Jon Brunner, Ph.D.
Director, Counseling and Health Services
FGCU Health and Wellness Services
 Student Health Clinic
 Counseling Center (CAPS)
 Adaptive Services for Students with Disabilities
 Prevention & Wellness Services (health education)
 Testing Center
Millennial Students: The Good, the Bad, and the Ugly
(Born between 1982 through to today)
 They tend to:
 not to learn from failure.
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idealistic—hopeful of the future
 have increasing levels of stress and anxiety
 be more nurtured than previous generations.
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parents tend to be overprotective and highly involved
exposed to more structured upbringing
Greater expectation for personal and immediate resolutions
 have been raised by parents believing in the importance of self-
esteem
 have been pushed to study hard and succeed

to choose careers that “pay off” nicely
 multi-task well

having juggled sports, school, and social interests as children
Millennials contd.
 be quite interdependent (i.e. on friends, family, teachers/role
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models)
be more inclusive and tolerant of religions, ethnicity and sexual
orientations
have exposure to vast information but go less in-depth
acknowledge and respect positions, titles, and rules
 however, see it as a challenge to find a way around the rules.
value peer bonding (e.g. organized team sports, church groups,
clubs)
 banding together to date and socialize rather than pairing off
 work well in groups, preferring this to individual endeavors
be quite technologically savvy (self-taught from experimenting and
exploring)
 computers, internet, smart phones, pocket pc
American College Health Association (ACHA)
National College Health Assessment (NCHA)
 The largest known and most comprehensive data set on the
health of college students
 Initiated in 2000
 Revised in 2008 (NCHA II)
 Last given at FGCU, Fall 2009
The Top 10 Impediments to Academic
Performance According to Students 2000-2007
 Stress- 32% (32.4%)
 Cold/Sore Throat- 26% (20.7%)
 Sleep Difficulties- 24% (27%)
 Concern for Family or Friend- 18% (21.2%)
 Depression/Anxiety- 16% (14.3%)
 Relationship Difficulty- 15.5% (17.6%)
 Internet/ Games- 15% ** (12%)
 Sinus Infection- 8.5% (8.5%)
 Death of Friend/Family- 8.5% (11%)
 Alcohol Use- 7% (4.5%)
ADHD 6%
The NCHA II Top 10 Impediments to Academic
Performance According to Students 2008-Present
 Stress- 27.3% (19.5%)
 Depression- 11.3% (13.9%)
 Sleep Difficulties- 19.6%
 Internet/ Games- 11.1% (10.3%)
(19.5%)
 Concern for Family or Friend Anxiety- 18.4% (19.9% #1)
11.0% (8.2%)
 Cold/Sore Throat- 17.3%
 Extracurricular Activities(16.4%)
10.6% (6.5%)
 Work- 13.3% (16.4%)
 Relationship Difficulty- 10.5%
(8%)
 ADHD- 6.7% #9
NCHA II Survey - Mental Health
2008-Present, Incidence in Last 12 Months
 46.3% felt hopeless once
 6.2% seriously
during the year (50.2%)
 48.4% felt overwhelming
anxiety (49.8%)
 38.1% felt overwhelming
anger (44.1%)
 30.3% reported being “so
depressed that it was
difficult to function”
(31.0%)
considered suicide
(6.0%)
 81% felt exhausted (not
from physical activity)
(84.5%)
 5.3% intentionally
injured themselves
(3.5%)
NCHA II Survey - Mental Health continued
 75.1% of students found some aspect of their life being
traumatic or very difficult to handle in the last 12 months
(77.3%)
 44.9% reported Academics (47.5%)
 27.3% reported Family problems (30.7%)
 32.3% reported Intimate relationships (36.5%)
 35.4% reported Finances (43.6%)
 24.4% reported Sleep difficulties (31.6%)
NCHA II Survey - Sleep
 Only 58.6% of students reported getting enough sleep to
feel rested in 3 or more mornings of the past 7 days (56.8%)
 60.5% of students reported feeling tired, dragged out or
sleepy during the day for 3 or more days of the past 7 days
(63.5%)
NCHA II Survey - Stress
 50.7% of students rated their level of stress as above
average or tremendous within the last 12 months (51.2%)
NCHA II Survey – Violence & Abusive Relationships
2008-Present, Incidence in Last 12 Months
 21.7% reported receiving a verbal threat (25.6%)
 10.6% reported unwanted sexual activity (8.4%)
 10.0% reported an emotionally abusive intimate
relationship (15.1%)
NCHA II Survey – Sexual Behavior
 68.0% had a sexual partner in the last 12 months
(72.3%)
NCHA II Survey – Alcohol & Other Drug Use
2008-Present
Substance Used
(within last 30 days)
Actual Use
Perceived Use
Alcohol
63.7% (62.9%)
94.3% (97.1%)
Marijuana
14.0% (9.8%)
78.2% (88.9%)
All Other Drugs
13.6% (12.9%)
76.6% (87.9%)
 Number of drinks consumed that last time students
“partied” or socialized – Median of 4 (4)
 33.1% of student reported binge drinking (five or more
drinks per sitting) within the past 2 weeks (27.9%)
CORE Survey
 Developed by the Department of Education
 Published by the CORE Institute
 University Southern Illinois
 Measures alcohol and drug usage attitudes, related
events and perceptions of students
 Completed online
CORE Survey Forms
 CORE Alcohol and Drug Survey-Long Form (Core
Survey)
 Survey of Students’ Perceptions of Campus Alcohol
and other Drug Norms (Norms Survey)
2004 Both Surveys Special Question n=640
“ I feel comfortable in situations where alcohol is
consumed.”
