President Sandoval: Welcome back Wolf Pack Family. I'm your host Brian Sandoval, a proud graduate and the president of the University of Nevada. For those in need of mental health services help is available right here at the University of Nevada. The University's Counseling Services offer confidential support for students. All members of the University and local community can access low cost therapy through the Downing Counseling Clinic and the Psychological Services Center on campus. Today’s guest oversees University Counseling Services and has dedicated his career to supporting student mental health initiatives. Dr. Yani Dickens is the Director of Counseling Services at the University of Nevada, Reno, a licensed psychologist and a certified mental performance consultant specializing in sports psychology and mental health advocacy. Since joining the University's counseling services in 2008, he's expanded campus mental health services, established an APA accredited doctosral internship, and led one of Nevada’s largest mental health training programs. Beyond his university role, Dr. Dickens co-chairs the Nevada System of Higher Education Mental Health Task Force, and has published research on athlete psychology, self-talk in sports and mental health interventions. Today's podcast is being recorded in the at @one audio recording studio of the Matthewson IGT Knowledge Center. Dr. Dickens, I look forward to this important discussion about mental health and the ways in which your team supports students on campus. So welcome.

Dickens: Thank you so much for having me.

Sandoval: Yeah, it's going to be a really interesting conversation. So, let's dive right in. What are some of the most pressing mental health challenges you're seeing among college students today and how have these evolved over the past few years?

Dickens: Well, once again, thank you for the opportunity. So, what we've seen over the last two years and recently is a lot more anxiety, more stress, more depression, more trauma and more eating disorders. What stands out as well, since COVID is the complexity, a lot of people have more than one problem and students are no different. COVID was challenging for all of us and students at this university and other universities had to balance doing their coursework over Zoom. They had access to our services, they got those over Zoom as well. And then when we opened the campus again, they came in person and they had more social anxiety after not being around people as much. They had more academic stress. Those concerns seem to be settling a little bit, but they're higher than they ever have been amongst college students for decades, and they're not slowing down and coming down enough as we'd like to see it. And so we're serving students with all these challenges. And then to add complexity to that, we've got national and global events that are stressing students out all of the time, whether they're more political or whether they're more cultural or both. So, our clinicians are working hard to support students by providing a range of services to help them with these struggles and changing how we do things in innovative ways. Students want support more rapidly than they used to, and they want us to be flexible about how we provide support to them. And so, we're working hard to deliver that to them and also to be culturally responsive to their needs.

Sandoval: So what would you say, because some skeptics out there would say, back in my day, we didn't have this, we didn't need that.

Dickens: Yeah. One thing I would say is you probably did, but you just didn't know what it looked like. It might've been you. It might've been people around you more likely. So there's much more awareness and much lower stigma for having mental health concerns and a lot more talking about it openly than there ever used to be. And with that comes more strain on resources because people want the help. Now, I think a generational difference, I think those of us who are older might buy into stigma a lot more than students. But our own students, only 6% of them in a recent survey would let stigma for seeking help get in their way when it comes to mental health services. Yeah, I think the problems have always been there. The difference now though is that they are higher in prevalence and they are higher in severity in general, but particularly amongst college students than they have been in previous decades.  So it's increasingly important to try to support them at a critical time because college is really a fork in the road for a lot of students. If they can hang in there and cope with stress, they can do wonderful things and contribute to the community and the economy and the workforce. But if they struggle and they can't make it through, that's a very different experience for them and their second chances in life. Not everyone has to go to college when they're 18. People can take gap years. People can try change when their mind go into the workforce, do other things and come back later. That's important to realize too, I think. But having care when it's needed and college is a critical time, I think is super important. And I think another thing to build on that is there used to be an opinion that college students were pretty privileged, mostly OK, maybe a little worried. Well, and we find college students now to be not that way, to be under financial distress, housing insecure food, insecure to be, our particular students tend to work a lot more than students and other colleges, so they're really managing a lot and it's a critical time for them to develop coping skills that can actually help them throughout the course of their lifetime if they learn them at the right time. And so that's one of the reasons we're here is to help them through all that.

