Morehouse School of Medicine Department of Psychiatry & Behavioral Sciences HBCU - Center for Excellence in Behavioral Health

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1 Morehouse School of Medicine Department of Psychiatry & Behavioral Sciences HBCU - Center for Excellence in Behavioral Health BEHAVIORAL HEALTH WEBINAR SERIES In Partnership With Offices of Policy, Planning, Innovation and Behavioral Health Equity For more information go to or call HBCU (4228)

2 OVERVIEW Through a Cooperative Agreement with the Substance Abuse and Mental Health Services Administration s (SAMHSA), Center for Substance Abuse Treatment, (CSAT) and Center for Mental Health Services, (CMHS) Morehouse School of Medicine established the Historically Black Colleges and Universities Center for Excellence in Behavioral Health (HBCU-CFE), funded as Grant No. TI

3 The Goals of the HBCU-CFE Promote student behavioral health to positively impact student retention Expand campus service capacity, including the provision of culturally appropriate behavioral health resources Facilitate best practices dissemination and behavioral health workforce development

4 HBCU - Center for Excellence Our Team HBCU Center for Excellence Gail A. Mattox, M.D., FAACAP, DFAPA HBCU-CFE Project Director Eugene Herrington, PhD, LCSW Co-Project Director Dollmesha Greene, BS Program Manager Joan Trent, BA Program Coordinator Latrice Rollins, MPH, PhD Lead Evaluator Prevention Research Center Tandeca King Gordon, M.Ed. Evaluation Team Tiffany Zellner, MPH Evaluation Team Charles Robinson, MPH Evaluation Team Steering Committee Phillip Dunston, PhD Chairperson of Religion and Philosophy Clark Atlanta University Shirley Labbe, M.A. NCP-BCCP Associate Director of Counseling Xavier University Art Romero, MA, LPCC Clinical Supervisor and Therapist New Awaking Rio Rancho Ozietta Taylor, PhD. Associate Professor Coppin State University Charles Ochie, Sr., PhD Chairperson of Criminal Justice Albany State University Angelina Yelverton, Student Sophomore, North Carolina A & T Project Officers Shannon B. Taitt, MPA Public Health Analyst Division of Services Improvement SAMHSA/CSAT Sherresa A. Bailey, MPA Public Health Advisor Division of State and Community Systems Development (DSCSD) SAMHSA/CMHS

5 Dr. Sabriya Dennis Sabriya Dennis serves as Project Coordinator for the Get SMART Project at Morgan State University (MSU), School of Community Health & Policy. Get SMART is a SAMHSA funded MSI-CBO health prevention program targeting risk behaviors of emerging adults related to substance use and HIV/AIDS transmission. Prior to coming to MSU she worked as a clinical case manager and therapist specializing in youth populations. Dr. Dennis research interests include exploring health disparities among emerging adult populations and the intersection of culture, trauma and mental health outcomes of minority/underserved populations.

6 Coping with Trauma Health Behaviors & Outcomes of HBCU Students Presented by Sabriya Dennis, Post Doctoral Fellow Morgan State University School of Community Health & Policy

7 Trauma Defined Trauma: an event, series of events, or set of circumstances experienced as physically or emotionally harmful or threatening with lasting adverse effects on functioning and well-being Traumatic stress: occurs when exposure to traumatic events overwhelm a persons ability to cope

8 Group Based Traumas Historical/ Intergenerational Trauma is a multigenerational trauma experienced by a specific cultural group. It can be experienced by anyone living in families at one time marked by severe levels of trauma, poverty, dislocation, war, etc., and who are still suffering as a result Race-Based Trauma is a consequence of emotional pain experienced after encounters with racism, which can be understood in terms of specific types of acts (as distinct types: racial harassment or hostility, racial discrimination or avoidance and/or discriminatory harassment, aversive hostility) Community Trauma occurs when a community is subjected to a threatening event, have a shared experience of an event that has an adverse and or prolonged effect

9 Individual Traumas Childhood Abuse/Neglect Sexual abuse or assault includes unwanted or coercive sexual contact, exposure to age-inappropriate sexual material or environments, and sexual exploitation Actual or attempted infliction of physical pain (with or without the use of an object or weapon) Acts, which include verbal abuse, emotional abuse, and excessive demands or expectations, may cause an individual to experience conduct, cognitive, affective, or other mental disturbances.

