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Andrew Hibel, HigherEdJobs: Dr. Burcin, you are the Director of Healthy Carolina, University of South Carolina, Columbia. Please briefly describe your role, and also what attracted you to this position?
Michelle Burcin, Healthy Carolina, University of South Carolina, Columbia: I was hired into my current role as Director of Healthy Carolina in December of 2005. I had, however, worked at USC for two years as a GA in Campus Wellness and 3 1/5 years as a part of the professional staff in Campus Wellness. So, most of my professional career had been spent at the University of South Carolina working in wellness and prevention. In the spring/summer of 2004, our Associate Vice President for Student Affairs, Dr. Gene Luna, asked me and a couple of faculty members to do some research about healthy campus initiatives. During this research process, I became very excited about the possibilities such a position could offer. And I guess you could say the rest is history. In this role, I am charged with creating a campus environment that encourages and promotes the development and maintenance of a healthy body, mind, and spirit through the collaborative development, promotion and assessment of a wide-ranging array of wellness programs and services for all students, faculty and staff at the University of South Carolina. Our Healthy Carolina initiative is a campus-wide effort, so it targets not only students, but also faculty and staff.
Hibel: Adjusting to the sometimes challenges of a college or university setting can often lead to issues related to a student's overall health. What would you say are the top health-related issues on campus today?
Burcin: Well, if you look at national health data, specifically the National College Health Assessment conducted by the American College Health Association, you will see that stress is the leading health indicator negatively impacting academic performance. So, I would be mistaken to not say "stress." However, I am extremely concerned about the maladaptive ways students are handling this high level of stress, such as high-risk drinking, poor dietary choices, and declining physical activity. The research has also shown an unsettling trend with regards to the mental health status of our students.
Hibel: Do you think these have changed over the past 10 years, or have the same issues remained constant? If they have changed, why? If they have remained static, do you think this will hold true for the future?
Burcin: Stress has been the leading health indicator for some time, but I think the possible reasons for this high level of stress have changed. For example, our campus has reported a sharp increase in the number of financial aid applications being processed. When economic times were better, students may not have felt the financial pressures they do today. We are also pretty aware of the impact that gaming and internet use has had on our students. Distracters such as Facebook and Wii have meant that students are being required to implement time management skills, which can be a huge hurdle for many students.
Hibel: Obviously, privacy is an important issue related to students' records on campus. Would you briefly describe the basic points of the Family Educational Rights and Privacy Act (FERPA)1 and how it relates to a student's health records?
Burcin: Folks that work in student health are required to uphold not only FERPA laws, but also HIPAA (Health Insurance Portability and Accountability Act) laws. Both of these laws protect the student's privacy. HIPAA says that as a health care professional, I cannot discuss or disclose a student's health history to anyone without their written permission. To be honest, HIPAA plays a much larger role in the clinical side of student health services than it does in the prevention side.
Hibel: In a recent article on NPR.org,2 it was stated that mental health, specifically dealing with stress, is a major factor on campus. What are your tips for staff and faculty of warning signs of students experiencing high stress and/or how they can help students alleviate pressures?
Burcin: Many campuses -- post the Virginia Tech tragedy -- have implemented Behavioral Intervention Teams (BIT) on their campuses. These multi-disciplinary teams work to promote the safety of students by addressing disruptive behaviors on the campus. At USC, faculty and staff are able to make "BIT referrals" via an online incident report, which alerts this team of the employee's concerns.
Hibel: What would your advice be to faculty or staff members who do not have BIT training about when they should get a team involved?
Burcin: I think the most important thing to do is not ignore signs that something is wrong. This could be concerning writings on a Facebook page or within an English paper, or it could be a complete withdrawal from previous activities and organizations. Either way, I think we have all learned that telling someone of your concerns is always the safest option.
Hibel: Stress can often lead to something more severe, such as depression. What are some common signs of depression, and how do you advise someone be helped if they are exhibiting these symptoms?
Burcin: A faculty or staff member may want to alert their division of student affairs, as this large department on a college campus is very focused on providing services and programs, and would probably be best prepared to address the situation at hand. Depression symptoms, according to the Mayo Clinic, include:
- Feelings of sadness or unhappiness
- Irritability or frustration, even over small matters
- Loss of interest or pleasure in normal activities
- Insomnia or excessive sleeping
- Changes in appetite -- depression often causes decreased appetite and weight loss, but in some people it causes increased cravings for food and weight gain
- Agitation or restlessness -- for example, pacing, hand-wringing or an inability to sit still
- Slowed thinking, speaking or body movements
- Indecisiveness, distractibility and decreased concentration
- Fatigue, tiredness and loss of energy -- even small tasks may seem to require a lot of effort
- Feelings of worthlessness or guilt, fixating on past failures or blaming yourself when things aren't going right
- Trouble thinking, concentrating, making decisions and remembering things
- Frequent thoughts of death, dying or suicide
- Crying spells for no apparent reason
- Unexplained physical problems, such as back pain or headaches
Hibel: Alcohol consumed by college students is a situation with which many institutions must deal. According to the University of Oregon's website, "Alcohol and other substance abuse is the leading cause of death in college-aged students, with 1,400 college students dying from alcohol related circumstances each year. A recent study found that 12% of all college students meet the criteria for alcohol dependence, yet only 1.2% receive counseling or treatment for an alcohol problem while in college."3 What are your thoughts on these statistics, and how do you think staff and faculty of higher education institutions can help in reducing the negative alcohol situations around campus?
