Category: Mental Health

Last August, as Kent State University students were busy reconnecting with friends and settling into another year of college, professors John Gunstad and Karin Coifman were launching a research initiative that could improve their wellbeing and that of the thousands of students who come after them. The new Student Life Study is the largest and most ambitious investigation into the health and wellbeing of college students ever conducted. It will collect a high-dimensional data set on a group of 10,000 students and follow them throughout their lifetimes, providing real-time data on student mental and physical health. Gunstad and Coifman believe a study of this magnitude will eventually identify best-practice interventions, provide immediate access to health and wellness resources, re-structure university programming and decision-making, and even predict outcomes after graduation. 

“Our goal is to create a comprehensive understanding of what it’s like to be a modern-day college student in order to help them live happier and healthier lives,” said Dr. Gunstad. 

Longitudinal, population-scale research projects, like the Harvard Study of Adult Development, can provide a treasure trove of data as they follow individuals over the course of their lifetimes. But no studies of this scope and intensity have ever focused on college students. Dr. Karin Coifman is a clinical psychologist whose research focuses on following people over extended periods of time, particularly through stages of stress—including normative, developmental stressors like the transition into college. Dr. John Gunstad is a clinical neurologist interested in tracking changes in the brain over the course of a lifetime. Their combined expertise is now fully dedicated to helping improve the overall wellbeing of college students by looking at all the contributing factors – including mental and physical health, social belonging, academic and career success and equity and inclusion. 

An unmet need

The Student Life Study’s abstract states that “Current students represent a unique generation, the first raised entirely within the broader context of social media. Presently, U.S. colleges and universities do not have adequate resources to address this increased demand and existing surveillance and broad-scope interventional tools are limited. The Kent State Student Life Study (SLS) is designed to investigate complex and dynamical developmental shifts in psychological health and functioning in this generation of college students.” By understanding the unique social, cultural, and psychological challenges faced by these students, Dr. Coifman and Dr. Gunstad believe that universities can better accommodate their needs and support their development. 

A population-scale study of this magnitude and with this intensity of measurement has never been conducted on college students.

As Dr. Coifman explains, “college is a developmental period when the bad habits that drive many health concerns later in life are formed. There’s a shift that happens when kids leave home and come onto the college campus. They come with their history. They come with their risk. They come with their experiences and certainly patterns of behavior. But those things dynamically shift during the college years, and we don’t yet understand exactly how that occurs—which means we’re not very good at intervening.” 

Both Dr. Gunstad and Dr. Coifman speak passionately about the research methodology and the rigor of the study. The Student Life Study aims to gather data on a sample of 10,000 college students—not only while they are on campus, but after graduation and throughout their lives. The research methods range from surveys and video responses to physical health assessments, the combination of which is itself precedent setting. The model of the study involves both tracking behaviors and testing methods of intervention, discovering what works in real time. When something works, the researchers will make it available without delay—an intervention found to be effective will be available to all students and continuously refined. 

The process of data collection is equally rigorous, agile and ever evolving. “To capture developmental processes, you have to use a dynamic model for research,” Dr. Coifman says. “It’s often called a measurement burst framework, where you do these fits of intense measurement, and then you wait, and then you do them again, and then you wait and repeat. We’re doing that within a platform that’s really comfortable for this population. We rely on a lot of remote assessment, such as surveys delivered through the smartphone, as well as a process called ecological momentary assessment, a technique that allows researchers to observe behaviors and experiences in real time.”

In the Student Life Study, this assessment takes place during one week of each semester, when students will report their behaviors and experiences 5 times a day for a period of 7 days. “We’ve paired these periods of ecological momentary assessment with passive biosensing,” Dr. Coifman explains. This means hardware and software integration, pairing survey data with health data collected by a Garmin device such as a Fitbit or Apple watch. 

The study has “enormous scientific potential,” Dr. Coifman explains, in part due to the scope and methods of data collection. A population-scale study of this magnitude and with this intensity of measurement has never been conducted on college students. It allows the researchers to make better, more nuanced scientific inferences. “There are lots of population-scale studies following individuals over the course of their lifetimes, but the intensity of measurement is gathering data maybe once or twice a year. We are doing continuous, intensive sampling, and we’re also collecting biological data that other samples haven’t.” 

Phase 1 of the study began last fall and involves measuring the health, social behavior and academic performance of 10,000 college students during their time on campus. Phase 2 will follow these same students after graduation, studying how their physical health, mental and emotional wellbeing, social and professional lives play out over the course of their lifetimes. The researchers will use information gathered in both phases to identify predictors of successful outcomes, develop effective interventions for issues like substance abuse or mental health concerns, and understand how students’ college years affect the rest of their lives. 

The ultimate goal of the Student Life Study is to work with university administrators and decision-makers at Kent State and beyond to implement resources and best practices based on the findings of the study.

“We’re trying to capture all domains of operations,” Dr. Coifman says. “We are, of course, interested in psychological states, but we’re also interested in basic biological functions. We want to know how people are sleeping, how they’re eating, how they’re moving; what their social networks look like and how they experience social connection.” Additionally, the researchers will collect data on difficult experiences in students’ lives—as well as how they think about those experiences, and how different ways of thinking about difficult experiences affect life outcomes. At the end of every semester, students complete a survey detailing the primary stressors they encountered, as well as completing a video prompt where they discuss those sources of stress. They use the same method to record positive experiences and achievements. The video offers a platform for narrative response and, importantly, a window into the way students think. 

“Often what people say is much less useful for predicting outcomes than how they say it,” Dr. Coifman explains, adding that “subtle things, like how people use words or how the syntax moves in their phrasing” can help researchers glean qualitative information about how they are processing positive or negative events and emotions. Beneath the content of what students say, the psychology of how they feel about what they are saying opens another world of interpretation. 

With this ambitious undertaking comes a tremendous potential for meaningful change. The ultimate goal of the study is to work with university administrators and decision-makers at Kent State and beyond to implement resources and best practices based on the findings of the study. Dr. Gunstad emphasizes that helping universities reallocate their resources to better serve students in an important benefit. “Universities have limited funds for programming to help students succeed,” he says, noting that much of that funding is misallocated to interventions whose efficacy is unproven. “If we can help universities be smart about how they use those funds, we can create better outcomes for students.”

