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Fifteen percent of college students suffered from depression last year, up from 10 percent in 2000, according to The American College Health Association. Mental health professionals on college campuses expect the percentage to rise again this year, but St. Lawrence University is addressing the problem by participating in a national pilot project to improve screening and care for students with depression.

According to an article published in the April 6 issue of Psychiatric News, St. Lawrence is one of eight institutions in the study and the only small private liberal arts institution. The goal of the project, which runs this academic year, is to ensure that students with depression do not slip through the cracks, but rather are identified and treated as soon as symptoms arise, says Director of Health and Counseling Services Patricia Ellis.

Ellis reports that staff have screened nearly 90 percent of student walk-ins to the health and counseling center, using a nine-item depression screening instrument known as a Patient History Questionnaire, or PHQ-9, which takes students only a few minutes to fill out, often while they wait to be treated for a minor ailment. By year's end, Ellis expects to have screened more than eight out of 10 students.

The PHQ-9 screening tool is based on a number score, with mild depression being a score between 5 and 14; moderate between 15 and 19; and severe 20 and above. Ellis says those with moderate or severe PHQ-9 scores are referred to a counselor on the spot. A goal of the project is to reduce depressed students' PHQ-9 scores by at least five points over an eight-week period or to below 10 in a 12-week period.

"We had a student recently come in complaining of a cold," Ellis says. "She took the PHQ-9 and her score was an 18. We immediately began counseling on a weekly basis. The student is now doing well academically and feeling much better. I have no doubt that our early screening and treatment avoided negative consequences."

Such consequences, she says, typically include poor grades, flunking out of school or in serious cases, doing harm to oneself or others. Suicide also is rising steadily among adolescents, Ellis notes.

"Of all the students we screened this year, about five percent required follow-up counseling," says Ellis.

Ellis says the 11 primary care and counseling staff are treating more students than ever before, but they now collaborate more efficiently because the PHQ-9 screening tool gives the primary care and counseling staff a common language to use in discussing students' evaluations.

"The need for mental health services among college students is growing," Henry Chung, M.D., told Psychiatric News. Chung is the principal investigator for the project and assistant vice president of student health at New York University, one of the participating schools. Other participating schools are Cornell University, Princeton University, Hunter College, Baruch College, Case Western Reserve University and Northeastern University. The Aetna Foundation, New York Community Trust and the New York City Department of Health and Mental Hygiene provide funding for the project; the American Psychiatric Institute for Research and Education provides expertise.

Posted: May 3, 2007

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