UNC has boldly confronted mental health. A new program looks like an exception | Opinion

The University of North Carolina System has mounted a strong response to rising mental health concerns among students by expanding clinic hours, setting up hotlines, creating a telepsychiatry program and training faculty and students to recognize depression and the potential for self harm.

System President Peter Hans knows what is at stake. He’s open about his own struggles with depression and he’s well aware of the mental stress among students.

In March, speaking to 400 UNC staff and faculty engaged in mental health programs, he said that since 2010, “The percentage of American undergraduates diagnosed with anxiety or depression has more than doubled. And rates of self-harm and suicide have all risen sharply.”

But UNC’s broad response – boosted by the governor’s office providing $7.7 million in federal funds to support student mental health care – has taken a turn that some mental health experts say is a wrong direction.

The UNC System is now seeking to build “resilience” among students on all of its campuses. It has contracted with a University of Pennsylvania center headed by Martin Seligman, the founder of “positive psychology.” The website of his Positive Psychology Center at the University of Pennsylvania says, “Positive psychology is the scientific study of the strengths that enable individuals and communities to thrive.”

Starting this fall, the center’s Penn Resilience Program will train 72 staff and faculty, who will in turn train more than 1,500 UNC student “resilience ambassadors,” who will use the program’s methods to “build resilience, well-being, and optimism” among students. The 72 initial instructors will receive a $3,000 stipend for completing five days of in-person training. The project’s overall cost is $750,000.

Companies and schools have engaged the Penn center to build mental resilience among employees and students. The problem is that there is little independent evidence that programs based on positive psychology achieve this aim.

A 2016 meta-analysis of the efficacy of the Penn Resilience Program (PRP) said: “No evidence of PRP in reducing depression or anxiety and improving explanatory style was found. The large-scale roll-out of PRP cannot be recommended.”

The U.S. Army, facing rising levels of suicide and post-traumatic stress disorder (PTSD) during the Iraq and Afghanistan wars, turned to the Penn Center to build mental resilience among troops. But some in the mental health field say the results didn’t justify the millions of dollars spent on the program.

One of the leading critics of the center’s work with the Army is Bryant Welch, a psychologist practicing in Sausalito, Calif., and a former executive director for professional practice with the American Psychology Association.

Welch told me this week that by going with the positive psychology approach, the Army was saying, “Let’s not work on the problem. Let’s just say we have. It was a charade.” He added that the project “was absolutely a boondoggle, and that’s being kind.”

Welch, who received his doctorate from UNC-Chapel Hill and worked there in student mental health services from 1976 to 1983, said if the same approach is used at UNC, “I would just be mortified if that is what they are doing to students.”

Seligman declined to comment, but he has said that claims that resilience programs don’t work are “grossly false.”

Dr. Harold Kudler, a psychiatrist formerly with the Durham VA Medical Center and an expert on PTSD, takes a gentler view of the effort to improve resiliency among Army troops, but he agrees that the effort showed little effect.

“People wanted it to work, and probably more importantly they needed it to work, and so they invested a lot of money in making this an Army-wide project,” said Kudler, now an associate consulting professor at Duke. “Unfortunately I don’t think anybody ever demonstrated that it actually worked.”

Kudler said the tenet of positive psychology is appealing: Focus on encouraging mental health, rather than treating mental illness. But the concept doesn’t hold up in practice. “It’s not clear that you change people’s temperament or world outlook,” he said. “I’m trained in psychoanalysis. I believe I can help people cope better with life, but I don’t think I can turn a pessimist into an optimist.”

Kudler told me, “I can see why UNC would look for a program like this. They would like something to work, it’s being proposed by smart people who I think believe in what they are doing, that it does work, but I don’t think there’s great deal of evidence that it works.”

With the resilience program ready to launch, the widespread training and instruction in resilience will go forward. Kudler said, “The prudent thing ” would be for UNC to draw up a clear evaluation program beforehand.

“Then they can see if this is working for them. If it’s not, they should let it go,” he said, “If it it is, they should figure out why it’s working and really double down on that.”

The UNC System is trying to address a real problem. It ought to spend its money on real solutions. Positive psychology doesn’t appear to be one of them.

Associate opinion editor Ned Barnett can be reached at 919-404-7583, or nbarnett@ newsobserver.com