had to do. I wanted to work on finding ways to show a little bit more personality and even more passion for the stuff I’m doing, and about to showcase a different side of me and ultimately make me a better leader,” he said.

Gavin was trying to find ways not just to tell people what to do, but also help them grow, and if they couldn’t relate to him and trust him, it was turning into a roadblock. Through the Doerr programs, particularly the one-on-one coaching, he found himself able to immediately apply work on his skills to his part-time job as a data scientist at a tax analytics company.

“I’d say I’m a natural introvert, but I find I’m able to come out of my shell when I’m talking about something I’m excited about, or encouraging people to partake in something I’ve found really beneficial. These qualities transcend leadership, listening well and dealing with conflict, and make you a more complete and better person, overall.”

Like Rice, Washington University in St. Louis has a new initiative dedicated to developing leaders, and like Rice, it came through the generosity of a visionary alum. The $20 million George and Carol Bauer Leaders Academy places values-based leadership development at the center of the university for all students, building on the philanthropy of previous gifts supporting pockets of leadership—for Danforth Scholars, and the business school.

The Academy, still in its first year, will support research and oversee student leadership programs across schools and all ages of students in co-curricular programs, imbuing them with the best practices in leadership development and personal character formation. It also benefits the campus community with workshops, faculty grants, professional coaching, and a campus-wide Leadership Week.

“We look at leadership through what we call the 70-20-10 model, with 70% of your leadership development coming through experiences, 20% through mentoring and coaches, and 10% through academic coursework,” said Julia Macias, director of student leader development for the Academy. “This might be a little shocking, coming out of an academic institution, but we really think there are a lot of different ways to exercise what you’re learning and try things out and innovate what’s ultimately going to solidify their leadership development. Everyone, regardless of formal status, has the potential to influence and energize others to achieve a common goal. And so we really think about ourselves as developing people to become purpose-driven leaders of character and capability.”

Those character skills, and their wide-ranging benefits in both work and life, are a critical part of what so many students find binds disparate parts of their lives into a cohesive, values-based whole.

“Before, I didn’t think about how much being a good leader has to do with being a good person. Like, you have to work on yourself, first. And when I did my first program, they told me I should really work on my optimism and my empathy. And I was like, What does that even have to do with being a leader?” says Thara Venkateswaran, a Rice senior in ROTC headed to commission as a Naval officer in May. “But I realized that it really does, and emotional intelligence plays a huge role.”

As an executive officer, the second in command of the entire unit, she is responsible for managing 45 people, including all the freshmen. “Honestly, it’s a constant process of reflection and working on yourself. Because there is a lot of overlap between personal struggles and leadership struggles, professional and personal life. Really, everything is applicable to everything.”

Healthier Campuses

Posted on by Dana Humphrey

Dr. Sarah Lipson waited all year to get the report she hoped would confirm that last year’s data was not an outlier. 

“Each year over the past decade had been the worst we’ve seen in terms of prevalence rates until the 2022-2023 survey indicated things got a little better in terms of anxiety, depression and flourishing,” she said. “With the 2023-2024 data now in, it looks like we may be turning the corner.” 

Dr. Lipson is a principal investigator of the national Healthy Minds Study, one of the largest data sets used to determine the mental health and wellbeing of the college student population.  The data she awaited indeed showed that the prevalence of depression, anxiety, and suicidality among college students has decreased for two consecutive years for the first time in a decade. Meanwhile, flourishing (positive mental health) among students has increased during this same time frame, having been in decline for ten straight years. 

The latest data were collected between September 2023 and May 2024 from over 104,000 undergraduate and graduate students at 196 institutions, including community colleges, technical colleges, HBCUs and other minority-serving institutions. The variances were small – a 5% drop in anxiety, a 6% drop in depression and a 6% increase in flourishing — but the change itself is significant. 

“Because it’s a population-based survey, Healthy Minds is often a starting point where we can say ‘here’s what we see at a population level in terms of trends,’” said Lipson, who is also an associate professor at the Boston University School of Public Health.  “The levels are still very high, but we are hopeful we have the start of a positive trend.” 

Asked what might be driving the shift, Lipson said, “There’s a broader context for sure, but I’d like to think that a lot of it has to do with what’s happening on campus in terms of increased awareness and support and more schools taking a public health approach to addressing student mental health.  I hope so.”