The Student Life Study is funded by a competitive “Game Changer” award sponsored by the Division of Research and Economic Development at Kent State University, which provides internal pilot funds to research projects at the university. When Phase 1 launched in August of 2023, the Student Life Study had amassed around $450,000 in funding to cover the first two years of the study. Dr. Coifman and Dr. Gunstad are grateful for the university’s investment into the program, and they agree that Kent State is the ideal setting for an initiative of this size, scope and potential outcome. 

With nearly 35,000 students across 8 campuses, the university’s geographic spread includes both rural and urban campuses in Ohio. Additionally, more than a third of Kent State students are first-generation college students, and a longitudinal study could have meaningful implications for that population of students. “These are individuals who are the first in their families to make their way into college,” Dr. Gunstad says. “Being able to capture information on that group is critically valuable to their development, and also valuable to us as a country and a society.” 

Dr. Gunstad also points out that past longitudinal and life course studies have typically looked at populations on the east and west coasts. Kent State’s midwestern location means that the study will fill in what past research has missed: “flyover country,” as Dr. Gunstad affectionately puts it. 

Additionally, Dr. Coifman emphasizes institutional support as a crucial element to the study’s success. “The potential of the study is in the commitment of this institution to this project. We are reaping the tremendous benefit of many institutional resources. I suspect that lots of institutions are very concerned with the fact that it’s incredibly hard to meet the needs of students today, and they simply have inadequate funding available to do it. The gap between the need and the resources is just getting wider and wider,” she says. Institutional investment into the Student Life Study may eventually mean that those limited resources can be reallocated to better serve students at colleges and universities across the country.

To learn more about the Kent State University Student Life Study, visit https://www.kent.edu/student-life-study. 

The following is a transcript of LearningWell Radio Episode 1: Understanding Languishing and Flourishing with Dr. Corey Keyes. You can listen to the episode on Apple Podcasts.

Marjorie Malpiede: This is LearningWell Radio, the podcast of LearningWell Magazine, covering the intersection of higher education and lifelong wellbeing. I’m Marjorie Malpiede, the Editor of LearningWell and your host today. Our first guest for our first episode of LearningWell Radio is Dr. Corey Keyes, the renowned sociologist and psychologist who has introduced groundbreaking work in the areas of flourishing and languishing. Welcome, Corey.

Corey Keyes: Hello and good morning.

MM: As a faculty member at Emory University, Dr. Keyes taught The Science of Happiness. He has a new book coming out called Languishing, and it’s actually available this week. Corey, let me say, I knew that you were a brilliant sociologist and psychologist, but I did not know that you were such a talented writer. Your book is really terrific.

CK: Thank you. I appreciate that. I take great pride in trying to write in a way that communicates the nuances and stories behind the numbers of our science.

MM: Well, I have to say that is exactly what my reaction was. I loved your opening, where you take us back to your teenage years and you’re listening to Jackson Brown’s “Running On Empty.” Loved that song. And of course, the reference to the King Biscuit Flower Hour. That was awesome. What a throwback. But the whole book is like that. It’s really very enjoyable to read. So anyway, big thumbs up for me as one reader, one reviewer, but let’s get into the book a bit and give a little bit of a preview for our audiences. First thing I’d like to ask you is, what motivated you to write this, Corey? You’ve been publishing for a long time, but this is really something special.

CK: Well, for a long time I’ve had a passion for advocating for better treatment and approaches to helping people with mental illness, and especially trying to get people invested in preventing it in the first place. Because I know we’re all on the same page when we hear again and again in the news that there’s a crisis in mental illness and that it’s growing. And the fact that I continue to hear about this crisis and that it’s growing, has led me to feel I’ve heard this enough, because the problem is nothing is changing. And I’ve waited and done the science for 25 years on promoting positive mental health in order to prevent, and I’ve felt that the science was solid enough, that there was enough there to write a book. And my dream is that this begins to encourage public health systems and systems like higher education, not the least of which I would also hope in public K-12 education, to begin thinking about prevention by promoting flourishing. So, my book is about trying to change the discourse and introduce another way to deal with the crisis of mental illness by promoting good mental health.

MM: Yeah, and it really does come across very loud and clear in the book. Reading it, it’s clear that it’s about the reader, so it will be about the person who could be benefiting from this information, but it’s also about all the sort of systems and institutions that influence what you describe as flourishing and languishing. I think my next question, for people who think they know the term but really don’t, I think commonly don’t, is how would you describe languishing? Because it’s not always what people think it is.

CK: No. And in fact, I think sometimes the simple descriptors don’t do it justice, because people will use the words either, “Meh,” which Adam Grant did in his New York Times op-ed, or “Blah.” And I don’t think those two terms do it justice, because I want to get back to the way I measure it, which is 14 questions that constitute measurement of the presence of good mental health, which I refer to flourishing, and languishing is the absence of some of these very important things. So to languish is not only to have lost a sense of interest in life or you’re not feeling happy or satisfied, but along with that, at least six or more things are missing in your life, like a sense of purpose, a sense that you’re growing as a person, a sense of self-acceptance that you like most parts of your personality. There’s some social components, like a sense that you are making contributions or you will make a contribution to the world or your community, a sense of belonging to a community, a sense of coherence, which is that you can make sense of what’s going on in the world around you. So, languishing is a constellation of things, but it’s the absence of functioning well, combined with the absence of feeling anything good or not feeling much of anything about your life. So in that sense, languishing is a lot more than just, “Blah.” It’s the absence of what makes life meaningful and gives you a sense that you matter and so forth.

MM: So, something you say in the book is interesting to me and it gets to that same sense of, do we really understand the language around this? So you say, “Don’t be fooled by feelings.” Explain that a little bit and how people may not understand if they’re languishing or flourishing.

