Mental Health

January 15, 2014

Where does Campus Recreation fit in?

Alison Epperson, Ph.D.
Assistant Professor, Health Ed.
Murray State University

As more and more young adults come to colleges and universities seeking an education, they bring with them high-risk health behaviors that can impede their academic success. Post-secondary institutions have programs, services, and supports in place specifically designed to ease the transition into college, provide academic assistance services, promote a safe learning and living environment as well as facilities and departments dedicated to raising awareness of and maintaining physical and mental health.

Along with alcohol, mental health has become a major concern for institutions of higher education as many times, the two go hand in hand. What may be considered ‘typical’ college student behavior, could in fact, be masking underlying issues which can include, but are not limited to; lack of sleep and physical activity, drastic mood swings, and social isolation.

Growing concerns of behaviors among college students, most commonly associated with mental health, have resulted in a call for post-secondary institutions to consider implementing Healthy Campus 2020. Healthy Campus 2020 is the National College Health Associations adaptation of Healthy People 2020. Healthy People 2020 is a 10-year initiative sponsored by the Department of Health and Human Services which monitors the health status and behaviors of Americans. The National College Health Association also partners with NIRSA, NASPA, ACPA and The BACCHUS Network.With the academic goals of institutions of higher education in mind, Healthy Campus 2020 has identified five objectives with the greatest combined frequency and severity of impact, based on Spring 2010 ACHA-NCHA II data which included:

– Stress;
– Sleep difficulties;
– Anxiety;
– Cold/flu/sore throat, and
– Work

Additionally, Objective 7-3 as listed on the Healthy People web site for the 2020 recommendations ( reads:
Increase the proportion of college and university students who receive information from their institution on each of the priority health-risk behaviors (unintentional injury; violence; suicide; tobacco use and addiction; alcohol and other drug use; unintended pregnancy, HIV/AIDS and STD infection; unhealthy dietary patterns; and inadequate physical activity) (USDHHS, 2011).

In addition, it is important to understand the underlying issues associated with mental health specific to post-secondary institutions (e.g., the increasing diversity among college students [minorities and International students as well as gay, lesbian, transgender and bisexual], an increase of female students and first generation college students, and increased average age of undergraduates).

On the same front, campus counseling centers are now dealing with a variety of problems that stem from family/ home life (e.g., domestic abuse, dysfunctional family situations, previous hospitalization for prior mental health issues, suicides, self-mutilation, eating disorders, stalking [both in person and via technology] and relationship violence) (Gallagher, Zhang & Taylor, 2003).

The following information was taken from the National Survey of Counseling Center Directors [on college campuses], which was conducted by Robert Gallagher from the University of Pittsburgh in conjunction with the American College Counseling Association (ACCA) (Gallagher, 2010). This 2010 survey consisted of responses from counseling center directors from 320 institutions representing 2.75 million students who are eligible for counseling services. This detailed report indicated that 91% of directors noted the trend of more and more students with severe psychological problems. The following percentages reflect significant increases in perceptions of directors over a five-year period.

– 70.6% crisis issues requiring immediate response;
– 68% psychiatric medication issues;
– 60% learning disabilities;
– 45.7% alcohol abuse;
– 45.1% illicit drug use (other than alcohol);
– 39.4% self-injury (cutting to relieve anxiety);
– 25.2% sexual assault on-campus;
– 24.3% eating disorders;
– 23.2% career planning issue;
– 23.1% prior sexual assault / abuse related issues and;
– 95% who are already on psychiatric medication (Gallagher, 2010).

During the 2009 school year, directors involved in this survey reported 133 student suicides, 13% of which were current or former clients, 79% were males, 88% were undergraduates, 83% were Caucasian, 84% were undergraduate (Gallagher, 2010). Furthermore, 56% of these students were known to have reported relationship problems, 84% were depressed, 20% had academic problems, 18% had financial concerns, and 12% had health issues (Gallagher, 2010). Likewise, 28% of directors noted an increase over the previous 5 years of student violence on campus, equating to 358 cases of obsessive pursuit or stalking during the past year (Gallagher, 2010). Included in these 358 cases, 168 students were physically injured; and seven were killed by their pursuers.