Always – 20.9%
Often- 37.4%
Sometimes- 24.8%
Rarely- 11.3%
Never- 5.8 %
Norm Survey:
Alcohol Use
General Student
Perceived Norm
Actual Norm
Binge Drinking
54%
38%
Average Drinks
Consumed
5.8
3.2
Abstinence from
alcohol
17.8%
17.3%
Norm Survey:
Attitude Toward Alcohol
Response Options:
a. Drinking is never a good thing to do
b. Drinking is all right but a person should not get drunk
c. Occasionally getting drunk is OK as long as it does not
interfere with academics or other responsibilities
d. Occasionally getting drunk is OK even if it does interfere
with academics or responsibilities
e. Frequently getting drunk is OK if that’s what the
individual wants to do.
Norm Survey:
Attitude Toward Alcohol
Response Options:
a. Drinking is never a good thing to do (.3%)
b. Drinking is all right but a person should not get drunk
(5.0%)
c. Occasionally getting drunk is OK as long as it does not
interfere with academics or other responsibilities (52.1% median)
d. Occasionally getting drunk is OK even if it does interfere
with academics or responsibilities (20.5%)
e. Frequently getting drunk is OK if that’s what the
individual wants to do (22.1%)
Student Perceptions of Alcohol Use
 77.2% breaks the Ice
 75.6 % enhances social activity
 74.4% gives people something
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to do
68.7% gives people something
to talk about
62.3% allows people to have
more fun
61.8% facilitates a connection
with peers
59.1% facilitates male bonding
 53.9% facilitates sexual
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opportunities
48.4 % facilitates female
bonding
27.7% makes women sexier
17.8% makes men sexier
17.5% makes me sexier
FGCU CORE Survey Comparison
2001
2004
2008
Reference
Group
Consumed alcohol
in past year
85%
81%
83%
84%
Consumed alcohol
in past 30 days
72%
69%
64%
72%
Under age
consumed in past
30 days
68%
65%
54%
68%
Binge drinking in
previous 2 weeks
36%
38%
37%
47%
Average # drinks a
week
3.6
3.2
4
5.8
Driven Under the
influence
31%
18%
27%
26%
2008 CORE Survey
Illegal Drug Use (2004 Comparisons)
 Marijuana
 28.7 % used in past year (30.6%)
 14.8% used this past 30 days (17.5 %)
 11.4% used illegal drug other than marijuana in past
year (16.0%)
 4.2% used illegal drug other than marijuana in past 30
days (5.3%)
Student Health Services (SHS)
Location: Wellness Center
Hours: **8:30am – 5:30pm Mon.-Thurs
**9:00am-4:30pm Fri
**Hours subject to change per semester
Phone: 590-7966
Appointments are strongly recommended
walk-ins accepted
Health Center Services
 All Services are Free and Confidential
 SHS uses EMR
 Provide Routine Medical Care
 General Physicals
 Health Education
 Women’s Health
 Vaccinations
 Birth Control/Medications
 HIV Orasure Testing
 After Hours Service through NURSE RESPONSE
 Supplies e.g. band-aids, crutches, condoms)
Student Health Services Rendered
(last year/outside of routine care)
 Nearly 50% of FGCU students use SHS
 Flu Shots-2602
 Women’s Exams- 214
 STD Tests-529
TOP Five Diagnostic Reasons Students Seek
Health Services
 Upper Respiratory Infection
 Contraceptive Management
 Reproductive Health Issues
 Dermatological Issues
 Genital/Urinary Issues
 12,449 student visits in 2009
Student Health Services Staff and Insurance
 Staffed by:
 Medical Doctors
 Nurse Practitioners
 Registered Nurses
 Voluntary Student Health Insurance through

Academic Health Plans (not needed to receive health
center services and available for year or semester)
Under age students need parent approval (forms
available)
Parent Tips
 If your student is sick, tell them to go to the health center
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first (its free, accessible and good first response)
If they are told to take pain relievers, drink fluids, and get
plenty of rest, tell them that is a good thing
Remind them about Nurse Response for non-service hours
Remind them there are cost recovery charges for tests and
medications
Remind daughters to keep up with female health exams
Ask them if they are keeping up with sleep and dietary
needs (remind them there are free nutritionist services)
2009-10 Student Survey of Health Services