CK: I think there is this obsession, and I think we in this country are particular leaders in the obsession with happiness, or what I would call the emotional part of flourishing, what I call the emotional wellbeing. This gets a lot of attention, and indeed, every year there’s what we call the World Happiness Report, which measures things like life satisfaction, “Do you feel satisfied or do you feel happy about your life?” And we rank countries based on the happiest and think they’re doing really well, and those countries that aren’t very happy. But flourishing is so much more feeling good. And I argue that if you focus only on and prioritize only feeling good, it will not be your North Star. ‘Cause I think of flourishing as my North Star because it’s what kept me in recovery from my own mental disorders of depression and PTSD, and it’s where I feel most at home. If you only prioritize feeling good without functioning well, you will not be doing well. And not the least of which is there are college students, a lot of them, about 20%, that would meet the criteria for flourishing in terms of happiness or feeling good, but they’re languishing when it comes to the criteria of functioning well. That means they have low levels of either psychological or social wellbeing, or both. And they have five times the rate of mental illness as those students who are flourishing. And by flourishing, I mean they’re functioning well. They have six or more of the criteria of functioning well every day or almost every day, combined with feeling good. So that in and of itself suggests that feeling good is not enough of a criteria or it cannot be considered a gold standard alone for doing well in life or even be considered mentally healthy. It’s not the feeling good, the feeling happy that’s really driving the benefits of flourishing, it’s the functioning well. Purpose in life, belonging, contribution, mastery, growth, and acceptance, all those good things that represent that we’re doing well in life. And so I always argue, put functioning well first and you will feel good about a life that’s meaningful and has substance.

MM: I think that’s so interesting because so many of us just think about the standards around feelings, happiness, or sadness, or excitement, or motivation, and we are not really thinking about the processes behind that. So that’s a really interesting way of looking at it. And is this really what you’d call your dual continuum model, that you can be mentally ill and mentally healthy at the same time?

CK: I review, in one of the chapters, an array of evidence that supports what I call the dual-continuum model, not the least of which is the research on the neuroscience of emotions. Now, I didn’t do this research, but I’ve reviewed it, and a lot of it is focused on negative and positive emotions, sadness in particular, and happiness. What they found in the brain is that sadness and happiness share some things in common when it comes to being activated in our brain, but they have a lot of distinctive things that go on. So when we’re feeling sad, the fact that they don’t overlap completely, meaning that when we’re sad, happiness isn’t completely downregulated in our brain, that’s not the case. We can feel both sad and happy at the same time, because they don’t share everything in common when it comes to activation in our brain. And I was writing about this very thing in my book when I realized that Susan Cain was about to publish a book as I was writing my book, and she wrote a book called Bittersweet. And I was writing about the fact that you can have bittersweet moments and feelings precisely because the brain is wired in the two continuum when it comes to just emotions. You can feel a little happy and a little sad at the same time. And on college campuses, I used to love teaching this particular part of my Happiness class during the spring semester when I had almost all graduating seniors. And as we got closer and closer to graduation, it became clear and clear that they understood this because they were feeling poignancy and bittersweet about their time at college and the fact that they now were about to leave it. They felt happy because they had accomplished something worthy of their effort and they felt sad because they were leaving behind something meaningful. So it goes much deeper than that. And mental health and mental illness belong to separate continuums. They’re correlated. But not correlated so strongly that the absence of mental illness means that you’re automatically flourishing. So, there is very strong evidence in a lot of that research I’ve done and done with colleagues, even at the genetic level, showing that we inherit two sets of genes. One set is what I would call risks, genetic risks for mental illness, and then there’s flourishing or positive mental health, which is also equally heritable as things like depression. But there’s only a modest overlap of the genetic variance or the genes for mental illness and mental health. So that means you can inherit a low genetic risk for something like depression, but the absence of genetic risk for depression doesn’t mean that you’ve also inherited a high genetic potential to flourish. But it also goes the opposite way, Marjorie, you could inherit a high genetic potential for depression, but you could have also inherited a high genetic potential for flourishing. And we now know that genes alone do not determine our outcomes. It requires environmental activation of a lot of our genes. So as I like to say, when you’re in that situation where you’ve inherited high genetic risks along with high genetic potential, you ask yourself the version of the negative wolf and the bad wolf, which one wins? The one we feed. Right? So there’s very strong evidence of the dual-continuum model, and that makes the case very strongly that even if we could find a cure, and we’re not anywhere close, even if we could cure all mental illnesses tomorrow, it wouldn’t necessarily mean everyone’s mentally healthy, and we could have just left them in another equally bad condition, languishing.

MM: So, Corey, let me just say, what I love about your work is that it gives people hope, and it looks at these issues in a way that not just destigmatizes them, which you’ve done, but also allows people to give themselves a bit of a break around this. But let’s talk about Languishing and why you wrote this, because so many people are languishing. And you talk about the pandemic and how that obviously accelerated these issues, but also, they weren’t the cause of them. In fact, I think one of the things you say is, because we were sort of sliding into languishing, it was harder for us to be resilient to what happened in the global pandemic, if I got that right? But let me ask a few questions again about the mental state and how people can get out of it. So you talk about why languishing is really a risk to your mental and physical health. Can you talk a little bit more about that?

CK: Sure. In fact, I list at the very beginning a lot of evidence that supports, I call it the 13 reasons why you want to take languishing very seriously, and why we want better mental health and flourishing. Not the least of which I haven’t focused as much on physical health, there’s a little evidence I review when it comes to aging, but the one in particular that really stood out for me is this very strong body of evidence that has to do with what’s called the conserved transcriptional response to adversity. Not my words. That’s the words that some biologists and geneticists gave to this genetic propensity we all have. And the CTRA is activated when we experience adversity, and it’s not healthy for us, because when that CTRA, forgive the abbreviation ’cause it’s a lot to say, is activated, it downregulates antibody production, which is not good. We want antibodies for our immunity, immune responses. So when the CTR is activated, antibody production is suppressed and inflammation is accentuated or activated. Again, inflammation in and of itself is not good for us. And so researchers have been looking for things that actually buffer, mitigate the CTRA when we are experiencing adversity. And here is the amazing thing about the distinction between feeling and functioning when it comes to flourishing. Feeling happy and satisfied has no relationship to modulating the CTRA, but when you have higher levels on functioning well, that is, that goes into my measurement of flourishing, higher levels of particularly psychological wellbeing, people then have a much more modulated or controlled CTRA response. It means that if you are functioning well and you are experiencing stress and demands and adversity, you are protected against the CTRA. And if you aren’t functioning well, higher psychological wellbeing, the CTRA is activated very strongly when you experience adversity. So that’s just one very strong physical underlying genetic /physical response. It’s deeply connected to the functioning well part of flourishing, not the feeling good.

