|The WHO World Mental Health Surveys International College Student Project (WMH-ICS)|
The college years are a crucial time period when students make the transition from late-adolescence to adulthood. Importantly, this transition takes place during an extremely sensitive part of the life cycle when emotional problems and mental disorders commonly occur. Approximately 75% of all lifetime mental disorders have their onsets prior to the age of 24, and these early-onset cases are related to poorer clinical and functional outcomes than later-onset cases. Additionally, the college years are associated with a significant increase in risky health behaviors, such as excessive alcohol and cannabis use, and suicide is the second leading cause of death among college students. Collectively, these disorders and behaviors are associated with low academic attainment, and perhaps most alarmingly, only a minority receive effective treatment to address these debilitating issues.
The WHO World Mental Health Surveys Initiative International College Student Project (WMH-ICS) aims to obtain accurate longitudinal cross-national information about the prevalence and correlates of mental, substance, and behavioral disorders among college students worldwide. The main goals of the project include: assessing unmet need for treatment, targeting students in need of outreach, and evaluating model preventive and clinical interventions. The initial phase of the project consists of the implementation of an online survey framework with representative samples of college students to estimate the prevalence of mental disorders, associated impairments, adverse social and academic consequences, and patterns of help-seeking. During the second phase of the project, the initiative will use the protocol developed for implementing these surveys to target students in need of outreach and will evaluate the effects of interventions implemented based on this targeting.
The initial phase of the WMH-ICS uses a flexible and cost-effective college student survey data collection instrument and protocol that (1) generates reliable screening estimates for a broad range of mental disorders (e.g. Major Depressive Episode, Generalized Anxiety Disorder, Panic Disorder, Bipolar Disorder, adult ADHD, substance abuse and dependence, and suicidal thoughts and behaviors), (2) tests the predictive validity of new methods of screening for risks of suicidal thoughts and behaviors and other behavioral/mental health and academic problems, (3) examines the use of services, predictors of service use, and barriers to help-seeking among college students, (4) estimates the burden of emotional problems, mental disorders, and suicidal thoughts and behaviors among college students and their association with academic functioning.
For the second phase of the project, students who satisfy criteria for a mental disorder (or problem behavior) are offered access to internet-based treatments. Leveraging our large cross-national sample, the ultimate goal is to identify which students will respond to low-cost, easily disseminable treatments. Working closely with institutions, the goal is to use a stepped care model in which students are triaged to more costly, labor intensive treatments only when it is known that they would be unlikely to respond to internet-based interventions. This exciting initiative is now ongoing in several countries around the world (e.g., Belgium, Germany, the Netherlands, and the United States).
The WMH-ICS Project is being completed as part of the WHO World Mental Health Survey Initiative (http://www.hcp.med.harvard.edu/wmh). The WMH-ICS is coordinated by an executive committee of WMH researchers: Randy P. Auerbach (Columbia University, US), Corina Benjet (National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico), Ronny Bruffaerts (Katholieke Universiteit Leuven, Belgium), Pim Cuijpers (Vrije Universiteit Amsterdam, The Netherlands), David D. Ebert (Friedrich-Alexander-University Erlangen, Germany), and Ronald C. Kessler (Harvard Medical School, US). For more information about the WMH-ICS project, please contact us here: email@example.com.
Nigeria (Oye Gureje)
South Africa (Dan J. Stein)
Hong Kong (Arthur Mak)
Australia (Penelope Hasking)
New Zealand (Charlene Rapsey)
Belgium (Ronny Bruffaerts)
France (Mathilde Husky)
Germany (David D. Ebert)
Netherlands (Pim Cuijpers)
Northern Ireland (Siobhan O’Neill)
Portugal (José Miguel Caldas-de-Almeida)
Spain (Jordi Alonso)
Saudi Arabia (Yasmin Altwaijri)
Canada (Daniel Vigo)
Mexico (Corina Benjet)
United States (Randy P. Auerbach)
Argentina (Daniel Vigo)
Colombia (Sergio Aguilar-Gaxiola)
Sampling: The first phase of the WMH-ICS consists of web-based self-report surveys administered to representative samples of college freshmen in the Fall of their first year of college along with tracking surveys administered each subsequent year of college. The baseline survey focuses on the assessment of risk factors for negative outcomes as well as strengths that guard against such outcomes. The subsequent tracking surveys include update information on the course of baseline emotional and behavioral problems as well as assessments of the subsequent onset of additional problems along with information on the occurrence of positive and negative life experiences and outcomes of interest (academic achievement as well as functioning in other important role domains). This enables us to study patterns of emotional problems/mental disorders among emerging and young adults in terms of prevalence, incidence, and persistence.
