The JED Campus advisors described their impressions of Dartmouth’s campus culture based on data collected via the Healthy Minds Study survey, interviews with students, and their own experiences and observations during during their campus visit. While the identified concerns are not unique to Dartmouth, they impact student wellbeing. The JED Campus advisors recommended that Dartmouth address these concerns by cultivating a culture of wellbeing to counteract or replace the following unhealthy attitudes, beliefs, and behaviors.

• Perceptions of down time as “wasted” time. Active and engaged in high school, undergraduate students arrive at Dartmouth and see a cornucopia of possible activities, clubs, and opportunities. Their schedules fill quickly, often to the point of leaving little time for relaxation and rejuvenation. The rapid ten-week terms and the D-Plan structure can amplify these commitments and create an overcommitted and a highly-stressed state. Similarly, graduate and professional students feel pressure to fill their resumes and CVs with activities, honors, and awards in the hope of distinguishing themselves from their peers when they enter the job market.
• Perfectionism and fear of failure. Dartmouth students are accustomed to high-level achievement and have excelled in in academics, athletics, music, clubs, and volunteer activities prior to arriving here. Many are unfamiliar with disappointment or the disquieting emotions of failure, and a number struggle to recover after experiencing failure.
• Highly engaged alumni. Dartmouth’s alumni maintain strong connections with their alma mater. Their strong involvement offers students unparalleled opportunities and extensive networks. Many alumni send their children to Dartmouth, passing down knowledge and a sense of familiarity with the campus that in turn equips their children to better navigate it as students. In turn, Dartmouth can feel like a privileged and closed community for other students, especially for undergraduates who are first-generation college students.

Strength

Stakeholder engagement and an all-Dartmouth approach. The JED campus advisors noted that Dartmouth’s commitment to assessing and reviewing each population of students is a strength. By creating separate assessments for undergraduate, graduate, and professional students, each population’s unique needs can be accounted for in developing an overall plan for improving mental health and wellbeing.

Recommendations

Future strategic plans. The JED Campus advisors recommended that a strategic plan should explicitly address connections to student mental health and wellbeing to ensure that the relevant considerations are built into those plans, regardless of the strategic plan’s primary areas of focus or the subsets of the student population that they are intended to serve.

JED Campus defines "life skills” as skills used for bystander intervention, career planning, conflict management, diversity/equity/inclusion, healthy relationships, social justice and advocacy, stress management, study skills, and other topics that can enhance mental health and improve resilience.

Strengths

Undergraduate life skills development opportunities. The JED Campus advisors found that life skills development opportunities at Dartmouth varied by type of student with undergraduates having access to a wide range of opportunities through several offices.

Recommendations

Improve life skill development opportunities for graduate and professional students. The JED Campus advisors recommended increasing life skills development offerings for Dartmouth’s graduate and professional students.

Expand offerings for physical activity and wellbeing. The JED Campus advisors recommended that Dartmouth build on its physical activity and wellbeing opportunities by inviting feedback from students  and collaborating with staff and student peer educators to expand programming options and attract students who have been less interested in current offerings.

Regular life skills inventory. The JED Campus advisors recommended that Dartmouth regularly  inventory life skills programming to uncover overlaps, gaps, opportunities for collaboration in the work.

Strengths

The JED Campus advisors recognized that Dartmouth supports social connectedness in many ways, such as student organizations, sports, religious and student life groups, leadership opportunities, and identity groups tailored to the interests and needs of students from backgrounds historically underrepresented in higher education.

Recommendations

Greater inclusion of graduate and professional students in campus life. The JED Campus advisors found that campus resources are targeted toward undergraduate students making the campus feel less inclusive for graduate and professional students. They recommended creating additional opportunities for graduate and professional students and/or providing access to many of the offices and resources that currently focus only on undergraduates. 

Rural location. Dartmouth’s rural location can make it challenging for students from historically underrepresented backgrounds to make cultural connections beyond campus. The JED Campus advisors recommended creating opportunities for strong social connectedness within the college and surrounding communities.

Engage with student influencers to promote mental health and wellbeing. Students involved in Greek life and student-athletes are influential in Dartmouth’s undergraduate social scene. The JED Campus advisors recommended leveraging their social influence for promoting mental health and wellbeing.

Cultivate social opportunities beyond Greek life. Dartmouth’s undergraduate social scene revolves around fraternities and sororities where high-risk drinking and exclusionary social situations can be present. The JED Campus advisors recommended that Dartmouth cultivate options for healthy, inclusive social interaction that are perceived as high value by students. 

