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Masters Theses Graduate Research and Creative Practice

4-26-2022

An Examination of Mental Health in First-Year College Students

Emily Jolin Luettke
Grand Valley State University

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https://scholarworks.gvsu.edu/theses/1037

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An Examination of Mental Health in First-Year College
Students
by
Emily Luettke
April 2022

Master’s Project
Submitted to the College of Education and Community
Innovation
At Grand Valley State University
In partial fulfillment of the
Degree of Master of Education
The signature of the individual below indicates that the individual has read and approved the
project of Emily Luetke in partial fulfillment of the requirements for the degree of M.Ed. in
Higher Education, College Student Affairs Leadership.

______________________________________________________
Laila McCloud, Project Advisor April 29, 2022

Accepted and approved on behalf of the Accepted and approved on behalf of the
M.Ed. in Higher Education Program Ed. Leadership and Counseling Dept.

Catherine Meyer-Looze
Karyn E. Rabourn, Graduate Program Director Catherine Meyer-Looze, Unit Head
April 29, 2022 April 29, 2022
 3

Acknowledgments

Thank you to my project advisor, Dr. Laila McCloud, for your feedback and

attention to detail in every step of this final project. Many thanks to my cohort

members and professors at Grand Valley State University for your constant support

and encouragement during my time in the College Student Affairs Leadership

program. Lastly, this couldn’t have been possible without my friends and family who

push me to great things that I never thought were possible.

Emily Luettke
 4

Abstract

Research shows that first-year college students are likely to struggle with their

transition into a higher education institution, which can lead to an influx of various

mental health issues. This project explores factors that impact the adjustment to

college as well as examines barriers that individuals face that keep them from seeking

professional help. As mental health issues are on the rise, especially with the

occurrence of the COVID-19 pandemic, it is crucial to have conversations with

students on mental health. The goal is to educate students in an effort to reduce

mental health stigma and share information about resources that are readily available

on campus. Research has shed light on the use of mindfulness-based programs that

strive to teach students ways they can better cope with mental health struggles. This

project introduces a five-week program that focuses on mindfulness, goal-building,

stress management, and coping strategies.

 5

Table of Contents

Title Page……………………………………………………………………………...1

Approval Page………………………………………………………………………… 2

Acknowledgments……………………………………………………………………..3

Abstract……………………………………………………………………………….. 4

Table of Contents……………………………………………………………………... 5

Chapter One: Introduction

Problem Statement………………………………………………………………... 8

Importance and Rationale of Project………………………………………………8

Background of the Project………………………………………………………... 8

Statement of Purpose……………………………………………………………. 10

Objectives of the Project………………………………………………………… 10

Definition of Terms………………………………………………………………11

Scope of Project…………………………………………………………………. 12

Chapter Two: Literature Review

Introduction……………………………………………………………………… 13

Theory/Rationale…………………………………………………………………13

Positive Psychology: A Conceptual Framework……………………………. 13

Well-being Theory…………………………………………………………... 14

Broaden-and-Build Theory of Positive Emotions……………………………14

Research/Evaluation…………………………………………………………….. 15

The Transition……………………………………………………………….. 15
 6

Contributing Factors to Mental Health Concerns…………………………… 15

Social Support…………………………………………………………… 15

Childhood Adversities…………………………………………………… 16

Drugs and Alcohol………………………………………………………. 17

Self-Image and Eating Disturbances……………………………………. 18

COVID-19 Impacts……………………………………………………… 18

Barriers to Receive Help…………………………………………………….. 19

Strategies to Better Cope with Mental Health Issues………………………...19

Mindfulness……………………………………………………………… 20

Summary………………………………………………………………………… 21

Conclusion………………………………………………………………………. 22

Chapter Three: Project Description

Introduction……………………………………………………………………… 23

Project Components……………………………………………………………... 24

Session One: Introductions and Purpose……………………………………. 24

Session Two: Introduction to Mindfulness………………………………….. 25

Session Three: Identifying Risk Factors and Setting Goals………………….26

Session Four: Stress Management and Coping………………………………26

Session Five: The Big Picture and How to Move Forward…………………. 27

Project Evaluation……………………………………………………………….. 27

Project Conclusions……………………………………………………………... 27

Plans for Implementation……………………………………………………….. 28

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References…………………………………………………………………………… 29

Appendices

Appendix A- Mindful Moments Flyer…………………………………………... 35

Appendix B- Mental Health Survey…………………………………………….. 36

Appendix C- NCSSLE Safe Place Self-Care Plan……………………………… 39

 8

An Examination of Mental Health in First-Year College Students

Chapter One: Introduction

Problem Statement

For first-time first-year college students, the transition to college may present an influx of

personal challenges, which can lead to numerous mental health issues especially amidst a global

pandemic (Fruehwirth et al., 2021; Wyatt et al., 2017). When starting college, this could be the

first time students are on their own without caregivers living with them. Moving away from

home all while trying to make new friends, excel in academically challenging coursework, and

get involved on campus can lead to new stressors that students might not have been prepared for

(Pritchard et al., 2007). These stressors could lead to students facing numerous mental health

challenges if proper coping strategies are not utilized (Wyatt et al., 2017).

Importance and Rationale of Project

Mental health issues are becoming more prevalent in college students and these

challenges could threaten a student’s well-being as well as their academic performance (Tinto,

1975). While all college students may be impacted by mental health concerns, first-year students

face unique challenges as they transition from high school to a higher education institution.

