The Michigan.Daily - michigandaily.com Thursday, April 5, 2012 - 5A The Michigan Daily - michigandailycomThursday, April 5, 2012 - RESOURCES From Page 1A psychiatric and psychological professionals, administrators and an attorney from the Office of the General Counsel who recommend improvements to mental health prevention and treatment servic- es on campus. CAPS offers scheduled appointments for students who do not require immediate care but would still like to talk with a therapist. Drop-in therapygroups are also available, as well as crisis intervention services. In addition to scheduled appointments, Sevig said CAPS also offers same-day walk-in care for individuals who require immediate psychological assis- tance during their business hours. In addition to CAPS' many pro- active education and prevention programs, Sevig said CAPS staff has trained more than 3,000 stu- dents, faculty and staff to notice if their peers begin to demonstrate mental health issues through the Question Persuade Refer pro- gram. The program educates people on how to respond to situ- ations in which an individual has suicidal thoughts. Though he encouraged indi- viduals to become trained in QPR, he stressed that those who are not QPR-trained can still follow the general tenets. "The first thing is to take time to talk with the person and to listen," Sevig said. "The second thing is to say, 'Gee, I'm wonder- ing, are you thinking about hurt- ing yourself?' And then, the third thing is to persuade that person to get help." Sevig encouraged friends and professors who are concerned about an individual to personally help them through the process by referring the student to CAPS. UMHS PSYCHIATRIC EMERGENCY SERVICE ASSISTS DURING EMERGENCIES Much like the University Hospital's emergency room, the University of Michigan Health System Psychiatric Emergency Service serves as an emergency center for individuals experi- encing mental health issues that require urgent attention. Rachel Glick, medical director of the UMHS PES, said the ser- vice - which is located near the UMHS medical ER - is staffed with about 70 mental health professionals, including psychia- trists, social workers, nurses and medical assistants and is open 24 hours a day, seven days a week. Glick said patients who initially enter the medical ER are often referred to PES if their symptoms are psychiatric in nature. Though individuals may be confused as to when they should come to PES as opposed to CAPS or another mental health resource on campus, Glick said those who notice "significant suicidal thinking or behavior" or behavior "that is out of the ordinary, unusual or poten- tially dangerous" should visit PES for treatment. The service's 24/7 hours makes it particularly resourceful for individuals who might have walked into CAPS for an urgent appointment during business hours. Like CAPS, Glick said PES staff members also assess a significant number of individuals who are experiencing a crisis, meaning that they may not have expressed suicidal thoughts,but desireguid- ance as to whatthey can doto pre- vent depression or other disorders from progressing. When a person enters PES, Glick said they're immediately triaged by a team of nurses and medical assistants who deter- mine their mental health status. Subsequently, a clinician, usually a social worker, spends time with the patient to assess their history and specific symptoms in order to develop a plan of treatment. Lastly, a psychiatrist briefly dis- cusses drug treatment options with the patient. PES is one of only a few psy- chiatric emergency rooms in the state, according to Glick. She said a large number of patients requiring treatment for behav- ioral issues end up in medical emergency rooms. "Even if a hospital doesn't have a dedicated psychiatric emergency service, they're still getting patients who are hav- ing these kinds of emergencies," Glick said. "They're just taking care of them in the medical emer- gency world." PES also operates a 24-hour crisis line - featuring psychi- atric evaluation and treatment recommendations according to the PES website - which can be reached at (734) 996-4747. Glick said PES is just one part of a large network of mental health facilities on campus. "I see us as sort of an integral part of a whole system to support our whole community," Glick said. UHS ALSO OFFERS AN ARRAY OF MENTAL HEALTH SERVICES The University Health Service also offers several psychological and psychiatric services. Robert Winfield, the University's chief health officer and director of UHS, said if a student, staff or faculty member is certain they are in psychological distress, they should first look to facili- ties such as CAPS or the PES ER, whose primary mission is to treat students for psychological issues. However, he emphasized that if a person in distress does come to UHS, the clinic's staff is capable of assisting them. Winfield said without an appointment, an individual in distress may be seen by a UHS nurse practitioner, who will assess their needs and direct them toward the appropri- ate services, whether that be a referral to CAPS, UHS's part- time psychiatrist or the UMHS PES. Winfield added that if UHS providers can prescribe psychi- atric medication if they deem it appropriate, such as when a stu- dent has run out of medication or believes that a medication will resolve his or her problem. If a person's mental health issues are not severe, Winfield said UHS clinicians may even be able to treat the patient in-house. "Health Service is one resource, but not the first resource for people that are very depressed," Winfield said. He added: "It's an alternative resource, which will typically not have the level of expertise for somebody who is severely depressed, but can help people who have less severe difficulties." What might be most notice- able to students who visit UHS is the implementation of two patient questionnaires that were launched in August. Individu- als who visit the UHS walk-in clinic are now asked to fill out the PHQ-9 questionnaire, a widely used test that assesses an indi- vidual's level of depression, in addition to an audit that screens for alcohol abuse. If an individual scores high on either the 27-point depres- sion questionnaire or the alcohol audit, Winfield said UHS staff members work directly with the patient to provide them with the necessary resources to resolve possible problems. "We are very pleased with the work we've been doing on this because we have identified a good number of students who had not come in just to seek help just for psychological or alcohol issues, but we were able to iden- tify these and reach out to them," Winfield said. Between Aug. 22, 2011 and Nov.22, 2011, Winfield said about 6,000 patients took the PHQ-9 questionnaire. He said 0.6 per- cent of the patients were deemed to be severely depressed, 1.5 percent were suspected to have moderately severe depression, 4 percent scored as moderately depressed and 11 percent scored as mildly depressed. If a patient scores as moderately severe or severe, UHS social workers