What’s New in the Study of Mental Health and Student Retention?
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What’s New in the Study of Mental Health and Student Retention?. John Achter, Ph.D. AUCCCD – Fall 2008. Collaborators. Co-Investigators Kristina Gorbatenko-Roth , Ph.D. – Dept. of Psychology Jenna Maas , M.A. – Applied Psychology masters program Assistants

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What’s New in the Study of Mental Health and Student Retention?

John Achter, Ph.D.

AUCCCD – Fall 2008


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Collaborators Retention?

Co-Investigators

Kristina Gorbatenko-Roth, Ph.D. – Dept. of Psychology

Jenna Maas, M.A. – Applied Psychology masters program

Assistants

Bob Spencer, Jenna Simon, Abby Laib, EmmaLee Ericksen, Katie Hosley, and Sara Grzelak – Applied Psychology program

Lindsey Grush and Mark Mittag – Mental Health Counseling program


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Study 1 - Introduction Retention?

  • The relationship between mental health and student retention has been understudied, despite a strong focus on uncovering predictors of retention in higher education contexts

  • Existing research among counseling center samples generally shows a retention advantage for students receiving counseling for personal problems compared to non-counseled students

  • Limited research exists examining the effect of mental health issues on retention among a general student population


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Study 1 - Methods Retention?

Questions

  • Does mental health status predict retention rates of college students?

  • For those with mental health needs, does seeking mental health care predict retention?

    Sample

  • 2201 undergraduate students at midsized Midwestern public university

    • 57% female; 93% Caucasian; equal class representation

    • Representative in terms of ACT, HS Rank, College GPA


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Study 1 - Methods Retention?

Procedures

  • Step 1: Assessed undergraduate mental health needs and treatment seeking via electronic health survey to all students (39% response rate) – Spring 2006

    • MH Need Status: “As a college student, have you ever needed healthcare services for mental health concerns (e.g. stress, depression, relationship issues)?”

    • MH Care Seeking Status : “Did you ever actually seek care anywhere for mental health concerns?”

  • Step 2: Assessed retention status in Spring 2007 (1 year post-survey)


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Study 1 – Results Retention?

Descriptives

  • Experienced a Mental Health Need During College

    • 16.8% (N=369) of total sample (N=2201)

  • Sought Mental Health Care Anywhere

    • 62.3% (N=230) of people with need sought care

    • 37.1% (N=137) of people with need did NOT seek care

    • 0.5% (N=2) no response to item query


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Study 1 – Results Retention?

Retention Comparisons


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Study 1 -Results Retention?

Significant Bivariate Relationships (Test of Independence (2)

CΦ: Cramer’s V

Black= Negative Relationship (positive on condition = less likely to be retained)

Red = Freshmen & Seniors less likely to be retained then Sophomores and Juniors


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Study 1 - Results Retention?

Binary Logistic Regression – Full Sample (n=1402)

  • Block 1: Academic & demographic predictors

    • Gender, Minority status, Low income status, 1st Generation status, Year in College, ACT, High School Rank, Cumulative GPA

    • Nagelkerle R2= .199

  • Block 2: Mental health status during college

    • Nagelkerle R2= .199

  • Mental Health need did not account for additional variance

  • Significant predictors (p ≤ .02) and direction of relationship

    • Class year (mixed), Cum. GPA (+), high school %ile rank (+), 1st gen. status (-)


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Study 1 - Results Retention?

Binary Logistic Regression – Mental Health Sample (n=219)

  • Block 1: Academic & demographic predictors

    • Nagelkerle R2= .272

  • Block 2: Mental health care-seeking during college

    • Nagelkerle R2= .321

  • Seeking MH treatment accounts for 5% more retention variance and increases ID of non-retention by 10.8% (full model=18.9%; reduced model=8.1%)

  • Significant predictors (p ≤ .02) and direction of relationship

    • Class year (mixed), Care seeking (-), 1st gen. status (-), low inc. status (+)


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Study 1 - Conclusions Retention?

  • Mental health (MH) need related to lower retention in bi-variate but not multivariate analyses (possible co-variation effect)

  • For those with a MH need, seeking care was predictive of retention, above and beyond traditional predictors

    • 2nd strongest predictor after year in college

  • Unexpectedly, seeking care was related to lower retention.