Students must navigate a new social environment while managing their academic

responsibilities. With the stigma that surrounds mental health, few students receive professional

help (Ebert et al., 2019). The most common reasons to not seek help were the preference to

handle the problem independently or wanting to talk to friends or family instead (Ebert et al.,

2019). As stress levels increase and mental health concerns arise, academic performance may be

negatively affected (Tinto, 1975). With the occurrence of the COVID-19 pandemic, mental

health issues have been on the rise, which proves why more attention needs to be focused on

student mental health (Fruehwirth et al., 2021). When students are not succeeding academically,

the institution could struggle with retention and the whole campus culture can be impacted

(Kalkbrenner et al., 2021).

Background of the Project

First-year college students report higher rates of self-injury and are more likely to

seriously consider suicide than upperclassmen (Wyatt et al., 2017). As students adjust to life at a

higher education institution, they experience a variety of unique emotions. Three-fourths of

individuals with mental health conditions show symptoms by the age of 24, thus students are
 9

either entering college with previously diagnosed conditions or they experience onset symptoms

shortly after arriving on campus (Kessler et al., 2005). While many students face mental health

issues, over 75 percent of first-year students reported that they would be hesitant to seek help

(Ebert et al., 2019). The COVID-19 pandemic has led to isolation and loneliness (Ensmann et al.,

2021) and has increased the number of students who deal with mental health issues (Fruehwirth

et al., 2021).

Now, more than ever, students are faced with challenges that negatively impact their

well-being and their academic performance. Institutions must work to combat the stigma around

mental health while providing adequate and accessible resources to students. By focusing on

mental health in first-year students, institutions can establish an environment of togetherness,

where students are comfortable in getting treated for their mental health concerns and can

properly cope with stressors and emotions. Mental health concerns for first-year students fit into

the larger educational context in terms of retention and persistence. If first-year students are

struggling with the transition to college and are not receiving the support they need to combat

mental health issues, their performance in the classroom could decrease. Decreased academic

performance could lead to students dropping out of the institution, thus impacting retention.

Mental health concerns on college campuses could also negatively impact the learning and social

environment for all students.

Mindfulness-based intervention programs have been used to teach students ways to better

cope with life stressors and improved the student’s overall well-being (Akeman et al., 2020; Aree

et al., 2020; Carmody & Baer, 2007; Conley et al., 2013; Dong et al., 2021; Dvořáková et al.,

2017; Gray et al., 2018; S.Y. Kim et al., 2021; Koydemir & Sun-Selisik, 2016). Mindfulness can

increase awareness which helps students adapt to challenges and changes while they transition to

college (Dong et al., 2021). Multiple mindfulness programs have taught students various

breathwork practices to increase awareness and bring one's attention to the present moment

(Dvořáková et al., 2017; Gray et al., 2018; S.Y. Kim et al., 2021). Other programs included

elements of mindfulness such as the practice of observing, describing, awareness, non-judgment,

and non-reactivity, all of which are components of meditation practice (Carmody & Baer, 2007;

Dong et al., 2021; Gray et al., 2018). Meditation leads to higher levels of mindfulness, and by

teaching students about meditation, they will be better equipped to cope with mental health

issues (Carmody & Baer, 2007).

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Statement of Purpose

Literature showing trends in the mental health of first-year college students will be

analyzed. Factors that lead to mental health concerns among first-year college students will be

explored in order to bring awareness to commonalities that first-year students face. The literature

reviewed will guide how institutions can better support first-year students to combat mental

health struggles during their transition to college. The goal of this project is to bring awareness to

the prevalence of mental health issues on college campuses across the United States and to

promote the importance of well-being to first-year students. The purpose of this project directly

addresses the initial problem mentioned by educating students on ways they can reduce or cope

with stressors in their lives that lead to serious mental health issues.

The project features a mindfulness-based program, called Mindful Moments: A

Mindfulness-Based Program for First-Year Students. The purpose of this program is to educate

students on the tools they can use to proactively manage the stressors that come with the

transition to college. The Mindful Moments program is designed for college students to support

their mental well-being and aid in their transition into higher education. Each session is 50

minutes long and the program takes place during the first five weeks of the fall semester.

Students will take a mental health survey before the start of the program to establish a baseline,

and they will be asked to take this survey again after the program is complete. Each week will

have key themes such as introductions, mindfulness, risk factors, goal-setting, stress

management, coping, and accessing resources. Each session will have homework for the student

to complete prior to the following group meeting. Homework consists of journaling prompts,

various forms of meditation, and creating a self-care plan.

Objectives of the Project

There are three objectives of Mindful Moments. The aim of the Mindful Moments

program is to bring awareness to the mental health issues first-year students face when

transitioning to college. The first objective is to increase the number of students who seek

professional help. Mindful Moments will teach students about mental health to reduce the stigma

of getting professional help when struggling. Key factors that lead to mental health struggles for

first-year students will be identified in order to show students that they are not alone and foster a

sense of community. The second objective is to educate students on ways to better cope with

stressors that might arise during their transition to college. Mindful Moments will provide
 11

students with the tools they need to proactively cope with mental health issues and foster a sense

of greater well-being. The third objective is to bring awareness to the resources available on

campus that can support students if they are struggling with their adjustment to college. Mindful

Moments strives to promote the overall well-being of students and will share information about

additional resources on campus such as counseling services, academic support (tutoring, success

coaching), career advice, multicultural center, LGBTQ+ resource center, disability support

resources, center for women and gender equity, financial aid support, TRIO resources, and center

for diversity, equity, and inclusion.

Definition of Terms

Throughout this paper, key terms have been utilized that warrant definition to assist in

common understanding. These terms are presented below in alphabetical order.

