There are many critical health issues facing today’s college students and, their physical and emotional health and behavioral choices can significantly affect their academic success. To that end, college health services have a large responsibility. At Santa Barbara City College, the Student Health Services and Wellness Program is considered one of the fundamental support services for student success. This comprehensive program recently was recognized by the Board of Governors to receive the State Exemplary Program Award.

Now more than ever, we need to recognize the significant contribution that college health centers across the state provide for the academic, personal and future success of their students. With the significant budget cuts the state educational system is facing, we need to demonstrate the importance of student support services in the overall mission of the 108 community colleges in the state of California. At a recent Board of Governors meeting in Sacramento, Santa Barbara City College Student Health Services and Wellness Program was one of six community colleges recognized with the State Exemplary Program Award. This was a significant acknowledgement that the health of our students and the services provided by all California Community Colleges plays a significant role in student success. Student health centers across the state are in jeopardy as budget cuts and elimination of student fees are being discussed. The following program description will give you an example of how important it is to maintain health services in our college system.

Santa Barbara City College (SBCC) Student Health Services and Wellness Program (SHSWP) is one of the fundamental support services for student success. The SHSWP serves a college population of 16,500 students and provides over 14,490 (duplicated) annual student clinical contacts and 35,515 (duplicated) health education and media contacts. College health services have a unique role on college campuses. Physical and emotional health and behavioral choices play an increasing role on academic, social and public health issues leading to the need to integrate both clinical and health education/prevention strategies for campus programs and services. Programs and services need to address student’s realization and maintenance of complex issues of optimal physical, emotional, intellectual, social, environmental and spiritual health. Medical and counseling services along with strong health education and prevention programs are the key elements of our comprehensive scope of health services. SHSWP addresses the many critical health issues facing today’s college student that include alcohol, tobacco and drug abuse, eating disorders, sexual health issues, stress management, health advocacy and a myriad of other health issues. As our campus health services respond to the broad health needs of the student population, a window of opportunity is opened to influence health behavioral changes that can positively affect their health, personal and academic success.

The SBCC SHSWP is funded by the collection of a mandatory student health fee as permitted by AB3571. Students pay $12 for fall and spring semesters and $9 for summer session. Students who receive Board of Governor Grants (BOGG) are waived of paying the health fee but receive full services. At Santa Barbara City College approximately 27% received BOGG waivers in the 2001-2002 academic year. Historically it has been as high as 36%. In addition, the program receives approximately $20,000 grant funding from various sources particularly for the health education programs. The average annual budget for the SHSWP is around $330,000. This budget pays for faculty and staff salaries, benefits, campus accident insurance, medical and health education services, supplies, travel and capital outlay needs. The full-time faculty mental health counseling position, adopted by Academic Senate ranking, is funded through district faculty growth dollars. The SHSWP staff consists of two full-time faculty, three full-time classified employees, 10 part-time professional and ancillary staff, 4 part-time students and 7 professional volunteers.

The SBCC SHSWP is located in a high traffic area allowing easy access while providing optimal confidentiality. Medical services include nursing assessment, health counseling, physician diagnosis and treatment, men and women’s sexual health management, first aid, emergency medical response and coordination of community medical referrals and resources. To strengthen the promotion of health behaviors, numerous brochures, books and videos are available to complement the education process of self-care, provide an understanding of the disease process, encourage prevention and promote health advocacy. Basic medical services are often a part of many college health programs. The SBCC SHSWP is an exemplary program that utilizes a uniquely comprehensive health model integrating a strong mental health component, a broad-based health education and prevention program and an active collaboration with academic curriculum theory.

Core components that build this comprehensive health model include:

• Medical care services: as described above
  
• Mental health counseling: screening, emergency crisis response, consultation services and education programs that include workshops, class presentations, faculty/staff professional development seminars and a mental health/student success feasibility study
  
• Health education programs: a peer health education program, social norming and marketing media campaigns, classroom presentations, campus-wide themed health events, educational check points, website education access, community service projects and data collection from the American College Health Association National Health Risk Survey, other survey instruments, focus groups, program evaluations and quality assurance programs
  
• Academic programs and services: Service learning, curriculum infusion and development, Student Success Advising Program, Learning Skills Workshops, credit course development and collaboration with Disabled Student Program/Services (DSPS)
  
• Local, state and national mentoring and technical assistance: Conference presentations, publications, national American Association of Community Colleges (AACC) and the Centers for Disease Control (CDC) mentoring program, consultative site visits and replicable program design
  