The latest healthy Minds survey report is a glimmer of hope for colleges and universities yearning for some form of good news related to the mounting mental health problems their students have reported over the years. Yet despite the progress, this year’s data still produced last year’s headline: too many students are emotionally unwell.  According to the survey, a third of students screened positive for some form of anxiety and almost four in 10 met the criteria for moderate or severe depression. 

Furthermore, the 2023-2024 changes in anxiety, depression and flourishing were a return to what students were reporting before the spikes caused by the pandemic.  And while cautiously optimistic, Lipson points to data in the report that reveals one of the most tenacious problems in college student mental health – the unmet need for services among students who need them. According to the 2023-2024 report, almost 40% of students who screened positive for anxiety or depression are not receiving any kind of mental health services.

“The levels are still very high, but we are hopeful we have the start of a positive trend.” 

“Even though the rates of treatment seeking have gone up, there’s still a significant unmet need that exists, with a lot of inequities in it,” she said.  “From a public health perspective, this is a missed opportunity during a really epidemiologically vulnerable, psychosocially significant time between 18 and 25.”

The Long and Winding Road

According to the Healthy Minds study, rates of depression and anxiety among college students doubled from 2010 to 2021 (from 20% to 44% for depression; and 20% to 37% for anxiety).  An early sign of the looming crisis was the increase in demand for campus counseling services which often went unmet.

According to the Center for Collegiate Mental Health at Penn State University, between fall 2009 and spring 2015, counseling center utilization increased by an average of 30-40%, while enrollment increased by only 5%. More serious consequences ranged from significant stop-out rates due to mental health problems to tragic deaths by suicide on campuses throughout the country. The pandemic fueled what was already a burning fire, adding isolation and lack of connection to the myriad of potential drivers.  In a 2021 survey by the American Council on Education, college presidents rated student mental health their number one concern.

Since then, most colleges and universities have put in place a range of responses, from service improvements to preventative strategies aimed at improving overall wellbeing. By the time the US Surgeon General came out with his young adult mental health advisory in 2021, it was hard to find an institution in the country that wasn’t working hard on mental health, or at least talking about doing so. Most schools have increased capacity for services through a number of strategies including utilizing a triage approach that prioritizes services by acuity, digital mental health interventions like apps and teletherapy and increasing staff when feasible. 

Cultural changes on campus have included prioritizing mental health through chief wellness officer positions and ongoing student-driven initiatives like awareness campaigns that reduce stigma and peer counseling which many students, particularly those of marginalized identities, find accessible and effective. The focus on student mental health and wellbeing on campus has encouraged other student-centered initiatives involving equity and basic needs and has raised questions about faculty’s role in student mental health and what academic policies or pedagogical changes may be needed to improve wellbeing. 

The question, which the recent Healthy Minds data raises, but does not fully answer, is, has all this activity had an impact?

“I agree with the Healthy Minds team that increased attention to mental health since the pandemic and additional resources for mental health are likely contributing factors to the slightly declining trend in anxiety and depression and slight increase in flourishing,” said Nance Roy, Chief Clinical Officer at the Jed Foundation, the country’s leading non-profit dedicated to protecting emotional health and preventing suicide in young people.

Roy also theorized that students have gotten better at distinguishing between “normal” feelings of anxiety and depression and clinical anxiety and depression. She believes the change in the way we talk about mental health – away from “crisis” and toward positive mental health – has been helpful.

The Jed Foundation itself may have had a role to play in the potential turnaround by providing schools a response to mental health issues, including suicides on campus, with mental health strategic planning support.  Launched in 2013 and now in 500+ campuses, the JED Campus Program engages colleges and universities in collaborative work over the course of four years. After conducting an initial needs assessment, a JED advisor draws on the data to create a strategic plan that, when implemented seriously by leadership on down, has led to impressive outcomes. Its recent impact report suggests that the students on campuses who engaged with JED reported lower rates of anxiety, depression and suicidality and increased flourishing, GPA and retention rates.

Another major player that emerged during the consecutive years of escalating prevalence rates is telehealth or teletherapy, most often provided by a third party.  First introduced as a potential way to expand capacity within counseling centers, telehealth became a permanent fixture during the pandemic and is now widely used.  These services range significantly in scope but the most popular provide components such as a clinically-staffed, 24/7 crisis line; online therapy appointments with a remote clinician one can choose, and apps or access to wellbeing supports such as mindfulness.  There are a number of advantages to these services, staring with convenience in time and place, a prerequisite for flexibility-focused Gen Z.

