Change for Learning Richard P. Keeling, M.D. September 28, 2012 Higher Learning on Healthy Campuses: A Radical Re-design of Post- secondary Education BC Healthy Minds/Health Campuses 2012 Summit Revolutionizing Campus Wellness: A Vision for Healthy Campus Communities 1 Friday, September 28, 12

Critical questions of institutional mission, organizational structure and policy, and the nature and formation of programs and services designed to provide personal and academic support to students link our essential discussions of healthy campus living and leaning environments, the dynamics and quality of student learning, the well-being of campus communities, and students' readiness to learn. The learner matters in the learning; it is no longer intellectually or practically feasible to conceive of learning as a segregated intellectual activity that engages the mind, but not the brain, the emotions, and the body. Achieving the promise of developmental and transformative higher learning for all students will require far more than simply screening students and providing responsive psychological services; to help all students be ready and able to learn, and to ful336ll the promise of post-secondary education, we must imagine far-reaching changes in institutional cultures, organizational arrangements, and educational policies and practices. A radical re-design of higher learning and the institutions that offer it is needed to achieve the goal of healthy minds on healthy campuses. Abstract/Summary 2 Friday, September 28, 12

Mission = learning = 322student success323 3 Friday, September 28, 12

Graduationin X years Mission = learning = 322student success323 3 Friday, September 28, 12

Graduationin X years Higher Learning Mission = learning = 322student success323 3 Friday, September 28, 12

Graduationin X years Higher Learning Components General education, disciplinary content, cognitive skills, preparedness for work, citizenship, global literacy, personal and relational competence, identity, resiliency... Mission = learning = 322student success323 3 Friday, September 28, 12

Graduationin X years Higher Learning Components General education, disciplinary content, cognitive skills, preparedness for work, citizenship, global literacy, personal and relational competence, identity, resiliency... Integrated Person Healthy Mind Mission = learning = 322student success323 3 Friday, September 28, 12

Graduationin X years Higher Learning Components General education, disciplinary content, cognitive skills, preparedness for work, citizenship, global literacy, personal and relational competence, identity, resiliency... Integrated Person Healthy Mind Mission = learning = 322student success323 How do students learn? What helps them learn? What gets in the way of their learning? What can/should post-secondary institutions do to promote learning? 3 Friday, September 28, 12

Philosophical inquiry, observations, and postulates [epistemology] Cognitive, behavioral, educational and clinical psychology Research and scholarship on 322adult learning323 Pedagogy; scholarship of teaching and learning Documented 322real world323 experience [corporate training, military training, museums] Basic and clinical neurosciences [anatomical and functional] Emerging disciplines and schools of thought: pure and experimental neurophilosophy; neuroconstructivism Ways of knowing about learning 4 Friday, September 28, 12

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Holistic Constructed Meaning Making Integrative Contextual 6 Friday, September 28, 12

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University of Michigan [2009]: Healthy Minds Study; 56% response rate from a broad random sample of undergraduate and graduate students at Michigan. Main points: 245 Depression has a signi336cant negative association with GPA (reduction by 0.17) 245 Co-occurrence of depression and anxiety associated with signi336cant further drop in GPA (reduction by total 0.40) 245 Anxiety without depression not associated with GPA 245 Depression associated with higher likelihood of dropping out of university 245 All nine primary symptoms of depression (DSM-IV and PHQ) are independently and negatively associated with GPA 245 Findings true for men and women, undergraduates and graduate students, and not modi336ed by 336nancial status or exercise Eisenberg, Golbestein, and Hunt. Mental Health and Academic Success in College. The B.E. Journal of Economic Analysis and Policy 2009: 9(1): 1-35. De336nitive Study 9 Friday, September 28, 12

Lost opportunities: personal and academic transformation 10 Friday, September 28, 12

Lost opportunities: personal and academic transformation 10 Friday, September 28, 12

Lost opportunities: personal and academic transformation 10 Friday, September 28, 12