The 2010 Surgeon General’s Report, further indicates a connection between obesity and mental illness. As many as 83% of individuals with mental illness meet the criteria for the classification of overweight (BMI of 25-29.9) or obese (BMI of 30 or greater). Mental illness and obesity often create the following cycle: social isolation-sedentary lifestyle – physical inactivity — mood instability — low self-esteem (Benjamin, 2010). Youth and adolescents between the ages of 4-19 undergoing treatment for serious mental illness can experience up to a 7% total body weight increase within 12 weeks (Benjamin, 2010).

Furthermore, individuals with severe mental illness also have a decreased life expectancy of only 53 years of age, a result not of the mental illness, but of the obesity-related complications and/or diseases (Benjamin, 2010).

Even though the term “mental health” is finally emerging from a long history of stigmatization, depression is often mistakenly associated with someone who ‘just can’t pull it together.’ Depression can be minor or major and takes on different forms resulting from life altering events, holidays, and even weather. Because depression in and of itself, is so broad scope, I am including the link to the National Institute of Mental Health’s informational page which includes; signs/symptoms, causes, diagnosis, treatment, and those at risk (

As we approach Holiday Season, it is important to understand that for every person who finds excitement and joy, is another who feels loneliness, isolation and sadness. Holidays trigger unpleasant emotions for those who have lost a loved one, are going through a divorce or family situation, are unemployed, or may not have, or be able to spend the holidays with family/friends.

This time of year is also associated with Seasonal Affective Disorder (SAD — ironic acronym), which is associated with shorter, colder, darker days, is more common in females, and in the colder, northern states. Symptoms of SAD include; irritability, weight gain (craving carbs in particular), lack of motivation, anxiety, social withdrawal, oversleeping, loss of interest in activities, difficulty concentrating (

So what exactly does this mean for your Campus Recreation program? Think about the opportunities you have to identify the warning signs of depression. Wellness centers are usually high-traffic areas for students, faculty and staff. Most likely you have ‘regulars’ in all aspects of your programming. It is not uncommon for staff members to establish a friendly relationship with these regulars. For some people, participation in your programming may be the only opportunity they have for social engagement or to see a friendly smile.

I would recommend taking the time to educate your staff on the signs and symptoms of depression, mood/behavior changes. In doing so, it is critical for everyone to understand how important the recognition/identification of these behaviors can be. In some cases, it may result in saving someone’s life. Likewise, when providing this education, it is also critical to remind others that depression is real, and not something that people ‘snap out of.’

It is fairly common in our society to ‘respect boundaries’ so to speak when making the decision as to whether or not to approach someone and ask if they are ‘okay.’ We often feel like its intrusive/invasive and not our business or concern. While some people truly do not want to be asked, you might find others to be suffering in silence and thrilled that someone cared enough to ask. This is where the personal relationship with your participants can be to your advantage. I’m not recommending that you grab a clipboard and conduct an interview, but simply making a note of, or sharing a concern with a co-worker may result in the discovery that others feel the same way, or have noticed changes in behavior.
On our campus, we have a “Troubled Student Intervention Team” (link provided below) which is comprised of representative from various Student Affairs departments to regularly communicate across campus students who have shown behaviors either towards themselves or others which could be indicators of impaired mental health. In this regard, we can work collaboratively to promote the health and safety of not only our troubled students, but those who could inadvertently find themselves in a dangerous situation as a result of a failure to act.

In conclusion, as the people on the forefront of health and wellness through the number of opportunities provided within Campus Recreation and Sport Clubs, understanding the connection between co-morbid behaviors (more than two which negatively impact health) such as alcohol, drug use, stress/anxiety, etc. which can add to or result in depression is critical. As institutions of higher learning, it is also our duty to meet the needs of a growing number of students who may be suffering in silence as students who do not possess total wellness are unable to maintain academic success.


American College Health Association. (2012, June). Healthy Campus 2020. Retrieved 11/8/2013, from

Benjamin, R. The Surgeon General’s vision for a health and fit nation 2010. U.S. Department of Health and Human Services. Retrieved from
Seasonal Affective Disorder. (2011, September). MayoClinic. Retrieved 11/13/2013, from

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