Kimberly Moore: Hello, I'm Dr. Kimberly Moore, your Dean of Students…and we need to talk. The we need to talk podcast is a production of the Office of the Dean of Students. In this episode, we have some incredible guests here to talk with me about mental health and emotional well-being. These two things are often conflated. Our emotional well-being is tucked under the broad umbrella of mental health. Our intent today is to establish a distinction and identify some key takeaways to help our students take care of both their mental health and their emotional well-being. I look forward to the conversation. Thanks for joining us today. Steve, why don't you start by introducing yourself and your role at Miami.

Steve Large: Well, you bet, Kimberly, and thanks for having me. I am a gigantic fan of all things Dean of students. My name is Steve. I serve as Miami's Assistant Vice President for Health and Wellness. In that role that means I oversee a few different departments, student counseling, student health, and student wellness. I've been here since 2018, and I also happen to be a clinical psychologist. That's the boring stuff, the fun stuff is that I live in Oxford, and I have a really obnoxiously friendly dog named Joey, and I like to go on long walks around Oxford with him. If anyone sees me out with him, say hello.

Kimberly Moore: I can verify that he is adorable. To frame the conversation today, Steve, I know you and I both are out and about across campus, and we are talking to students, faculty, staff, community partners, parents…and we inevitably get asked about one thing more often than anything else, and that's mental health. I think to start the conversation, it's important to establish a common set of language. I think a lot of times, particularly I see this in parents and individuals who are carrying anxiety or worry about a student sometimes there's a conflation of what mental health is as opposed to the more nuanced understanding of well-being. I'm wondering if you can help us establish the start to the conversation and offer some definitions or some common language set to understand what mental health is as opposed to emotional well-being.

Steve Large: For sure, and I'm just so glad that you're asking this question and be that it's one of the first questions because it's so important. You alluded to it, Kimberly, already differentiating the two, but if I really had to just simply make it in the simplest of terms, when I think of mental health, I think of symptoms, I think of diagnoses. When I think of emotional well-being or emotional health, I think of humankind, I think of normative, I think of developmental. At the end of the day, we all have emotions, and we all have emotional well-being or some variation of emotional well-being. Kimberly, you do, I do. We may not all have mental health concerns, though. It can be subtle, but it's important because sometimes folks might want to start using mental health words or lingo or perhaps even diagnoses to describe something that's actually just part of the human condition.

Kimberly Moore: Absolutely. I was just having a conversation with a student who was worried about appear. I think it is evident that our students really care about one another's mental health or well-being and I was talking to a student who's worried about their friend who just went through a breakup, and they were saying that their friend was depressed. I had asked, they said, "Is your friend really working through clinical depression and you're wanting to get them connected to resources? Or is your friends sad because they are experiencing a loss in their life?" That's one example in distinction. I don't know if you could speak to a few more.

Steve Large: Yes. I think what is happening is the more clinical terms like depressed or anxious, or those are probably the two most common. Those are so familiar and so easy. But here's the truth. The truth is that emotions are not easy. They are dewy. They are hard to measure, they're hard to describe. I sometimes think our wonder if folks are more inclined to just say, yeah, I'm depressed or so and so's depressed or anxious, when in reality, if they pause and actually thought about what is going on in their spirit and really try to spend some time feeling whatever that feeling is and putting words to it now at the end of the day, sometimes they really may be depressed or anxious and that's okay too. But I just wonder if it's just easy to get caught in that trap of just going with the quick, familiar wording instead of really pausing and examining what's going on.

Kimberly Moore: I think it's really important to speak to this distinction because sometimes students are seeking resources they don't actually need for what they're experiencing. It's important to normalize mental health. Of course, that's critically important. I think that's happening nationally, which is great progress. But it's also really important to normalize emotional well-being and the things that detract from that. And so normalization on both fronts is critically important.

Steve Large: I couldn't agree more, and honestly, to me, it's about connection. The more people can just connect and accompany each other, so much beauty comes from that. Now sometimes we also need an accompanier that has some clinical training and psychologists or therapist or whatnot. But all of us here on campus can accompany each other wherever our emotions may be that day.

Kimberly Moore: Absolutely. Let's talk a little bit in broader scale beyond Miami. There's a lot of national statistics on college mental health, and it seems like a never-ending conversation using the language of mental health, particularly around our young people. When I say young people, I always feel really old, but it really is the national conversation, and it tends to focus on youth or young people. From your perspective, what is the state of student mental health? Broadly and then particularly what you see on Miami's campus and then if you could also speak to the state of student emotional well-being on campus.

