When assessing a populations vulnerability which would the community health nurse identify as a predisposing factor?

Overall, the exemplar college campus lacks resources to fully manage the number of students requiring mental health care, although it is acknowledged that individual college campuses have differing circumstances, strengths, and weaknesses. According to the American Psychological Association (2013), 95% of college counseling center directors agreed that college campuses were lacking the necessary resources to manage students with mental health needs.

Limitations and strengths of available resources on the exemplar campus

The most profound limitation identified on the exemplar campus was the lack of mental healthresources as described. The student-to-specialist ratio was severely deficient according to the national standards, thereby placing students with mental health issues and those around them at risk for potential harm. Another limitation identified was the lack of information the college campuses can provide to faculty about students of concern. College campuses attempt to implement safeguards to protect all students while maintaining privacy protections for those individuals with mental health concerns. The Americans with Disability Act gives the students with mental illness the right to enroll in college courses unless they become disruptive to the environment (Campus Violence and Mental Health, n.d.). However, according to the National Association of College and University Attorneys, “the Family Educational Rights and Privacy Act, permits the disclosure of information from student education records to appropriate parties in connection with an emergency if knowledge of the information is necessary to protect the health or safety of the student or other individuals” (Campus Violence and Mental Health, n.d., p. 5).

A strength identified on the exemplar campus was the participation in a nationally recognized Mental Health Awareness Week and Depression Screening Day. During this time Each Mind Matters joined the exemplar campus in supporting mental health. Individuals were made aware that they could become involved by taking a pledge against stigma and show commitment by becoming a change agent. Individuals also demonstrated their support online by adding a lime green ribbon to their profile pictures and followed Each Mind Matters on Facebook and Twitter. Additionally, supporters wore lime green ribbons to show support around campus.

An additional strength identified on this campus was the presence of a police department with 24-h patrol in both marked and unmarked vehicles. Also available to students was an emergency alert system using cell phone text messaging to notify the college community of an emergency. The system does require a student to sign up providing their contact information and cellular phone number. The police department website provides daily crime reports, active shooter information, and fulfills requests for safety escorts along with a plethora of other useful safety information.

The APRN role in health promotion on college campuses

Access to behavioral health for the underinsured and uninsured is often a challenge for individuals seeking mental health care. A shortage of qualified mental health providers and insurance coverage limits are often contributing factors to this challenge. Telehealth is becoming acceptable among other specialties to provide access to care to those in need. Telehealth is defined as “the use of technology to deliver care through techniques like videoconferencing” (U.S. Department of Health and Human Services, Health Resources and Services Administration [HHS, HRSA], 2013, p. 2). TeleMental Health consultations can be the first line for identifying emergent psychiatric needs and triaging according to priority by a behavioral health specialist such as a Psychiatric-Mental Health Nurse Practitioner. Implementation of care via Telehealth provides a cost effective, efficient, healthcare delivery system, while providing an expanded network of healthcare providers to patients with mental healthcare needs (HHS, HRSA, 2013).

College campuses could benefit from TeleMental Health implemented by the APRN. The University of Maryland, Department of Psychiatry established a TeleMental Health program to provide cost effective care with flexibility, rapid communication, and culturally competent care, and has proved to be successful (University of Maryland School of Medicine, n.d.). In a literature review conducted by Hilty et al., (2013), TeleMental Health was found effective for diagnosis and assessment across many populations including: adults, children, geriatric, and various ethnicities. TeleMental Health was additionally found beneficial for multiple mental health disorders in many settings and comparable to in-person encounters (Hilty et al., 2013). TeleMental Health is currently being explored by the HRSA to provide grant funding for clinics willing to provide mental healthcare services to low-income populations (HHS, HRSA, 2013). TeleMental Health could potentially be widely accepted by the present-day, technologically savvy generation of students on campus, and ultimately prove beneficial to their learning outcomes.

Conclusion

In the past decade, college student mental health issues and violence have been on the rise, illustrating a tremendous need to address mental health issues in this important age group. Evidence suggests that college students are experiencing greater levels of stress, anxiety, and psychopathology than ever before, regardless of campus location or size, leading to unhealthy outcomes. Utilization of a vulnerability model populated with publically available data of an exemplar college campus detected a lack of mental health resources available on the campus. Multiple studies have clearly shown that early identification and intervention, with mental and behavioral health support systems, can improve student life and potentially prevent a significant proportion of violence and crime seen on college campuses today. The most recent survey of college counseling center directors found that 59% of students who had received treatment indicated that therapy had a significant impact on remaining students in school and improved their academic performance (American Psychological Association, 2014). Despite the complexity of mental health issues on college campuses, the overall picture is clear. Today's college students are facing a serious mental health crisis and changes should occur to improve student health and safety on campus. APRNs and student health centers are well positioned to utilize the vulnerability model in order to assess and improve the outcomes of college students. Furthermore, APRNs should consider using such a model to assess their own campus and communicate findings with university administration.

References

American Psychological Association. (2014). The state of mental health on college campuses: A growing crisis. Retrieved from http://www.apa.org/about/gr/education/news/2011/college-campuses.aspx

Campus Violence and Mental Health. (n.d.). Campus violence and mental health. Retrieved from http://www.csg.org/knowledgecenter/docs/ MentalHealth-CampusSafety.pdf

Committee on Educational Policy. (2009). Report of the Student Mental Health Oversight Committee. Retrieved from http://regents.universityofcalifornia. edu/regmeet/mar09/e3pp.pdf

Cranford, J., Eisenberg, D., & Serras, A. (2009). Substance use behaviors, mental health problems, and use of mental health services in a probability sample of college students. Addictive Behaviors, 34(2), 134–145. doi: 10.1016/j.addbeh.2008.09.004

de Chesnay, M., & Anderson, B. A. (2012). Caring for the vulnerable (3rd ed.). Burlington, MA: Jones & Bartlett Learning.

Hilty, D., Ferrer, D., Parish, M., Johnston, B., Callahan, E., & Yellowlees, P. (2013). The effectiveness of telemental health: A 2013 review. Telemedicine Journal and E-Health, 19(6), 444–454. doi: 10.1089/tmj.2013.0075

Selegean, J., & Iannucci, A. (2011). UCI undergraduate student data Fall 2011. Retrieved from http://www.assessment.uci.edu/undergraduate/documents/ UCIUndergraduateStudentDataandTrendsF11.pdf

Shi, L., & Stevens, G. (2010). Vulnerable populations in the United States (2nd ed.). San Francisco, CA: Jossey-Bass.

UC Student Mental Health Committee. (2006). Student Mental Health Committee: Final Report [report]. Retrieved from http://regents.universityofcalifornia.edu/regmeet/sept06/303attach.pdf

University of Maryland School of Medicine. (n.d.). TeleMental Health. www.medschool.umaryland.edu

U.S. Department of Health and Human Services, Health Resources and Services Administration [HHS, HRSA]. (2013). Increasing access to behavioral health care through technology. Retrieved from http://www.hrsa.gov/publichealth/ guidelines/behavioralhealth/behavioralhealthcareaccess.pdf​

How would a community health nurse define vulnerable populations?

What factors make a population vulnerable?

What are vulnerable populations at risk for?

What are some vulnerable populations in healthcare?