MM: So, if I’m understanding this correctly, it’s almost like you can strengthen your flourishing muscle, so to speak. Right? To have some of what is happening in terms of the languishing and the conditions and elements around that, you can influence or even prevent it. Correct?

CK: Yes. In fact, there’s two studies I reviewed that I just love, one of which is in the work. And you can think of college, a university setting in the same way you can think of a workplace. And this particular study was done in Australia, and they asked workers, “Yes or no, are you currently working in a high stress or hostile, if you will, work environment?” That was the beginning of the study. And then they measured psychological distress over time, and they measured at time one their level of positive mental health. What was remarkable, is over time, if you were flourishing, working in a high stress or high conflict work environment did not result in any more distress than compared as those who are working in a low stress, low conf environment. But if you were languishing and working in a high stress and high conflict work environment, you had a markedly higher increase in distress over time than if you were flourishing. So flourishing in the work settings protected you from having stress and conflict undermine your mental, emotional life. And then there was this second study that I reviewed that followed people over a three-week period and every day asked them whether they had experienced any of several sources of stress, things like the typical sources of stressors, like there’s conflict at work, you had an argument with your boss or your spouse or your friend and so forth. What was amazing about this study, was if you were flourishing, you experienced the same amount of sources of stress as those who are languishing. And in fact, in a three-week period, 84% of the days of those three weeks were filled with sources of stress. So most days. You only had three days out of the three-week period where you didn’t have any source of stress. So everyone was experiencing stress, but then they measured negative mood that day. And here’s the remarkable thing, if you were flourishing and you experienced source of stress, you’re much less likely to have negative mood as a result of it compared to those who are languishing. If you’re languishing, those sources of stress resulted in a much more negative and foul mood at the end of the day than if you are flourishing. So it’s not like if you’re flourishing, you don’t have bad days, you have as many bad days, if you will, or sources of stress at least as those who are languishing. But again, there’s something about flourishing that protects you from having bad things really result in bad feelings. Again, we don’t know why, but then again, I go back to the following thing. Did we not need to know how smoking caused cancer in order to prevent cancers from smoking? No, we just needed to know that smoking caused cancer. And here, I’m not so interested in how flourishing protects us, just that it does, and we need more of it in our students and we need more of it in our lives, in the workplace.

MM: So Corey, I’m completely convinced that flourishing is the goal, and I think to learn how to get into that state of flourishing is part of what you do in the book, and I want to get to that. Am I correct in saying that there are kind of two elements here to unpack? One is, and I love that you do this, you talk about in your book the propensity for society to consider whether you’re languishing or flourishing to be a matter of personal responsibility. It’s either you do it or you don’t, and it’s all about you. But you do point out that many times our systems are failing us. Can you talk about that in the context of higher education?

CK: I couldn’t help but be the sociologist because I’ve been living a lot of my life in both in psychology and sociology, and I’m amazed the amount of work that’s been published in positive psychology, and psychology in general, that simply ignores the power of context and institutions and culture and values and so forth. And so it was clear to me. I talk about my own personal experience. Before I was adopted at the age 12, things were horrible for me. And I was going in one direction and it was in the wrong direction. I was in detention more than I was anywhere else after school, and I was not doing well and so forth. And when I got adopted into my grandparents’ home, it was a 180 degree change, and it was remarkable to see and I still marvel at it. I went from being in detention to honor roll student, every semester, to quarterback of the football team, playing basketball, in the choir. Something in me changed, but it was because I was transplanted in a place where I could flourish. And so I knew that was the first time I experienced flourishing. And in my dedication to my book, my whole book was dedicated to my nana and papa, who when I experienced that, they gave me the seeds of flourishing because I never forgot that. And so it’s clear to me that people are really struggling, even people in high-level professional jobs like medicine. And I write about one op-ed that just floored me, but this was not the only doctor who’s lamenting the fact that they’re having to work in a, they call, a corrupt, profit-driven institution that’s demoralizing them. Because they have to cut corners and they can’t do the things that they want to do and need to do as doctors to help their patients because hospitals are sitting on massive profits, but they’re cutting corners. And what’s happening to people is they can’t live their values. And when that happens, when they’re demoralized, you start to destroy the person that came to you with values and dreams of using their work to do good. And when you prevent people from doing and living their values to do good things through their work, you begin to destroy them. And that’s what languishing is often described as, “I’m dying inside,” or, “I feel dead inside.” Now, I won’t say that higher education is doing the same, but I do worry that, I think, there’s a lot of, well intentioned leaders, people who want students to find purpose and live their values, but I saw this firsthand, we’re grooming our youth to value one thing, money and power, by everything is boiled down to grades. And I know you’re going to say, “Well, what do we replace grades with?” But grades are all that matter because that’s all that matters to us. And at first, I was frustrated as a professor. I would’ve kids coming into my office crying because they had an A minus or a B plus. Something is wrong with what we value in higher education.

MM: LearningWell Magazine examines the intersection between higher education and lifelong wellbeing. So not just how we experience college and what happens to our mental health at college, but how college influences our wellbeing over time and over your lifetime. So obviously, it is a great conversation for anyone who cares about any of those issues. Not to put you on the spot in terms of specifics, but if flourishing is the end goal for our students, and we’re faced with the mental health crisis that we all know and are working hard to address, shouldn’t we, and what could we be doing to really try to promote flourishing on college campuses?

