As experts nationwide point to a mental health crisis among teens and young adults, a pilot program teaching mindfulness and coping techniques to students at the University of Washington has helped lower stress and improve emotional well-being.
New studies by the psychology researchers who created the program find that the strategies, offered first in residence halls and later through classes and other organized campus groups, have provided participants with successful methods for coping with stress, managing their emotions and learning self-compassion.
Researchers say the results show the potential for preventive mental health services offered in an accessible, peer-group environment.
"This program is not a substitute for campus mental health services for students. But with a preventive program, our goal is to reduce general distress in college students and hopefully prevent need for increased or more intensive services," said Liliana Lengua, psychology professor and director of the Center for Child and Family Well-Being at the UW.
Recent studies of the program's rollout point to its success. Results from the program's first year, when it was offered in 2017-2018 in residence halls on the UW's Seattle campus, were published March 10 in Anxiety, Stress & Coping. Results of its second year, provided during the 2019-2020 academic year by trained university staff in campus settings such as classes and student organizations, were published Feb. 12 in Frontiers in Psychiatry. Student participants reported significant improvements in their psychological well-being that lasted three months after the sessions ended.
During the pandemic -- with millions of young people studying remotely -- the importance of teen and college student mental health has grown. According to the CDC, 1 in 4 young adults between the ages of 18 and 24 has considered suicide in the past year, while separate studies of college students in recent months have found more than 70% report serious distress.
But even before the pandemic, campuses nationwide were reporting high levels of student stress and anxiety, with college mental health directors noting need for services that far outpaced availability. Academic demands, financial pressures, social tumult and, especially among first-year students, the transition to campus life all affect student mental health.
Against this backdrop, the authors decided to come up with a short intervention at the UW that would provide real-world coping strategies in an environment that students could access easily -- without an appointment or any fee, in the casual atmosphere of a group, and where they already live, study or socialize. The program, called Be REAL, or Resilient Attitudes and Living, combined traditional cognitive behavioral coping strategies -- such as planning, positive reframing and acceptance -- with mindfulness practices focused on regulating breathing, meditation and accessing feelings of compassion, tolerance and gratitude toward oneself and others. By having staff who are already working with student in various settings offer the program, it can potentially reach more students.
"The idea behind Be REAL was to have a new model to promote student well-being and mental health. Traditional counseling systems are unlikely to keep pace with demand, so we wanted to think of a program that could be delivered more broadly by nonclinical staff members," said Robyn Long, director of community programs and training for the Center for Child and Family Well-Being.
The first year, 208 students signed up for the program across three academic quarters. Facilitators trained in mindfulness techniques led six evening sessions at four residence halls. Among the more than 80% of students who attended the majority of the sessions, results from pre- and post-surveys showed significant improvements in mindfulness and self-compassion, greater resilience and lower stress. These findings held steady in a three-month follow-up survey of participants.
Those results led to the expansion of the program to other campus settings, with associated university staff -- from the recreation department, for example, as well as those connected to student organizations -- voluntarily trained in the Be REAL program. This approach aimed to reach additional students, particularly those from underrepresented groups, in spaces they already frequent. Of the 271 students who enrolled in Be REAL programming, 116 agreed to participate in the study; more than half were students of color.
Researchers found results that were similar to the residence hall study, especially regarding stress and emotional regulation. In their comments on post-study surveys, students reported using meditation and breathing techniques to help focus or calm down, and developing habits to handle stress.
The results raised other issues that researchers are exploring further, such as whether providing the lessons in a class that students take for credit creates more of a perceived burden -- and thus, leaves less of an impact -- than sessions in which students simply choose to participate.
A new, ongoing study is examining how about 100 university staff from all three UW campuses, trained in offering the program remotely, along with still more students, respond to the techniques for improving mental health. Those results may suggest opportunities for students and staff alike to benefit from the strategies in a range of environments, on any college campus, and to possibly change a campus culture around supporting student well-being. The Center for Child and Family Well-Being is collaborating with the UW Resilience Lab to expand the program and facilitator training to staff.
"Expanding Be REAL to promote staff well-being and training is important because their work, especially with the pandemic, can be stressful," Long said. "They've even shared how the practices are shifting their interactions with children and loved ones at home. Our expansion of the program goes beyond individual well-being -- it's also about strengthening our community on campus."
Both published studies were funded by the Maritz Family Foundation. Max Halvorson, a doctoral student in the UW Department of Psychology, was a co-author of the study published in Anxiety, Stress & Coping. Co-authors of the study published in Frontiers in Psychiatry were Katie Malloy Spink, research coordinator for the Center for Child & Family Well-Being, and Megan Kennedy, director of the UW Resilience Lab.