There's no way to get around it: It’s a hard time to be a University student. Just ask Mackenzie Callaway, who’s earning her Ph.D. in biomedical engineering at the U of M’s College of Science and Engineering.

“I think there are just a lot more stressors for young people these days,” Callaway says. “There’s climate change, the economy, politics. There is an increase of students who are homeless or facing food insecurity. And on top of that there’s Covid-19. There are so many things happening in the world right now. It’s a strain on our collective mental health.”

The collective strain that Callaway mentions is top of mind for University of Minnesota President Joan Gabel, who, from the first days of her administration, has identified student mental health as a central focus. To emphasize that, in February 2021, Gabel announced the creation of the President’s Initiative for Student Mental Health (PRISMH), a systemwide effort designed to bring together University services, programs, policies, and academic practices to address student mental health by using a public-health approach grounded in data, practice, and research. 

The PRISMH initiative will focus on creating a centralized listing of the mental health supports already existing at the University while also identifying key new areas for inquiry, research, and partnership. Two respected members of the University community, Maggie Towle (B.A. ’81), senior associate vice president for student affairs, and Tabitha Grier-Reed (M.A. ’99, Ph.D. ’04, Ph.D. ’05), professor of family social science, are leading the effort. Both Grier-Reed and Towle say they realize that they have their work cut out for them, but are excited to take on the challenge.

To give a sense of the level of need among students, Towle points to the semiannual student health survey released by the University’s medical center for students, Boynton Health. “In the past years, we’ve seen the mental health [concerns] numbers go up,” she says. “In the last survey, for instance, 42 percent of our incoming class has a preexisting diagnosis for mental illness. That number has increased every year.”

Grier-Reed has also seen signs of strain in the students taking her classes, which, during spring semester, were all held virtually. “I’m seeing more D and F grades than I would typically see,” she says. “I’m seeing more incidents of academic dishonesty than I would typically see.” She chalks some of that up to the, “cognitive strain of being on the internet all of the time,” which puts psychological pressure on students who are already experiencing decreased social support.

Echoing Callaway, Grier-Reed adds: “I could say that the last several years it’s been a very difficult time for students. We’ve been seeing lots of racial trauma. The last two presidential election seasons have been pretty traumatic, not to mention the pandemic, where people are isolated from each other. For the most part, we’re social creatures, so the current state we’re in puts pressure on all of us.”

Student-Centered

Gabel’s focus on student mental health was inspired by her early interactions with students, Towle says. “Even before President Gabel arrived on campus, she was hearing from students about their concerns around access to mental health resources.” Gabel, Towle adds, took what she was hearing from students seriously: “By the time of her inauguration week, she’d made mental health the big theme. She had public forums around mental health and did some fundraising, too. The issue clearly became a top priority.”

Lauren Meyers, a senior finance major in the Carlson School of Management, describes her journey through the University’s mental health care system as “a wild goose chase,” that sent her from one source of care to the next and then back again.

“I felt like I didn’t have the tools and information to know where I should start,” Meyers says. When she was seeking treatment for depression and anxiety, she discovered that it took serious work and commitment to get the help she felt she needed. There was no clear centralized source to explain different mental health resources already available for students.

“For me, one of the biggest takeaways I had from this experience was that when you’re a student at the University, getting the help you need takes a lot of work. It can be really frustrating. There are already so many barriers to admitting that you want or need help for your mental health: It shouldn’t be hard to figure it out once you’ve made that step.”

Grier-Reed recalls that when President Gabel approached her about heading up the initiative, she explained that the initiative’s priority would be to create a clearinghouse of sorts, a centralized place where all mental health resources across the University system would be easily accessible. This felt like an exciting—and worthy—challenge.

“The University is a big place,” Grier-Reed says. “It is resource-rich. I have no doubt there are a lot of exciting initiatives and resources that already do exist and are being developed as we speak. It is going to be important to learn what those are and find a way to elevate them in a format that is easy for students to access. We also have to identify gaps—and come up with ways to fill them.”

In a sense, Towle says, the ultimate goal of PRISMH is putting an end to the frustrations encountered by students like Meyers: “We want to limit the hurdles, to make caring for your mental health as easy as caring for your physical health.”

While there is much excitement around its potential, PRISMH is still in its infancy. “We haven’t really formed yet,” Grier-Reed notes, adding that the initiative has many stakeholders with many priorities and that updates on the project will come as the group learns more. “We haven’t really developed a plan of work. We haven’t named a committee,” she says. But the work is beginning and important change, she believes, is on the horizon.