Uwill is a leading mental health and wellness company serving 3 million students at 400+ institutions in all 50 states and 40 countries.  Students begin their Uwill experience by indicating  how quickly they want to see a licensed therapist, with the option to choose a same-day appointment as well as preferences such as race, ethnicity, gender and clinical need.  Amaura Kemmerer, LICSW ,is Uwill’s Director of Clinical Affairs and the former Associate Dean for Wellness at Northeastern University. She says that teletherapy options solve a number of problems that had always existed for mental health providers on campus. 

“Traditionally, students embraced in-person therapy over teletherapy.  However, in-person creates a barrier in trying to serve students after hours, off campus, or out of the state or country” she said. “During the pandemic, there was no choice but to move online and what has happened since is that students and counselors have realized the advantages – students can access therapy wherever they are and whenever they need it, or if they are uncomfortable going to a center, and they can choose the type of therapist they want to see, which is really important for students of certain identities.”

Kemmerer says over 60% of students engaged with Uwill report never having gone to therapy before, underscoring its benefit as a new onramp to care for students who might not otherwise seek help.  Ironically, while introduced as a salve for the capacity problem, digital therapy may be providing access to care for a new population of students who have not been seeking help on campus. But most college health professionals would agree that’s a good thing and are comfortable with its place among their care continuum.

According to the Healthy Minds study, rates of depression and anxiety among college students doubled from 2010 to 2021 (from 20% to 44% for depression; and 20% to 37% for anxiety).

“Even though the restrictions around the pandemic have eased, our students are still preferring digital therapy due to convenience,” said Dr. Zoe Ragouzeos, the Executive Director of Counseling and Wellness Services at New York University.  “And the data still reflect that the efficacy of remote treatment compares to that of in-person care.” 

It is clear that technology-based mental health support is here to stay but the lack of data on the full range of digital mental health tools – including apps that are self-directed or only include partial coaching — is a concern of Dr. Lipson’s.  She and her colleague, Dr. Daniel Eisenberg recently published a paper sponsored by the Ruderman Family Foundation concluding “although research has demonstrated that DMHI (Digital Mental Health Interventions) can be effective at improving mental health, the majority of widely used DMHIs in college settings have limited direct evidence of effectiveness in student populations.”

While they are supportive of the adoption of DMHI’s, Lipson and Eisenberg recommend colleges consider how these tools fit into campus mental health and wellbeing plans that take a preventative, population-based approach.  They call for rigorous evaluation of commonly used programs and more information about user engagement, particularly regarding whether or not these services are being accessed by students of color or groups that may be needing help but not seeking it.  In a separate effort, the researchers are working to create a comprehensive student mental health repository where easy access to evidence-based best practices will help campus professionals understand which interventions are best for which students. 

As campuses continue to work at improving student mental health in a variety of ways, Lipson believes we will need several more years of prioritizing mental health at a population level to truly understand how far the needle has moved.  In the meantime, the Healthy Minds team will continue to produce the indicators. 

The “weird” attack on higher education

Posted on by Dana Humphrey

Listen Here:

In a season filled with political one-uppmanship, the word “weird” has become a catch phrase for all things suspicious or “dodgie,” effectively putting a spotlight on views outside the mainstream. The highly politicized attacks on higher education might well fit into this same category, considering the fact that the many criticisms against colleges and universities are, indeed, bizarre and unsupported by the majority.

While the most aggressive denunciations of higher ed are catnip for the media and burrow into the public consciousness, many of these criticisms come from a vocal minority. Even some of the most politically charged topics, where one might suspect the arguments to have persuaded a larger share of the public, aren’t producing these outcomes. Consider the aggressive anti-DEI (Diversity, Equity, and Inclusion) stance that has gripped the attention of the media and the public: despite the buzz, banning programs that help students feel they belong on campus is incredibly unpopular. Only 27% of Americans, and less than half of Republicans, oppose DEI initiatives in colleges, according to a 2023 YouGov poll. The same goes for controlling what subjects students can learn in college, another pervasive yet unpopular battle cry. Only 33% support government regulation of public college professors’ classroom speech, according to a separate YouGov poll.