Mental Health Counseling Services: The mental health program is a proactive counseling model that offers interventions aimed at promoting student success. Seven counselors (1-FT and 2 PT licensed MFTs and 4 state registered volunteer MFT interns) are available for 80 counseling hours to provide individual, group and crisis counseling to assist students in overcoming roadblocks impeding their academic coursework. The counseling services utilize a short-term model that provides a solution-focused, decision-making intervention framework. The program includes an extensive outreach component that serves to educate students, faculty and staff on the correlation between psychological issues and student academic and personal success. Mental health screenings are conducted throughout the year to provide early identification and intervention for psychological issues. These include screening tools for depression, anxiety disorders, eating disorders, alcohol and other drug abuse, anger management, relationships and stress. A Mental Health Feasibility Study was conducted to determine the correlation between mental health counseling services and student success and retention. The results showed that mental health counseling services is an integral component of programs supporting academic retention and course completion at an institution of higher education.

Health Education Programs: This comprehensive program focuses on college health lifestyle issues. The program goal is to create an educational process and supportive environment that shifts the campus cultural norms and health behaviors. Project HOPE (Helping Others through Peer Education) is a student driven campus organization of trained peer educators offering a multi-program approach designed to reach the needs of a continually changing and diverse student population. Proactive methods have been chosen based on behavioral change theory and research data to involve and empower students to effect positive change in their own lives, the college environment and in the greater community. Social marketing media campaigns are designed to recognize the power of the media and apply basic marketing principles to health issues. Social norming is a research driven approach that introduces accurate healthy protective norms associated with the majority of the target population dispelling perceived myths “that everyone is doing it”.

Academic Programs and Services: SHSWP initiated an academic based service-learning program on the SBCC campus through a national grant. Service learning is a teaching pedagogy that combines academic course curriculum with community service, bringing together a focus on critical, reflective thinking, and personal and civic responsibility. The student applies course curriculum theory to real life experience. The college institutionalized this program through the Career Advancement Center, upon grant completion. Curriculum infusion activities were developed for multiple courses including communication, graphic design, theater arts, journalism and statistics. A specific replicable and published curriculum was designed for communication classes to develop communication, negotiation, and refusal skills that promote sexual health, enhance intimacy skill and reduce alcohol and other drug risk behaviors. Two approved credit courses include: Personal Development PD120: Peer Education/Lifestyle Choices and PD 4: Personal Awareness. Four Learning Skill Workshops were developed with the Learning Resource Center and are provided each semester: Test Taking, Note Taking, Time Management and Stress Management. A Student Success Advising (SSA) program was conceived, designed and implemented through SHSWP to reach at-risk students. An advisor trained in personal counseling assessment skills identifies and assists students on academic probation, progress probation or disqualification. The SSA identifies psychological, social, physical and learning roadblocks to student’s academic success and provides appropriate campus referrals for intervention and support.

Local, State and National Mentoring and Technical Assistance: Program staff has presented various health models and programs at multiple regional, state and national conferences. Independent publications and references to successful SBCC SHSWP models include: a web based curriculum published on the Association of American Colleges and Universities website, Contraceptive Technologies, AACC Bridges to Healthy Communities Lessons Learned Project Brief, Faculty Professional Development web site, Bacchus and Gamma Peer Education Journal and the SHSWP web site. Two program staff were selected to participate in a national five-member mentor team supported by the CDC and the AACC to reduce the incidence of HIV/AIDS and other related health issues in the community college population. The mentors provide technical assistance, consultation, education and site visit activities to selected community colleges involved in the Bridges to Healthy Communities grant. The program director was invited by the Higher Education Center to participate in a roundtable discussion on alcohol and violence prevention in community colleges across the nation.

Program Specifics:

Data demonstrating that the program has a direct effect on students:

• Mental health screening provides early identification and intervention for psychological issues that can impede students focus on college coursework.
  
• Research literature indicates a positive link between mental health counseling and student academic retention and success. (Drs. Napoli and Wortman, “Psychosocial Factors Related to Retention and Early Departure of Two-Year Community College Students”, 1997, Wilson, Mason and Ewing, “Evaluating the Impact of Receiving University-Based Counseling Services on Student Retention”, Journal of Counseling Psychology, 1997, Eric Heilingenstein, MD, “Depression and Academic Impairment in College Students”, American College Health Association, September 1996 ).
  
• The SBCC Mental Health Feasibility Study survey showed 92% of students who utilized mental health counseling services stated that the counseling services helped them to more effectively cope with the stress and pressure of college life.
  