Steve Large: You're asking a lot of me, Dean Moore.

Kimberly Moore: Just your perspective.

Steve Large: I know. Yes, everyone is talking about mental health, whether that be students themselves, their peers and friends, their parents, the president of the university, the board of trustees, everyone. The beauty in that, though, is that it's also a really strong opportunity for universities to demonstrate care, to demonstrate that they're listening, so absolutely to your first point that it's on everyone's minds and hearts. It seems like the state of student mental health. If I had to think of the easiest way to describe it, the first word that comes to mind for me is pronounced that back to that idea that everyone is talking about it, it's on everyone's radar. But the more nuanced explanation is, are we experiencing this flood of students with mental health concerns and diagnoses? Or is it a flood of students that are having feelings that they don't know how to experience and manage? Or is it a combination of the two? I might argue that it's probably a combination of the two. But amongst all of this, though, I think it's so important for us to remember, folks are talking, and to me, that is what's most important here is people are increasingly willing to put words to their internal experience, and I might say that there's only good things can come from that.

Kimberly Moore: Absolutely. From my perspective, I sit in proximity and I sit with students who are in distress and experiencing feelings and challenges and what I would say is that more people are talking about it. It doesn't mean that more people are experiencing mental health crisis and it's really important to know the distinction. That is a good thing, like you just said. It's a good thing that folks are talking about it, but it doesn't mean that everybody is carrying a clinical diagnosis. But like you said earlier, everybody carries emotions and is moving through those feelings in the ways that they have skills that encoping mechanisms that they've developed over their span of their lifetime and some people have more skills to do that than others.

Steve Large: You're so right. I liked that you mentioned that the dialogue itself doesn't necessarily equate to reality. It's great that everyone's talking about it, but it doesn't necessarily mean that that's what we're experiencing. I will say though I was just thinking, if I was a listener right now, I might be wondering, well then how do you know? Like how do you know if it's sadness or depression or if it's heartbreak or grief or whatever it is and I have a little trick. I don't know should I share my screen?

Kimberly Moore: Yes please. I get to take away too in a little bit. We'll get into that a little bit more, but please, Yes.

Steve Large: Well, so when I tried to think about differentiating what might be clinical, I think of duration, context and severity. Duration, how long have you been feeling this? Have you been feeling it for a day, a week, a month, a year? How severe is the emotion? Is the feeling? Is it causing you so that you can't function in class, you're not getting out of bed and then the context is what else is happening around you that might help speak to that feeling. Are you just randomly feeling sad or is your heart hurting because you just saw your ex with their new partner. So context, duration, severity, those are three things to keep in mind as you're trying to figure out is what I'm experiencing, perhaps more symptomatic or just human.

Kimberly Moore: Love it. I think I just want to speak to the severity component of it as we were talking about like, hey, what is the state of this on our campus? I think that honestly, the state of student well-being is that's pervasive because we're everywhere and we all feel different emotions and so those things can be heightened or not heightened at any given time and as far as the state of student mental health on campus, I would say we are seeing more severe cases, but at the same time, not a far more expansive number that means that we have more students that are in counseling or more students experiencing new diagnoses and those things. Would you say that that's accurate?

Steve Large: One hundred percent agree, Kimberly.

Kimberly Moore: Awesome. Give me a little insight on why you think the narrative is so persistent right now.

Steve Large: I wondered about that myself. The one thing that comes to mind for me when I hear the word narrative, I think about people like to story tell around things that are either intriguing to them or that they don't understand, or that they want to judge. I think around mental health and emotional well-being that could be personally intriguing for someone. They might not understand it, or they may want to judge it and so I wonder if that's why the narrative is so strong, particularly for older generations can really like yours [inaudible 00:11:39] I'm sorry. But, in all seriousness, I do wonder if this generation I adore how unbothered they are to share their truth and to put words to what they're experiencing. But that wasn't always the case. I almost wonder if it's just perhaps others are talking about that dynamic because it's so unaccustomed to what they're used to.

Kimberly Moore: I love that. I also think that the inter-generational lens is critically important because the circumstances of yesteryear forced and produced a particular developmental arc for older generations. The need to be independent sooner, the more responsibility younger. There are some of these things that just sort of the context of the times helped build a set of skills in older generations that the progress of our society now has changed and technology and the introduction of technology into the younger generations lives and how that has impacted how they develop certain skills to process and manage either emotions or challenge of a mental health diagnosis.

Steve Large: Well said.