The reality is that most of our friends and neighbors still want their kids to go to college, where they hope they’ll grow personally and intellectually, finding a sense of identity, agency and purpose that sets them up to flourish throughout their lives. It’s time to embrace the fact that, despite its flaws and the genuine need for improvement (particularly in affordability), college remains a positive force for young people and society at large.

Also, in the realm of the “weird” is the notion that college exists solely for skills training and job placement, an idea that doesn’t align with the wants of students, their families, or employers. According to Pew Research Center, 73% of college graduates with two- or four-year degrees found their degree very or somewhat useful for both personal and intellectual growth. Additionally, 90% of employed adults emphasized the importance of interpersonal skills such as patience, compassion and getting along with people to their work – attributes cultivated by a well-rounded college experience that includes mentorships, teamwork, and applying what is learned in the classroom to real world problems. Monster’s Future of Work report highlights that employers value dependability, teamwork, flexibility, and problem-solving – skills often honed through a well-rounded education.

To reassert the value of the college experience and restore public trust, we must provide the type of higher education experience that people want.

Just as the idea that higher education should simply deliver skills is out of step with the American public, so too is the belief that college is no longer worth it. Polling shows that 75% of people believe there is a good return on investment in a college degree, and nearly 70% say a close family member needs at least an associate’s degree for financial security. In a 2024 Gallup-Lumina poll, 94% of adults said at least one type of postsecondary credential is “extremely valuable ” or “very valuable.” Moreover, research shows that higher education is linked to improved health and wellbeing, including reduced risk of heart disease, high blood pressure, diabetes, anxiety, and depression. College graduates exercise more, drink less, and are more likely to seek preventive healthcare. They report higher levels of self-esteem and job satisfaction than high school graduates who do not go on to earn higher education degrees.

But just as the data show we cannot believe all of the anti-higher education rhetoric, we must not ignore that people are upset with the sector, and for valid reasons. We must address the affordability issue, a major driver of the anger and frustration directed at colleges and universities. And we must work harder to make a stronger case for the value of higher education on human development, workforce development, and society overall that can be embraced by Americans of all viewpoints. Forty-five percent of Americans believe colleges and universities have an overall negative impact on the country – this in spite of the data showing that college graduates are more likely to vote, volunteer, donate to charities, join community organizations, and participate in educational activities with their children than non-degree holders.

Rather, to reassert the value of the college experience and restore public trust, we must provide the type of higher education experience that people want: one that fosters personal and intellectual growth, offers a transformational experience, and lays the foundation for a lifetime of flourishing.

Dana Humphrey is the Associate Director of the Coalition for Transformational Education. The Coalition for Transformational Education is a group of leaders in higher education dedicated to evidence-based, learner-centered education that lays the foundation for wellbeing and work engagement throughout life. Through assessment, collaboration, and best practice-sharing with our member institutions, we strive to inspire the academy to prioritize lifelong wellbeing.

Talking student mental health and wellbeing with experts on campus

Posted on by Dana Humphrey

Dr. Zoe Ragouzeos, Vice President for Student Mental Health and Wellbeing at New York University and Dr. Eric Wood, Director of Counseling and Mental Health at Texas Christian University discuss what they are seeing in students returning this fall, how traumatic events of the past several years are affecting incoming students, and trends in the way we think about student behavioral health and wellbeing in higher education. 

You can listen to the episode on Spotify or Apple Podcasts.

Dr. Estevan Garcia is at the Table

Posted on by Dana Humphrey

Given his background, Dr. Estevan Garcia might be considered an unusual member of a college president’s cabinet. But as Dartmouth’s new Chief Health and Wellness Officer, the physician and public health expert works directly with President Sian Beilock on an issue she has made a well-publicized priority in her first year in office – protecting the mental health of students, faculty and staff. Garcia, who is a pediatrician specializing in emergency medicine, came to Dartmouth from the Massachusetts Department of Public Health where he helped led the effort to address the behavioral health crisis in emergency departments during the pandemic.

It is now Garcia’s job to lead Beilock’s health and wellbeing agenda, most specifically through the implementation of the school’s comprehensive strategic mental health plan called the “Commitment to Care.”  The origins of the plan predate Garcia’s arrival and was informed by a collaboration with the Jed Foundation, a non-profit organization dedicated to protecting emotional health and preventing suicide in young people. Beginning in 2020, the Dartmouth community lost several students, including by suicide, as the pandemic eclipsed college life.