    • Current study is 1st known to look at a population (vs. treatment) sample and to control for other variables related to retention

    • Hypothesis: seeking MH care is a proxy for MH severity

  • More research is needed to tease out the complex relationship between mental health needs, treatment, & college persistence.


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Study 1 - Limitations Retention?

  • Self-report data

  • No measure of type or severity of mental health issue

  • No data on whether treatment was actually received, nor on type or amount of treatment

  • No information available regarding reasons students were not retained


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Future Research Retention?

  • Seek replication of findings among other general university populations

  • Examine several types of mental health related data, not just self-report data

  • Examine whether type or amount of treatment impacts retention

  • Examine whether severity of mental health need relates to retention


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Study 2 - Methods Retention?

Questions

  • Among counseling center clients, does severity of distress predict retention?

  • Among counseling center clients, does treatment length predict retention?

    Sample

  • 757 undergraduate students at midsized Midwestern public university, seeking counseling from 2003-2007

    • No career counseling; no mandated alcohol clients

    • 69% female; 94% Caucasian; Class year: FR-30%; SO-22%; JR-22%; SR-26%

    • Representative in terms of ACT, HS Rank, College GPA


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Study 2 - Methods Retention?

Measures

  • Retention: Students were considered retained if they earned credits or graduated within one year after a treatment episode

  • Episodes: defined as specific periods of treatment need for each subject

    • 865 treatment episodes; 80% had 1; 16% had 2

    • # of sessions ranged from 1-51; Mean=5.26; Median=3

  • Severity: Subject’s maximum score during episode on the “Outcome Questionnaire 45.2” (OQ-45.2)

    • Mean=75; SD=25


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Study 2 – Results Retention?

Retention Rates by Class Status


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Study 2 - Results Retention?

Retention: Significant bi-variate relationships

  • Year in College: 2 (3) =58.513, p=.00

  • # Treatment Sessions: r =.109, p=.001

  • Severity of Mental Health Need: r = -.08 (p=.02)

    Note: Severity of need and # of sessions also correlated r = .153, p=.001. This suggests a possible interaction and the need to look closer at relationship between these variables and how they impact retention.


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Study 2 - Results Retention?

Binary Logistic Regression

  • Block 1: Academic & demographic predictors

    • Age, Gender, Low income status, 1st Generation status, Year in College, ACT, High School Rank

    • Nagelkerle R2= .142

  • Block 2: Severity and treatment length

    • Nagelkerle R2= .183

  • Severity and Treatment Length accounted for 4% more variance and increased ID of non-retention by 11.8% (full model=13.6%; reduced model=1.8%)

  • Significant predictors (p ≤ .04) and direction of relationship

    • Freshman status (-), OQ score (-), # of sessions (+)


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Study 2 - Conclusions Retention?

  • Results were in expected directions

  • As severity of distress increased, the likelihood of being retained decreased

  • As treatment length increased, the likelihood of being retained increased

  • Treatment length and severity of distress predicted retention above and beyond academic and demographic factors

    However. . .

  • Retention rates among counseling center clients is lower than in the general student population


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Study 2 - Limitations Retention?

  • Self-report data

  • No information available regarding reasons students were not retained

  • Did not look at reasons for seeking counseling


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Future Research Retention?

  • Seek replication of findings among other university counseling center populations – include effect sizes

  • Examine several types of mental health related data

  • Look at interactions between severity and treatment length variables

  • Look at changes in distress over time

  • Control for other variables known to impact retention


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Implications Retention?

  • I still can’t explain study 1 results!

    • Could avoidance be functional?

    • Are treatment-seeking students more severe? Did they really seek help?

  • It may not be that counseling centers can boast higher retention rates than the general student population—at least not for those presenting with mental health needs

  • Nonetheless, studies like Wilson et. al (1997), and the present study, show that for this at-risk population, students who need treatment are more likely to be retained if they get treatment than if they don’t

  • The more severe the distress, the more intervention may be needed. Are our centers equipped for this?


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Implications Retention?

  • Do we have sufficient resources to reach out and identify the most at-risk students, and to provide adequate services once they seek help?

  • Your thoughts?


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