August 21st, 2010

E-mail screening for depression studied

In an age in which most college students spend vast amounts of time online, screening for depression via e-mail might make sense as a simpler, more cost-effective alternative to in-person screenings, recent research from a Massachusetts General Hospital team suggests. Prompting depressed students to get professional help, however, is still a challenge.

An MGH team led by Irene Shyu, B.A., a former research coordinator at the hospital’s Depression Clinical and Research Program, invited undergraduate and graduate students at four unidentified U.S. colleges to complete a depression screening survey online. A total of 631 consented.

Shyu says the study was an attempt to work around the staffing and expense involved in live, on-campus screenings.

“Because college students are always using the Internet in one way or another, Albert Yeung [director of primary care research at the Depression Clinical and Research Program] thought we might be able to reach students more effectively via e-mail,” Shyu says.

Participants answered questions related to demographics and treatment history, and then completed the Patient Health Questionnaire 9 (PHQ-9). Eighty-two students (14.5 percent) met the criteria for major depressive disorder (MDD); 73 (12.9 percent) had suicidal symptoms.

The students meeting MDD criteria were given links to information on depression, some of it from the National Institutes of Mental Health. They also received information about on-campus peer groups.

In a follow-up survey of the depressed students eight weeks later, only eight (21.1 percent) said they had used the resources. (Seven had read the depression-related information and one had met with a peer group).

That the students didn’t take advantage of psychological services wasn’t a surprise, says Dori Hutchinson, Sc.D., Director of Services at the Center for Psychiatric Rehabilitation at Boston University.

She cites a recent survey of 26,000 college students by The National Research Consortium of Counseling Centers in Higher Education that found that two-thirds of students in distress turn to their peers rather than an adult.

“There’s still a lot of stigma in seeking help,” she says. “[Students] don’t want to walk into a behavioral medicine program.”

Hutchinson and Margaret Ross, M.D., director of behavioral medicine at Boston University’s Student Health Services, agree that students may be more comfortable with e-mail screening because it allows anonymity.

“You’re talking about people who may not have come in, but they’re in their rooms and feel they can answer more honestly,” Ross says. She adds that if e-mail screening were to be implemented on a wide scale, there should be a way to monitor it in real time, for student safety.

Among other initiatives Boston University has taken to try to encourage students to seek out mental health services is a new peer-training program, funded through a Substance Abuse and Mental Health Services Administration (SAMHSA) grant. The program, led by Hutchinson and aimed at suicide prevention, will teach students identified as leaders on campus to listen to and interact empathically with distressed students, and refer them to Behavioral Services if needed.

In addition to taking part in National Depression Screening Day in October, the school will also make available a voluntary electronic mental health screening for incoming freshmen.

By Ami Albernaz

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