Tell me a little about yourself and your involvement with Mental Health on Yale’s campus.
I am a clinical psychologist by original training, and now I teach at the Yale School of Public Health. Since shifting to Public Health, I focus on prevention strategies for mental health, specifically for students on campus. I have never worked at Yale Health in that capacity; I used to be a supervisor at the Yale Psychology Training Clinic, which is on campus but is for anyone in the community seeking services as well as Yale students. The clinicians there are all graduate student trainees who are supervised by a licensed clinical psychologist. I was around that side of campus providing clinical supervision and training there up until two years ago when I moved over to the School of Public Health full time where I do more of this prevention work.
What do you believe to be the biggest problem that Yale undergrad students face right now with mental health?
I think there are several different factors going on. First of all, developmentally, we know that this age is a pretty high risk time for the onset of mental disorders, but I think that there are also some unique contributing factors about the college experience, as well. For example: moving away from primary support groups, moving away from family, experiencing new stressors like increased academic demands, potentially financial stress as well, and then general college culture. “Oh, I pulled an all-nighter” and “Oh, I signed up for this extracurricular” and “I’m taking this many courses.” There is really almost a normative unhealthy lifestyle, which spans from nutrition and mostly sleep deprivation to not letting oneself have enough fun. [My study] ruled that pleasurable event scheduling is actually a technique that is used for the treatment of depression because we are creatures that need to laugh and have fun and enjoy ourselves. When we deny fun and work too much, it contributes to general feelings of depressed moods and anxiety as well.
This discussion shouldn’t leave out things like binge drinking and substance use. Of course, drugs have known neurochemical effects on functioning that students might not even think about it. On a neurological level, it takes the brain a couple days to come back from heavy drinking. I have heard patients reflect and note that on Sundays, they start to feel depressed. However, they have also been heavily drinking on Thursday, Friday, and Saturday, so specific neurochemicals build up. You feel a slump when the chemicals come back down for homeostasis. There are about ten or twelve different lifestyle factors that are completely normal, statistically normative, that come together in college to create the perfect storm.
How successful and widespread is your suggested approach of a more proactive treatment of mental health?
Yale is one of several Universities that has an optional screening website where people can go in and anonymously respond to questions about their current functioning and get an automatized, real–time response. This might say, based on one’s responses, that you would likely benefit from mental health counseling. It points you towards resources for setting up an appointment with a healthcare provider. And that’s really all that is necessary. It is much more about equipping the individual with knowledge of their own health. We are encouraged to get annual physicals where you get your blood count, your eyes, and your thyroid checked. We are required to do this on a University level; you have to have a physician sign off a medical check-up before matriculating. It is not meant for the physician to say that yes, this person is in perfect health, but that a physician has been in touch with this person, and that they are aware of their health. And that’s my primary suggestion with regard to mental health: to provide information to the individual. It is not about going to the administration; in fact, the only information I would want going to the administration is yes, this person has undergone some evaluation.
You spoke a little about changing this “normative unhealthy lifestyle” of college students. What are three suggestions you would give a student to combat that culture?
I actually offered my [YSPH] students in my classes extra-credit for engaging in a variety of wellness behaviors. Students self-selected their own daily wellness initiatives, which ranged from reserving time each day to have fun, writing in a journal, setting a bedtime to adhere to, to performing thirty minutes of cardio-vascular exercise. I offered extra credit to students who maintained their initiatives for the whole semester, and as a result, I found decreases in depression, anxiety, and stress. The results ran completely counter to all of the research showing that depression, anxiety, and stress worsen over the course of a semester. So, in terms of changing that, it may come from the administration to offer incentives or to encourage people to go to health-promotion activities of their own. I used what was available to me to incentivize that: grades. People could raise their course grade by an entire letter grade by reserving time to, for example, listen to comedy for thirty minutes a day. That is the kind of thing that gets sacrificed in the mindset of, “this a constrained time of four years where I need to work really hard, and then I can attend to my health after.” But, what sometimes gets skipped over is that NOT attending to your health or having fun or getting enough sleep right NOW can actually cause the whole system to collapse. There is great value in these health behaviors. Even though we all sort of know this, no one is willing to sacrifice putting in those 45 minutes of additional study before an exam.
To learn more about Dr. Marney White’s work regarding mental health, check out her “Inspiring Yale” talk that highlights various important self-care strategies.
Interview by Beatrix Thompson.