Original Article

A Retrospective Study of Students Referred to a Psychiatric Clinic at a College Counseling Center in Appalachia

Authors: Brittani Lowe, MD, Kristina Bryant-Melvin, MD, Mark Peterson, MD, Nafeeza Hussain, MD, MPH, Suzanne Holroyd, MD

Abstract

Objectives: This study describes the clinical problems and psychiatric diagnoses of college students who sought services at a student counseling clinic and were subsequently referred for evaluation by a psychiatrist. Several important psychiatric problems present before leaving for college that could mandate the selection of a college with psychiatric services at the university or nearby community. This study confirms the importance of having psychiatric consultation available in addition to the range of counseling services found in a campus mental health clinic.

Methods: We conducted a retrospective chart review of 150 patients who were referred for psychiatric care from an on-campus mental health clinic at an Appalachian university (Marshall University). Demographic and clinical data were collected, entered into SPSS version 24, and analyzed.

Results: The most common diagnosis was that of a depressive disorder (76.7%). The next most common was an anxiety disorder (60.7%). In addition, 43.3% of students had suicidal ideation within 1 month preceding their appointment with the psychiatrist, 24% had attempted suicide at least once in their life, and 36% had a history of nonsuicidal self-harm. Almost 81% had prior psychiatric diagnoses, and of those, 22% had a history of inpatient psychiatric care.

Conclusions: These results indicate that this student sample referred for psychiatric treatment has significant psychiatric illness. Our findings also confirm the need for the availability of psychiatric consultation as a part of college mental health services. Those students most in need of psychiatric consultation had almost all received psychiatric treatment and almost half had suicidal ideation in the month preceding the appointment with the psychiatrist. The specific problems that may lead a student applying to college to take into consideration the availability of psychiatric services include a previous psychiatric hospitalization, previous suicidal ideation that had already come to the attention of a mental health professional, or a previous diagnosis of depressive disorder or anxiety disorder.

 
Posted in: Mental Health43

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Eisenberg D, Hunt J, Speer N, et al. Mental health service utilization among college students in the United States. J Nerv Ment Dis 2011;199:301-308.
2. Appalachian Regional Commission. Subregions in Appalachia. https://www.arc.gov/research/MapsofAppalachia.asp?MAP_ID=31. Published November 2009. Accessed August 15, 2018.
3. Appalachian Regional Commission. Creating a culture of health in Appalachia: disparities and bright spots. Health disparities in Appalachia.
4. Gibb S, Fergusson D, Horwood L. Burden of psychiatric disorder in young adulthood and life outcomes at age 30. Br J Psychiatry 2010;197:122-127.
5. Eisenberg D, Hunt J, Speer N. Mental health in American colleges and universities. J Nerv Ment Dis 2013;201:60-67.
6. Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, US Department of Health and Human Services, RTI International. Results from the 2017 National Survey On Drug Use and Health: detailed tables. Table 8.56B. https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2017/NSDUHDetailedTabs2017.htm#tab8-56B. Accessed October 1, 2019.
7. Whitlock J, Muehlenkamp J, Purington A, et al. Nonsuicidal self-injury in a college population: general trends and sex differences. J Am College Health 2011;59:691-698.
8. Mackenzie S, Wiegel J, Mundt M, et al. Depression and suicide ideation among students accessing campus health care. Am J Orthopsychiatry 2011;81:101-107.
9. Blanco C, Okuda M, Wright C, et al. Mental health of college students and their non-college-attending peers: results from the National Epidemiologic Study on Alcohol and Related Conditions. Arch Gen Psychiatry 2008;65:1429-1437.
10. Mortier P, Cuijpers P, Kiekens G, et al. The prevalence of suicidal thoughts and behaviours among college students: a meta-analysis. Psychol Med 2017;48:554-565.
11. Schulenberg J, Johnston L, O’ P, et al. Monitoring the future: national survey results on drug use, 1975-2018. Volume II: college students and adults ages 19-55. http://www.monitoringthefuture.org/pubs/monographs/mtf-vol2_2017.pdf. Published July 2018. Accessed October 1, 2019.
12. Whitlock E, Polen M, Green C, et al. Behavioral counseling interventions in primary care to reduce risky/harmful alcohol use by adults: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2004;140:557.
13. US Department of Health and Human Services. Helping patients who drink too much: a clinician’ guide. https://www.integration.samhsa.gov/clinical-practice/Helping_Patients_Who_Drink_Too_Much.pdf. Published 2005. Accessed March 2, 2020.
14. Anastopoulos A, DuPaul G, Weyandt L, et al. Rates and patterns of comorbidity among first-year college students with ADHD. J Clin Child Adolesc Psychol 2016;47:236-247.