Lessons from CME Snack activity: Saving lives with depression screenings on campuses
The ACHA-NCHA study on depression in college students left CME Outfitters staff thunderstruck by these eye-opening stats:
- 50% of students reported feeling so depressed and so hopeless at some time in the prior year that it interfered with their functioning
- 37% of college students reported depression severe enough to impact function
- Nearly 10% of students report that they’ve had serious thoughts of suicide
- Between 1-2% of college students report they’ve had a suicide attempt in the prior year
News articles on CNN and in the New York Times have also drawn attention to the gravity of student depression on college campuses. We felt this topic needed its own spotlight, and with the right format and expert faculty, we could build a course that could potentially have a real impact on patient outcomes.
We knew the right partner for this activity would be the JED Foundation, a leading non-profit organization committed to promoting emotional health and preventing suicide. CME Outfitters previously collaborated with JED on a successful project that educated campus staff on integration of returning military veterans on campus. Additionally, JED Foundation’s Victor Schwartz, MD, Chief Medical Officer and Nance Roy, Ed.D, Chief Clinical Officer, were uniquely positioned to lead the conversation due to their extensive background in the field.
We decided our CME Snack format was the optimal vehicle for the activity. CME Snacks are less than 20 minutes long, get to the essence of important topics, and quickly deliver learnings that participants can implement immediately. This nimble format has proven popular, as learners desire shorter, easier to consume content via phone or web.
CME Outfitters and the JED Foundation leveraged JED’s vast network of campus relationships and together examined how college medical centers work and the behavior among college students when it comes to seeking help. Notable to us was an opportunity to train and provide useful tools to primary care doctors and medical staff seeing college students to screen for depression and help them understand the warning signs to look for.
The result was Mental Health 101: The Class No One Wants to Talk About, which responds to a critical need in campuses across the U.S. in addressing depression in college students.
For our learners, specific insight included:
PHQ-2 or PHQ-9 Tools addressed the importance of screening students in the primary care setting. In the session, Dr. Roy indicated that “Students who were screened in primary care, it resulted in catching many, many students who might otherwise have fallen through the cracks.”
The importance of following up with patients; Dr. Roy added that “Anecdotally, what students reported as a result of that project was that the variables that were the most salient, that had the biggest impact on them, was that a doctor that they trusted cared enough to ask about their mood and then cared enough to follow up”
Medication Management including special concerns for dosage levels, emphasis of counseling students on the risks of mixing medication with abusive drugs and/or alcohol, the importance of timing in a medication plan, and augmentation strategies.
Integration of Services and Thorough Communication; Clinical services need to work together. Coordination and communication between health and counseling are critical to providing a holistic care plan to students. This includes continuance of care for students going to college who are already on a treatment plan.
The activity has garnered sizeable reach and feedback. For example, not long after we launched Mental Health 101: The Class No One Wants to Talk About, one of our participants, Dr. Bennett*, reported that he had the opportunity to screen a student who had come into a college health center where he volunteered. Dr. Bennett’s feedback resonated powerfully with our team:
“I watched the depression in college students activity over the weekend. Very well done. I also volunteer at [redacted], a local community college on Monday evenings. I was treating a for generalized pain and was focused on her pain complaint. I did screen her for depression and let me say that almost an hour later we worked through all the noise and recognized that she was having a significant depressive episode and actually had been thinking of driving her car off a ramp on the interstate! Your program put screening for depression and suicide at the top of my mind….”
For Dr. Bennett and others who watched Mental Health 101: The Class No One Wants to Talk About, Drs. Roy and Schwartz presented resources, campus programs, pharmacological, and non-pharmacological strategies for addressing the problem of depression amongst college students.
Dr. Roy stressed the importance of primary care in identifying depression in students: “We know that the large majority of students do access their health center on campus for a cold or the flu, etcetera. Far more students than ever go to their counseling centers, even though counseling centers are full to see the students and meet the capacity that they have. Still, we catch far more students in primary care.”
Dr. Schwartz underscored the necessity for the student, family, and clinicians both at home and on campus to be coordinated: “It’s really essential before they come to school that their families, their clinicians from back home, the student and the clinical services on campus work together to create a transition of care plan.”
The feedback we have received from learners has validated our work. They have said the most useful information learned was….
“…lecturers gave statistics on percentage of college age students with symptoms in this area; stressed coordination between student’s prior (pre-college) doctor, and the at-campus doctor.”
“…JED campus program has developed a lot of good programs for colleges that certainly were not there when I was an undergraduate”
“…focus on college students and how they are impacted by depression and the need for services for them”
“…Reaching students in nontraditional ways.’
“…understanding of the goals, purpose and involvement of JED campus activities. I really like this format, it is convenient and allows me to earn CME in addition to keeping up with new information and programs that are relevant to my practice and to my patients
Access more information about related CME Outfitters activities and resources:
CME Outfitters Depression Educational Activities: http://www.cmeoutfitters.com/activities/depression/
Set To Go, a JED Program: https://www.settogo.org/
JED Campus: https://www.jedcampus.org/
JED Foundation: https://www.jedfoundation.org/
American College Health Association – National College Health Assessment: http://www.acha-ncha.org/overview.html
* Some names have been changed