CK: Well, the second half of my book talks about what I’ve come to call the five vitamins for flourishing deficiency. And those five activities that flourishing people do more of than people who are languishing, which is they prioritize some form of helping others. They prioritize learning something new and growing personally, they prioritize spiritual or religious activity, they prioritize socializing or connecting warmly and belonging, and they prioritize play. Now, those five things I was just thinking about this morning before we got on, and it occurs to me that you would think that those five things are already happening on most college campuses, maybe not as much play, but wouldn’t you think every day a college student learns something new and sees him or herself growing? And I see it that college students connecting and socializing every day, not everyone perhaps engages in spiritual or religious activities, but many of them do and so forth. My question becomes, if many of the students are doing those five things already, but they’re not flourishing, what is it about colleges that may prevent those five activities from being as beneficial as they could? ‘Cause they are for adults who aren’t in college or who are after college. And I wonder sometimes if it’s just that students, like many of us as adults, would read a book like this and say, “Well, let me fit in some of these things in 5 or 10 minutes of my busy day or my busy week.” And I didn’t write it that way. In fact, I was sometimes encouraged by people around me saying, “Well, just tell people what they can do in the 10 minutes they have if it’s a typical day or a busy day.” And I was like, “No, I’m not going to do that. That’s not the way this works.” Because people who were really benefiting from those activities did more of it in that day. They helped more. They didn’t just help someone. They engaged in more helping behavior that day and they had a much better day and they stayed flourishing. And if they were languishing, or in the study, there were some people who were depressed who did more of each of those vitamins. And they didn’t have to do all five, by the way. They just picked one and they did more of that day. Even if they were languishing or depressed, they had a better day. And over time, they moved away from languishing or depression, and inch by inch closer and closer to flourishing over time. So those five activities aren’t things to just do as a sort of 5 minute or 10 minute exercise, like breathing or taking a couple deep breaths, or meditating for a minute and quieting your stress response. These are things that have to become important parts of each day. And that’s why I’m convinced, even if people on college campuses or administrators read the book and say, “Wow, I think most of my students are doing these five things, or at least three out of the five, but they’re not flourishing.” Well, it’s because their priorities are much more related to one thing, study, study, grades, grades, degrees, degrees, and the next step.

MM: So it’s almost like if institutions, colleges, and universities really made flourishing their North Star, that would really change the conditions by which students could be working to engender their own flourishing. Would you say that’s right, Corey?

CK: Yes. I could imagine a university prioritizing and measuring this and taking it just as important as GPAs and resumes, and that they prioritize those five vitamins to such a degree that they counted in the same way that taking a class is given credit and you get graded. ‘Cause that’s the one thing I learned, if students don’t get credit, they don’t think it’s important because they infer the institution doesn’t think it’s important. And so somehow, I think we need to teach these things and value them to the same degree, and measure them and monitor them in the same way that we monitor grades and provide that. And my dream, as I said in some of my writings, as when a student walks across that stage to get their diploma, we can tell them, to the same degree, that their flourishing has grown as a result of being here to the same degree that their knowledge and GPA reflects their learning. When that happens, I’m convinced students will get the message. They will learn about their own wellbeing, their own mental health, and what it means to them that the institution values it as much as they do, and that this is what you’re given as your journey through adulthood from this institution. Not just a degree, but a sense that your wellbeing is something you need for this journey.

MM: That’s awesome. So Corey, we have learned so much today, and obviously I would encourage our listeners to read the book and learn even more. When you think about all of the important messages here, who would you say you wrote the book for?

CK: Well, you will notice that this is part memoir because my research was, as I said, me-search for a better way. And I wrote this, forgive the phrase, but it’s part of my heart, for all of the lost souls. And there are many of us, and I think many of us are lost without knowing it. And there is this poem I want to read to you, this is why I wrote it. And it’s a poem written by Athey Thompson, and it’s taken from her book, A Little Book of Poetry. And I wish I’d seen this poem before I finished the book because it would’ve been the way I ended it, but here it goes. “I shall gather up all the lost souls that wander this earth, all the ones that are broken, all the ones that never really fitted in. I shall gather them all up and together we shall find our home.”

MM: Well, that needs to be the last words for the interview. That was amazing, Corey, and I thank you so much. So, we’re talking to Dr. Corey Keyes. His new book will be out at the end of February, it’s called Languishing, and it will be an important experience for anyone who reads it. Corey, we are so excited that you came and talked to us today and shared all of your wisdom. I am so grateful. Thank you so much.

CK: Thank you for having me.

Ian Elsner: This has been LearningWell Radio, a production of LearningWell, for more information about our work, go to learningwellmag.org. And if you like what we’re doing, leave us a rating or review. LearningWell Radio is engineered by me, Ian Elsner. Thanks so much for listening.

Around the turn of the century, psychiatrist Holly Rogers noticed an emerging trend among her student clients at Duke University. Many of them were coming into the student counseling center with a variety of mental health problems driven by what seemed to be a lack of resilience; an inability to sit with discomfort, distress or disappointment. She concluded that helping her students develop the coping skills needed to confront these emotions would lead to a myriad of benefits, including alleviating what would soon grow to be a capacity crisis at college counseling centers across the country. 

Nearly a quarter century later, Rogers’ professional observation has become a personal mandate to help address some of what today’s college students are struggling with – including anxiety, depression and loneliness. She is even more convinced today that practices such as mindfulness can help many college students regulate their own wellbeing in a world that has only become more stressful. She and her colleague, Libby Webb, the former associate director of counseling and psychological services at Duke, founded the Mindfulness Institute for Emerging Adults (MIEA) to bring the evidence-based program in contemplative practices developed at Duke to colleges and universities around the country.

“Something more has got to be done,” said Rogers, MD. “There needs to be a top-level paradigm shift to change the culture on our campuses so we don’t have academic success over here with all its metrics and then ‘here’s a few things we do for wellness.’”  

Rates of anxiety and depression reported by college students have been on the rise for more than a decade, and the responsibility of addressing the crisis has been largely laid at the door of college counseling centers. But capacity problems have coincided with a growing recognition that subclinical emotional issues can and should be addressed by opening up the circle of care on campus, and that combatting the college mental health crisis requires adding a preventative, public health approach, along with a treatment response. Enter mindfulness. 

“Mindfulness is the skill and capacity to bring our minds to the present as opposed to galloping towards the future or dwelling in the past,” said Webb, MSW. “And doing so with a non-judgmental awareness of where our minds tend to go. You just notice it and bring your attention back to the present.”

