Mental Health Resilience: How one student's letter sparked university-wide change in addressing mental health

Posted: February 24, 2021


Cara Braido, BSN 2019

A cascade of personal events had College of Nursing student Cara Braido feeling emotionally raw in her final term. In a span of a few months, her parents decided to divorce and a sibling was physically assaulted. These events hit Braido while she was still recovering from the suicide attempt of another sibling a few years earlier.

As she and her family worked together to recover, and as she focused on wrapping up her nursing studies, Braido started to think about ways she could help others who were also struggling with psychological and emotional distress.

“I thought to myself, if I can just help one person, it will be worth it,” Braido says. “I didn’t want anyone to suffer in silence.” That’s when she decided to write to UK President Eli Capilouto to express her concern for student mental health and the need for administrators to provide more robust outreach and support. In her letter, written in spring of 2019, Braido referred to the January 2019 suicides of two UK students, whom she did not personally know. “Our system failed [them],” she wrote. “[And] the response and resulting actions following the deaths of these two students is nothing short of disappointing.”

Her letter didn’t just spark conversation— it sparked a small revolution.

PUTTING A SPOTLIGHT ON MENTAL HEALTH

In the months since her letter, Braido has worked with College of Nursing administrators and professors to put in place a slew of mental health projects to help nursing students. She has also started surveying nursing students about their mental health, and the findings of those surveys have exposed a student body that is at times overly stressed, overly tired and overly anxious—much like the U.S. population as a whole.

“Some of the responses made me want to drop to my knees,” Braido says of her first survey. “Students talked about being suicidal themselves or losing a friend to suicide. They were so open.” Braido’s mental health advocacy didn’t escape the notice of College of Nursing Dean Janie Heath, who paired her with Lee Anne Walmsley, PhD, MSN, RN, assistant professor and director of work-life and student wellness, military and veteran student liaison. Walmsley worked with Braido to create a student mental health task force, which, in part due to its own success and usefulness, has been turned into a permanent college committee, with members meeting monthly.

“Dean Heath has been a strong advocate for student mental health resources,” Walmsley says. “She sponsored one of the first meditation rooms on campus and encourages all of us to cultivate resilience. She also made it clear when we started the task force that she wanted to destigmatize mental illness. It’s not something anyone should be ashamed of.”

KEEPING STUDENTS HEALTHY

One of the first things the mental health group did was create a mental health resource page that is linked on every online course homepage. This way, students won’t have to look far to find a list of roughly 20 campus mental health counseling services. Next, the group created a folder for faculty and staff that lists resources and guidelines for helping a student in crisis.

The result was that faculty and staff didn’t feel as anxious about dealing with a student who was in a state of panic or emotional distress,” says Walmsley. “With the guidelines, they know exactly what to do and who to call.”

For example, faculty and staff now know that if at the end of 10 minutes the student in front of them is still in crisis and not a threat to themselves, they should call Walmsley or Joanne Davis, assistant dean of students, and one of them will walk the student directly to the UK Counseling Center for immediate evaluation by a professional psychologist. Walmsley says she and Davis are called at least once a semester to deliver a student safely to the counseling center.

“Our academic program is rigorous and there are pass and fail points with checkoffs and exams,” says Walmsley. “This academic pressure coupled with the stress of work and family life can culminate in a breaking point.”

PRACTICING MINDFULNESS—DAILY


Pictured above from left to right are Kent Brouwer (BSN 2018) and Dr. Lee Ann Walmsley

In an effort to help nursing students start thinking about the importance of mental health from day one of their education, Walmsley and UK Nursing alum and DNP student Kent Brouwer (BSN 2018), who is also a member of the Student Mental Health Awareness Committee, have started talking about the importance of self-care and resilience at all College of Nursing new student orientations. Brouwer, who studied psychology during his undergraduate years at the University of North Carolina, Chapel Hill, is focusing on the practice of mindfulness in nursing as part of his doctoral thesis.

Brouwer was also part of previous campus mental health awareness efforts. Last year he worked with College of Pharmacy student Jordan Potter, who has since graduated with his PharmD, to create MINDS of Healthcare (Mindfulness in Newly Developing Students). This group worked to promote the benefits of mindfulness among all health care students on the UK campus.

In addition, the College of Nursing has instituted a weekly self-care challenge that encourages students to focus on some aspect of mindfulness or emotional reflection. One week the challenge might be to find some reason to laugh; the next, to unplug from electronics and screens. The latter challenge resulted in several of Walmsley’s students actually deleting certain apps on their cell phones.

“They had no idea how much time they were spending on their phones,” she said. “They were spending up to five hours a day on social media apps and were not even aware of what they were doing.”

For Brouwer, the interaction with students is important because he hopes to help them realize, sooner rather than later, that college courses are just the tip of the iceberg when it comes to situations that induce unhealthy feelings of competition and failure. By talking with students during their orientation, he says he wants to get them on the right track—early.

“School is just the beginning of a multitude of stressors that will become a part of your life and nursing career as you progress,” he says. “It’s a scary thing to say that to young people who are just starting out, but it’s true. Students need to think about and be aware of resources, such as mindfulness, that can help them navigate through these difficult times. Many of them have never heard of mindfulness before we talk to them about it.”

A LOOK AHEAD

Members of the Student Mental Health Awareness Committee see this new focus on mental health as a paradigm shift that could have far-reaching ramifications.

“I believe that the work of the mental health committee is crucial for the overall health of the College,” said Chizimuzo “Zim” Okoli, PhD, MPH, MSN, RN, CTTS, associate professor and director of Behavioral Health Wellness Environments for Living and Learning (BH WELL) and UK Nursing alum (BSN 1999, MSN 2002, PhD 2005, MPH 2005). “I believe our work will directly impact several of the College’s strategic plan goals, including making us more inclusive while fostering a culture and environment where students’ health and well-being are truly central in our operations.”

And although Brouwer and other UK Nursing faculty and staff have started taking their mindfulness talks to fraternities and sororities, there is talk of expanding this outreach to even more students on the UK campus. During the COVID-19 pandemic, Walmsley encouraged clinical faculty members to check in with nursing students, some of whom were self-isolating alone, to ensure their basic needs were covered and they were feeling OK.

Braido, who launched the mental health movement with her letter, has since graduated from the College of Nursing and now works as a pediatric nurse for UK HealthCare, still serves on the College of Nursing Student Mental Health Committee, and does her mental health survey. In fact, she’s now collecting survey responses four times a year and sharing all results with her fellow committee members. She’s proud to say that the percentage of students who say they know how to access mental health information and resources has jumped from 15 percent to 75 percent.

"This whole experience has been so rewarding,” Braido said. “I had no idea of the magnitude of what this would turn into or that things could change so quickly. I’m very proud of our accomplishments.”

The above article appeared in the University of Kentucky College of Nursing's 2020-2021 edition of Engagement