Strengths

Clinical Services Available to All Students. JED Campus advisors acknowledged several strengths pertaining to healthcare delivery in Dartmouth’s primary care, counseling, and inpatient nursing departments.

• Primary care services. Providers in the Primary Care and Preventive Medicine (PCPM) department at Dartmouth College Health Services (Dick’s House) are knowledgeable about mental health and provide roughly half of the depression and anxiety prescriptions issued by Dick’s House.
• Counseling Center Staffing. Dartmouth Counseling Center has fourteen clinicians, including two psychiatrists who can prescribe and manage medications and a case manager. Half of the clinicians identify as Black, indigenous, or people of color (BIPOC) and several identify as LGBTQ+. The Dartmouth Counseling Center offers counseling in four languages: English, Mandarin Chinese, Portuguese, and Taiwanese.
• Inpatient nursing department. The on-campus Inpatient Nursing Department/Infirmary (IPD) at Dartmouth College Health Services (Dick’s House) is one of only a few in the country where students can stay overnight with mental health or other medical concerns. This is a valuable service given Dartmouth’s rural setting and intense ten-week terms for undergraduates and some graduate and professional students.

Substance Use Resources. JED Campus advisors highlighted multiple strengths pertaining to substance misuse.

• Substance use education. Dartmouth provides students with AlcoholEdu, ECheck-up, and Brief Alcohol and Screening and Intervention for College Students (BASICS) education, all related to substance use.
• Naloxone. Dartmouth offers termly trainings to Greek life leaders so that each of the Greek life houses can possess and administer that medication when needed. Naloxone is a medication that can reverse the effects of an opioid overdose. Although reported opioid use among Dartmouth students is very low, the JED campus applauded this effort. 

Recommendations

Add teletherapy. At the time of the review, Dartmouth relied on campus-based counseling. JED Campus advisors recommended adding a teletherapy service to meet additional needs, including offering a wider range of scheduling hours, more counselor choices for students preferring to see a counselor with their shared linguistic or cultural identity, and counseling for students who are off campus.

Access to information. In many instances, the JED Campus advisors could not find clear, concise, and consolidated information across Dartmouth’s websites about mental health resources. Instead, they found information dispersed across many Dartmouth webpages. They recommended that we improve our web presence.

Alcohol consumption. At Dartmouth, many students engage in high-risk drinking. The JED Campus advisors recommended that Dartmouth offer more attractive, peer-driven social activities that do not involve alcohol as well as educate students on relationships between mental health and substance use.

Expand Naloxone access. The JED campus advisors recommended that Dartmouth consider making Naloxone available to more student groups and employees.

Strengths

Crisis support. The Counseling Center offers 24-hour on-call crisis counseling for students or for those who are concerned about a student. Any student in a crisis can talk with a counselor that same day.

Case management.

• All crisis situations are handled by the designated dean on-call.
• The Undergraduate Deans Office (UDO) and deans from the respective graduate and professional schools collaborate with colleagues at Dick’s House to provide support to students experiencing a crisis.
• When needed, a case manager in the Department of Health Services (Dick’s House) can assist students with a variety of tasks such as coordinating hospitalizations and hospital discharge and after-care planning (e.g., referrals to community providers). This case manager can also help with referrals for students taking time away from Dartmouth for medical reasons and for students transitioning back to campus. The case manager also provides support to students in less acute situations (e.g., help navigating primary care, counseling center, and other departments on campus; referrals to community providers).

Postvention. Dartmouth has a postvention protocol in place that is consistent with best practice recommendations endorsed by the Higher Education Mental Health Alliance (e.g., timely notification of the College community, balancing students’ desire for information with affected family members’ wishes about privacy).

Recommendations

Increase communications about help-seeking in emergencies. The JED Campus advisors recommended that Dartmouth increase its communication about how to report/get help for emergencies both during the daytime and after-hours.

Postvention Refinement and Education

• Community gatherings. While the JED Campus advisors understood that opportunities for the community to come together after a student death were disrupted by COVID-19 protocols on physical distancing, they encouraged Dartmouth to create consistent opportunities for community members to come together after a student death.
• Postvention protocol. As Dartmouth’s postvention protocol was originally developed for undergraduates, the JED Campus advisors recommended a language and process review that would be inclusive of the graduate and professional schools.
• Educating students on protocol. JED Campus advisors suggested that Dartmouth consider educating students across Dartmouth about the protocol, especially regarding the communicating about the death and respecting the family’s wishes.

