In over 20 years of teaching college classes, CUNY Professor Bill Ferns has met many students who were suffering from mental distress. Some were severe cases, such as the student he witnessed having a psychotic episode, while others were more subtle, like the student facing family pressure to go into a career he didn’t want or those who were overwhelmed trying to balance school and work.
When Professor Ferns realizes he has a student in need of help, he talks to them and refers them to the college counseling center. “They just want someone they can talk to,” he said. “But I’m not the best person to talk to, and neither are their parents or friends. What these students need is someone with an objective interest in their well being and someone who’s trained to handle these sorts of situations.”
As part of his interest in helping students, Ferns recently completed an online training simulation called At-Risk, which educates university faculty and staff on identifying, approaching, and referring students in mental distress. In the simulation, which was built using unique simulation technology, users assume the role of a faculty member in a fictional university where they must analyze students’ profiles to identify those who are potentially at-risk, engage those virtual students in simulated conversations, and determine whether and how to refer them to the campus counseling center.
Though he’s had several real-life referral conversations with students, Ferns says getting practice with virtual students and receiving feedback on his decisions and techniques throughout the conversation was an eye opening experience. “It got me to think past my first impressions about students… to focus on their behavior, instead of trying to make a quick diagnosis,” he said.
At-Risk was created by Kognito Interactive, a developer of training simulations and educational games, in partnership with the Mental Health Association of New York City (MHA of NYC). A recent study of At-Risk, conducted at over 42 universities, showed that nearly 90% of faculty and staff felt better prepared to identify, approach, and refer students after completing the simulation. A demo of the product and a detailed report of the study can be viewed at www.kognito.com/atrisk.
Mental Distress on Campus
Mental illnesses such as depression, anxiety, and substance abuse are more common on college campuses than many realize. In the American College Health Association’s 2006 survey, over half the students said they’d felt so depressed at some point in the year that it was difficult for them to function. Ten percent said they’d seriously considered suicide.
“It’s a considerable problem,” said Dr. John Draper, Director of the National Suicide Prevention Lifeline, which is administered by MHA of NYC. “There are a number of students who are depressed or having anxiety issues, nervous about their school performance, about being away from home, about their future, or about being in a social setting that is unfamiliar and challenging to them. And we also know that a number of mental illnesses tend to take hold and become manifest between the ages of 18 and 24. So this is a very sensitive and vulnerable time in many young people’s lives.”
Universities recognize the strong connection between mental distress and academic performance. “We see a real link between students’ mental health and their school performance and retention rates,” said CUNY Director of Students Affairs Christopher Rosa. “One of our goals at CUNY is to foster our students and make sure they get the assistance they need so they can do well and graduate successfully. Making sure they find appropriate mental health resources is an important part of that vision.”
Unfortunately, while most universities provide counseling services for students, many still go undetected and untreated. In fact, it is estimated that 80% of students who commit suicide are never seen by a counselor.
After the Virginia Tech shootings, many educators and administrators have begun to realize the importance of proactively identifying distressed students and getting them help.
“I didn’t think about it very much until Virginia Tech,” said CUNY Professor Ted Henken, who also took At-Risk. “You realize that anything can happen. You think most of that is dealt with at the high school level, but we realized that it’s not.”
Gatekeeper Training
To reduce the number of undetected students, universities are increasingly relying on gatekeeper training, like At-Risk. Gatekeeper training focuses on those who have the most direct contact with students—faculty, staff, and resident assistants—and teaches them how to identify at-risk students and refer them to the counseling center.
Of the gatekeeper population, faculty are usually in the best position to recognize signs of distress and make referrals. Faculty not only have regular interaction with students, but they can also observe declining academic performance, a highly prominent sign of distress, according to The National Research Consortium of Counseling Centers.
“Many faculty members are aware that there are students in their classrooms who are having problems… problems that are interfering with their ability to participate in class or perform to the degree that they could,” said Draper. “But they just don’t always know how to deal with it.”
Though faculty can often perceive when students are showing signs of psychological distress, it is common for them to second guess their initial reactions and ultimately ignore the issue, especially when a student’s behavior is not disruptive in the classroom. Furthermore, even when faculty do believe a student is at-risk, they may still choose to ignore the problem, as they are uncertain what they can do to help.
“It’s a quandary for many faculty members who would like to help but who just do not know how,” said Draper. “The purpose of the At-Risk simulation is to teach them skills that will enable them to approach students in an appropriate way and to give them confidence in their ability to help. I think faculty members will look at [At-Risk] and say, ‘I can do this.’”
At-Risk
At-Risk is a highly interactive simulation where users assume the role of a faculty member in a fictional university and, through this avatar, must identify, approach, and refer several at-risk students in the faculty member’s class.
(click to enlarge) Kognito At Risk Product Snapshot
Built using Kognito’s patent-pending simulation technology, the 45-minute simulation enables users to practice having conversations with realistic virtual students who possess their own memory and emotions. These virtual students respond to users’ decisions via voice and body language. Some things the user chooses to say may make a student more comfortable and increase his or her receptivity to the conversation. Other dialogue options may make the student defensive or upset.
As the conversation unfolds, users determine whether the student needs to be referred to the counseling center. If so, they must refer the student and use appropriate language to motivate him or her to go.
Each of the virtual students in At-Risk has a distinct personality, and each displays different symptoms of mental distress. These symptoms were carefully chosen to reflect those that are often indicative of the most common and most severe psychological illnesses among young adults, including alcohol/substance abuse, schizophrenia, depression, thoughts of suicide, and panic disorder.
“When faculty go through At-Risk, they’re going to see a lot of students they’re familiar with,” said Kognito CEO Ron Goldman. “There’s the student with unusually high anxiety, the student who is always morose, the student who has stopped turning in assignments. These situations are very realistic.”
Throughout the conversations, users receive advice on their decisions so they can learn what they are doing well and also how they can improve. In addition, the students’ body language and verbal responses are strong indicators to users about the effectiveness of their actions.
“What’s interesting about this simulation is that it actually gives faculty and staff practice talking to students and referring them to counseling. So even our newer faculty, who have maybe never had this kind of conversation with a student, can become more comfortable and more likely to have successful referral conversations when the time arises,” said Rosa.
Those who have taken the simulation say that, in addition to its pedagogical value, it is also quite entertaining. “It is fun,” said Draper. “If a learning exercise is not engaging, you don’t learn as much. So the fact that this is both stimulating and fun and also meaningful to the users is highly important.”
Conclusion
Draper says he is excited about the use of simulation technology to provide practice and learning opportunities in interpersonal areas of mental-health training. “If we can make training not entirely dependent on face-to-face interactions,” he said, “we’ll be able to train a lot more people to be able to do a lot more good in the field of mental health.” As for Ferns, he says he believes the simulation will benefit his colleagues at CUNY. “It will open up a whole new dimension of what teaching is about,” he said.
A demo of At-Risk is available at www.kognito.com/atrisk.
Jenelle Boucher is VP of instructional design at Kognito Interactive and led the development of At-Risk.
(Article posted on behalf of Ms. Boucher by CFisher)
Editorial Note From CFisher: As the managing editor of this website, I seldom allow vendors to write a review of their own commercial product. However, I believe this to be a worthwhile and important topic that needs discussion in light of the escalation in violence and suicide at university campuses. Hopefully this post raises awareness of violence/suicide prevention programs, such as At-Risk, that are available to university administrators, faculty, and students. Faculty and students may want to alert their university administrators about At-Risk since its effectiveness relies on training all faculty. BMED Report received no revenue of any kind for publishing this article.
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