• American College Health Association Health Risk Survey data that drives SBCC SHSWP program design:
  
  • Students identified that the following factors affected their individual academic performance within the last year (i.e. received an incomplete, dropped a course or received a lower grade in a class, on a project or an exam): 29% cold and flu, 17% alcohol use, 12% drug use, 3% eating disorder, 30% sleep difficulties and 34% stress, 16% depression, 24% concern for a troubled friend or family and 20% relationship difficulties.
    
  • Students responded that one or more times within the last twelve months: 68% of students felt that things felt hopeless, 55% felt so depressed that it was difficult to function, 15% seriously considered attempting suicide and 3% attempted suicide.
    
  • 90% of students believed that the information they received from health services and health educators was credible whereas only 20% believe health information they obtained from their friends was believable.
    
• Studies have shown that social norming has been successful in changing the health behaviors on college campuses nationwide especially in the areas of tobacco use and frequency of alcohol and other drug use. (Perkins et al., Misperceptions of the Norms for the Frequency of Alcohol and Other Drug Use on College Campuses, Journal of American College Health, 1999).
  
• A research study summary of service learning in higher education (At a Glance: What We Know About the Effects of Service Learning, 1993-2000 compiled by J. Eyler, D. Giles, C. Stenson and C. Gray) showed that service learning participation increases cultural competency, civic responsibility, student retention and development of a meaningful philosophy of life. In addition, service learning increases the likelihood of graduation, contributes to career development, helps students develop stronger relationships with faculty members and has a positive effect on interpersonal development and ability to work with others.
  
• Peer education is an effective means of delivering messages to any target population. People are more likely to hear and personalize a message that may result in changing their attitudes and behaviors if they believe the messenger is similar to them in lifestyle and faces the same concerns and pressures (Journal of American College Health, Volume 41, Number 6, May 1993).
  
  

Data demonstrating the impact of the program:

• The SHSWP serves a college population of 16,500 students and provides over 14,490 (duplicated) annual student clinical contacts.
  
• Utilization rates have increased by approximately 110% over the last five years
  
• Faculty and staff referrals have increased by approximately 200% over the last five years.
  
• Program efficacy was recognized nationally and staff was invited to participate in a national program, conferences and two national Roundtable discussion-planning sessions.
  
• Initial participation of the grant funded service-learning program included: 20 faculty, 450 students and 20 community agencies.
  
• Every faculty member has been given a handbook developed by SHSWP, Assisting Distressed Students, providing a broader based dissemination of assessment and intervention strategies for at-risk students.
  
• Over three hundred full and part-time faculty and three hundred-fifty classified staff have participated in professional development seminars presented by SHSWP staff. These seminars provide increased faculty/staff awareness of health services issues and teach them valuable skills for identifying, dealing with and referring students.
  
• Critical Incident Stress Management (CISM) is a set of interventions that can be effectively utilized in the event a traumatic incident occurs affecting SBCC students, faculty or staff. Research has shown that individuals who experience a traumatic event and experience a CISM intervention recover more quickly from the trauma and can more successfully return to their academic and/or career focus. SHSWP staff received national CISM certification and have trained campus personnel on the principles and theories. CISM interventions have become integrated into the Santa Barbara City College Crisis Intervention Protocol and Disaster Management Plan.
  
• Strong community support and ties have been bridged with the Santa Barbara County Public Health Department and numerous other community based organizations. These ties strengthen community collaboration, program recognition and grant/funding opportunities, bringing the campus and community closer to the student.
  
• Project HOPE has won the club of the year award five times since 1995.
  
• In the 2001-2002 academic year Project HOPE:
  
  • Made 35,515 duplicated student contacts (individual, group and media).
    
  • Trained 23 student peer educators, provided 47 classroom presentations, 8 large scaled campus events and 32 educational checkpoint tables, 26 new student orientations, 3 community service projects.
    
    

Demonstration of increased access, retention, completion or transfer rates for under-represented students:

• The SBCC Mental Health Feasibility Study revealed a 72% course completion rate by students utilizing mental health services, whereas a general student retention study showed 68%. This is significant considering that mental health counselors are working with an “at-risk” population.
  
• 17% of the students who utilize mental health counseling are international students. Due to the difficulty of enculturation, loss of family support systems and increased pressure to succeed, we have found that international students seek our mental health services at a disproportional rate than the general student population.
  
• 42% of the students that utilize mental health services are re-entry students (over 25 years of age). Many issues surface for re-entry students include feeling lost and out of place in an academic environment, lack of self-confidence and stress and family pressure. Student retention increases when students can address and resolve these issues.
  