aid the individual in gaining access to the necessary resources to treat their depression. WEBSITE SERVES AS PORTAL FOR INFORMATION ON MENTAL HEALTH ISSUES The University also hosts a website that specifically helps students with ongoing health disorders called Campus Mind Works. Stephanie Salazar, project coordinator for Campus Mind Works, said the site is a portal of information for students on how to manage their disorder while studying at the University. "Everything on there is really focused on that student with the ongoing health disorder and how to navigate through the Univer- sity," Salazar said. "And we also have information about what to do if you're hospitalized, and what the process is to get back into school and what resources are available to you." According to Salazar, the site also works with the College of Engineering and the Universi- ty's Psychological Clinic to pro- vide free education and support groups for students on campus. Salazar said prevention and education are crucial in proac- tively monitoring the campus community for mental health issues. "Obviously, prevention is important when we're talking about mental health because it's so much easier to tackle a prob- lem before it gets really bad," Salazar said. She added that when the site was being developed, many stu- dents surveyed were unaware of the options they had in tak- ing a semester leave, dropping classes or reducing their work- load. According to the academic section of the website, students with certain mental health dis- orders can request a, waiver from the University's Services for Students Disabilities, which will state that they are taking a reduced course load but should still be recognized as a full-time student. Campus Mind Works also has resources for parents who may be concerned about their stu- dent's mental health. Salazar said the information is intended to give parents an overview of how they can effectively support their children. "(There is) some informa- tion about what parents can do to support their student's men- tal health because I know a lot of parents have trouble sort of navigating both being support- ive but not overbearing especial- ly if their student is away from home," Salazar said. COMPLIANCE From Page 1A they've changed how many peo- ple have to disclose (conflict of interest information), (and) the time in which you have to dis- close." Pollack said the University consulted with peer institu- tions on how to minimize costs accrued by the new regulations, and it chose to focus on human resources rather than expensive software systems to comply with federal guidelines. "Originally, we were going to put in place some permanent staff positions, but what we learned based on other people's experi- ence with workflow was that after a year or two, things settled out, so we can budget for some term- limited positions," Pollack said. Pollack emphasized that despite NIH's focus on conflict of interest information in the most recent update to the federal guidelines, managed conflicts of interest pose no issue for the Uni- versity. "Conflicts of interest in (them- selves are) not a bad thing. A bad thing is having a conflict of inter- est that's not managed," Pollack said. "You have to disclose it and make sure it's properly managed, or if it can't be managed, that you don't act on it." According to a University report released last Friday, a snap- shot of projects on Feb. 9 revealed that more than 5,200 projects at the University are under reviewby the Institutional Review Boards, one of the leading compliance oversight bodies in University research which monitors research activities and protocols to be sure they meet regulations and ethical standards. More than 4,000 of the projects are medically related, and they often require the strictest oversight. Judy Nowack, associate vice president for research at the Uni- versity, said despite the new regu- lations, the University has tried to increase the IRBs' responsiveness to project petitions from faculty. Many non-medical projects are now exempt from the formal proj- ects review or subject to an "expe- dited review." In 2011, fewer than four new non-medical proposals went before a full IRB committee for review each month. "We're trying to take low risk determinations to educated staff, rather than taking faculty time to do it," Nowack said. "It's all a balance. We do it; we look at the effect ... We don't want to increase risk in the system." Nowack added that the Univer- sity's Office of Human Research Compliance Review independent- ly oversees and educates the IRBs and faculty on protocols and com- pliance issues at the University. According to Nowack,the OHRCR also conducts surveys to measure risk in the research system. "We do subscribe that we pro- vide protection to vulnerable groups," Nowack said. "Our fac- ulty members pretty well realize that if somebody gives us a bad reputation in the community, where we draw our subjects, then their own research is going to suf- fer." Nowack added that violations of compliance issues within the research unit seldom require direct response from the OHRCR. "It's very rare that we get really serious things that come all the way up to the top," Nowack said. "We try to keep our fingers on the pulse." Fiona Linn, senior policy and projects adviser in the Office of the Vice President and General Counsel, said the University has not followed in the footsteps of many peer institutions in cen- tralizing compliance operations under one office. She added that the complexity and large variety of University compliance opera- tions prevented the University from pursuing that route. "We made a deliberate choice at U of M not to centralize all of the compliance functions, which a number of universities have done," Linn said. "They've done it following a very corporate model in which you have one senior vice president or similar role (who) is responsible for all issues in com- pliance." Linn helped oversee the cre- ation of the Compliance Resource Center website, which is available for University students and staff. It currently serves as a launch- ing point and information clear- inghouse for compliance issues that allows users to access more detailed information and contacts. ""'^ "'^to 1')I';n - -'i-- ---" on duplication of effort," Linn including links to privacy rights said. "Previously, you had people in disclosing grades and finan- in various schools and colleges all cial aid rights. trying to answer the same ques- "That's been one underlying tion (in) duplicative, and by coor- assumption of all the work we've dinating these resources, we're done ... we've kept assuming that hoping that it saves time people we're dealing with a whole lot of spend across the University." smart people who want to do the Linn added that outside of right thing," Linn said. "We want research, the compliance web- to give them information to help site also deals with student them know what the right thing rights and responsibilities, looks like." 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