Mindfulness has become a big business, complete with YouTube channels and celebrity endorsements, and it is clear the practice can work for people of any age. But Rogers and Webb believe it is particularly beneficial for emerging adults: traditional college-age students who are navigating emotional land mines such as test anxiety, social media-induced self-doubt, and vulnerability to substance use. “What we know about this developmental stage is that it is filled with ambiguity,” said Webb. “‘Who am I? What do I care about? Who am I going to love?’ And we know that the brain doesn’t like ambiguity. It detects a threat, so it’s a time of high unease.” 

Webb says that because their brains are still fluid, young people are more adept at flexing into other patterned behaviors if exposed to them. Skills-based practices like mindfulness can calm their brains, which helps them make better choices, examine their purpose, and identify what is important to them. In 2023, the American Council on Education strongly endorsed mindfulness programs with supervised practice in its report, “What Works for Improving Mental Health in Higher Education,” adding to a strong body of evidence already in the literature.

“Research is showing us more and more that this capacity to be in the moment reduces suffering and improves attention,” said Webb.

For several years, Duke offered the program developed by Rogers and her colleague Margaret Maytan, MD, in the form of a four-week, opt-in course, involving a teacher and group discussion.  While it was slow to catch on, it eventually took on waiting lists. They called it Koru, a Maori word used for an unfurling fern frond symbolizing stability in the center of unfolding growth. With refinements to the curriculum over the years, they began an effort to assess its effectiveness in 2012. The results of its randomized controlled trial were published in the Journal of American College Health and became that publication’s most downloaded article in 2014, around the same time the Healthy Minds survey showed a solid upward trend in mental health problems among college students. In the trial, students who had taken Koru reported a reduction in stress, an increase in restfulness, and a greater sense of self-compassion, among other findings.  

Skills-based practices like mindfulness can calm their brains, which helps them make better choices, examine their purpose, and identify what is important to them.

Interest in practices like Koru on college campuses has grown steadily since then, motivating Rogers and Webb to leave their positions at Duke to focus full-time on expanding the program through a “train the trainer” model. Individuals from other universities began coming to the center, recently renamed MIEA, in Durham, NC, where they receive training to become MIEA-certified teachers and then go back to their campuses and offer the courses in a variety of forms. 

Since the pandemic, MIEA has offered the certification program online, which has accelerated the number of schools and individuals participating in the program. Rogers said that MIEA has now trained 1,500 teachers in 14 different countries and taught over 70,000 students. Institutions range from the Ivies to community colleges. You don’t have to have a clinical background to become a MIEA teacher, only some background in contemplative practices. If you don’t, they will help you cultivate one.  

MIEA’s first non-Duke client was Harvard University, which continues to offer a variety of classes each semester and has 12 MIEA-certified teachers within its Center for Wellness and Health Promotion. “I have been teaching MIEA classes for over 10 years,” said Amanda Ayers, MPH, Harvard’s Director of Health Promotion. “It is such a joy to see the changes that students make in just four weeks. They are able to be more present in their everyday lives, spend less time on social media, and are kinder to themselves.” 

How mindfulness practices are taught and who chooses to teach them illustrates their versatility and low barrier to access. In an environment as siloed as a college campus, mindfulness curriculum like that offered through MIEA can weave through departments and requirements – a credit-bearing course here, an elective there. Mindfulness teachers are often connected to traditional fields like health promotion but can include anyone in any discipline who sees the value of improving student wellbeing. Evidence on the connection between mindfulness and attention attracts professors and academic advisors worried about student disengagement and burnout.

“You can embed this curriculum into your first-year seminars, your physical education classes, or as an extra credit elective,” said Rogers. “We have faculty in business schools who are offering the curriculum in conjunction with their academic material.”

The individualized nature of the MIEA program is both an advantage and a challenge. The curriculum, which comes with an app and a teacher dashboard, takes different forms at different price points. To date, MIEA’s business model is to sell the program to individuals within schools such as faculty or staff working in the wellness center who might use professional development funds to pay for it. Rogers points out that this case-by-case model lacks the consistency and traction needed to make mindfulness a universal benefit. Professors get busy. Funds dry up. The team is now offering the MIEA program directly to institutions at a much larger scale, hoping the urgency of student mental health will spur a university-wide commitment to wellbeing.  

“We’re asking universities to make a commitment both to us and to their teachers if they want to really make a difference on their campus,” said Rogers.  

Mindfulness in Action

Eric Teske directs the Office of Health and Wellness Promotion at Indiana University, Indianapolis. His interest in the MIEA program came from his desire to “take pressure off of the counseling center” by offering a program that could be taught by trained teachers to students who could be helped in non-clinical contexts. After hearing a presentation by Libby Webb during the pandemic, Teske was determined to get a number of people on campus trained and certified through MIEA. Making it a free professional development opportunity was an added incentive. He funded the trainings through a grant from the state’s Division of Mental Health and Addiction.  

“In helping students understand their own thoughts and feelings, we are equipping them with self-regulatory skills, self-management, and that is all part of alcohol and drug prevention,” said Teske, MS, CHWC, who urges institutions in other states to explore the use of similar public funding.

The person who brought Libby Webb to IU was Nancy Barton, MS, a senior lecturer in the School of Health and Human Sciences’ Department of Kinesiology. With a background in meditation, Barton had been interested in becoming MIEA certified but didn’t find the time to pursue it until the pandemic,when the online option provided an opportunity — and even more students were reaching out for help. 

“Once I got it [the certification], I really wanted to work with my university to see it take off,” she said.  “So many people would say to me, ‘I am really worried about the mental health of my students, but I don’t know what to do.’ Now I could say,‘here’s something you can do.’”

Teske and Barton were part of the university’s Wellness Coalition, an ad hoc group of wellness enthusiasts who informally met to strategize about tactics to use on campus. Another member was Lisa Angermeier, PhD, MCHES, a senior faculty fellow in the Institute for Engaged Learning, which focuses on first-year experience and high impact practices. Together, they led an effort to embed the MIEA curriculum as a pilot program into selected sections of the first-year seminar. Now, the course is not just a credit-bearing option in the Department of Kinesiology, but a required course for first-year students.