● Anxiety: In this project, anxiety will refer to general anxiety disorder, which is excessive

anxiety or worry, most days for at least 6 months, about a number of things such as

personal health, work, social interactions, and everyday routine life circumstances

(National Institute of Mental Health, 2018a).

● Depression: Depression (major depressive disorder or clinical depression) is a common

but serious mood disorder. It causes severe symptoms that affect how one may feel,

think, and handle daily activities, such as sleeping, eating, or working (National Institute

of Mental Health, 2018b).

● Eating Disturbances: Within the context of this project, eating disturbances will include

common eating disorders such as anorexia nervosa, bulimia nervosa, and binge-eating

disorder, which are all severe disturbances in people’s eating behaviors and related

thoughts and emotions. Preoccupation with food, body weight, and shape may also signal

an eating disorder (National Institute of Mental Health, 2021).

● First-time first-year college student: a student who has never been enrolled as a full-time

student within an institution. This includes students who are coming right from high

school and students who graduated from high school and had a gap before deciding to

attend college.

● Mental health: a state of well-being in which an individual realizes their own abilities,

can cope with the normal stresses of life, can work productively, and is able to make a

contribution to their community (World Health Organization, 2018).

 12

● Mindfulness: the practice of continuously returning to the present moment without

judgment to increase awareness.

● Wellbeing: Refers to one’s overall physical and mental health. Well-being is the balance

of facing challenges and then having the resources to provide support (Dodge et al.,

2012).

Scope of Project

Mindful Moments is geared towards first-time first-year college students who live on

campus. This project will bring light to mental health issues on college campuses and will

suggest ways in which students can prioritize their personal wellbeing. Students will be taught

various tools to proactively cope with mental health issues that may arise as they transition to

higher education. In addition, it is important to note the limitations of Mindful Moments. It is

beyond the scope of Mindful Moments to diagnose mental health issues and cannot be used in

place of proper treatment from a health professional. This will be communicated to students in

the initial email sent to students when they register for this program. This will also be noted

during the first session. This program is intended for first-time, first-year college students rather

than transfer students or upperclassmen in order to focus on the students who have never been to

college before. There are various factors that are out of control from program facilitators such as

support from administrators, resources available on and off-campus, student and parent buy-in

for participation in the program and certain institutional policies regarding the COVID-19

pandemic. These factors may impact the overall success of the Mindful Moment program.

In order for this project to be effective and implemented, the institution must provide the

following resources: a video conferencing software (e.g., Zoom or Ring) a counseling center on

campus; graduate-level and professional staff members who have completed trauma-informed

training to run the program; financial support for professional staff; and funds and resources

allocated for the mindfulness program. To start this program, the counseling center will need a

small grant to get this program started. The grant requested will be $2,000 which will cover

promotions, materials needed for the program to run, and the meditation teacher. Since the

program will be part of the counselor, clinical interns, and graduate student duties, minimal cost

will be needed to hold the program. The guest speakers from housing, recreation and wellness,

and the academic success center will be asked to volunteer their time to share a brief overview of

the services their offices provide.

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Chapter 2: Literature Review

Introduction

First-year college students are an impressionable group of students as they adjust to life at

a higher education institution. Students are not only adjusting to a new school but also adjusting

to a career choice and navigating their social lives (Cao, 2021). During this vulnerable, yet

exciting, time in their lives, first-year students are at-risk for serious mental health issues (Wyatt

et al., 2017). In order to examine this issue with a critical lens, a discussion of the theory and

rationale for this project has been included. Within this literature review, the reasons why first-

year college students are prone to mental health concerns will be explored. Further, common

mental health concerns among college students will be identified in order to make readers aware

of warning signs that a student could be struggling. The barriers that keep students from

receiving professional help will be examined in an effort to encourage help-seeking behavior for

individuals who struggle. Lastly, the ways in which students can cope with mental health

struggles will be identified and explored.

Theory/Rationale

Positive Psychology: A Conceptual Framework

Higher education institutions must make the well-being of first-year students a priority in

order to prevent emotional and behavioral problems from occurring later on in their academic

careers (Koydemir & Sun-Selışık, 2016). Well-being is a concept that comes from positive

psychology, which examines factors that can impact the positive mental health of students

(Seligman & Csikszentmihalyi, 2000). Before positive psychology emerged, mental health

professionals focused on curing diseases and treating their negative emotions, however; the

purpose of positive psychology is to focus on an individual's strengths in an effort to cultivate

positive emotions and enhance either emotional or mental health (Seligman & Csikszentmihalyi,

2000). Seligman (2002) explains that the aim of positive psychology is to place emphasis on the

best qualities in life rather than repairing the worst things in life. Seligman (2002) states, “To

redress the previous imbalance, we must bring the building of strength to the forefront in the

treatment and prevention of mental illness” (pg. 3). Positive psychology focuses on positive

subjective experiences like well-being and satisfaction from the past; joy, happiness, flow, and

sensual pleasures in the present; and optimism, hope, and faith for the future (Seligman, 2002).
 14

Historically, psychology has been the study of disease, weakness, and damage; however, positive

psychology is the study of strength and virtue (Seligman, 2002).