“I’m a hopeful person. For the most part, my students, even those that aren’t excelling at the moment, they’re still showing up for classes. They are trying to get to a better place.” This, Grier-Reed, believes, is “a microcosm of what we’re trying to do as a society. I’m hopeful that on balance, we’re moving in the right direction.” The PRISMH project, with its focus on highlighting and developing mental health care options for all, will represent essential progress toward that goal.

Top of Mind Podcast Highlights Student Mental Health

Sometimes the most important conversations can be the most difficult. In the past, talking about poor mental health or mental illness was generally considered taboo, something that could negatively impact a person’s social life or reduce their prospects in school or work. Then young people slowly began opening up about their mental health journeys, and the world began to take notice.

By sharing their struggles, these young mental health crusaders are working to reduce stigma and discrimination against mental challenges. This new reality inspired University Relations writer and editor Rick Moore to create a podcast called Top of Mind that highlights the issue of mental health at the U of M, though interviews with students, staff, and faculty. The podcast also addresses trends in student mental health and the services and programs offered to students.

The podcast’s heavy focus on student stories was intentional, Moore says. He wanted his listeners, many of whom are students, to be inspired and comforted by the words of their peers. The young voices in Top of Mind, Moore explains, “normalize and destigmatize mental illness. If students are listening to the podcast, they can say, ‘I’m not so unusual,’ and get the help they need.”

So far there have been two episodes of Top of Mind, with more likely on the way. “In my original design for the podcast, I envisioned it as being either one episode, or two or three, but not one that goes on forever,” Moore says. But the student voices he’s collected have been so compelling that his plans may change: “What they’re saying is important. Now I think it may go on for a while.”

You can listen to the podcast at twin-cities.umn.edu/news-events/ top-mind. —AS

New Emergency EmPATH Unit Designed for Those in Mental Health Crises

The emergency department (ED) is probably the worst possible place to go when a person is in the midst of a mental health crisis, but the reality is, that’s where most folks turn when they desperately need help.

“In general, mental health crises do not occur during convenient weekday office hour times,” says Lewis Zeidner, M Health Fairview’s system director for clinical triage and transition services. At M Health Fairview Southdale Hospital alone, he says, more than 2,500 patients a year turn to the ED when they are experiencing a mental health or addiction crisis. “As a result, many patients first access care for their mental health and addiction needs through a hospital emergency department.”

While in recent years many emergency departments have worked to improve the mental health care they provide for patients, Zeidner explains there still challenges, including the reality that EDs are designed to focus on physical trauma and other urgent medical conditions, not mental health. The fast-paced, loud environment can often even exacerbate mental health conditions.

By design, ED staff are generalists, trained to respond to many different medical issues, but few have specialized training in treating people in a mental health crisis. Another intentional element of EDs is their speedy response to physical symptoms, but people in a mental health crisis may need more time to discuss their symptoms and care needs.

This spring, in response to this care mismatch, M Health Fairview has created an EmPATH (Emergency Psychiatric Assessment, Treatment, and Healing) unit at M Health Fairview Southdale Hospital designed to address the unique care needs of people in mental health crisis. There are a few EmPATH units in hospitals around the country, but Fairview Southdale’s is the first in Minnesota.

Zeidner explains that EmPATH units provide a quiet and comfortable environment—the opposite of a busy ED. And rather than being generalists focused on speedy response to physical traumas, all EmPATH staff—physicians, therapists, and nurses—are trained as mental health professionals. They work at a pace designed to help patients get the focused help they need without creating further agitation or anxiety. Treatment spaces feel almost homelike, with natural light, comfortable seating, and quiet sensory rooms.

“The timeline for care is not rushed,” Zeidner says, “and [it] can easily take a couple of days to ensure that patients have the time required on a timeline that fits their needs.”

While hospital care is appropriate for some people in mental health crisis, admission to the hospital can be an expensive and unneeded option for many others. Care in an EmPATH unit reduces hospitalizations through a model that relies on a specifically designed physical space to help inspire calm and help patients explore new ways of managing their symptoms and life situations.

“The EmPATH model starts with the understanding that most patients were functioning day to day prior to the crisis, and with support, many can quickly return to that level of functioning,” Zeidner says. “The model seeks to maintain patients’ agency as an adult while being supported in managing their symptoms and life stressors.”

The Southdale EmPATH unit is designed to serve adults age 18 or older. Because they know that younger people can also experience mental health issues, M Health Fairview decided to create an additional unit more suitable to the needs of younger patients. Next year, the system will open two more EmPATH units on the Fairview campus, one designed to serve adolescents and children, and other focused on adults. The units will be open to any patients as long as they are medically stable. —AS

Andy Steiner is a freelance writer in the Twin Cities.