Burcin: These statistics are pretty alarming, but honestly, I am not "shocked" by them. The use of alcohol by college students has been an issue facing college health professionals for years. However, the recent and more alarming trend of heavy alcohol abuse is concerning. Faculty and staff are seeing the side effects of this dangerous use of alcohol not only in the classroom, but also in the residential halls, Greek houses, etc. I think one of the best ways for faculty and staff to handle the issue is to actually address it! All too often I hear faculty and staff "norming" the high alcohol use on campus when comments are made like: "Since I know everyone will be drinking tonight, I have moved our test to Tuesday." These types of comments send a supportive message to our "drinkers" and also tell our students that choose to not drink that they are in the minority, which is NOT the case.
Hibel: Problems associated with body weight issues and/or eating disorders have been prevalent on the college campus for many years. Why do you think this is such a common problem, and what can staff and faculty do to help in fighting this battle?
Burcin: Body image and eating disorders are more prevalent during the college years, and I think this is a direct result of peer pressure and the appearance-driven culture we currently live in! I think as faculty and staff members, we need to not only model health behaviors (e.g. eating healthy, exercising, etc.), but we also need to not validate "fat talk" that occurs on campus. What I mean by "fat talk" is the constant negative comments that students make about their personal appearance. We need to help students critically review the messages (both written and picture) that they are sent daily via magazines, newspapers, and television.
Hibel: From an administrator's full plate, to a faculty member's full teaching load, to a college student's busy course load, fitness and proper nutrition could easily be overlooked. What are some tips to maintain proper fitness and nutrition whether working or living on campus?
Burcin: I always encourage folks to incorporate physical activity into their daily lives the same way they do their classes and meetings. So, if we put "work out" on our calendars, we are more likely to stick to our plan. The research has also shown that working out with a partner increases the likelihood that we will follow through with the activity. So, we need to find others on campus who like to walk at lunch or play racquetball after work. Many of our campuses are very spread out so we can increase our daily physical activity by just walking on campus to either our classes or meetings instead of driving. We can also utilize the stairs instead of the elevator as a means of incorporating more physical activity into our lives! With regards to eating healthy, the most important thing to do is PLAN. When we pre-plan our meals we are more likely to eat healthy. This may mean that we pack our lunch instead of buying it. We also have a wealth of resources at our disposal that allow us to look up the calories associated with various meals on our campus. Use these resources to your advantage.
Hibel: According to a recent study, approximately 2 to 4 percent of college students report significant symptoms of ADHD, including difficulty with attention, impulse control, and restlessness.4 Do you think staff and faculty are aware of the possibility that students could be affected by ADHD?
Burcin: I haven't seen research in this specific area, but I would just assume they are aware because of the recent national attention in the various news outlets. The thing they may not be aware of is the impact such a diagnosis can have on the student's academic performance. Many campuses have student disability services that are there to help the student succeed inside and outside the classroom.
Hibel: Have you seen a change in the use of tobacco on campus? If so, why do you think this has occurred?
Burcin: Yes -- thankfully! Many college campuses have implemented tobacco related policies on their campuses, which is helping to curb the smoking rates. I think campuses have also directly benefited from the local community, city and state tobacco policies, as these policies have made it harder for students to smoke when off campus. We have also seen a drop in the smoking rates among high school students, so we are inheriting these healthy behaviors as well.
Hibel: As faculty and staff in higher education, and specifically in the health services field, what do you think is the number one priority that should be addressed for assisting the student community with health issues?
Burcin: I personally think it is important for faculty and staff to be aware of the services and programs available for students. As faculty and staff members, we are resource guides for our students, and we can only help if we know what is available. To just name one "health issue" is too hard, as each campus has a different culture of health.
Hibel: What would be your advice to someone that is considering a career in the area of health services in higher education?
Burcin: I would recommend that they volunteer within a student health services department, and/or look at this campus department for graduate assistant positions, etc. As an undergraduate student, the easiest way to get involved is via a peer health education program. Peer health educators are usually a part of the prevention staff. This opportunity will open up so many doors for a student thinking about such a profession.
Hibel: Managing health on campus is an important role. What do you think are some of the major rewards of working in this field? Do you encounter challenges?
Burcin: I really enjoy seeing the students have "light bulb" moments when they realize the impact a healthy lifestyle can not only have on their academics, but also their personal life. With regards to challenges, there is never enough money or time to address all the issues we would like to tackle. I think it is just important to remember that we can't do everything. As health professionals, we need to model healthy behaviors too, but this isn't always easy given the long hours this type of job often requires.