Well-being Theory

Seligman’s (2011) well-being theory explains the five pillars of positive psychology

which are positive emotions, engagement, relationships, meaning, and accomplishment- or

PERMA, which are all independently part of a flourishing life. There are two approaches to

well-being theory: a hedonic approach and a eudaimonic approach. The hedonic approach, or

subjective-well-being, focuses on increasing life satisfaction and positive affect while decreasing

negative affect (Diener et al., 1999). This approach places emphasis on the outcome of pleasure

and happiness (Ryan et al., 2008). In contrast, the eudaimonic approach examines factors like

purpose, growth, and acceptance, with more emphasis on the process of living well (Ryan et al.,

2008). Results from two studies of college students using cross-sectional and longitudinal data

have found evidence that suggests the structure of well-being leads to a flourishing life, and that

well-being can be validly measured through PERMA. Additionally, PERMA was found to be

useful for predicting the physical health and college success (Coffey et al., 2014). This means

that colleges could use well-being theory to track and promote well-being, which could be used

to assess the campus climate or could be used to identify students who may be at risk for

psychological distress, academic problems, or poor health (Coffey et al., 2014).

Broaden-and-Build Theory of Positive Emotions

The broaden-and-build theory of emotions is a theory that comes from positive

psychology that “describes the form and function of a subset of positive emotions, including joy,

interest, contentment and love” (Fredrickson, 2004, p. 1367). Joy creates the urge to play, push

limits, and be creative. Interest creates the urge for exploration of new experiences and

information. Contentment creates the urge to savor current life circumstances and integrate them

into new views of self and the world. Lastly, love creates cycles of urges to play, explore, and

savor loved ones (Fredrickson, 2004). Through these various tendencies, Fredrickson (2004)

explains that positive emotions expand one’s momentary thought-action repertoire. An

individual can build personal resources, including physical, intellectual, social, and

psychological resources that can be accessed later to improve coping capabilities. These

resources could be drawn on to better cope with struggles, particularly mental health issues

during one's first year of college.

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Research/Evaluation

The Transition

While college is a time for growth and development, it can also be a challenging time for

first-year college students as they transition to a higher education institution. The adjustment to

college can bring on extra stress for first-year students (Pritchard et al., 2007). First-year college

students report higher rates of self-injury and are more likely to seriously consider suicide (Wyatt

et al., 2017). This suggests that students in their first year of college may not be seeking

treatment for mental health troubles. Further, one’s first year in college is the prime time to

address mental health issues and promote students getting professional help (Wyatt et al., 2017).

Understanding the transition from high school to college in terms of a student's social, emotional,

and academic needs may help explain why first-year students are at risk for mental health issues

(Wyatt et al., 2017). When a student moves away from home to attend college for the first time,

they are impacted by new social networks and will need to form a new social circle, which could

lead to increased levels of stress (Brandy et al., 2015). These heightened stress levels have been

found to correlate with difficulty adjusting to the college environment as well as decreased

academic performance (Tinto, 1975). Since the first semester of college is a season of change for

most students, having a program that supports their mental health as they adjust to college life

could be helpful.

Contributing Factors to Mental Health Concerns

Social Support

Once first-year students arrive at their institution, they may require extra support from

friends, family, and staff members in order to make their adjustment to college life easier.

Students who perceived high levels of support from staff members at the beginning of the

academic year reported a greater sense of belonging at the institution five weeks later (Secui et

al., 2021). This was found based on the relationship between academic self-efficacy, general

self-efficacy, and perceived social support. With higher levels of self-efficacy, the more the

student believed that they had the skills to succeed and adapt to new challenges that they faced

(Secui et al., 2021). This proves that students value the support they receive from their institution

even if they are lacking familial support.

Students are coming from a wide range of backgrounds and have life experiences that are

unique to them. With this in mind, it is important to acknowledge that the student may have
 16

negative life experiences that could make their adjustment challenging. Students who

experienced more negative life events were more likely to have problems adjusting to college

social, however; support has been found to mediate the relationship between negative life

experiences and the transition to college (Cao, 2021). This was because of higher levels of social

support and higher levels of problem-solving skills buffered the negative effects that stressful life

events had on emotional and behavioral problems for students (Cao, 2021). A program focused

on the well-being of first-year students could give the students the extra support they while they

transition to college. Further, students who connected with peers that had a shared experience of

mental illness reported feelings of empowerment and community, knowing that they were not

suffering alone (Turosak & Siwierka, 2021). Having a program that focuses on student mental

health to reduce the stigma could strengthen bonds between students as well as the campus

community as a whole. With a greater sense of belonging, students are more likely to have a

successful transition into college, and therefore, programing focused on the well-being of first-

year students is essential to their adjustment (Secui et al., 2021).

Childhood Adversities

While attempting to make new friends and create a new life at college, students are also

facing the stress of coping with challenges they have faced in the past such as bullying and

victimization. The long-term effects of bullying and victimization during a student's childhood

could impact them as they transition to college (Reid et al., 2016). First-year students who were

previously bullied reported higher rates of depression in the spring semester, which could have

been caused by a lack of perceived social support (Reid et al., 2016). Students who were bullied

are more likely to experience depression and anxiety while adjusting to college as compared to

students who were not bullied (Holt et al., 2014). While childhood bullying could impact a

student's adjustment to college, there have been ways to reduce the long-term impact. Having a

strong familial support system during the initial adjustment period to an institution may help to

protect first-year students who were bullied in the past (Reid et al., 2016). The students who had

a history of being bullied and who also had perceptions of social support were less likely to

experience poor mental health outcomes, including depression and anxiety (Reid et al., 2016).

Childhood adversities (including parental psychopathology, emotional, physical, and sexual

abuse, neglect, bullying victimization, and dating violence) have been found to contribute to

mental health disorders found in college students (Huskey et al., 2022). Further, over 75% of
 17

college students have reported exposure to at least one of the childhood adversities listed above

(Huskey et al., 2022). Other factors that have led to depressive symptoms of first-year students

were the absence of personal goals, high anxiety levels, dysfunctional thoughts regarding

success, receiving little encouragement from parents, and being attracted to members of the same

or both sexes (Villatte, 2017). Students coming into college are showing up to campus with a

plethora of unique past experiences. While some adjust quickly to the college environment, other

first-year students may need additional resources and support to ease their transition. While

resources are available to help students who struggle with their mental health, students might not

be aware of the extra support that is available.

