Here to Help: Combatting a Mental Health Crisis

CONTENT WARNING: This article discusses suicide and suicidal ideation. If you or someone you know is suicidal, please call the wellness center at 610-409-3100 (for students and employees on campus during business hours during the academic year); campus safety at 610-409-3333 (for students and employees on campus after hours or during the non-academic year); the National Suicide Prevention Lifeline at
1-800-273-TALK; or 911.

Bill Norcross M.D. ’70 has spent the last 15 years of his 48-year career at the University of California San Diego (UCSD) School of Medicine working to improve—and save—lives, but not only those of his patients. After a devastating decade during which UCSD averaged approximately one physician or medical student suicide annually, Norcross and his colleagues implemented a life-saving program. Now, thanks to the efforts of two of his former students who wanted to honor his legacy of advocating for mental health support for healthcare employees, an endowed fund in his name at Ursinus College will provide financial support for students seeking internships and externships in mental health advocacy, addiction and recovery, and suicide prevention. It’s just one of the new ways Ursinus is working to prioritize mental health.

Growing up in Toms River, N.J., Bill Norcross knew by sophomore year of high school that he wanted to be a doctor. Specifically, a family doctor in a rural area where an entire community would see him for their medical care. The first-generation college student, whose parents didn’t finish high school, graduated from Ursinus in 1970 with a degree in chemistry and then returned to New Jersey to attend Rutgers New Jersey Medical School for $750 per year. At the end of a residency at the University of California San Diego (UCSD) School of Medicine, he was asked to stay—just for one year—in a faculty position. One year turned into another, and now the semi-retired Norcross is approaching his 50-year anniversary with UCSD.

“That’s how it happened,” said Norcross. “It was just one year at a time. Then I built up a practice. As a family doctor, when you take care of people over their whole life in continuity of care, you become quite attached to them.” It was a dream fulfilled (minus the rural setting), and leaving his patient population three years ago was difficult.

However, Norcross continues to work on initiatives he helped lead during his years at UCSD. It was 2006 when he joined the long-standing Physician Well-Being Committee (PWBC). All hospitals accredited by the Joint Commission must have a PWBC, which is dedicated to recognizing and offering assistance to staff experiencing substance abuse, or physical or mental illness.

He had served only two years on the committee when UCSD faced a tragic 10-year stretch that saw an average of one physician or medical student suicide annually. “The PWBC had a moment of self-reflection,” said Norcross. “Here we were supposedly the well-being committee and none of the people who [died by] suicide came to us for help. I believe the problem, at least among doctors, is that the culture of people who go into medicine is one that they themselves will not ask for help, even under the most dire circumstances.”

“What we were doing in the PWBC was essentially like having an office with a sign outside that read, ‘If you need help, please come in,’ and that wasn’t working. To this day, I’m not sure whether that’s a characteristic of the medical profession or human beings in general. But we understood if we were going to make an impact on depression and prevent suicide, that we would have to be more aggressive. We had to get in people’s faces.”

The result was the Healer Education Assessment and Referral (HEAR) Program, established in 2009 in collaboration with UCSD’s department of psychiatry and the American Foundation for Suicide Prevention (AFSP). Knowing that depression is among the leading causes of suicide, members of the HEAR program created a conference to address depression and mental health problems, in a general sense and also specific to the medical profession, but they also quickly decided they needed a way to gauge the mental health of employees. They developed a confidential questionnaire that is now sent not only to physicians, but also to every employee, including medical students.

“We ask people questions about their mental health, not just depression and suicidality, but a number of things, so that we can have an ongoing measure, both collectively and individually.” People who need help receive it— confidentially (using AFSP software that keeps identities private) and immediately (thanks to a network of area psychiatrists and counselors who are willing to be on call). Employees can also refer a colleague they believe is suffering.

Since its inception, HEAR has referred more than 500 people to mental health professionals, and the program has been acclaimed as a best practice in suicide prevention by the American Medical Association.

“Because it’s confidential, there are some things we will never know for sure—What’s the denominator? Is this how many people really have problems? How good are we at detecting them?—because people still have a right to remain silent about the issue if they want to. But we’ve certainly helped a lot of people.”

In addition to his role as a clinical professor of family medicine and director of the Physician Assessment and Clinical Education (PACE) program (a title he still holds), Norcross also served as the director of residency training at one point. It was in that role that he met and mentored John Alchemy M.D. and Bradford Stiles M.D. when they were residents.

The pair wanted to honor Norcross’s passion for physician wellness, so in the fall of 2021 they helped Ursinus establish the William A. Norcross M.D. ’70 Fund for Internships in Mental Health Advocacy, Addiction and Recovery, and Suicide Prevention. The endowed fund provides two $2,500 awards to Ursinus students who are sophomores, juniors, or seniors. The goal is to free up a student from needing a summer job and instead provide them with an important educational experience interning at a nonprofit or, specifically, with the American Foundation for Suicide Prevention.

“The Norcross Fund will help inform students for years to come about the very serious challenges and issues of physician mental health,” said Alchemy. “Dr. Norcross has educated and touched the lives of countless doctors during his teaching career at UCSD. I wanted his values and mission to be shared and built upon by the next generations of mental health workers and doctors.”