Sandoval: So, I really appreciate your discussing all of that. So, we have a lot of parents who listen to this podcast and perhaps they're worried about their son and daughter who's on campus, and perhaps that student doesn't know or isn't aware of this service. So, what can you say very quickly where they should go to get the help?

Dickens: Yeah, I think more students than ever simply find us online. You go on unr.edu and type in counseling in the search, you'll find us right away and students can schedule same day appointments to see us, particularly if they schedule those in the morning and there's appointments in the afternoon. And if it's later in the day, they can usually find one the next day. And we have crisis appointments if students need to walk in and other things like actually nonclinical consultations at our Great Basin Annex where students can just walk in and not even need to be a client, but talk to a therapist for 20 to 30 minutes and get a good problem-solving session and some advice in. So, there's multiple ways to get in now, and that's what I mean by when I was talking about students' expectations that we be flexible and provide service to them in a timely manner. That's what we're trying to do these days.

Sandoval: That's great. So, one of the university's strategic goals is to improve access to mental health services. How are we working to reduce barriers, whether logistical, cultural or financial for students, faculty and staff?

Dickens: Yeah, sure. So I actually started working at the university in counseling services 17 years ago and we had a traditional model back then where people called and made appointments and appointments could be had for the first time days in advance and students, then their needs might change and they may or may not arrive, and it wasn't very efficient. And then they'd go on a waiting list and finally they'd get in. And we adapted that model to an absorption model a few years back when we moved into our new building. And then a couple years ago, we changed it to a same day session, step care model. And what that means is we provide a range of services from prevention and education. We tell students during orientation that we exist in all the things that we do. We do tabling events on campus. We do education inside and outside of classrooms.
We're there at the Annex to do workshops with students. And those drop-in “let's talk” sessions. So that's kind of the front end, the range of preventative services that we provide. And then the clinical services we provide out of the Pennington Student Achievement Center, room 420. Those are individual and group counseling sessions. We do ADHD assessment, and we have a few tracks where students can get a little bit and more depending on their needs. We have specialized tracks for eating disorders, trauma and other things. We have to operate in a brief counseling model. We don't have fixed session limits, but because we want to tailor what we do to our individual clients. But they may come in and they may get a single session and they may decide that's enough for now. They may come back and have another one or they may go on to individual or group counseling.  It's important to know that although we do brief individual counseling, students can come in multiple times in their career, especially if they're interested in group services. And we have a very robust range of innovative groups that are tailored to the needs of students as well. A very strong groups program. And this is common amongst college counseling centers, but most people don't know that we serve a crisis walk-in function. Most outpatient clinics in a community would not do that. They'd say go to the emergency room, but we know our students won't do that and sometimes need crisis sessions. So we provide that to them as well. So that describes our step care model and how it works to get the right service to the person who needs it at the right time. And more college counseling centers are moving toward that model. And we're seeing good results.  A lot of students utilize our services. I think access to our services is better than ever. The results are really good in terms of consistently, more than 90% of students are satisfied with our services when they get them. The rates are similar when we ask students or our clients and students who we survey with independent vendors and our services are really effective. We have session by session ratings where we can anonymously compare the impact we make on our students to our peer institutions and colleges across the nation. And we're more effective than at least 90% of college counseling centers at helping students with moderate to elevated distress. And we know our services have a really good retention value. We help students stay in school, and I think that's one of the main reasons why we exist.

Sandoval: And before we talk more about the work of counseling services, let's take a sidebar to explore your background. Did you always want to work as a psychologist?