Drugs and Alcohol

Once students arrive at their institution and begin to form their new social circle and

identity, they may be exposed to experiences such as alcohol and drugs. College alcohol beliefs

are the expectations that students have regarding college drinking culture, such as that college is

a time to experiment with alcohol or that getting drunk is a rite of passage (Osberg, 2021). While

the majority of college freshmen are under the legal drinking age, 32.7% of college students

reported heavy drinking, which is defined as having five or more drinks in one sitting, in the past

two weeks, and 34.8% reported being drunk at least once in the last month (Johnson et al., 2012).

These heavy drinking patterns can lead to serious mental health issues as well as suicide attempts

(Stanciu, 2021). With higher levels of depression, stress was positively associated with alcohol

use and misuse (Stanciu, 2021). First-year students who experienced high levels of anxiety were

found to consume a greater amount of alcohol more frequently and the same thing was found for

students who experienced high levels of depression (Kenney et al., 2018). Among college

freshmen, neuroticism was a top predictor of alcohol use and misuse and can be used to

determine at-risk populations (Stanciu, 2021). Students who have high levels of neuroticism are

more likely to have feelings of anxiety, depression, anger, and guilt, and have a harder time

responding to environmental stress (Leary & Hoyle, 2009). This suggests that students who

struggle regularly turn towards unhealthy coping strategies such as alcohol and drugs. First-year

students should be educated on ways to proactively handle challenges that they face in order to

combat the misuse of drugs and alcohol.

 18

Self-Image and Eating Disturbances

Another contributor to mental health concerns is low levels of perceived self-image and

eating disturbances. College students who are living away from home for the first time may find

that their eating habits shift from what they were accustomed to growing up. Eating behavior,

body image, and feelings of one’s appearance can not only further impact mental health but can

lead to academic functioning problems among college students (Hautala et al., 2020). Further,

students who participated in a fasted diet, in which they abstain from food intake for an extended

period of time, were more likely to engage in substance abuse behaviors as well as indicators of

poor mental health such as anxiety, eating disorder symptoms, self-injury, and suicidal ideation

(Ganson et al., 2021). Binge eating and purging behaviors were found to be common among

first-year college students (Serra et al., 2020). These behaviors were regularly associated with

mental health problems and low academic performance (Serra et al., 2020).

While many college-age students have been found to meet eating disorder criteria, few

students seek help due to barriers. These barriers include inadequate mental health literacy, lack

of guidance from healthcare providers, lack of support from friends and family, feeling ashamed

for seeking help for mental health concerns, and the stigma around eating disorders in general

(Nicula et al., 2022). If symptoms of eating disorders are not identified and properly treated by a

professional, the student can face ongoing challenges related to functionality, their mental and

physical health, social relationships, and academic success (Öztürk et al., 2022). Additionally,

factors such as social appearance, relationship to family, eating attitudes, and anxiety should also

be kept in mind (Öztürk et al., 2022).

COVID-19 Impacts

The COVID-19 pandemic and sudden shift to online remote learning for students brought

increased levels of anxiety for first-year students and an increased need for empathy,

communication, interaction, and flexibility with their academic coursework (Ensmann et al.,

2021). In first-year college students alone, the prevalence of moderate to severe anxiety

increased by over seven percent within four months after the pandemic began, and the

prevalence of moderate to severe depression increased by over ten percent (Fruehwirth et al.,

2021). The increase in depression and anxiety was found to be associated with difficulties with

distanced learning and social isolation (Fruehwirth et al., 2021). Further, the prevalence of
 19

alcohol use disorder and binge-eating disorders also increased during the pandemic (H. Kim et

al., 2021).

Barriers to Receive Help

While mental health concerns are prevalent among college students, few students seek

professional help. Over 75 percent of first-year students reported that they would be hesitant to

seek help if they had a future emotional problem (Ebert et al., 2019). The two most common

reasons to not seek professional help were because the students preferred to handle the issue by

themselves and that they would rather talk with friends or family instead (Ebert et al., 2019).

Further, a lack of knowledge about mental health resources on campus is an additional barrier

that keeps students from getting help (Pace et al., 2018). The stigma surrounding mental health

was another common theme to explain why students are hesitant to seek help. Students may fear

that they will be looked upon differently for seeking help because they believe society holds

negative views of those with mental health issues (Pace et al., 2018). In terms of stigma, students

reported that they have been impacted by microaggressions made by other students about the

topic of mental health. Microaggressions can downplay or invalidate a student’s experience and

can serve as another barrier to not seeking additional support (Turosak & Siwierka, 2021).

Strategies to Better Cope with Mental Health Issues

While it is not uncommon for students to turn to destructive ways of coping with mental

health issues such as alcohol and substance use, there are healthier ways to manage symptoms.

