The email went out at 4:55 p.m. on a Thursday afternoon, sent to a select group of Northwest faculty, coaches and staff Nov. 12, alerting them of a budding crisis gripping the University in what the subject line captured in three unassuming words: “Mental Health Awareness.”
Dispatched from Vice President of Human Resources Krista Barcus only to employees designated as “leaders of people,” the email, obtained by The Missourian, was concise. In the span of three sentences that stretched across two paragraphs, Barcus alerted the designated employees of “a concerning increase in suicide attempts by students on our campus.”
Along with an attached document providing mental health-related tips and resources to employees, the email served as one of the earliest, most direct steps the Univesity has taken in responding to a budding mental health crisis — one prompted by six acute suicide attempts over a 10-day span on Northwest’s campus and within the student population from Oct. 30 to Nov. 6.
“In four decades of policing here at Northwest, we’ve never had that level of severity, acuteness in such a compressed time frame,” said Clarence Green, the University police chief and vice president of culture. “And so, we really don’t have a reference point for why that would have happened.”
The six active attempts come amid a global pandemic that, as Green put it, has left students and staff alike in a certain degree of constant isolation, one forced by social distancing and exacerbated by mitigation measures like online courses and face coverings that mount barriers in identifying signs of mental health struggles.
These circumstances have left Green, a member of Northwest’s Leadership Team and the team’s representative on the University’s Behavioral Intervention Team, to combat a dual-edged health crisis alongside dozens of other University administrators without any blueprint on how to do so.
Facing the concerning uptick in attempts, the University’s response has centered around a blitz of messaging and information surrounding mental health awareness and resources, with the email from Barcus marking one of a number unprecedented steps Northwest has taken, Green said.
Over the last month, the University has delivered a persistent stream of information to students and staff, highlighting its employee assistance program and details from the University's health insurer, sharing tips on handling and encountering mental health struggles, and most importantly, Green said, urging Northwest community members to engage with and help monitor the student population.
In its attempt to spread awareness and increase reporting of mental health struggles, the University has fine tuned its Twitter usage, using a bevy of Northwest-affiliated accounts on the platform to share encouraging messages and information regarding support services, both on and off campus. Additionally, Northwest’s Wellness Services and Residential and Auxiliary Services launched a survey program via a platform called Intrinsic, one meant to gauge how students are doing “holistically,” Green said, in an effort to identify which students might be in need of a face-to-face check-in.
Combined, the battery of steps Northwest has taken seems to match the seriousness of the moment, a response Green said the University started putting together after seeing three or four attempts in a compressed time frame that heightened the institution's urgency in combating mental health struggles.
“Once it reached that threshold, I was able to look back to think about, ‘Have we ever experienced this before? What’s going on? Is this leading to a possible death?” Green said. “And we want to negate that, and so, at some point, we need to sound every whistle that we can.”
Early indicators suggest Northwest’s response has been effective in helping to identify students who might be facing mental health challenges, Green said. In all of its messaging surrounding the topic, including in a mass email to students from Northwest President John Jasinski Nov. 23, the University has urged students and staff to report any concerns to appropriate offices, Wellness Services or Kori Hoffmann, the assistant vice president of Student Affairs and the chairman of the Behavioral Intervention Team.
Reporting was largely down from year-by-year averages in the weeks and months leading up to the six suicide attempts and Northwest’s subsequent barrage of messaging, Green said. In the days and weeks since the University’s response took effect, reporting has increased, Green said, though he wasn’t sure whether reporting levels are any higher or lower than they normally are this time of year, with the holiday season and final exams serving as the annual backdrop to a high-stress environment, one now compounded by COVID-19.
“Having an increase in reporting, in my mind, is the best thing we can have,” Green said. “Because if we can get to folks beforehand, we don’t have the acute ones. That’s what I believe. Based off the data that I’ve seen so far, I believe in the past what was different was we got to individuals before it reached that level. We’re still trying to figure that out.”
Green deferred specific data-related questions to the Behavioral Intervention Team’s chairman and gatekeeper, Hoffmann, who did not respond to multiple interview requests.
Green said the pandemic’s impact on mental health has been twofold. The increased isolation that has accompanied the coronavirus has left students largely alone, a factor that has an impact on personal mental health as well as the likelihood of concerning behavior getting reported. There are simply less touchpoints between University employees and students now than ever, Green said, and fewer in-person events to stress the importance of mental health awareness.
The pandemic’s impact on both outreach and prevention left the University handcuffed in the early stages of the semester, still used to relying on face-to-face contact as the primary means for any stage of intervention.
“We’re still trying to figure that out,” Green said. “We have to use all types of different media to connect with people and all different types of methods and modalities. … We haven’t figured that out yet, but we’re trying through (the Intrinsic) platform, we’re using social media differently. And it’s hard, because our style and what we’re built off of is personal conversations and personal contact.”
The Behavior Intervention Team headed by Hoffmann has been a key factor in the University’s evolving response to mental health struggles while alleviating the immediate shortfall in reports of concerning behavior, Green said. Serving as what Green called a “fusion center,” the team combines representatives from more than a half-dozen University departments and offices, meeting weekly to examine University touchpoints with students.