Mode: All surveys use a web-based data collection method, which enables us to conduct surveys much more cost-effectively than would be possible otherwise. Surveys take an average of 20-30 minutes to complete. The web-based nature of the surveys also allow for the addition of online interventions once high-risk students are identified.
Measures: The WMH-ICS survey instrument consists of a broad range of screening instruments that include the CIDI-Screener, the AUDIT, and the ASRS-6. The instrument also includes items from common clinical measures like the Columbia Suicide Severity Rating Scale, the NIDA-Modified Assist-Prescreen, and specific modules from the CIDI-3.0. The use of these instruments enables us to generate reliable screening estimates of DSM-5 disorders including, Major Depressive Episode (MDE), Generalized Anxiety Disorder (GAD), Panic Disorder (PD), Social Phobia (SP), Separation Anxiety Disorder (SAD), Bipolar Disorder (BD), adult ADHD, a range of eating disorders (anorexia nervosa, bulimia nervosa, binge-eating disorder), substance abuse and dependence, and suicidal behaviors. The instrument also generates reliable estimates of self-reported health, use of services for emotional or mental health problems, college expectations, adaptation to college life, and academic outcomes.
Training and Field Procedures: The WHO translation and harmonization protocol was used to create instruments and training materials in a wide range of languages. Standardized descriptions of the goals and procedures of the study, data uses and protections, and the rights of respondents are provided in written form for review and discussion by all eligible respondents before obtaining informed consent for participation in the survey. Quality control protocols are standardized across settings to guarantee accuracy and to specify data cleaning and coding procedures. The institutional boards of the colleges that carry out the surveys approve the surveys before they are implemented and monitored compliance with procedures for obtaining informed consent and protecting human subjects. All these implementation procedures have been codified in a fashion that makes them easy to export to other settings in order to expand the number of institutions in the initiative.
Alonso, J., Mortier, P., Auerbach, R.P., Bruffaerts, R., Vilagut, G., Cuijpers, P., Demyttenaere, K., Ebert, D., Ennis, E., Gutierrez-Garcia, R.A., Green, J.G., Hasking, P., Lochner, C., Nock, M.K., Pinder-Amaker, S., Sampson, N.A., Zaslavsky, A.M., Kessler, R.C., WHO WMH-ICS Collaborators. (2018). Severe role impairment associated with mental disorders: Results of the WHO World Mental Health Surveys International College Student Project. Depression and Anxiety, [Epub ahead of print]. PubMed Abstract
Auerbach, R. P., Mortier, P., Bruffaerts, R., Alonso, J., Benjet, C., Cuijpers, P., Demyttenaere, K., Ebert, D. D., Green, J. G., Hasking, P., Murray, E., Nock, M. K., Pinder-Amaker, S., Sampson, N. A., Stein, D. J., Vilagut, G., Zaslavsky, A. M., Kessler, R. C., & WHO WMH-ICS Collaborators. (in press). The WHO World Mental Health Surveys International College Student Project: Prevalence and Distribution of Mental Disorders. Journal of Abnormal Psychology.
Bruffaerts, R., Mortier, P., Kiekens, G., Auerbach, R. P., Cuijpers, P., Demyttenaere, K., Green, J. G., Nock, M. K., & Kessler, R. C. (2018). Mental disorders in college freshmen: Prevalence and academic functioning. Journal of Affective Disorders, 225:97-103. PubMed Abstract
Harrer, M., Adam, S.H., Fleischmann, R.J., Baumeister, H., Auerbach, R., Bruffaerts, R., Cuijpers, P., Kessler, R.C., Berking, M., Lehr, D., Ebert, D.D. (2018). Effectiveness of an Internet- and App-Based Intervention for College Students with Elevated Stress: Randomized Controlled Trial. Journal of Medical Internet Research, 20(4):e136. PubMed Abstract
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Mortier, P., Cuijpers, P., Kiekens, G., Auerbach, R.P., Demyttenaere, K., Green, J.G., Kessler, R.C., Nock, M.K., Bruffaerts, R. (2018). The prevalence of suicidal thoughts and behaviours among college students: A meta-analysis. Psychological Medicine, 48(4): 554-565. PubMed Abstract