Dickens: I didn't always want to, but I did decide fairly early on. I was a student here at this university actually. I went to McQueen High School, so I grew up in Reno and then came here and I was part of the honors program. I was a pre-med major, and I just found in my sophomore year that the social sciences were more appealing. They came a little more naturally to me. And I took a Psychology 101 class that was self-paced, and I enjoyed it so much that you could finish it early. And I finished it in half of the semester. So, I just decided to sign up for more courses the next semester. And I was a dual major in psychology and sociology. I just sort of noticed that I always been a pretty good listener and enjoyed talking to people and wanted to be in the helping field in some capacity and psychology made sense to me. It came naturally. Sport performance was interesting to me too. I was coaching soccer at the time, and I found a way to blend the interest of psychology and sport together. And then studied that in graduate school where I went to the clinical psychology PhD program at UNLV and then came back to Reno to work here. And then about 10 years after that got an MBA in our MBA program here, which I thought was fabulous as well. So that's kind of my path to this work.

Sandoval: We're so glad you landed here. So, getting back to the work of your unit, can you share some of the new work expanded programs our counseling center has implemented recently to support mental health? And I think you talked a little bit about  it.

Dickens: Yeah, absolutely. A few years back, two or three, we opened a new satellite clinic just in a really high traffic area in between the residence halls across from North Virginia Street. And so students come across our walk bridge and see us right there. It's called the Great Basin Annex. And we renovated that space and we provide walk-in hours where students can do that “let's talk” program I was describing, which are nonclinical consultations with students where they can do problem solving or get advice. We also have peer mentoring, a strong peer mentoring program now that we've grown through the annex and we're out on campus in a lot of places today, for example, doing having therapy dogs on campus and tabling. And I would say that we have really grown the external community campus work that we do a lot. We don't just sit in our offices and wait for students to find us.  We get out there a lot and let them know that this is a service that they can benefit from. And then, as I mentioned, our step care model, our new service delivery model doesn't conceptualize things like we used to where we'd say everyone could benefit. And it's true. Everyone who is motivated to do individual sessions can benefit from them, but not everyone needs that. Some people really respond well to a single “let’s talk session” or a single clinical therapy session or a few of them. And so that's how we've evolved recently quite a lot. And I'd say another important shift has been our view that mental health is not just the responsibility of the individual students to do something about. It's the responsibility of the entire university. And we got a grant a few years back to start doing adult Mental Health First Aid where we train student, faculty and staff on campus to have conversations about mental health with people who are struggling, where they can listen actively and recommend how folks can get help and refer them accordingly. So, what we're trying to do there is to make an impact on the entire campus community to make it a campus that cares about students and their wellbeing and the wellbeing of faculty and staff as well.

Sandoval: So we're coming to the end of the episode. I can't believe how fast this has gone by, but I want to ask one more question, and what would you say to a student, staff or faculty member who's struggling right now, but unsure whether to reach out for support?

Dickens: I would say don't wait. I would say that stress is normal, but suffering doesn't have to be. I think that in my view, access to mental health is a basic human right and you may need to hustle or struggle to find services, particularly if you're not a student, if you're a faculty or a staff member or member of the community, it's hard to find quality care and get access to it in the community, but it's there and it's worth finding. And we're here to help students if they are in need, and we can help faculty and staff and steer them in the right direction to resources in the community that they can benefit from in the form of referrals that we can make.

Sandoval: But it's a new day where you talked a little bit about stigma and students, faculty, staff, but particularly students are more willing to come forward and get the help that they need.

Dickens: They definitely are.

Sandoval: Yeah. Well, unfortunately, that is all the time we have for this episode of Sage Brushers. Thank you for joining us today, Dr. Dickens. Really appreciate it. Really important conversation.

Dickens: Thank you so much for having me.

Sandoval: Yeah. So, join us next time for another episode of Sagebrushers as we continue to tell the stories that make our university special and unique. Until then, I'm University President Brian Sandoval, and of course, Go Pack! And, an important message, if you or someone you know is struggling with mental health or facing a crisis, you're not alone and help is just a call or text away. Call 988 to reach the suicide and crisis lifeline, available 24 hours a day, seven days a week. You can also call Crisis Support Services of Nevada at 1-800-273- 8255, or text the word CARE to 839863. Thank you.