Students who had a level of self-awareness in regards to their symptoms found that they could

make conscious decisions to focus on their mental health. This included setting boundaries to

ensure they do not over-commit themselves, having alone time, journaling, and exercising

(Turosak & Siwierka, 2021). Moreover, various programs that focus on wellness have been

found to reduce various symptoms of mental health issues. Programs that ranged from five days

to eight months all found significant positive effects by reducing stress and improving overall

well-being (Akeman et al., 2020; Conley et al., 2013; Dong et al., 2021; Dvořáková et al., 2017;

Gray et al., 2018; S.Y. Kim et al., 2021; Koyemir et al., 2016). These programs focused on

themes such as mindfulness, stress management, communication, resilience, goal setting, and

problem-solving (Akeman et al., 2020; Conley et al., 2013; Dong et al., 2021; Dvořáková et al.,

2017; Gray et al., 2018; S.Y. Kim et al., 2021; Koyemir et al., 2016).
 20

Mindfulness

Amongst other programs that focused on student wellness, the use of mindfulness as an

intervention was found to be the most prominent and impactful. Education on mindfulness led to

students being more aware of their body sensations, thoughts, and emotions with less reactivity

(Dong et al., 2021). This awareness made it easier for students to adapt to new challenges and

environments such as adjusting to college life (Dong et al., 2021). Several mindfulness programs

focused on breathwork, such as the Learning to BREATHE (L2B) program, which was created

to represent the developmental tasks of college transition (Dvořáková et al., 2017). Other helpful

breathing techniques included belly breathing, dynamic breathing, counting breaths, the S.T.O.P

method, which stands for Stop, Take a breath, Observe, and Proceed, and simple mindful

breathing, which is the simple attention to the flow of the breath, in and out (Gray et al., 2018;

S.Y. Kim et al., 2021).

Another avenue to channel mindfulness is through the practice of meditation.

Mindfulness through meditation “seeks self transformation through self-observation. It focuses

on the deep interconnection between mind and body” (Aree et al., 2020, p. 162). When

practicing meditation, the goal is to continuously return to one chosen focal point again and

again. This is done through awareness of sensations, such as breath, noticing the physical body in

space, sound, repeating a phrase or mantra, among many other techniques. Carmody and Baer

(2007) explain that “the elements of mindfulness include capacity for self-awareness; attunement

with embodied experiences; and nonjudgment [sic] about physical sensations, emotions, and

thought” (p. 24). This practice allows one to pause and respond to stimuli with awareness

(Carmody & Baer, 2007). The five elements of mindfulness including observing, describing,

awareness, non-judgment, and non-reactivity (Carmody & Baer, 2007; Dong et al., 2021; Gray et

al., 2018). Observing in terms of a mindfulness practice means noticing stimuli, both internal and

external, such as emotions, sensations, sights, sounds, and smells. Describing is the ability to

label the stimuli with specific words. Acting with awareness is to be present in the given

moment, rather than being absent-minded or behaving automatically. Non-judging means

refraining from evaluating one's inner experiences such as emotions or sensations. Lastly, non-

reactivity means to refrain from getting caught up in thoughts or feelings but rather allowing

them to come and go (Carmody & Baer, 2007). The practice of meditation has been found to

lead to higher levels of mindfulness, which can reduce mental health issues and lead to improved
 21

well-being (Carmody & Baer, 2007). Further, mindfulness as an intervention has been found to

improve the transition into college for first-year students (Conley et al., 2013; Dong et al., 2021;

Dvořáková et al., 2017).

Summary

First-year college students are often faced with challenges while adjusting to college and

experience a great deal of stress (Pritchard et al., 2007), which impacts their mental health and

academic success (Wyatt et al., 2017; Tinto, 1975). The transition to college may challenge

students in terms of navigating a new social environment (Brandy et al., 2015), especially if they

are lacking social support from family, friends, and institution staff members (Secui et al., 2021;

Cao, 2021; Turosak & Siwierka, 2021). Childhood adversities such as being bullied as a youth

may impact this transitional time (Reid et al, 2016). Since this could be the first time students are

truly independent, they may be faced with making choices regarding drugs and alcohol use,

which could further hinder their mental health and well-being (Osberg, 2021; Stanciu, 2021;

Kenney et al., 2018). One’s perceived self-image could negatively impact self-confidence which

could affect eating habits, leading to eating disturbances, mental health issues, and poor

academic performance (Hautala et al., 2020; Ganson et al., 2021; Serra et al., 2020; Öztürk et al.,

2022).

The COVID-19 pandemic has played a major role in a student’s transition into college

and has caused students to feel isolated and in need of empathy, communication, interaction, and

flexibility with their academic coursework (Ensmann et al., 2021). In first-year students, the

prevalence of both anxiety and depression increased after the pandemic began, due to difficulties

with distanced learning and social isolation (Fruehwirth et al., 2021). Alcohol use disorder and

binge-eating disorders also increased during the pandemic (H. Kim et al., 2021).

While many students struggle, few seek professional help (Ebert et al., 2019). Barriers to

receive professional help include shame and the stigma associated with having mental health

issues (Pace et al., 2018), would rather handle the issue by themselves or with friends or family

(Ebert et al., 2019), and the lack of knowledge about mental health resources on campus (Pace et

al., 2018). While many students choose not to get help, there are other ways to cope with mental

health issues. Utilizing various breathing techniques has led to students being more aware with

less reactivity, making it easier to adapt to new challenges and environments (Dong et al., 2021).

Meditation leads to higher levels of mindfulness, reduces mental health issues, improves well-
 22

being (Carmody & Baer, 2007), and has been found to improve the transition into college for

first-year students (Conley et al., 2013; Dong et al., 2021; Dvořáková et al., 2017). Utilizing the

principles of positive psychology, the overall well-being of first-year college students can be

observed and improved with strong social support systems (Seligman & Csikszentmihalyi, 2000;

Cao, 2021; Fredrickson, 2004; Cohen & Wills, 1985).

