Can E-Mail Help Screen For Depression?

Depression and other mental health problems represent an increasing concern on college campuses. Now to me this is worth some analysis and speculation as there are so many preventative services (community mental health centers, informed pediatricians, skilled private practitioners, extensive work-ups by elementary, middle, and high school child study teams and school psychologists)available to young people before they enter college. One might expect that problems would have been identified and treated. On the other hand, being away from home, the stresses of college, and the emergence of some mental health problems during the 18-22 year-old period increase vulnerability. Christopher Overtree, Director of Psychological Services at University of Massachusetts notes:

“The number of students who come to college with mental health conditions is dramatically increasing and the level of severity that some of those students experience is a lot worse than it has been previously. In part that’s because quality treatment has been made available to students to enable them to achieve in ways they haven’t in the past,” he said in an interview. “The good side is we see more students who might in the past have struggled and not been able to make it to college. … But that leaves universities faced with the task of providing services to a much needier population than maybe 10 years or 15 years or 20 years ago.”

A team of researchers from Massachusetts General Hospital distributed a questionnaire to students at four unidentified colleges throughout the United States in an effort to identify the percentage who were depressed and if they were receiving treatment:

“The students answered questions about their moods and whether they had been treated for depression. Fifty-four students said they were taking medications, receiving therapy, or both. In all 82, or 14.5 percent of the students responding, scored high enough to fit the criteria for major depressive disorder. The prevalence of major depression among US adults ranges from 6.6 percent to 10.3 percent in a year.

“The 82 students who screened positive for depression were given online links to information on depression as well as resources for finding local treatment. Eight weeks later, 38 of those students completed a follow-up survey. Eight students said they looked at the online resources sent to them and one found a peer counseling group. Six said they didn’t seek help because they were worried about treatment showing up on their tuition bills. The others did not seek help from either source.

“E-mail appears to be a feasible and inexpensive way to screen college students for depression,” Shyu said in a conference call yesterday with reporters after presenting her team’s results at a meeting of the American Psychiatric Association in New Orleans. Findings made public in meetings such as these are considered preliminary because they have not been peer-reviewed as they would be for publication in academic journals. ‘In the future, we should look to see how we can reach out to these depressed college students with other resources that may be tailored more to the college student population.'”

For me this report raises more questions than it answers. How can confidentiality and anonymity be promised? (As I write this, the effect of the WIKI Leaks are being discussed worldwide.) Are students concerned that any treatment they receive will go into their permanent computerized health care record? Is computer screening really more effective than talking to students at orientation, talks in the dorm and classrooms, etc.? At Catholic colleges, can campus ministry provide an additional level of care? And still the question, “Why so much depression when so many other expensive programs are and have been in place and when there is so much information already out there, from Oprah and beyond?” What do you think?