* 77% agreed the Student Health Center is their usual source of care
and/ or primary care provider while enrolled at FGCU
* 85% was satisfied with the ease of scheduling an appointment that
meets their needs
* 89% was satisfied with the efficiency of the check-in and checkout process
* 91% was satisfied that the provider listened carefully to their
concerns
* 94% was satisfied that their confidentiality and privacy were
carefully protected
* 83% was satisfied with their overall visit at Student Health
Services
* 84% agreed they are very likely to recommend the health service
to another student
Prevention and Wellness Services (PWS)
 Health Education Programming
 MYSTUDENTBODY (online for all students and parents)
 Alcohol and Drug Education
 Peers Care (Student group)
 Health Fair and Guest Speaker Services
 Prevention Extension (Gazebo)
 Graduate Student Assistantships
 Nutritionist Care
 Massage Therapy
Prevention and Wellness Programs
 Men’s mental health (emotional issues)
 Cookies, cokes and conversation series (housing 6 weeks series)
 Weight loss myths (healthy weight loss)
 Walking Wednesday (noon time walk for all)
 Social hosting (for Greeks)
 Health Fair (all campus event)
 3Cs of Stress (stress management)
 Sexual Jeopardy (sexual health)
 What’s in your lunch? (nutrition)
 McDreamy or McNightmare? (relationships)
 Party Smart (alcohol)
 Fitness-tips-to-go (physical health)
 Free 10 minute massages (stress relief)
 Total number of programs=322 Participants=6940
Counseling and Psychological Services
(CAPS)
Located: Second Floor Howard Hall
Hours 8:00 – 6:00 Mon.-Thurs.
8:00 - 5:00 Friday
Phone: 590-7950
Provides 24 hour Emergency Services
CAPS Services
 Personal Counseling & Therapy
 Career Counseling
 Psychiatric Services
 Consultation
 Referral
 Case Management
 Emergency On-call (24/7 availability)
 Outreach Programs
 Assessment Services (neuropsych testing for LD/ADHD)
 Website http://studentservices.fgcu.edu/Counseling/ (mental health
screening and other electronic resources)
Top 8 Reasons Students Come to CAPS
(2008-2010)
1. Anxiety
2. Stress
3. Depression
4. Self Esteem
5. Relationship
6. Academic
7. Dating/Marriage
8. Family
5,626 Sessions in 2009
The National Survey of Counseling Center
Directors (NSCCD) of 2009
 Conducted since 1981
 Data provided by administrative heads of college and
university counseling centers in the United States &
Canada
 Designed to stay abreast of current trends in
counseling centers
NSCCD 2009 Survey Highlights
 The 302 centers surveyed represent 2.6 million students
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who are eligible for counseling services at their institutions.
6.1% of centers charge for personal counseling, down from
a peak of 17.2% in 1996. Only 1.7% of centers collect third
party payments.
10.4% of enrolled students sought counseling in the past
year. This represents approximately 270,000 students from
the surveyed schools.
The ratio of counselors to students in 1 to 1,527.
The average number of counseling sessions for all students
is 6.2 sessions per client.
61% of the surveyed directors have access to on-campus
psychiatric consultation.
2009 NSCCD Findings
 93.4% of directors report that the recent trend toward
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greater number of students with severe psychological
problems continues to be true on their campuses.
Directors report that 48.4% of their clients have severe
psychological problems. 7.4% of these have impairment, so
serious, that they cannot remain in school or can only do so
with extensive psychological/psychiatric help
40.9% experience severe problems but can be treated
successfully with available treatment modalities.
60.6% increased the amount of time training faculty and
others to respond in a helpful way to students in trouble
and to make appropriate referrals.
53% expanded external referral networks.
2009 NSCCD Findings continued
 48.7 % provide psycho-educational assistance on center
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websites.
47.4% increased training for staff in working with difficult
cases.