Dr. Estevan Garcia

Four years later, the Jed Foundation featured Dartmouth as a success story in its impact report and Garcia is now focused on the longer term outcome data that will provide a more precise evaluation of their recent work.  He views the plan as a pathway to a wellness culture at Dartmouth that prioritizes self-care, community care and mental health innovation. With an increased staff and budget behind him, Garcia is addressing a number of wellbeing issues often associated with elite institutions, particularly ones like Dartmouth, located in remote areas with less community resources.  These include the stress of perfectionism among high-performing students and the lingering lack of belonging many students feel, particularly those with mental health issues and/or those with diverse identities. As the fall semester brings new and familiar challenges to students’ wellbeing, Dr. Garcia is ready and at the table.

LW: What was the thinking behind having a new position in this area reporting directly to President Beilock?

EG: I think her vision for the role was to elevate student mental health and wellness as a high priority but also to bring under one umbrella campus-wide health and wellbeing. Part of my portfolio is faculty and staff health and wellness so it was important to President Beilock to have that direct communication on all of the activities in this area across campus.

LW: How has your background in public health prepared you and/or motivated you to take on the position of Chief Health and Wellness officer at a college? 

EG: What brought me to this work came from what I saw in emergency departments during, and predating COVID, with adolescents and young adults in crisis. To me, that was really shocking.  When I started in the Department of Public Health {in Massachusetts} I partnered with the Mass Department of Mental Health through the community behavioral health programs, providing options that would divert the mental health crisis from emergency departments when appropriate.  I spent those two years heavily involved in the work we were doing to create an actual road map for behavioral health in Massachusetts. 

My background is in emergency medicine.  I useasthma as an example of the way we look at illness in the emergency department.  You would come to the emergency department after you had gone through your asthma action plan – “I’m a green, I’m a yellow, I’m a red,” — here’s how I step up my care so by the time you came to us, you had exhausted your plan.  Westarted to view behavioral health in the same way.  “I’m at home fighting with my parents, or “I’m depressed, I can’t leave my room” or “I’m in crisis, potentially I’m suicidal” – all of those scenarios have varying degrees of illness and severity.  Ifwe treated them all as emergencies, we would be failing our patientsand our ability to manage true crisis and emergencies.

LW: Do you have a similar strategy around health and wellbeing that you are utilizing at Dartmouth?

EG: When I first came here, it was important to explain to my colleagues what we mean by health and wellness because not everyone understands this. One of the things I did was develop a pyramid that shows the different degrees of mental health needs. The base of the pyramid is the 70% of the students we have here – very successful, high achieving – experiencing the stress that comes with that.  There’s another 20 to 25% who could use some clinical support.  The final piece at the top of the pyramid is the group of students who were most clinically concerning, potentially suicidal, and these are the student we need to act quickly to support and get into the appropriatesetting. 

The goal of this kind of structure is to understand that much of what we do is at the base – that 70% of our students need easy access to services and almost no barriers to the many wellness activities we should be providing across campus. The idea is that college is the right timeto experiment with wellness and to build your portfolio of activities and support strategieswhen you are successful – when you are at the base – so you can manage the challenges that will come your way.  You will be more prepared when you fail a test, or break up with your girlfriend, or have other challenges– all the things that challenge yourequilibrium andcould push you into crisis.

“College is the right timeto experiment with wellness and to build your portfolio of activities and support strategies when you are successful –- so you can manage the challenges that will come your way.”  

For the 20 to 25% in the middle, we have clinical  supports that help themmanage their illness, while also providing access to wellness activities.  With the smaller group, my job is to really help identify them as their situation evolves and get them the support that they need, and this can be a protective setting in a hospital if that’s necessary.  And it is really important that we don’t make them feel that they are alone.  You have to care enough about the students that require services outside of the college to partner with them – to give them time away, with support, and then bring them back with the appropriate accommodations. This is how I see my job.

LW: What have been some of your early priorities?

EG: President Beilock has recently completedher first year as presidentbut was very involved in the creation of the strategic plan for mental health and wellness before that. I would say the majority ofmy work since I came to Dartmouthhas been to implement that plan.  It has multipledeliverables and my job was to take that on and run with it, delivering on health and wellness as a priority for the president and for the campus.