Lost opportunities: personal and academic transformation 10 Friday, September 28, 12

Lost opportunities: personal and academic transformation 10 Friday, September 28, 12

Lost opportunities: personal and academic transformation 10 Friday, September 28, 12

Taking responsibility 11 Friday, September 28, 12

I understand the argument that the university can325t do everything . Academic courses, it goes, are for the mind. Let the home and the church and the psychotherapist and the athletic program attend to the spirit and the body and the rest311We can325t be therapists and doctors and spiritual directors, too. Taking responsibility 11 Friday, September 28, 12

I understand the argument that the university can325t do everything . Academic courses, it goes, are for the mind. Let the home and the church and the psychotherapist and the athletic program attend to the spirit and the body and the rest311We can325t be therapists and doctors and spiritual directors, too. What I am asking for is a more holistic approach to learning , a disciplinary training for people who teach in college that takes into account the fact that we are educators of whole human beings, a form of higher education that would take responsibility for emergence of an integrated person. Taking responsibility 11 Friday, September 28, 12

Community/ Group Individual/ Personal Capacity/ Agency Taking responsibility for the development of an integrated person 12 Friday, September 28, 12

Community/ Group Individual/ Personal Capacity/ Agency 12 Friday, September 28, 12

Community/ Group interdependence connectedness inclusion Individual/ Personal resilience re337ection identity purpose Capacity/ Agency health ability adaptation creation 13 Friday, September 28, 12

Community/ Group interdependence connectedness inclusion Individual/ Personal resilience re337ection identity purpose Capacity/ Agency health ability adaptation creation Integrated Person 14 Friday, September 28, 12

Community/ Group interdependence connectedness inclusion Individual/ Personal resilience re337ection identity purpose Capacity/ Agency health ability adaptation creation Integrated Person 15 Friday, September 28, 12

Community/ Group interdependence connectedness inclusion Individual/ Personal resilience re337ection identity purpose Capacity/ Agency health ability adaptation creation Integrated Person Human Flourishing Healthy Minds, Healthy Campus 16 Friday, September 28, 12

Ottawa Charter for Health Promotion Health promotion is the process of enabling people to increase control over, and to improve, their health. To reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment. Health is, therefore, seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities. Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy life-styles to well-being. Taking Responsibility for the Emergence of an Integrated Person: Ottawa Charter for Health Promotion [1986] 17 Friday, September 28, 12

Re-orienting health-related services 18 Friday, September 28, 12

!The responsibility for health promotion is shared among individuals, community groups, health professionals, health service institutions and governments. Re-orienting health-related services 18 Friday, September 28, 12

!The responsibility for health promotion is shared among individuals, community groups, health professionals, health service institutions and governments.!They must work together towards a health care system which contributes to the pursuit of health. The role of the health sector must move increasingly in a health promotion direction, beyond its responsibility for providing clinical and curative services. Re-orienting health-related services 18 Friday, September 28, 12

!The responsibility for health promotion is shared among individuals, community groups, health professionals, health service institutions and governments.!They must work together towards a health care system which contributes to the pursuit of health. The role of the health sector must move increasingly in a health promotion direction, beyond its responsibility for providing clinical and curative services. !Health services need to embrace an expanded mandate which is sensitive and respects cultural needs. This mandate should support the needs of individuals and communities for a healthier life... Re-orienting health-related services 18 Friday, September 28, 12