“There is no greater future investment vehicle than students. Students need to have funding and institutional vision like the Norcross Fund to allow meaningful learning engagement to encourage direction and commitment in discovery.”

Norcross feels the fund could apply to students in any major. “Given that in the course of the average American lifespan about 40 percent of us will meet the criteria for a psychiatric illness, I can’t imagine there’s any student who would not benefit … from a greater understanding of mental health issues, especially depression and suicide prevention. I think it would be very unusual for a person to be able to say that no family member or friend has ever been affected by a mental health issue. I don’t know if there is such a person. So it’s good to know something about [mental health]. Even if you’re not a doctor or a nurse, an average person can sometimes intervene and help people in important ways.”

ADVOCACY IN ACTION

Allyson Meakim ’23, a psychology and educational studies double major, is the first recipient of the internship funding. (At press time, the second recipient had not been selected.) In May, the Pennsylvania native will return to Downingtown East High School to work with the psychology and counseling departments on a mentorship program she implemented when she was a senior.

“This opportunity allows me to pursue my passion for mental health advocacy and learn more about the related career paths,” said Meakim. “The Norcross Fund allows students to prioritize mental health initiatives and take down the negative stigma surrounding it. I hope to make a difference in the lives of others and show them that it is okay to not be okay. I want students to feel comfortable enough in school to understand that mental health should be prioritized as much as physical health.”

Meakim is also a member of the softball team and serves as a campus captain for The Hidden Opponent (THO), a national nonprofit that focuses on mental health in athletics. Students established an official chapter on campus last fall. The student-run group is open to the entire Ursinus community, regardless of athletic status.

Erin Drebushenko ’23, a health and exercise physiology major, is president of the chapter. “THO is extremely important to have on our campus since a large portion of our campus is composed of student-athletes, whether they are official NCAA Division III athletes, part of club or intramural sports, or simply have a love for being active,” said Drebushenko. “Additionally, as students, we are all prone to the declines in mental wellness that come with stress and having to rely on ourselves while we are away at school. To have a group of people who understand these experiences and who have support and educational resources is extremely beneficial and important to students on our campus.”

Another national nonprofit organization represented on campus is Active Minds, which was founded at the University of Pennsylvania by a student whose brother had died by suicide. Established at Ursinus in 2008, the student-run group supports mental health awareness and education for young adults. So far this year they have hosted destress coloring events and a speaker. They hope to sponsor a “rage room” by the end of the semester.

BOLSTERING RESOURCES ON CAMPUS

Beyond student-run groups, Ursinus has also fortified its official avenues of support. Earlier this year, as part of a leadership realignment to better support our next strategic plan, Every Student’s Success, Laura Moliken was named vice president for health and wellness, with a focus on community-wide holistic health and well-being. The division includes athletics, medical services, counseling and wellness services, and prevention and advocacy.

“The goal was to take a more holistic approach to how we’re maintaining physical, mental, financial, and spiritual health, and all different aspects of our well-being,” said Lauren (Finnegan) Martin, executive director of counseling and wellness. “We’re really thinking through how we can be intentional in our practices, so that we are prioritizing our well-being above all the daily stressors that we face on a regular basis.”

Nationwide, the highest levels of distress or disorders are associated with anxiety and depression, said Martin. Over the past year and a half, she and her staff have noticed that students who are seeking counseling are reporting higher levels of academic distress and social anxiety, which is “unique to this time and place. It speaks to some of the effects of the pandemic.”

In 2021, Ursinus conducted a student survey through the American College Health Association that, similar to Norcross’s HEAR program survey, directed users to confidential third-party counselors when needed.

“The on-campus demand for counseling continues to increase,” said Martin. “While we are doing everything we can to match the demand, it’s a consistent challenge.”

It’s a problem that most colleges in this country are facing. Many have implemented measures such as wait lists and session limits, but those are not things Martin wants to use. “We feel like that’s really restrictive in nature to a lot of our students who need to have a more individualized approach to their mental health. Focusing on what they need—and responding to how much support they require—feels more important to us than [implementing a process where] everyone gets four sessions and that’s it.”

In addition to providing counseling services, Martin’s team, which includes prevention and advocacy, hosts programs such as weekly therapy-dog visits, stress-reduction and mindfulness workshops, yoga, and training events to help faculty recognize students in distress or crisis.

In 2020, Director of Prevention and Advocacy Katie Bean—who was recently instrumental in planning and executing an all-campus community conference devoted entirely to well-being—oversaw the creation of UCrew (Ursinus Cultivating Respect, Education and Wellness), which was supported by a Pennsylvania state grant. As a result, the campus now boasts a group of seven nationally certified peer educators who try to raise awareness about substances and sobriety, and educate fellow students about harm reduction to help them avoid problems related to alcohol or drug use.

“With the new division, we’re trying to formalize what we’re offering so students see it as a part of their curriculum,” said Bean. “Part of what they’re gaining by being an Ursinus student is understanding their own health and wellness.”

“Mental health is a building block,” said Martin. “It’s the foundation everything else in our life is counting on. We do better when we’re feeling good, and feeling good doesn’t happen by accident. We have to make intentional choices and practices to ensure that we are focusing on our health and well-being. If we’re not prioritizing that, things start to fall apart. Supporting our students and finding ways to enhance their mental health practices is something that’s really important to us. It’s why we get up every morning and do what we do.”