Conclusion

Research has shown that first-year college students are highly susceptible to mental

health issues due to various factors such as a tough transition into college, past childhood

adversities, a lack of social support from friends, family, and institutional staff members, the use

of drugs and alcohol, poor perceived self-image and food disturbances such as binge eating

disorder, and the lasting impacts of the COVID-19 pandemic. While each student enters college

with unique and diverse experiences, it is important to educate students, faculty, and staff

members on potential factors that could impact a student’s mental health. Further, there are

various barriers that keep students from seeking help when they are struggling. In addition to

seeking professional help, students can use mindfulness, such as meditation and various

breathing techniques in order to better cope with negative life experiences, in an effort to reduce

mental health struggles in the future.

 23

Chapter Three: Project Description

Introduction

First-year college students face a wide variety of challenges during their transition into

college for the first time that can lead to an influx of mental health issues. The goal of this

project is to bring awareness to these challenges in order to better support students as they adjust

to college life. To provide support to students as they adjust to college, a mindfulness-based

intervention program called Mindful Moments: A Mindfulness-Based Program for First-Year

Students will be adopted in order to achieve three main objectives. The first objective is to

increase the number of students who seek professional help. The second objective is to educate

students on ways to better cope with stressors that might arise during their transition to college.

The third objective is to bring awareness to the resources available on campus that can support

students if they are struggling with their adjustment to college. In order to accomplish this, the

program will have four main topics: mindfulness, goal-building, stress management, and coping

strategies.

The first group session will go over the format of the program including how it will be

delivered, the duration of the program, who the program will be targeted towards, and who will

lead the program. This session will give a brief introduction to mindfulness to explain why

students are encouraged to attend the workshop. A proper, more in-depth, introduction to

mindfulness will take place during the second session. Throughout this program, students will be

instructed to complete various journaling exercises that reflect on their transition to college and

work to identify potential barriers that they are facing. The third session will begin the education

portion of the intervention program where students will be informed of the statistics on how

many students are impacted by mental health problems, what these problems could take shape as

(anxiety, depression, drug and alcohol use, self-image and eating disturbances) and how the

reasons why many students do not seek help. A deeper analysis of mindfulness will be explored

during the fourth session as a way to offer healthier coping strategies to students. During the

final session, students will be informed of resources available on their campus such as

counseling services, support groups, recreation classes offered, and how to refer a peer to help

who may need support.

 24

Project Components

First-year college students will have the opportunity to complete a mindfulness-based

program, Mindful Moments, that will meet for 50 minutes, once a week, for five weeks. This

program will be promoted by the counseling center during the student’s orientation visit to

campus. Further, a flyer will be posted and handed to students during the orientation visit (see

Appendix A). Currently, this program is only offered virtually due to the COVID-19 pandemic.

The program is facilitated by licensed clinical psychologists from the university counseling

center along with clinical interns or graduate students. All facilitators have trauma-informed

training and have had some experience with mindfulness. A staff member from the university's

recreation and wellness department, the housing department, success coach from the school's

academic success center, and a professional meditation teacher will also present supplemental

information from their fields.

Mindful Moments will begin on the first Sunday of the fall semester and each session

will start at 7 pm. Prior to the first session with students, the graduate student in the counseling

center will send students a survey that asks about their likelihood to seek professional help and

their knowledge of the resources available on campus for students who struggle with their mental

health (see Appendix B). The information collected from the survey will be kept anonymous. A

clinical intern from the counseling center will create a report of the data collected so that it can

be used in the future to assess the effectiveness of the program.

Session One: Introductions and Purpose

During the first initial meeting, the graduate student and clinical intern will take

attendance to track who comes to each meeting. The professional staff members will introduce

themselves and will give an overview of what Mindful Moments will entail. The staff members

will summarize what mindfulness is and will explain the intention of the program along with the

rationale behind it. Students will introduce themselves to the group by sharing their names, why

they signed up to do the program, and give one thing they are grateful for. This may be done in

smaller breakout rooms where there will be one licensed therapist per breakout room. The first

session will end with an introduction to meditation where students will be invited to participate

in their first loving-kindness meditation. This meditation will be no longer than five minutes. The

three phrases for the loving-kindness meditation will be “May we be happy. May we be healthy.
 25

May we live with ease and peace.” Students will then be assigned their homework for the week.

Week one homework is to write down a list of how you spend your time. After writing the list,

create a second list of the things that are most important to you. Examine the two lists and circle

recurring things or ideas and note what does, or does not, align with the two lists. Students will

be given a journal to write this in and will be asked to write down thoughts, questions,

observations, or anything else while enrolled in the program.

Session Two: Introduction to Mindfulness

Session two will start with a quick discussion on last week’s homework. Students will

have the chance to share their experiences from the journaling exercise and anything that went

well or didn’t go so well from the previous week. This session will feature a guest speaker who

is a meditation and breathwork teacher. The meditation teacher will teach students the purpose of

meditation and how to meditate. While many think that mediation is the act of clearing the mind

of any thoughts and must be done completely still, perhaps sitting cross-legged on a cushion, this

is not what mediation has to look like. Meditation is the practice of bringing one’s attention back

to a chosen focal point over and over again. This focal point could be breath, a mantra such as

loving-kindness meditation, or one of the five senses like smells, sights, or sensations in the body

(i.e. noticing one’s hands, noticing where one is connected to the floor). This can be done by

sitting still, typically sitting in a comfortable upright posture is helpful as it brings some alertness

to the body rather than laying down, which might cause sleepiness. Another way to meditate is to

partake in a moving meditation. This could be walking, cooking, drawing, knitting, or anything

else that you can do mindfully.