Part of those deliverables involved new permanent staffpositions – across ourstudent health and wellness divisions.  It was really a huge investment by the college and we had to make sure those were the right positions and we were utilizing them in the right way.  

The Dartmouth community has faced several challenges since I arrived.  I think it is helpful to have a clinician at the table.  Health and wellness staff arenot enforcers, but supporters.  We arevery much there to support students, and help them engage in tough conversations. I think partnering with students has been one of the strongest game changers for me personally. I worked with them before as patients but now they are really partners to me in the work we are doing around health and wellness.

LW: What was the history behind the Commitment to Care plan?

EG: When Covid started, we (in reference to Dartmouth) were doing the best we could, but clearly it was very isolating on this campus and colleges across the country. It was not your normal college experience by far here and of course everywhere.  Beginningin 2020, we had several student deaths including bysuicide, and it was clear they needed to address what was happening.  In the summer of 2021, they brought the Jed Foundation in and that led to a major mental health review –  campus visits, survey data, all of that.  Additionally, the provost at the time set up a steering committee to work on an all-Dartmouth strategic plan on health and wellbeing from May 2023 to September 2023, that was the foundation of the Commitment to Care. It was across all campuses – undergrad, grad schools, professional schools. 

What makes it unique is that it is very stakeholder-driven, very student-driven and the result is this multi-year, campus-wide engagement with actual deliverables. What I found interesting when I first came to campus, folks would introduce themselves – students, staff, faculty – and they would say “I was on the committee for mental health” or “I was on the committee for health promotion.”

LW: What are the elements of the plan?  

There are five pillars to the plan which drive the many activities and initiatives that we are working on.  (From materials): Center wellbeing in all we do both inside and outside of academics; Create an inclusive community to foster mental health and well-being for students with diverse lived experiences; Equip students with the resources and skills to navigate both success and failure with strength and confidence; Proactively address mental illness to aid students in reaching their goals; Invest in innovative applications of evidence-based approaches to respond to changing environments and needs.

It is a very broad approach involving all aspects of the college.  Regarding the second pillar, we pride ourselves on attracting first generation students and students with diverse lived experiences, and it is important for us to center those lived experiences in what happens on campus, particularly here in rural New Hampshire. This includes how we address mental health and wellness and creating a sense of belonging.

President Beilock was clear that focusing on wellbeing is critical to a successfulacademic career. One of the key pillars for us is helping students navigate success and failure, this is number three.  There is an understanding that our students are incredibly driven. They are gifted and they are used to being at the top. They are not used to failure. But failure is part of succeeding and it is how you pick yourself up and move forward that is important.  We call it normalizing life.

Regarding wellness services, we have made significant gains here.  One of the first things I did was to move wellness to be a separate divisionwith a director reporting to me.  Our health services are really top notch and I wanted wellness to be on equal footing.  Additionally, we are arural community sometimes makingrecruitment difficult.  To better meet the needs of our students, we needed to find ways of extending and diversifying our services.  We partnered with a tele therapycompany, that gives us 24/7 behavioral health support for students and that made a big difference in accessibility when our team was not in the office.  We have several hundred students who have engaged with the service.  We have unlimited access to 30 minutes therapy slots any time of day or night and will beexpanding that to 50 minutes for those who need it.

The addition of the tele service didn’t lower our need for in-person services but it enabled other students to access therapy who might have been uncomfortable doing so before.  We know that a quarter of our students utilize our mental health services and that is similar across our student groups.  That is a significant point since historically, underrepresented students seek help less frequently. 

And the other piece – which I think is one of the harder ones – is thinking about data analysis and evidence-based approaches to make sure that what we are doing is impactful. This is really important because as we are delivering on a lot of these initiatives, we need to know what is helpful and not helpful and then redirect our time, energy and resources accordingly.

LW: You have said that some of your work is inside as well as outside the classroom.  What has been your experience there?

EG: There are a few tracks to this work, one involving academic policies and calendars that students have said would be meaningful to them in terms of reducing their stress levels over academics.  There’s also some interesting things faculty are doing in their classrooms by integrating mindfulness techniques in their academic disciplines including physiology and languages.   These are just some of the ways we are partnering with academic leadership, and I will say it does make a difference now that we are at the table.