• SHSWP provides Spanish-speaking counselors and health professionals and Spanish translated literature to help reduce access barriers to health and counseling services.
  
• The SHSWP website www.sbcc.edu/healthservices provides health information and self-assessment tools increasing accessibility for non-traditional students or students who need to be able to access information if not on campus or during non-program hours.
  
• Free medical care and counseling services are available for low-income and underinsured populations. Medical services assist students in maintaining or restoring their health that increases class attendance and assignment completion.
  
• The SHSWP collaborates programs and services with DSPS providing increased access and support to students with disabilities.
  
• A survey showed that 97% of the SBCC faculty agreed that mental health counseling increases the possibility of success for at-risk students. 91% agreed that counseling helps with student retention.
  
• 93% of SBCC students surveyed agreed that there is a correlation between mental health counseling services and student success. 74% of the students that utilize mental health services stated that counseling helped them to focus and clarity their academic and career goals.
  
• Project HOPE tailors its programs to meet specific target group needs including Hispanic/Latino and the gay and lesbian population. Inclusive language is used in all literature produced and in presentations to students. Project HOPE peers receive intense diversity training. Multicultural and multidiversity approaches reduce alienation of target populations and increase the accessibility to health information.
  
  

Program replicability:

• The SBCC Mental Health Feasibility Study and program design has been presented at the National American College Health Association Conference, the State Health Services Association of California Community Colleges Annual Conference, the State Community College Mental Health Consortium and individually with several community colleges. We have hosted numerous site visits for other community colleges looking to establish mental health programs.
  
• Manuals containing program design, protocols, procedures, forms and industry standard guidelines have been developed for the medical, mental health and health education programs. These manuals can be utilized by other community colleges in developing similar programs.
  
• SBCC SHSWP staff have provided multiple site visits for consultation on program development and model design.
  
• A course curriculum has been designed for communication classes that can be accessed on a national resource data base www.nlrd.aacu-edu.org: Tell Me What is on Your Mind: Reducing Risk-Taking Behaviors and Increasing the Quality of Your Interpersonal Relationships through the Use of Effective Communication Strategies. The curriculum focuses on communication, negotiation, assertiveness training and refusal skills related to sexual communication and alcohol and other drug risk behaviors.
  
• A service learning module was created for a faculty professional development website www.4sbccfaculty.org (login: faculty, password: seminar). The module provides the theories and framework for developing service learning within a course curriculum.
  
• The peer education training credit course and workshop trainings have been developed and can be replicated.
  
• Social norming media materials, development strategies, focus group evaluations and media survey instruments can be shared with other community colleges to act as a model for replication.
  
• The peer education program activity “Chalk-It-Up” has been featured in the August 2001 Peer Educator Journal. Chalk-It-Up is a sidewalk chalk-drawing contest with highly visible health themed messages. The article offers a step-by-step process to conduct this activity on any college campus.
  
• The two Personal Development courses that have been developed have clear course content, syllabi, and handouts that can be replicated.
  
• The Student Success Advisor Program has developed a manual providing guidelines, protocols, roles and responsibilities, campus and community referral resources and assessment tools.
  
  

Support for students in achieving academic and coursework goals:

• The foundation of the Learning Skills workshops are designed to teach students basic skills and core competencies to improve performance and completion of degree applicable courses.
  
• The Student Success Advisor program assesses at-risk student’s skill levels to ensure that they are in appropriate class placement. The SSA also assesses psychological, social, emotional or learning style impediments to learning and connects the student with appropriate support services for intervention.
  
• The Personal Development 4 class is a one-unit class that teaches concepts of emotional health and effective behavior. This class guides students on how to deal effectively with life situations and helps improve student success.
  
• The service learning pedagogy increases knowledge of the subject, improves thinking and problem solving skills, provides reciprocal learning opportunities and increases critical and reflective thinking. Students report higher levels of satisfaction with the course and greater academic gains from the experience.
  
  

The Santa Barbara City College Student Health Services and Wellness Program is an innovative, multi-component and proactive program. The medical, psychological, health education and academic program integration components of this program have proven to be an essential support service for student success and retention. The combination of professionalism and dedication of a visionary team has created a highly visible and effective program. The Santa Barbara City College Student Health Services and Wellness Program is just one example of the many effective health services throughout the state of California. These crucial programs deserve the recognition of their contributions to the campus community and mission of their college.

Director of Student Health Services

Santa Barbara City College