Revolutionary Thinking 19 Friday, September 28, 12

Revolutionary Thinking Traditional Adaptive Radical Some students have psychological 322problems323 and/or addictions; post- secondary institutions should provide speci336c, limited services to respond to their concerns. The prevalence and intensity of psychological concerns demands an increase in the volume, diversity, and accessibility of services. Responding to the 322problems323 of certain students is an insuf336cient and potentially dangerous institutional policy; questions of the quality of the learning and living environment, campus culture, and human 337ourishing must be addressed. Resources are scarce; services must be allocated to address the most pressing needs, and students must seek care that falls beyond the capacity of the institution from other sources. Institutions must provide more resources in order to reduce risk, prevent incidents, and ensure that the most acute, urgent, and critical problems are recognized and addressed. This may require reducing outreach, liaison, and low-intensity services. Competition for resources should not occur in isolation within the realm of counselling services; institutions may reallocate resources currently devoted to other purposes to strengthen campus culture and support the creation of health campus communities. Students who have psychological concerns or addictions may experience academic, social, and personal dif336culty. Improved service models may make it easier to recognize and respond to students with psychological concerns or addictions: surveillance, screening, 322early alert323 programs. Many students may at various times not be ready to learn, and/or may encounter barriers to learning; a systemic, community-based approach to creating strong campus culture is needed. 322Healthy campus323 is an abstract concept that offers noble, general goals that primarily focus on certain elements of health status and health behaviors. 322Healthy campus323 models can provide an ecological perspective that emphasizes inter-dependence, community values and norms, and collaboration within the campus community. A 322healthy campus323 should be de336ned in positive ways that focus on strong developmental outcomes, 337ourishing at both individual and community levels, and new criteria and metrics. 19 Friday, September 28, 12

Revolutionary Thinking Traditional Adaptive Radical Some students have psychological 322problems323 and/or addictions; post- secondary institutions should provide speci336c, limited services to respond to their concerns. The prevalence and intensity of psychological concerns demands an increase in the volume, diversity, and accessibility of services. Responding to the 322problems323 of certain students is an insuf336cient and potentially dangerous institutional policy; questions of the quality of the learning and living environment, campus culture, and human 337ourishing must be addressed. Resources are scarce; services must be allocated to address the most pressing needs, and students must seek care that falls beyond the capacity of the institution from other sources. Institutions must provide more resources in order to reduce risk, prevent incidents, and ensure that the most acute, urgent, and critical problems are recognized and addressed. This may require reducing outreach, liaison, and low-intensity services. Competition for resources should not occur in isolation within the realm of counselling services; institutions may reallocate resources currently devoted to other purposes to strengthen campus culture and support the creation of health campus communities. Students who have psychological concerns or addictions may experience academic, social, and personal dif336culty. Improved service models may make it easier to recognize and respond to students with psychological concerns or addictions: surveillance, screening, 322early alert323 programs. Many students may at various times not be ready to learn, and/or may encounter barriers to learning; a systemic, community-based approach to creating strong campus culture is needed. 322Healthy campus323 is an abstract concept that offers noble, general goals that primarily focus on certain elements of health status and health behaviors. 322Healthy campus323 models can provide an ecological perspective that emphasizes inter-dependence, community values and norms, and collaboration within the campus community. A 322healthy campus323 should be de336ned in positive ways that focus on strong developmental outcomes, 337ourishing at both individual and community levels, and new criteria and metrics. 19 Friday, September 28, 12

Revolutionary Thinking Traditional Adaptive Radical Some students have psychological 322problems323 and/or addictions; post- secondary institutions should provide speci336c, limited services to respond to their concerns. The prevalence and intensity of psychological concerns demands an increase in the volume, diversity, and accessibility of services. Responding to the 322problems323 of certain students is an insuf336cient and potentially dangerous institutional policy; questions of the quality of the learning and living environment, campus culture, and human 337ourishing must be addressed. Resources are scarce; services must be allocated to address the most pressing needs, and students must seek care that falls beyond the capacity of the institution from other sources. Institutions must provide more resources in order to reduce risk, prevent incidents, and ensure that the most acute, urgent, and critical problems are recognized and addressed. This may require reducing outreach, liaison, and low-intensity services. Competition for resources should not occur in isolation within the realm of counselling services; institutions may reallocate resources currently devoted to other purposes to strengthen campus culture and support the creation of health campus communities. Students who have psychological concerns or addictions may experience academic, social, and personal dif336culty. Improved service models may make it easier to recognize and respond to students with psychological concerns or addictions: surveillance, screening, 322early alert323 programs. Many students may at various times not be ready to learn, and/or may encounter barriers to learning; a systemic, community-based approach to creating strong campus culture is needed. 322Healthy campus323 is an abstract concept that offers noble, general goals that primarily focus on certain elements of health status and health behaviors. 322Healthy campus323 models can provide an ecological perspective that emphasizes inter-dependence, community values and norms, and collaboration within the campus community. A 322healthy campus323 should be de336ned in positive ways that focus on strong developmental outcomes, 337ourishing at both individual and community levels, and new criteria and metrics. 19 Friday, September 28, 12