“We wanted to offer students more tools, right from the beginning of their college experience to help them deal with the stress they will encounter,” said Angermeier. “But we also see this as something they can take with them and use for the rest of their lives.” 

An assessment of the program indicates that 62% of the first-year students found the program to be valuable. The team considers this statistic a positive outcome, considering that students do not opt-in to the program. Requiring mindfulness courses is a matter of debate among experts, with some saying it takes away from the self-agency of the practice, but Angermeierviews it as a way to plant a seed of self-care, even for those students who may be reluctant. Equity was another driver. 

“Oftentimes with opt-in programs, we see that the students that get there first come in with more social capital while those who lag behind lose out,” she said. “These are the students who often need it the most.”  

Valencia College in Orlando, Florida is also utilizing the MIEA curriculum. One of the largest, multi-campus community colleges in the country, Valencia is diverse, both in terms of its students and in the broad range of developmental stages in which they come to campus. Marcia Roman, EdD, ThM, is a counselor and faculty member at Valencia, where she and her colleagues do case management-type work, connecting students to clinicians when necessary and providing workshops and skills-based training. She said the MIEA curriculum “blended beautifully” with their model.  

“Our students can learn basic skills that you might even describe as mechanical – like how to breathe in a way that activates the parasympathetic nervous system, which will calm them down – but it’s more than that. For some, it has been life-changing. With mindfulness, they can move through the difficulty in their lives as opposed to all the manner of ways we try to bypass it. And they can do so without tremendous cost and with little risk.”  

The accessibility of mindfulness is one of its biggest selling points and something Rogers and Webb are promoting before potential higher education clients. Vivien Roman-Hampton, MSW, LICSW, is MIEA’s new Director of Outreach and Teacher Development. Part of her job is encouraging MIEA teachers to become trainers with a particular focus on bringing in people with diverse backgrounds.  

Roman-Hampton believes that when colleges and universities offer these services to students of all backgrounds and abilities, it says to them, “We see you and we want to support you.”

“My focus is on ensuring that the practices are accessible to anyone who isn’t what we would call ‘mainstream,’” she said.

Her interest in MIEA is personal. A clinician who works with clients from marginalized communities and is from one herself, Roman-Hampton was drawn to MIEA’s work because of its low cost and long-term benefit. “So much about self-care costs money, and that becomes a barrier to people,” she said. But Roman-Hampton initially questioned the lack of diversity among the training staff, which she said would be an issue for her clients. When she expressed her concern to Rogers and Webb, they encouraged her to help diversify the practice, and she joined them officially two years ago.    

Roman-Hampton believes that when colleges and universities offer these services to students of all backgrounds and abilities, it says to students, “We see you and we want to support you.”

Asked if mindfulness programs offer a particular benefit for marginalized groups, she said, “I think the practice allows us to sit with things that might be really difficult — like how the world sees us versus how we really are. And while we can most definitely work to create change, it is also exhausting, and not everyone will change as a result. But that doesn’t mean we have to keep absorbing it the way we have historically. Mindfulness is a way to sit with suffering but not let it destroy you.”

Listen to this story:

When Joey left his hometown to attend a prestigious out-of-state university, his mother was in hospice care for a rare sarcoma, a terminal cancer affecting the body’s soft tissues and bones. Two weeks into his freshman year, her nurses warned the family that Joey’s mother was in the final days of her life. Joey returned home, and his mother died the next day.

Joey’s mom had encouraged him to go to college, find community, and engage academically and socially with his campus. In the wake of her death, he no longer knew what that looked like. Joey went back to school one week after losing his mother, uncertain of his options and fearing the academic consequences of missing classes. When he emailed a dean at his university to explain his weeklong absence, an administrative assistant wrote back, asking Joey to provide a copy of his mother’s obituary.

“I didn’t want to dig myself into a deep hole in my first semester,” Joey says. “My university didn’t really know what to do with me, so I went back after a week. That’s when things really started to go downhill.” He describes feeling “indirectly rushed” to return to campus, having no knowledge of the university’s academic accommodations or leave policies. No one from his university’s administration reached out to make Joey aware of his options for support in or out of the classroom. He did not know until his second semester, after months of depression and isolation had taken a toll on his transcript, that he could have been graded on a Pass/Fail basis, allowing him to proceed with a clean slate. 

“My grades were very poor,” he recalls. “I had no study habits whatsoever. Seeing my GPA, seeing that it didn’t reflect the kind of student I am, it just made me more depressed. And then socially, it also took a huge toll. I was living in my dorm room most of the time.” Watching his grades drop over the course of his first semester, Joey says, compounded the cycle of anxiety, overwhelm, and pain—but what choice did he have? Without clarity on his university’s policies on grief and bereavement, Joey believed his only option was to keep going, soldiering on through the daily slog of academia, held to the same standard as his peers.

Death is a sensitive subject even for family and close friends, often leaving us at a loss for words, choosing to say nothing for fear of saying the wrong thing—so how should a college or university respond when a student loses a loved one? That question, at once ethical and practical, is the driving force behind UGrieve, a new initiative by the Parmenter Foundation designed to help colleges support students as they navigate the loss of a loved one while balancing academic and social commitments at a time when they may be living away from home for the first time. 

Established in 1949 as a provider of medical care in MetroWest Massachusetts, the Parmenter Foundation offers end-of-life and bereavement programs, resources and education, as well as grant funding for other nonprofits that provide services such as grief support groups for all ages, guidance for educators, and hospice care. The foundation launched UGrieve with interviews of three college students who describe feeling isolated, disoriented, and unsupported while grieving on campus.

“Our understanding, based on anecdotes from bereaved students, parents, and also counselors and administrators, is that higher education institutions do not have systems, policies or protocols in place to support students who have experienced a death in their family,” says Angela Crocker, Executive Director of the Parmenter Foundation. “It seems colleges and universities can be accommodating to students who are grieving, but only if the students know what to ask for and whom to ask.” 