Kimberly Moore: The other thing that you mentioned too is you said they judge or they questioned things they don't understand. I also think the narrative could be pronounced due to fear and I know particularly from our parents and our faculty and staff who are doing everything they can to support their student in the ways that they know how and a lot of times fear drives the narratives we create in her mind and the search for new information so I think that's a component as well.

Steve Large: I'm so glad you said that. You're right because I think for anyone listening, it's important to remember that emotions don't have to be scary. They can be uncomfortable. What I sometimes will tell folks is discomfort can be a sign that you're on the right track so when you're having a conversation with someone and it starts feeling uncomfortable, that probably could also mean that you're being vulnerable, that you're sharing things that might be difficult but that need to be said. The same is true for a student, perhaps a faculty member, or an administrator that they're talking with, it can be uncomfortable, but that doesn't mean that we have to avoid it or run from it.

Kimberly Moore: Probably should go through it.

Steve Large: Yes, please.

Kimberly Moore: Wonderful. Well, here's an opportunity to myth bust. Are there any, either mental health or just general well-being myths that you'd like to burst.

Steve Large: For sure. When we talked about myth-busting, actually, my mind first goes to student counseling service here on campus because I think there's some myths there. One is that counseling is expensive. So the truth is that it can be, but it doesn't have to be. Student counseling, if you do go to counseling services on campus that are currently in Heritage Hall, they do start charging at your fourth meeting a $25 fee per session but that fee can quickly and easily be waived. You just have to ask your therapist. If you choose to engage in care with a therapist outside of student counseling service, therapists will use insurance and so you might have a co-payment, $20, $25, even if that 20 or $25 is problematic, we also have funds that can help cover those costs, essentially for you. We never want money or finances to be a barrier to getting care. People know that if they need care and they can get it.

Kimberly Moore: Let me ask you this on topic. Is counseling appropriate for both emotional, contextual in distress, as well as things that are severe?

Steve Large: I'm so glad you asked. Listen, counseling will not hurt, it will not well, actually, I shouldn't say that. Counseling could be uncomfortable if you're working through some things, but it will only advance you. Now that said, there are limited therapists on campus, there's limited slots and availability. In a perfect world, we'd be seeing students that have more mental health diagnoses and symptomatology and helping them navigate that. But at the end of the day, if a student is needing support and wanting someone to accompany them through some emotions, please reach out to student counseling.

Kimberly Moore: Absolutely. They can always start with if they live on campus, they can always RA or a resident director. If they're not sure, they can always contact the Office of the Dean of Students and we can help them navigate that, figuring out what resource they really need and we can get them connected to. What are your biggest concerns as it relates to mental and emotional well-being on campus? Are you sitting with a concern? Or does date of our campus around this topic feel good to you right now.

Steve Large: What feels good is that earlier where we talked about how it's on everyone's radar and everyone's talking about it, and that includes our highest-level administrators at the university. I'm encouraged by that, that people are wanting to talk about this and see what the university can do. But what causes me concern? There's a couple of things that come to mind. The obvious one that's hard to talk about, but is important is student death, death by suicide. That is, unfortunately, just a sober reality for any college campus, including Miami. That's also why it's so critically important to make sure access to care is unburdened as possible so that students that have that level of distress can be seen quickly so that would be the one big concern. The next level of concern that I have is just around the management of expectations, both from students, from parents, from faculty, and staff. It seems as if, at times, folks have a hard time with waiting, whether it's waiting for their next appointment, or whether it's waiting for an answer, whether it's waiting for guidance and they're looking outside of themselves for that information and not working on tolerating the discomfort within themselves. I don't know what to do with that exactly, but it's been something I've been noticing and it gives me pause.

Kimberly Moore: And it's why I wanted to have this conversation today.

Steve Large: It's why we need to talk. Right?

Kimberly Moore: Yes. So that we understand the differences and we can make sure we're getting the students with the right needs to the right resource. It's always critically important. We can't really do that unless we really talk to one another, and connect across differences in understanding and things of that nature. And I do think that this is a topic, although so many people are talking about it, they're talking about it in very different ways. For our campus, this is a critical conversation because I do want to normalize emotional distress as distinct and separate from mental health so that students can see that there's more than one option.

Steve Large: One hundred percent.

Kimberly Moore: Let's do this.

Steve Large: What are we doing?

Kimberly Moore: What are the key differences in how individuals take care of their mental health versus their emotional well-being?