Each department or office compiles a list of potentially concerning contacts or behaviors it has tracked in a student over the last week, bringing a catalog of names to cross reference with representatives on the Behavioral Intervention Team in an attempt to connect the dots, Green said.
Not every report, incident or tracked behavior change in a student makes its way in front of the Behavioral Intervention Team, with certain thresholds dictating whether a student’s name will be examined by the team as a whole. At UPD, Green said, well-being checks, repeated offenses and certain medical reports make their way to Behavioral Intervention Team meetings. Sharing information and reports helps the team build an individualized plan to help students succeed.
“A great example is, we have a person who, we see the name Johnny Harris,” Green said, illustrating the team’s operations using a hypothetical student. “When it comes to the fusion center, Johnny Harris may have had two incidents with UPD involving alcohol. And then Title IX might say, ‘Hey, we had a case with Johnny Harris.’ Somebody else — Res Life may say, “Boy, we’ve had an incident.’
“And so, you think, ‘Oh — in a compressed time, we’ve had seven or eight touchpoints, and it seems like behavior is escalating.’ And then, you know, academics can say, ‘Grades — not good. Should we be making contact with him — somebody on the team — to just kind of do a check-in?’”
The uptick in acute suicide attempts has led to longer meeting times for the Behavioral Intervention Team, Green said, as the group and the University as a whole attempts to alter its approach to mental health support. It comes as counseling visits to Northwest’s Wellness Center have increased by more than 11% over the last year and by more than 40% over the last four years.
In the fall of 2017, the Wellness Center hosted 681 counseling visits from Aug. 1 to Nov. 13, according to data provided by Evan Rand, the center’s assistant director of operations. In the same timeframe this fall, the Wellness Center tracked 1,005 counseling visits, up from 906 in 2019 and 820 in 2018.
Rand said the Wellness Center has been able to keep up with the increased demand for counseling visits in large part due to the designated wellness fee Student Senate passed in February. The Center hired an additional counselor. Wait times are down, Rand said. Wellness Services is doing all it can.
“Did the pandemic sort of heighten the need for mental health services? Maybe. Probably,” Rand said in a phone interview. “We also had expected this trend to continue just based on recent years and the growing need for mental health services. Ultimately, we hope to meet that need wherever it may go, and preferably reduce that need. … On the counseling side, we’ve met the student need to a greater degree.”
Meanwhile, mental health-related visits to the Wellness Center’s clinic are down this year, with the center tracking 104 visits from Aug. 1 to Nov. 13, the lowest total in the last four years. The decrease is another factor of the COVID-19 pandemic, which has forced the Wellness Center to prioritize clinic usage for virus-related visits. And the pandemic prompted Wellness Services to temporarily disable its online clinic appointment scheduling option for students, forcing students to call to make an appointment.
Rand said Wellness Services misses the luxuries of an online option as much as or more than students do, though he said the Center wasn’t hesitant to disable online scheduling after considering potential impact. The move was made due to the virus, with Wellness Center employees having to make follow-up phone calls to students to screen them for COVID-19 symptoms.
Still, Rand doesn’t see the lack of web-based scheduling as an increased barrier for students seeking mental health treatment, and the decision was endorsed by experts at Northwest’s School of Health Science and Wellness, including Elizabeth Dimmitt and Cris Jacobson, both instructors who have worked as counselors. Kristin Pelz, the Wellness Center’s assistant director of counseling, did not respond to an interview request, as the Wellness Center fights to meet the increasing need for mental health services.
“I would say we’re doing our best to meet that need,” Rand said. “I’m not even sure I have the right assessments to determine that, right? A mere visit count wouldn’t quite do that. I don’t know. … We wouldn't turn anyone away; it’s just, whereas in the past maybe we would see somebody same-day, this year perhaps we’re seeing them tomorrow.”
As Northwest enters a winter break set to stretch on for more than a month, Rand said Wellness Services hopes to analyze the web-based scheduling program, gauging the possibility of tweaking the model to accommodate for pandemic-related challenges. The Wellness Center has always required counseling visits to be made over the phone.
Green said UPD has been working for several years to identify an app-based program that would allow officers to help students make both counseling and clinic appointments in the field, but the University hasn’t found a viable service at an appropriate price point. There are no imminent plans to roll out an app-based program.
Until the pandemic subsides and face-to-face communications return to prominence, Green and the University are trying to evolve. The police chief is urging students to help spread the message of mental health awareness, even as the University amps up its own messaging. He is calling for students and staff to report any concerning behaviors in their peers, emphasizing the positive outcomes that accompany reporting. And he’s intent on helping students survive the mental health struggles they might be facing by openly talking about them, spreading information and awareness to every corner of Northwest’s campus in a dire attempt to normalize the normal.
“Because it’s normal,” Green said. “It’s normal to feel depressed. It’s normal to have anxiety. It’s normal to be pissed off. If things are not going well, and they’re snowballing on you, that’s normal.”