Mortier, P., Auerbach, R. P., Alonso, J., Bantjes, J., Cuijpers, P., Ebert, D. D., Green, J. G., Hasking, P., Nock, M. K., O’Neill, S., Pinder-Amaker, S., Sampson, N., Vilagut, G., Zaslavsky, A. M., Bruffaerts, R., Kessler, R. C., & WHO WMH-ICS Collaborators. (2018). Suicidal thoughts and behaviors among first-year college students: Results from the WMH-ICS Project. Journal of the American Academy of Child and Adolescent Psychiatry, 57(4):263-273. PubMed Abstract p>
** Mortier, P., Auerbach, R.P., Alonso, J., Axinn, W.G., Cuijpers, P., Ebert, D.D., Green, J.G., Hwang, I., Kessler, R.C., Liu, H., Nock, M.K., Pinder-Amaker, S., Sampson, N., Zaslavsky, A.M., Abdulmalik, J., Aguilar-Gaxiola, S., Al-Hamzawi, A., Benjet, C., Demyttenaere, K., Florescu, S., de Girolamo, G., Gureje, O., Haro, J.M., Hu, C., Huang, Y., de Jonge, P., Karam, E.G., Kiejna, A., Kovess-Masfety, V., Lee, S., McGrath, J.J., O’Neill, S., Nakov, V., Pennell, B.E., Piazza, M., Posada-Villa, J., Rapsey, C., Viana, M.C., Xavier, M., Bruffaerts, R. (2018). Suicidal thoughts and behaviors among college students and same-aged peers: Results from the World Health Organization World Mental Health Surveys. Social Psychiatry and Psychiatric Epidemiology, 53(3):279-288. PubMed Abstract
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Mortier, P., Kiekens, G., Auerbach, R.P., Cuijpers, P., Demyttenaere, K., Green, J.G., Kessler, R.C., Nock, M.K, Zaslavsky, A.M., Bruffaerts, R. (2017). A Risk Algorithm for the Persistence of Suicidal Thoughts and Behaviors during College. Journal of Clinical Psychiatry, 78(7):e828-e836. PubMed Abstract
Mortier, P., Demyttenaere, K., Auerbach, R.P., Cuijpers, P., Green, J.G., Kiekens, G., Kessler, R.C., Nock, M.K., Zaslavsky, A., Bruffaerts, R. (2017). First onset of suicidal thoughts and behaviours in college. Journal of Affective Disorders, 207, 291-299. PubMed Abstract
** Auerbach, R.P., Alonso, J., Axinn, W.G., Cuijpers, P., Ebert, D.D., Greif Green, J., Hwang, I., Kessler, R.C., Liu, H., Mortier, P., Nock, M.K., Pinder-Amaker, S., Sampson, N.A., Aguilar-Gaxiola, S., Al-Hamzawi, A., Andrade, L.H., Benjet, C., Caldas-de-Almeida, J.M., Demyttenaere, K., Florescu, S., de Girolamo, G., Gureje, O., Haro, J.M., Karam, E.G., Kiejna, A., Kovess-Masfety, V., Lee, S., McGrath, J.J., O'Neill, S., Pennell, B.-E., Scott, K., ten Have, M., Torres, Y., Zaslavsky, A.M., Zarkov, Z., Bruffaerts, R. (2016). Mental disorders among college students in the WHO World Mental Health Surveys. Psychological Medicine, 46(14), 2955-2970. PubMed Abstract
Blasco, M.J., Castellví, P., Almenara, J., Lagares, C., Roca, M., Sesé, A., Piqueras, J.A., Soto-Sanz, V., Rodrĩguez-Marín, J.,Echeburúa, E., Gabilondo, A., Cebrià, A.I., Miranda-Mendizábal, A., Vilagut, G., Bruffaerts, R., Auerbach, R.P., Kessler, R.C., Alonso, J. and on behalf of the UNIVERSAL study group. (2016). Predictive models for suicidal thoughts and behaviors among Spanish University students: Rationale and methods of the UNIVERSAL (University & mental health) project. BMC Psychiatry, 16, 122. PubMed Abstract
Cuijpers, P., Cristea, I.A., Ebert, D.D., Koot, H.M., Auerbach, R.P., Bruffaerts, R., Kessler, R.C. (2016). Psychological treatment of depression in college students: A meta-analysis. Depression and Anxiety, 33(5), 400-14. PubMed Abstract
Mortier, P., Demyttenaere, K., Auerbach, R.P., Green, J.G., Kessler, R.C., Kiekens, G., Nock, M.K., Bruffaerts, R. (2015). The impact of lifetime suicidality on academic performance in college freshmen. Journal of Affective Disorders, 186, 254-260.
Mortier, P., Demyttenaere, K., Nock, M.K., Green, J.G., Kessler, R.C., Bruffaerts, R. (2015) [The epidemiology of ADHD in first-year university students] (article in Dutch).Tijdschrift voot Psychiatrie. 57(9):635-44. PubMed Abstract** Based on data from the WHO World Mental Health Surveys
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