The instructor will lead the class through another loving-kindness meditation, offering the

same three phrases as last week but this time offering it first to someone in their life who is easy

to love (partner, friend, or maybe a pet). They will be instructed to think of this being while they

silently say “May they be happy. May they be healthy. May they live with ease and peace.” The

same phrases will then be offered again to the individual as they were in week one, “May we be

happy. May we be healthy. May we live with ease and peace.” This mediation will be no longer

than 10 minutes. Week two homework consists of completing the NCSSLE Safe Place Self-Care

Plan (see Appendix C). Further, students are encouraged to meditate every day (a podcast that

leads students through a short five-minute loving-kindness meditation will be provided).

 26

Session Three: Identifying Risk Factors and Setting Goals

The third session will begin with a short recap and discussion of the homework from

week two. Students are encouraged to share their experience with forming a meditation habit and

can share about their self-care plan. As a group, a clinical psychologist from the university

counseling center will share various factors that put students at risk for mental health issues. This

will also help students be able to identify other peers who may be struggling and should be

referred to the counseling center. These risk factors can include depression, anxiety, drug or

alcohol use, and poor self-image or eating disturbances. Students will learn about resources on

campus that can help them when they are struggling, such as free individual counseling, free

support groups, academic success coaching, and wellness classes through the recreation center.

They will also learn about what to do when they hear of a peer struggling, in which they can

refer them to the counseling center, contact a trusted mentor, or submit an anonymous tip online

that notifies administrators of the student who may be at risk.

The remainder of this session will feature a success coach from the university’s academic

success center that will go over how to create SMART goals, which stand for specific,

measurable, achievable, relevant, and time-bound. These outcome goals are included to ensure

that students know how to set realistic long-term and short-term goals for themselves that they

can reflect back on regularly. Week three homework includes daily meditation no longer than 10

minutes that includes breathwork, loving-kindness, or a body scan style all provided through a

podcast.

Session Four: Stress Management and Coping

The fourth session will start with a short discussion on the homework and any other

thoughts or experiences that have come up over that last week. A member from the counseling

center will start the discussion by having students write down what they do to currently cope

with stressors. The facilitator will then share ways students can better cope with mental health

concerns such as visiting the counseling center (will instruct how to set up an appointment),

finding a supportive group of peers to surround themselves with, partaking in daily mediation

sessions, and moving the body daily. A member from the recreation and wellness department on

campus will then share what specific resources they offer on campus to get students moving in a

way that is supportive for them. This could be a group fitness class like cycling or yoga, could be
 27

a hiking club, or could be meeting with a trainer at the recreation center to learn more about the

equipment. Week 4 homework focuses on active mindfulness (i.e. a moving meditation like

mindfully riding a bike or going on a mindful walk where you focus on sounds and smells

outside). Students are highly encouraged to try a new class at the recreation center which will be

free of charge while they are enrolled in the program.

Session Five: The Big Picture and How to Move Forward

The session will start with a recap of the previous week. Students will be broken up into

small groups with a professional staff member in each breakout room. Students will create a list

of the big picture ideas of what they have learned throughout this intervention program and will

have the opportunity to share what they will continue to implement after the program ends.

Students will then complete the initial survey again and compare their levels of mindfulness to

when they first started. Further resources will be shared such as books and podcasts that dive

deeper into mindfulness and forming healthy coping habits will be provided.

Project Evaluation

Once the mindfulness-based intervention is completed, the pre and post mental health

survey will be compared for each student by the clinical intern from the counseling center.

Students will be asked to revisit the first journal entry they wrote and they will redo this exercise

to see if their answers have changed. They will also look at the self-care plan they completed

during week two and note any changes they have made.

Project Conclusions

Using mindfulness as an intervention has been found to improve the transition into

college for first-year students (Conley et al., 2013; Dong et al., 2021; Dvořáková et al., 2017).

First-year students face numerous obstacles while they adjust to life in college and many have a

tough time coping with new challenges. These students may refrain from seeking help because

they feel the stigma that surrounds mental health challenges. Further, they may not even know

where to start in order to get help. Mindful Moments educates students on various mental health

issues they or their peers may face, in an effort to reduce the stigma. This program also offers

several tools that can help students cope with challenges rather than turning to unhealthy

mechanisms like drugs or alcohol. Lastly, Mindful Moments educates students on the resources

that are available on their campus in order to make using them more accessible and normalized.
 28

Plans for Implementation

Mindful Moments has been created for first-year college students in order to provide

additional support as they transition from high school to college. While this program is not

required, it is highly encouraged for all first-year students. The university counseling center will

do a majority of the promotion for the program and can partner with the housing department to

encourage first-year students who live on campus to sign up. Students who live off-campus will

still learn about the program when they attend orientation. Promotions will also be done in the

recreation and wellness department to reach students who may be seeking additional help.

Additional research should be done on positive psychology and mindfulness on first-year

college students specifically. While this program was encouraged and not required, this

intervention could be implemented in a first-year course that all, or most, students take during

their first semester of college. Further, education on mindfulness and the resources available on

campus to help support the mental health of students could be implemented for all students on

campus. Upperclassmen and marginalized groups of students could benefit from this program in

order to further encourage seeking help and reduce the stigma associated with mental health

issues.
 29

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Appendices

Appendix A- Mindful Moments Flyer

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Appendix B- Mental Health Survey

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Appendix C- NCSSLE Safe Place Self-Care Plan

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National Center on Safe Supportive Learning Environments. (n.d.). Staff self-care plan.

https://safesupportivelearning.ed.gov/sites/default/files/07_NCSSLE%20SafePlace_Hando

ut_Staff%20SelfCare%20Plan.pdf