A Successful Community-Based Intervention for Addressing College Student Depression

Campus personnel are concerned with the results of several studies showing high rates of depression on college campuses. A 2001 study of 1,455 college students from four universities (Furr, Westefeld, McConnell, & Jenkins, 2001) found that 53% of the respondents experienced some form of depression while at college. Additionally, 9% reported that they had thought of committing suicide, with 1% reporting a suicide attempt. The American College Health Association's (2001) National College Health Assessment found that 76% of students reported feeling "overwhelmed" during the previous year and 22% were sometimes so depressed that they could not function. In studying college impact, Astin (1993) found that after entering college, students show a number of positive and negative changes in personality and self-concept. The most notable declines during college years are in the student's sense of psychological well-being.

The stresses and costs that untreated depression places on institutions of higher education are very significant (Levine & Cureton, 1998). There is little argument that colleges and universities would benefit from programs that creatively engage their members in positive options for prevention and early detection of depression (National Mental Health Association, 2002). College counseling centers must move away from the traditional focus on reactive and remedial treatment of depression and instead build community investment in reducing stress, providing social support, and encouraging and sustaining self-care (Stone & Archer, 1990). Counseling center professionals on one urban campus used this approach to develop a community-based program, Action for Depression Awareness, Prevention, and Treatment (ADAPT).

The ADAPT program incorporates a community psychology perspective—that mental health problems are best understood and addressed within the context of an individual's environment (Miller, 1969; Sarason, 1974). Community psychology conceptualizes human behavioral problems and solutions as part of a social context (Zax & Spector, 1974). This perception has led to the view that student depression can best be understood as resulting from the stressful educational environment. In addition, the university is viewed as a system that can provide positive resources while serving to alleviate some problems that result from depression. The community psychology approach places an emphasis on collaboration across disciplines to respond to community needs and utilizes the knowledge and skills of the targeted treatment population (Dalton, Elias, & Wandersman, 2001). In the last three decades, professionals in both the field of student development (Astin & Sax, 1998) and community psychology (Bloom, 1975) increasingly have documented the important positive academic, emotional, and social benefits that students derive when they are actively involved in their college community. For counseling services taxed by high demand for individual services, the community psychology approach increases available resources for students at risk. With expertise in direct psychological treatment, the staff of the Counseling Center has initiated, coordinated, and evaluated the efficacy of this community intervention.

ADAPT: Action for Depression Awareness, Prevention, and Treatment

The ADAPT program was implemented in four incremental stages, each of which will be described in the following segments.

The Planning Stage

Successful community-based interventions require extensive input and involvement from all members of the university. Accordingly, the Counseling Center professionals developed programs based upon information and perspectives gained from focus groups, individual interviews, and written feedback from students, faculty, staff, and administrators. Psychologists from the Counseling Center received initial support for this project from the university president and the dean of the College of Arts and Sciences. University officials are particularly invested in addressing the problem of student depression because of media focus on suicides committed at a high profile campus (Farrell, 2002). With this support, Counseling Center staff members sent letters announcing the creation of a new depression prevention program, which solicited ideas about how to best meet the needs of the college community. The letter was designed to enlist participation from a broad spectrum of university members in order to identify the impact of student depression on the community, ways to reduce the risk of depression and decrease stigma that might prevent students from seeking help, and ways to provide support to those suffering from depression. These letters were followed...