Making learning321and learners321the top priority... ...signi336cant, not incremental, changes in concepts, policies, and practices throughout the academy...will require fundamental changes in academic, social, and campus cultures. What Must Be Done? 20 Friday, September 28, 12

Taking Responsibility 21 Friday, September 28, 12

First Quality Research -- Epidemiologic, Clinical, Treatment Outcomes, and Academic Outcomes: insuf336cient data currently to clearly map epidemiologic, clinical, or academic trends in mental health. Develop and test new program and service models. Taking Responsibility 21 Friday, September 28, 12

First Quality Research -- Epidemiologic, Clinical, Treatment Outcomes, and Academic Outcomes: insuf336cient data currently to clearly map epidemiologic, clinical, or academic trends in mental health. Develop and test new program and service models. Serious, Integrated Approach in Policy and Practice: health is not 322just the responsibility of the health sector323; all parts of a post-secondary institution must 322work together towards a health care system which contributes to the pursuit of health.323 [Ottawa Charter, 1986]. Implications: professional development for faculty and staff, attitudinal and cultural leadership from senior of336cers, reallocation of resources to promote readiness to learn and relieve/ameliorate barriers to learning. Taking Responsibility 21 Friday, September 28, 12

First Quality Research -- Epidemiologic, Clinical, Treatment Outcomes, and Academic Outcomes: insuf336cient data currently to clearly map epidemiologic, clinical, or academic trends in mental health. Develop and test new program and service models. Serious, Integrated Approach in Policy and Practice: health is not 322just the responsibility of the health sector323; all parts of a post-secondary institution must 322work together towards a health care system which contributes to the pursuit of health.323 [Ottawa Charter, 1986]. Implications: professional development for faculty and staff, attitudinal and cultural leadership from senior of336cers, reallocation of resources to promote readiness to learn and relieve/ameliorate barriers to learning. Emphasis on Creating and Sustaining Supportive Environments: Addressing sources of stress and dysfunction is a better investment than treating them. Ecological models of health arise from the importance of environmental and cultural factors in determining behaviors and promoting symptoms. Taking Responsibility 21 Friday, September 28, 12

Taking Responsibility 22 Friday, September 28, 12

Want Students to be Integrated Persons? Integrate Their Experience and Learning. Reconsider the traditional organization of post-secondary institutions, including the division of student learning experiences into academic and non-academic sectors; thoughtfully re-think the concepts of 322student services323 in the context of supporting learning; integrate classroom and out-of- classroom learning experiences throughout the student experience. Taking Responsibility 22 Friday, September 28, 12

Want Students to be Integrated Persons? Integrate Their Experience and Learning. Reconsider the traditional organization of post-secondary institutions, including the division of student learning experiences into academic and non-academic sectors; thoughtfully re-think the concepts of 322student services323 in the context of supporting learning; integrate classroom and out-of- classroom learning experiences throughout the student experience. Student-Centeredness/Holistic Learning and Experience: Focus on understanding all the factors that promote or impair learning and on intervening wherever possible to strengthen students and their communities; raise the standards for 322wherever possible323 to mean more than 322if convenient.323 Taking Responsibility 22 Friday, September 28, 12