The confusion and ambiguity that accompanies students reentering campus life after losing a loved one is an additional stressor for grieving families. “We’ve talked to moms who have lost a husband who say, ‘I’m grieving. I’m in shock. And then my son needs to go back to school, and I feel like I’m sending him into a black hole, and nobody’s looking out for him,’” says Jennifer Siegal, Communications and Programs Manager at the Parmenter Foundation.

The fear of sending a student back into a “black hole” of grief and bereavement protocol is far from unfounded, as Joey’s experience lays bare. Colleges tend to be pro-active only when a death (usually of a student) occurs on campus, assuming that what happens at home falls outside their institutional responsibility. As a result, according to Crocker, bereaved students are not only emotionally gutted, but often left feeling pulled between family and school obligations. 

“Colleges and universities can be accommodating to students who are grieving, but only if the students know what to ask for and whom to ask.” 

Joey’s older sister was their mother’s primary caretaker while their dad worked, he says. She made the preemptive decision to take the entire fall semester off from school, because she did not know when her mother would pass away. Joey describes feeling torn, longing to be at home to grieve with his loved ones but fearing falling behind in his academics. He reminded himself that his mother had encouraged him to make friends and “make his mark” on campus, something that seemed impossible as he struggled just to stay afloat.

“When college students have to confront the loss of a family member, they are immediately pulled between their two worlds of school and family life,” said Crocker, who noted the chasm is even wider for international students. “This pull is aggravated by geographic factors, multi-faceted academic demands, and oftentimes by the uncertain timeline at the end of their loved one’s life. No one is prepared for this. Colleges and universities need to understand this painful dynamic and provide balance and support—not demands—to students who are grieving.” 

Another barrier is the disconnect around bereavement and mental health support on campus. Siegal and Crocker emphasize that bereavement is a component of mental health, yet as colleges have increased cultural awareness and attention to mental health, grief and bereavement have been largely excluded from the conversation—despite the fact that the death of a loved one is correlated with a higher risk of depression, anxiety, post-traumatic stress disorder, and compromised physical health due to chronic stress.

How to Help

Colleges and universities do recognize the need. According to Siegal, administrators and decision-makers in higher education have expressed uncertainty surrounding best practices—they, too, operate in the dark, without a clear, universal protocol for students. “We saw that there was a demand for support in this area,” Siegal says, “so we started to put a program and initiative together. We interviewed students and created the video just so people could see that there really is a case for this work, and data show there are hundreds of thousands of students losing a loved one each year. This is not a small problem.”

“When college students have to confront the loss of a family member, they are immediately pulled between their two worlds of school and family life. Colleges and universities need to understand this painful dynamic and provide balance and support—not demands—to students who are grieving.”

The UGrieve program provides data and information about bereavement and makes recommendations to colleges on how to “build compassionate campuses” through policy changes. The UGrieve program urges colleges and universities to implement a “point person” to inform students of their options, communicate with professors, and coordinate accommodations as needed. The point person, she says, would ensure that grieving students will not be forced to make hurried decisions about their academic futures without full knowledge of the school’s policies and the resources available to them. “College students who have suffered a loss experience a sense of grief and isolation that inhibits them from navigating their classwork, effectively communicating with professors and accessing even the resources that are readily available on campus,” says Crocker. “Colleges and universities can overcome this disconnect by assigning a single point of contact to guide a grieving student on every accommodation available to them.”

Additionally, Siegal says, universities can implement training programs for faculty, staff, and students to make it easier for them to approach conversations with people who have lost loved ones. “It can be awkward,” Siegal acknowledges. “If someone brings up the death of a loved one, a roommate or professor won’t always know what to say.” Trainings and educational resources, she says, can create a grief-ready campus. The UGrieve mission is to “build compassionate campuses” where bereaved students are not neglected as they struggle to navigate classwork and social lives in a time of grief. On a compassionate campus, faculty will be better prepared to accommodate students who lose a parent, caregiver, or sibling. Bereaved students will have a point person to direct them to campus resources. Roommates and friends will be better equipped to recognize signs of isolation and depression.

UGrieve suggests that the first step to creating compassionate and informed campuses is to include grief and bereavement in conversations about mental health, including legal conversations. In 2023, several U.S. senators, including Massachusetts’ Edward Markey, introduced the Student Mental Health Rights Act, which would require the Department of Education to issue guidance to institutions of higher education to ensure compliance with federal law on mental health disabilities. But for some students, there is a glaring gap in the legislation: “It mandates colleges to provide accommodations for students who have anxiety, depression, substance use disorder, and they don’t include bereavement,” says Siegal. “So we’re working to compel them to include bereavement in the legislation. The accommodations they are proposing for supporting students with mental health struggles are very similar to what we are recommending for students who are grieving.”

With advocacy and hands-on resources, the Parmenter Foundation hopes all colleges and universities will examine the strength of their bereavement programs and consider them an important part of creating compassionate campuses.

After his mother was diagnosed with cancer, Joey says, “She fought till the very end. She wasn’t willing to give up or back down without a fight. It’s still a huge inspiration. When I’m thinking about giving up, or when I’m at my lowest point, I always think: What would my mom say? What would my mom do?”

When Joey returned to school for the second semester of his freshman year, he arranged a meeting with the dean of students and the dean of the business school. He described his experience, telling them that it was the experience of many students who were suffering in silence, not knowing where to turn for help. He says the deans listened: they wanted to do better. They listened to a student who had felt neglected, left to fend for himself—and they took his suggestions seriously, proposing new protocols for grief support with the goal of making campus resources clear and accessible to all students.

Now a finance major with a minor in economics, Joey has cultivated a sense of belonging and hope on campus, living a life beyond his dorm room. “I don’t hate this school,” he says. “I love being here. It’s a great fit for me. I just wanted to make it better.” He has worked with UGrieve to build a compassionate campus for future students, who he says he hopes “will be treated the exact opposite” of how he was. For Joey, a compassionate campus is one where students can spend time at home to grieve with their families, knowing that they will be accommodated and welcomed back to campus; where students know who to reach out to and where to go for help; where professors have built-in procedures to grant extensions and forgive missed work when a student loses a family member or caregiver. And a place where an administrator will be less likely to ask a student for his mother’s obituary as proof of death.

To learn more about UGrieve, visit https://parmenterfoundation.org/ugrieve/.