28.5% increased counseling center staff.
260 centers hospitalized an average of 8.5 students per
school (2,200 students in all) for psychological reasons.
The average number of hospitalizations per 1,000 students
was 1.5.
73% of directors describe their centers as primarily a
mental health/psychological services center.
2009 NSCCD Findings continued
 Directors reported 103 suicides in the past year.95.5% of
centers maintain the right to refuse treatment to a student
whose problems appear to be beyond the capability of the
center to handle. However, 46% of responding directors
report that they would not deny service in such cases if the
student refused an outside referral and demands to be seen
at the center.
 87% contribute to freshman orientation programs
Birth Cohort Increases in Psychopathology Among
Young Americans, 1938-2007:
A Cross-temporal Meta-analysis of the MMPI
An article written by Twenge, J. M., Gentile, B.,
DeWall, C. N., Ma, D., Lacefield, K., & Schurtz, D. R.
and published in Clinical Psychology Review, 30,
145-154 (2010).
Purpose of the study:
Use quantitative research with a large sample size to
explore 2 important questions:
 Is mental illness on the rise in emerging adults?
 What model might best explain such a rise in mental
illness?
Meta-Analysis
 What is a meta-analysis?
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A research method that combines the results of several studies to address
related research hypotheses.
This meta-analysis used mean scores that are reported as T-scores on the
MMPI measures.
 This meta-analysis looked at data from the MMPI, MMPI-2, and MMPI-
A for the years 1938 through 2007 (1951-2002 for the MMPI-A).
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In total, this study included 117 samples of 63, 706 college students and 14
samples of 13,870 high school students.
High school students were included to confirm data found in college
populations and attempt to rule out population changes in college
samples.
While the study may have included students who were seen at counseling
centers, to be included in the meta-analysis, a study had to report means
for all students, not those chosen for high/low scores, being current
clients, or otherwise indicating maladjustment.
What is the MMPI (MMPI-2, MMPI-A)?
 The MMPI is a widely used personality inventory that is designed
to assess individual personality structure and psychopathology.
 It was first published in 1943 and was originally developed to aid
psychologists and psychiatrists assign appropriate diagnostic labels.
 One of the most commonly used personality tests in the United States.
 Items were chosen because they differentiated “normals” from clinical
groups.
 The MMPI was revised and updated norms were calculated for the
MMPI-2, published in 1989.
 The current meta-analysis looked at data in reference to 8 clinical
scales, 2 non-clinical scales, and 3 validity scales:
Scale 1(Hs): persistent preoccupation with
the body and fears of illness and disease.
Scale 2(D): poor morale, lack of hope for
the future, general dissatisfaction with
one’s life situation.
Scale 3(Hy): disruption in mental, or
other, functionality
Scale 4(Pd): delinquent behavior, sexual
promiscuity, excessive drinking, etc.
Scale 6(Pa): feeling of persecution,
suspiciousness, grandiose self-concepts,
etc.
Scale 7(Pt): excessive doubts,
compulsions, obsessions, unreasonable
fears.
Scale 8(Sc): bizarre thoughts or
experiences, misinterpretations of
reality.
Scale 9(Ma): overly elevated mood,
accelerated speech, irritability, etc.
Scale 5(Mf): sexual identity
development.
Scale 0(Si): tendency to withdraw from
social contacts and responsibilities.
L Scale(Lie Scale): used to detect
attempt to present oneself in
unfavorable light, malingering.
F Scale(Infrequency): used to detect
deviant or atypical ways of
responding, such as not reading
items or random responding.
K Scale(Correction Scale): measures
tendency to obscure symptoms,
faking good or faking bad.
Hypotheses and Models
 The authors believed they might find increases in
psychopathology based on findings of previous
research.
 If those increases were indeed found, the authors
wanted to test three potential explanatory models:
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The extrinsic versus intrinsic goals model
The economic cycles model
The response bias model (psychopathology is more socially
acceptable)
Results
 *Keep in mind a mean of 50 and a SD of 10 for the MMPI; 2 or more SD
above the mean is considered clinically significant.*
 MMPI clinical scale scores rose steadily between 1938 and
2007 – US college students scored more than a SD higher
on the F scale, Pd, Pa, Sc, and Ma scales.
 US college students score more than ¾ of a SD higher on
Hy, D, and Pt scales.
 US college students scores .45 of a SD higher on Hs.
 In 1938, 1 – 5% of students scored above a 70 on the clinical
scales (this represents a significantly elevated score, 2 SD
above the mean)…by 2007, 40% scored above 70 on Ma,
33% on Sc, 28% on Pd, 19% on Pt, 19% on F, 18% on Pa, 10%
on Hy, 8% on D, & 6% on Hs.