Steve Large: Well, not to oversimplify it. Taking care of mental health I think of treatment. That might be counseling. It can be group counseling, individual counseling, it could be tele-counseling, it could be psychiatry, medication might be a part of that process for you. That's what I think about with mental health. With emotional well-being, I think more of self-care. Almost. Like how do you refuel your tank and your spirit and what brings either peace amongst you or a smile on your face. That's how I think about emotional well-being and taking care of that.

Kimberly Moore: Awesome. I think a lot of people talk about self-care and don't really understand what does that mean, and it's fair to remind folks that only they know what that means for them.

Steve Large: Yes.

Kimberly Moore: That I hear some critique around self-care. Is a bubble bath really going to show my pain, or my discomfort, my sadness, right now? It's like, well, probably not, but it might give you a moment of reflection, so you can live through it. It looks different for everyone, and I think it's important to prioritize self-care and to perpetuate that message, but also contextualize it and give folks permission to know that they author that. They're the ones who really get to decide what it is they need. I want to encourage students to try to do some reflection. I know not all students love it, but some reflection on what it is that brings them joy, and that might bring them peace as well.

Steve Large: Totally agree.

Kimberly Moore: My last prompt for you is some small steps or takeaways that a student or community member listening can do to prioritize and take care of their emotional well-being, versus their mental health.

Steve Large: One thing that comes to mind for me is, I might argue that all of us have some type of inner dialogue, oftentimes it can be an inner critic or a bully, not always. But a small thing that you can do that can have monumentus impact is to really pay attention to what that inner dialogue is, what it's saying about you or others, and to challenge it. More times than not that bully is just is totally inaccurate, totally unkind, and unfortunately can oftentimes be effective. This is where you have the opportunity though to fight back. That would be one, is to really dial into what that inner dialogue is for yourself.

Kimberly Moore: Love that, and to find a trusted conversation partner in that too to be reflective.

Steve Large: Yes.

Kimberly Moore: Make sure they're trusted, and it's the right person. I think this is an opportunity, and I'll ask Ben, our producer, to put together a list of resources too that we could link to this. Any websites, or hope lines, or anything you want to take this opportunity to remind students of resources we have on campus?

Steve Large: One hundred percent. There are student counseling service, all the different services that they have there, including their groups and things are on their website. There's also the hope line, which stands for help over the phone everywhere. That's a 24/7 line that all Miami students have access to, and that can be in times of where you're feeling more imminent distress, you can reach out and use that line. There's also a wellness navigator tool that you can find on the office of student wellness website, and that's a tool that you can use that will help guide you to what might be the next best step for you, if you're unsure where to start. That's another little trick. The only last thing that I might suggest for folks is just to really give themselves permission to feel whatever they're feeling and to go towards discomfort. It can feel so paradoxical, but I'm telling you avoidance only fuels negative stuff. The more you can feel the feeling and walk towards it, whatever it is that's causing it, it will really improve things, more times than not.

Kimberly Moore: Absolutely. That reminds me, too, some of our students choose maladaptive coping or escapism. Can you speak into that a little bit, and basically to the point you just made, it's better to go internal than to seek external distraction from what you're feeling? Can you speak to that a little bit?

Steve Large: Oh my gosh, yes. Listen, I get it. It is oftentimes easier and more fun to turn to the maladaptive strategies, whether that's alcohol, drugs, sleep, video games, all of these things can be fun in the moment, but when they're being used in a purposeful way to avoid distress, what's happening is then that distress is just compounding, and it's getting more and more dense and ultimately difficult to tackle. The sooner and quicker that you can walk towards the source of distress and start taking action on it, the better, and you have less of a fight in front of you then.

Kimberly Moore: Absolutely. I think the simplest way that I always remind students, if you're not sure, if you're managing and you're just not sure what you need but you're feeling in distress, just asked for help. The office of the dean of students, we pride ourselves on being that point of connection for students who need support and need resources. We're happy to do it, we're certainly not the only ones on campus. But for a quick reference, the office of the Dean of Students is here to help, just ask. We cannot read your mind, so raise your hand, and if that's to faculty, to staff, or to a peer, anybody can get you connected to us, and we'll get you connected to the right place. Steve, I'm so grateful to you for your time and for the important conversation. It was one in which we seriously needed to talk, and we'll continue with the conversation, of course. Again, thank you.

Steve Large: Thank you again for the invitation. Thank you for the good work that the dean of students office is doing, Ben, for putting this together. Will there be autograph signings at some point after this, for folks that maybe would want that?

Kimberly Moore: Only if we go viral.

Steve Large: We'll figure that out later. But seriously, thank you. I appreciate you.

Kimberly Moore: Absolutely.