Strengths

Safe medication disposal. Safe medication disposal is available at Dartmouth College Health Services (Dick’s House) for all students, staff, and faculty. The Dartmouth-Hitchcock Medical Center (DHMC) pharmacy offers safe medication disposal as well, which Geisel students and others visiting the DHMC campus can use.

Toxic substances. Toxic substances in labs are tracked, monitored, and controlled.

Recommendations

Environmental scans for means restriction. JED Campus advisors recommended conducting an environmental scan that includes facilities and campus security staff and develop a plan for remediation. 

Strengths

Routine screening in primary care. The Primary Care and Preventive Medicine (PCPM) department at Dartmouth College Health Services (Dick’s House) screens students for mental health related issues at all appointments, even if their reason for scheduling the appointment was unrelated to mental health.

Mental health training for faculty, staff, and students. The Counseling Center created Dartmouth Campus Connect, a training program for faculty, staff, and students to help them recognize the signs of mental health distress and connect students to campus resources. At the time of the first JED site visit, one hundred faculty had completed the training.

Online mental health screening tools. Dartmouth offers online mental health and substance use screening tools that students available on demand. Bi-annually, the Geisel School of Medicine offers the Interactive Screening Program through the American Foundation for Suicide Prevention.

Recommendations

Mental health trainings. The JED Campus advisors recommended that Dartmouth continue to increase the number of faculty and staff who participate in trainings like the Campus Connect training.

Training on other topics that affect mental health. JED Campus advisors recommended Dartmouth add training for faculty in areas that can improve mental health such as best practices in graduate student mentoring and in diversity, equity, inclusion, and belonging (DEIB).

Messages for matriculating students. The JED Campus advisors recommended sending messages about campus resources to incoming undergraduate, graduate, and professional students whose health histories at matriculation indicate past experiences with mental health and/or substance misuse challenges.

Online mental health screening tools. In addition to the screenings performed at Dick’s House, Dartmouth offers online mental health and substance use screening tools that students available at any time. The JED Campus advisors recommended making these screening tools more visible to students on Dartmouth’s website and using additional channels to publicize their availability with the goal of students assessing their own mental health status and seeking help.  

Strengths

Health insurance. JED Campus advisors appreciated Dartmouth’s comprehensive coverage for the treatment of mental health issues, addiction counseling, in-patient coverage, partial hospitalization, outpatient services, and more. Dartmouth requires matriculating students to maintain health insurance with the option of staying on an existing plan or opting into the Dartmouth Student Group Health Plan.

Medical amnesty (“Good Sam”) policy. Dartmouth has a Good Samaritan policy that prohibits students from being punished for possessing (or using) alcohol and other drugs if they call for professional help. The policy encourages students to seek medical help when they need it.

Peer mentoring. Dartmouth has multiple peer mentoring systems that contribute to a strong culture of caring among students. Examples include the following.

• The Sexual Violence Prevention Project (SVPP) engages undergraduate student facilitators to educate peers on healthy relationships, power and equity, bystander intervention, and local resources. Addressing these topics using peer educators supports healthy interpersonal interactions among undergraduates, increases knowledge of available resources, and helps to prevent violence that can adversely affect student mental health.
• The Mental Health Student Union, an undergraduate student organization, provides drop-in peer support sessions and educates students through its peer ambassador program.
• Geisel Wellness Representatives and Student Needs and Assistance Program (S.N.A.P.)representatives are available to their peers for support and linkage to resources.
• Tuck Mental Health and Wellness Initiative provides peer to peer mental health information.

Recommendations

Increase Knowledge of the Medical Amnesty (“Good Sam”) Policy. The JED Campus advisors recommended that Dartmouth raise awareness of this policy by posting the policy (or a summary) in locations across campus such as residence halls.

Streamline procedures for taking time away for medical reasons. The Jed Campus advisors recommended making the policy for taking time away more inclusive of graduate and professional schools and creating a streamlined system for students taking time away from Dartmouth under emergency situations, especially for undergraduates. This includes helping undergraduate students handle communications with multiple offices such as financial aid, housing, and the registrar.

Increase communications pertaining to taking time away for medical reasons. The JED Campus Advisors recommended that Dartmouth educate students about the policies and procedures for taking time away for medical reasons will help students to better understand the options available to them.