 These results were confirmed in the high school sample.
In plain language:
 (Ma) – more students are characterized by unrealistically
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positive self-appraisal, overactivity, and low self-control.
(Sc) – more students feel isolated and misunderstood.
(Pa) – more students may be described as sensitive and
sentimental.
(Pd) – more students are narcissistic, self-centered, and
antisocial or do not follow the rules and standards of
society.
General symptoms of anxiety are on the rise.
(D, Hs, Hy, & Pt) – more students report worry, sadness,
and dissatisfaction, and may express these through
physical symptoms.
(F) – more students are predicted to experience
moodiness, restlessness, dissatisfaction, and instability.
Which model best fits the data?
 The extrinsic versus intrinsic model -- linear increase in MMPI
scores…each successive generation showed an increase.
This suggests that a shift in American culture toward materialism,
individualism, unrealistic expectations, and unstable relationships
may account for the increase in psychopathology in young people.
-Young American’s focus on extrinsic goals is increasing.
-Developing a meaningful philosophy of life is less important.
-Divorce is indirectly impacting our young people.
“At the very least, college campuses now have a larger percentage
of students with more serious mental health problems”
Suicide Facts in the General Population
 In America 30,000 die from suicide
 Every day 80 Americans take their own lives
 Every day 1,500 Americans attempt suicide
 11th Leading cause of death
 3rd Leading cause of death among 15 – 24 year old
group
Center for Disease Control and Prevention (CDC)
 Developed National Violent Death Reporting System
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(NVDRS)
Over 50,000 violent deaths in the US annually
Started out with 7 states (up to 18 this year)
First data from 2003
Majority (56.6%) of deaths were suicide (latest data from
2007 and 16 states)
Followed by homicides at 28%
Most frequent method was firearms
Occurred at higher rate among males, native Americans,
non-Hispanic whites and persons ages 45-54
College Student Suicide Facts
 Suicide is the 2nd Leading Cause of Death for College
Students
 According to JED Foundation and NMHA over 1,000
College Students Die Each Year from Suicide
 Rate of Suicide is 7.5/100,000 Students
Do’s and Don’ts
DO:
Stay in touch; encourage; be realistic; allow space
DON’T:
Panic; tell them what to do; take over and assume
Responsibility; insist on frequent visits or phone calls; press
your child on what they will do after school
Remember the Developmental Issues
For Parents:
1. Competence-trusting your student
2. Redefining yourself-role change from caretaker to mentor
3. Separation-mange your anxiety
4. Intimacy-staying close without being over involved
For Students:
1. Achieving confidence and identity
2. Separation and independence
3. Managing emotions and achieving intimacy
Parent Tips (developing the supportive
partnership)
 If your student has had psychological issues that required
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counseling/therapy and/or psychiatric medication, refer
them to CAPS from the start
Find out if going to college is fulfilling their goals. Are they
happy?(monitor don’t over react)
Ask about what they are discovering in terms of a career (it
is OK to change)
Ask about how their relationships are going.
Ask them how they are eating and sleeping (seriously!).
Ask about the pressure and stress they are feeling. Try to
help them see through it and be supportive
Parent Tips (cont’d)
 Suggest they go to the CAPS website and take whatever
screening they think is relevant to how they feel.
 Normalize the idea of seeking help let them know it is not a
sign of weakness
 Suggest they go see a counselor or therapist in CAPS. They
can come just once to consult with a CAPS professional to
see what we think or might suggest.
 Tell them you understand college students drink, but that
you would hope that it does not interfere in their academic
or social life or put them or their friends at risk (explain
what you mean)
When should I be concerned about my
student’s mental and emotional health?
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Social Withdrawal
Marked change in appearance, self care, hygiene
Excessive self criticism
Tearful calls outnumber the others
Talk of hopelessness
Loss of motivation
Excessive fatigue or lethargic mood
Extreme increases in energy, rapid speech and thoughts
Inability to think and concentrate, dramatic change in grades
References to self harm or suicide
2006-10 Student Survey of CAPS Counseling Services
 96% agreed they were comfortable using CAPS services, would use
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them again and would refer others to CAPS
92% agreed that their counselor honestly cared about them
86% agreed they were better able to understand themselves
88% agreed they were able to better deal with their concerns/problems
86% agreed counseling had a positive effect on their overall campus
experience **
64% agreed that counseling made them better able to focus on
academic and study requirements
62% agreed that counseling made it possible for them to continue as a
student at FGCU**