Want Students to be Integrated Persons? Integrate Their Experience and Learning. Reconsider the traditional organization of post-secondary institutions, including the division of student learning experiences into academic and non-academic sectors; thoughtfully re-think the concepts of 322student services323 in the context of supporting learning; integrate classroom and out-of- classroom learning experiences throughout the student experience. Student-Centeredness/Holistic Learning and Experience: Focus on understanding all the factors that promote or impair learning and on intervening wherever possible to strengthen students and their communities; raise the standards for 322wherever possible323 to mean more than 322if convenient.323 Learning as Touchstone for Decision-Making: Assess all questions of resources, priorities, strategy, and tactics based on their projected effects on the quality and quantity of learning and their impact on the potential for a healthy campus community. Taking Responsibility 22 Friday, September 28, 12

Stop... 23 Friday, September 28, 12

Expecting that all students who face barriers to learning will self- identify and seek services or treatment. Most will not. Assume they exist, are among the community, and have needs. Stop... 23 Friday, September 28, 12

Expecting that all students who face barriers to learning will self- identify and seek services or treatment. Most will not. Assume they exist, are among the community, and have needs. Demanding/expecting heroism -- especially, thinking of heroic actions as ordinary and possible, blaming students for not taking those actions, or not recognizing what heroism is and requires. As in: 322Relax,323 or 322Get over it.323 Stop... 23 Friday, September 28, 12

Expecting that all students who face barriers to learning will self- identify and seek services or treatment. Most will not. Assume they exist, are among the community, and have needs. Demanding/expecting heroism -- especially, thinking of heroic actions as ordinary and possible, blaming students for not taking those actions, or not recognizing what heroism is and requires. As in: 322Relax,323 or 322Get over it.323 Working only on the 322personal skills323 part of health promotion. Doing that reinforces the need for heroism, and the assumption that heroism is ordinary and possible. Stop... 23 Friday, September 28, 12

Expecting that all students who face barriers to learning will self- identify and seek services or treatment. Most will not. Assume they exist, are among the community, and have needs. Demanding/expecting heroism -- especially, thinking of heroic actions as ordinary and possible, blaming students for not taking those actions, or not recognizing what heroism is and requires. As in: 322Relax,323 or 322Get over it.323 Working only on the 322personal skills323 part of health promotion. Doing that reinforces the need for heroism, and the assumption that heroism is ordinary and possible. Depending on 322quick 336xes,323 tool-kits, and easy answers. Creating the conditions that promote healthy minds on healthy campuses requires cultural change, cultural and social tools, political acumen, and serious engagement with students as integrating human beings; it will be ef336cient, fast, or cheap. Stop... 23 Friday, September 28, 12

Change Culture, Change Outcomes It is the synchronous coordination of all of these efforts that drives students toward the achievement of higher learning321and that creates the conditions for healthy minds on heatlhy campuses. 24 Friday, September 28, 12

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Commitment 25 Friday, September 28, 12

Courage Commitment 25 Friday, September 28, 12

Courage Resiliency Commitment 25 Friday, September 28, 12

Courage Resiliency Community Commitment 25 Friday, September 28, 12

Courage Resiliency Community Commitment Change 25 Friday, September 28, 12

Critical questions of institutional mission, organizational structure and policy, and the nature and formation of programs and services designed to provide personal and academic support to students link our essential discussions of healthy campus living and leaning environments, the dynamics and quality of student learning, the well-being of campus communities, and students' readiness to learn. The learner matters in the learning; it is no longer intellectually or practically feasible to conceive of learning as a segregated intellectual activity that engages the mind, but not the brain, the emotions, and the body. Achieving the promise of developmental and transformative higher learning for all students will require far more than simply screening students and providing responsive psychological services; to help all students be ready and able to learn, and to ful336ll the promise of post-secondary education, we must imagine far-reaching changes in institutional cultures, organizational arrangements, and educational policies and practices. A radical re-design of higher learning and the institutions that offer it is needed to achieve the goal of healthy minds on healthy campuses. Abstract/Summary 26 Friday, September 28, 12

Change for Learning www.KeelingAssociates.com 453 Hudson St., Suite 3 New York, NY 10014 Phone !212-229-4750 27 Friday, September 28, 12