10 Individual Traumas Interpersonal Violence includes extreme violence by or between individuals including exposure to homicide, suicide, and other extreme events Intimate Partner/Domestic Violence a pattern of abusive behavior in any relationship that is used by one partner to gain or maintain power and control over another intimate partner Sexual Assault any type of sexual contact or behavior that occurs without the explicit consent of the recipient

11 Differential Trauma Experiences

12 Trauma Experiences & Men: Interpersonal Violence Men ages experience higher rates of violence than any other age group Black men are more likely to be a victim of violence, witness violence and experience discrimination Homicide is the leading cause of death for black males ages % of gay & bisexual men report experiencing at least 1 sexual assault in their lifetime

13 Trauma Experiences & Women: Domestic Violence/Sexual Assault Women are more likely to experience sexual abuse or assault Black women more likely to experience multiple traumas compared to white women Black women ages have the highest rate of domestic violence victimization Lesbian & bisexual women 3xs as likely to report sexual assault compared to heterosexual women

14 Indirect Trauma Experiences

15 Indirect Trauma Experiences Secondary Trauma is the experience of post traumatic stress symptoms due to indirect exposure to trauma Previously used to refer specifically to those in helping professions working with traumatized populations (compassion fatigue) More people exposed to secondary trauma due to media coverage & advances in technology

16 Indirect Trauma Experiences & Social Media #Iamtrayvon #handsupdontshoot #icantbreathe #blacklivesmatter #justiceforfreddiegray #justiceforsandy

17 Social Media Usage & Emerging Adults 73% of African American internet users use a social networking site 96% of African American internet users ages use social media platforms Twitter use is highest among African American users 22% of those online, compared to16% of whites who are online

18 HBCU as Community

19 Defining the HBCU Community Types of community: A geographical space or area Bound by common geopolitical space A group of people with a common characteristic or shared interest A body of persons having a common history or social experiences

20 HBCU Demographic Profile 76% of all students enrolled at HBCUs are Black/African American Student population = 61% women; 39% men More than 70% of students attending HBCUs receive Federal Pell Grants- need based grant primarily for low income undergraduate students Almost 60% of students are first generation (first in their families to attend college)

21 Environmental Context of the Campus Setting Group Based Trauma Individual Trauma Secondary Trauma College Stressors Individual traumas occur within the context of community Individuals cope with their trauma experiences within the spaces of community Community can impact the healing & recovery process Communities can experience trauma

22 Student Mental Health & Well Being Common College Stressors Financial problems Academic challenges Relationship conflicts Family pressures Living on your own for the first time Student Mental Health Stress/mental health is the #1 health issue among college students Top presenting problems at MSU Counseling Center: Anxiety, Depression, Feeling Overwhelmed

23 Responses to Stress Excessive worry Crying frequently Increase in irritability, anger, and frequent arguing Wanting to be alone most of the time Feeling anxious or fearful, overwhelmed by sadness, confused Having trouble thinking clearly and concentrating, and difficulty making decisions Increased alcohol and/or substance use Increased physical (aches, pains) complaints such as headaches Trouble with your "nerves"

24 Adaptive vs. Maladaptive Coping Biological Impact of Stress on the Body Adaptive Coping Behaviors: Spirituality/prayer Seek social support Counseling services Exercise Resilient Behaviors: Increased bonding with community Renewed sense of purpose Commitment to personal mission Increased volunteerism Maladaptive Coping Behaviors: Compulsive (Overeating) Self-medicating (Substance Abuse) Impulsive (High Risk Sexual Behaviors)

25 Maladaptive Coping Behaviors Self- Medicating High Risk Behaviors Increased use of alcohol, marijuana and other substances Engaging in high risk sexual behaviors such as multiple partners, inconsistent/non use of condoms, hooking up Increase Risk of More TRAUMA

26 Alcohol & Substance Use 19% of college students meet criteria for alcohol abuse or dependence Consequences associated with use: Risk Behavior: 23% of youth report having unprotected sex due to substance use Sexual Assault: 75% of men and 55% of women involved in campus acquaintance rapes had been drinking or using drugs Violence: over 75% of female victims of domestic violence report their assailant had been drinking or using drugs

27 Sexual Health Behaviors Risky Sexual Behavior Sex under the influence of drugs and alcohol Inconsistent condom use Multiple sex partners STI/HIV Statistics: Persons infected with STIs are 2-5 times more likely to acquire HIV African Americans account for 44% of new HIV infections 1 in 4 new HIV infections occur in youth ages Approximately 60% of all youth with HIV do not know that they are infected, not getting treated and can unknowingly pass the virus to others

28 MSU Get SMART Project: Campus Assessment Alcohol and Substance Abuse 27% reported daily alcohol use 12% daily alcohol and marijuana use Males reported higher use of alcohol and drugs Sexual Practices 43% reported not using a condom during their last sexual activity 26% had sex while high on alcohol or drugs 43% stated they are unware of their HIV status

29 Managing Trauma On Campus Campus Culture/Climate Benefits Social Support Campus Organizations Campus Services & Intervention Programs Barriers Social Conservatism Stigma Campus Resources

30 Campus Service Example: MSU Counseling Center Counseling Center Services: Individual counseling Support Groups (Men of Power, Sister to Sister, LGBTQ, International Students ) Sexual Assault Education Dating Violence Assessment Alcohol Screenings Stress & Wellness Information Brown Bag Series (topics include: stress reduction techniques, healthy relationships, grief & loss, conflict and communication

31 Campus Intervention Example: Get SMART Project Community Social Marketing Strategy Health Education/Outreach HIV Testing Institution Policy change Increase access to services Interpersonal Intrapersonal/Individual Peer Education/Support Social Networks Social Media Substance abuse and HIV Education HIV Testing Substance Use Screening Counseling and Linkage To Care Fine Arts/Community Based Theatre

32 Promoting A Healthy Coping Environment SAMHSA s Key Principles of a Trauma- Informed Approach: Safety Trustworthiness and Transparency Peer support Collaboration and mutuality Empowerment, voice and choice Cultural, Historical, and Gender Issues

33 Tips for Students Coping with Trauma Talk about it: Talking with friends, classmates, professors, and family members will help you realize that you are not alone in your feelings. Limit media viewing: Take breaks from watching news coverage of the event. Take care of yourself: Taking good physical care of yourself with rest, exercise, and healthy eating will help your body to deal with stress. Do activities that you enjoy and find relaxing. Avoid excess: Avoid using alcohol, drugs, and tobacco products as a way of dealing with stress. Resume routines: Getting back to your daily routines in life can be a good method for regaining a sense of control. Get involved: Engaging in positive activities like group discussions and candlelight vigils can help promote comfort and healing

34 References Centers for Disease Control and Prevention (CDC). HIV Surveillance Report, 2013; vol Published February Accessed May 23, 2015 Douce, L., & Keeling, R. (2014). A strategic primer on college student mental health. American Council on Education. Washington, DC Mind Body Medicine COSC Symposium (2014). Naval Medical Center. San Diego, CA Morgan State University (2015). University Counseling Center. National Child Traumatic Stress Network. Center for Mental Health Service (CMHS). Substance Abuse and Mental Health Services Administration (SAMHSA), U. S. Department of Health and Human Services Pew Research Center, January Social Media Update 2014 available at: Substance Abuse and Mental Health Services Administration (SAMHSA). Trauma-Informed Care in Behavioral Health Services. Treatment Improvement Protocol (TIP) Series 57. HHS Publication No. (SMA) Rockville, MD: Substance Abuse and Mental Health Services Administration, SAMHSA s Trauma and Justice Strategic Initiative. (2014). SAMHSA s Concept of Trauma and Guidance for a Trauma-Informed Approach. SAMHSA

35 Contact Information Sabriya Dennis, DrPH, CPH Office: Website:

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37 Special Thanks Webinar Planning Committee Kim Dobson Sydnor, PhD Dean, School of Community Health and Policy Morgan State University Sabriya Dennis, PhD Researcher School of Community Health and Policy Lawrence Brown, PhD Assistant Professor School of Community Health and Policy 1700 E. Cold Spring Lane Portage Building - Room 302J Baltimore, MD Phone: Roslyn Holliday Moore Office of Policy, Planning and Innovation Office of Behavioral Health Equity SAMHSA Zina Peters, Intern Office of Policy, Planning and Innovation Office of Behavioral Health Equity SAMHSA Shannon B. Taitt, MPA Public Health Analyst Division of Services Improvement SAMHSA/CSAT Dr. Eugene Herrington, Co-Project Director HBCU - Center for Excellence Mrs. Joan Trent, Program Coordinator HBCU - Center for Excellence Mr. Charles Robinson, MPH Candidate Prevention Research Center (PRC)

38 HBCU-Center for Excellence at Morehouse School of Medicine 720 Westview Dr. SW - Atlanta, GA Office: HBCU (4228) Dr. Eugene Herrington Co-Project Director HBCU - Center for Excellence eherrington@msm.edu Mrs. Joan Trent Program Coordinator HBCU - Center for Excellence jtrent@msm.edu