Supporting Student Wellness: De-Stressing Initiatives at Memorial University Libraries

Abstract

Student mental health and wellness is a critical issue facing institutions of higher education across Canada. Mental illness is predicted to be the leading cause of disability at Canadian universities. This article looks at some of the recent data on how mental health issues such as stress, anxiety and depression are affecting academic performance. There is growing consensus amongst university administrators that student mental health is a campus-wide responsibility. Providing students with healthy and positive methods of relaxing and coping with stress is just another way that libraries can support learning and academic success and contribute to a campus culture that is supportive of wellness. Two branches of Memorial University Libraries in Newfoundland, the Queen Elizabeth II (QEII) and Grenfell Campus library, have undertaken initiatives to attempt to help decrease students’ anxiety levels during the particularly stressful end of semester, including extended-hours, yoga, pet therapy, games, fun “de-stressing stations”, and free hot beverages and snacks. Both branches surveyed students to obtain feedback on these initiatives and determine what impact students’ felt the initiatives had on their stress levels. These events also garnered positive exposure in both social and local media and provided a great promotional opportunity for the libraries.

Headnote

Abstract

Student mental health and wellness is a critical issue facing institutions of higher education across Canada. Mental illness is predicted to be the leading cause of disability at Canadian universities. This article looks at recent data on how mental health issues such as stress, anxiety, and depression are affecting academic performance. There is a growing consensus amongst university administrators that student mental health is a campus-wide responsibility. Providing students with healthy and positive methods of relaxing and coping with stress is another way that libraries can support learning and academic success and contribute to a campus culture that is supportive of wellness. Two branches of Memorial University Libraries in Newfoundland, the Queen Elizabeth II (QEII) and Grenfell Campus library, have undertaken initiatives, partially through partnering with the university's Student Services department, to help decrease students' anxiety levels during the particularly stressful end of semester. These include extended hours, yoga and mindfulness, pet therapy, micro-breaks, and free hot beverages and snacks. Both branches surveyed students to obtain feedback on these initiatives and determine what impact students felt the initiatives had on their stress levels. These events also garnered positive exposure in both social and local media and provided a great promotional opportunity for the libraries.

Keywords

Wellness, stress, anxiety, university students, academic

Why Should Academic Libraries Provide Wellness Support?

Mental Health of Canadian University Students

In 2013, for the first time, the American College Health Association (ACHA) National College Health Assessment included Canadian data compiled from 34 post-secondary institutions. What that assessment revealed about the mental health of students attending Canadian universities was troubling. 89.3% of Canadian students reported feeling overwhelmed by their workload, 86.9% reported exhaustion (not from physical activity), 56.5% felt overwhelming anxiety, 63.9% felt very lonely, and 68.5% felt very sad (pp. 13-14). Even more worrisome was that 37.5% reported feeling so depressed that it was difficult to function and nearly 10% had seriously considered suicide (p. 14). What is more, student stress and anxiety seems to be increasing rather than decreasing. Although no earlier Canadian ACHA data exists to provide a comparison, the most recent Canadian Campus Survey (2005) completed a decade ago by the Centre for Addiction and Mental Health compiled similar data. In comparing the results, we found evidence that stress and anxiety levels were rising. Forty universities participated in the 2004 survey making the sample size comparable to the 2013 National College Health Assessment.1 Only 47.3% reported feeling constantly under strain, 30.9% feeling depressed, and a mere 16.8% reported feeling unhappy (Adlaf, Demers, & Gliksman, 2005, p. 65). Interestingly, the Canadian Campus Survey reported that the prevalence of elevated psychological distress among undergraduates showed no statistically significant changes from that recorded in the previous survey conducted in 1998 (p. 114), suggesting that the increase in mental health issues is a more recent trend.

University administrators are becoming increasingly aware of the importance of addressing the issue of student mental health. At Memorial University, Dr. Norman Lee, chief physician at the St. John's Campus Student Health Centre, reported that the centre receives about 18,000 visits a year with the most frequent visits related to depression and anxiety (Barron, 2014, p. 1). Across the country at the University of Victoria, President David Turpin has stated the "prediction for 2020 is that mental illness will be the leading cause of disability at Canadian universities" (Hanlon, 2012, p. 1). In 2010, after Cornell University in New York had 6 students tragically commit suicide, President David Skorton acknowledged that the deaths were just "the tip of the iceberg, indicative of a much larger spectrum of mental health challenges faced by many on our campus and on campuses everywhere" (Lunau, 2012). In Canada, at Ontario's Queen's University, 4 suicides occurred within a 14 month period (2010-2011), prompting the school to establish a commission on mental health (Lunau, 2012).

Stress and Anxiety and Academic Performance

What impact do mental health issues have on students' academic performance? The National College Health Assessment (2013) asked students to identify factors affecting their academic performance within the last 12 months. Academic performance was defined as being affected if students "received a lower grade in the course; received an incomplete or dropped the course; or experienced a significant disruption in thesis, dissertation, research, or practicum work" (p. 5). The number one factor was stress followed by anxiety (see Figure 1).

As Dr. Lee put it, "If a brain is troubled, it doesn't learn" (Barron, 2014, p. 3). Studies of stress on the academic performance of university students have found that it can have a negative impact on academic success (Stoliker & Lafreniere, 2015; Andrews & Wilding, 2004; Lumley, Provenzano, & Harris, 2003; Klein & Boals, 2001; Misra, McKean, West, & Russo, 2000).

Wellness as a Campus-wide Responsibility

The report of the Queen's University Principal's Commission on Mental Health (2012) acknowledged the essential role the university has to play in supporting student wellness: "Good health - physical and mental - is an inextricable precondition for optimal academic and social success. The university community has a duty, obligation and an underlying commitment to promote and support student success" (p. 6). The prevailing school of thought is that student wellness is a campus-wide responsibility. For several years now, mental health advocates have emphasized a holistic approach to student wellness. Researchers Owen, Tao, and Rodolfa (2006) asserted that the "complexities of student psychological distress demand innovative approaches to creating a campus culture that increases protective factors (for example, social support, self-awareness, early identification) and decreases risk factors (for example alcohol use, depression, relationship difficulties)" (p. 27). Owen and Rodolfa (2009) emphasized that "[S]tudent mental health is a campus issue, not just a counseling center issue...everyone should be involved in creating a strong safety net for students" (p. 30). At Memorial, Dr. Lee, agrees. "This university is serious about health...The idea is that mental health is everybody's responsibility, from early detection to creating a supportive environment. It really is a group effort. We are trying to create a community, and we are trying to create community responsibility" (Barron, 2014, p. 3). The goal is the creation of a campus culture committed to student wellness.

Academic libraries have always supported learning and research, but now they have a new and very essential role to play as part of a broader campus culture that promotes and fosters wellness. In addition to the traditional roles of providing reference and instructional support, they are uniquely positioned to offer services that may alleviate the anxiety and stress many students are experiencing. The library is where students spend a great deal of time. Libraries are open in the evening and on weekends when many other departments on campus are not. Students frequent the library in greater numbers at the end of the semester and during exams, a time when they are likely experiencing the highest levels of stress and anxiety, making it an ideal location for wellness support. For example, the Grenfell library sees more than triple its typical number of users during the last three weeks of the semester.2 A similar increase is evident at the QEII library (see Figure 2). Librarians and library staff interact with students face to face on a daily basis. The notion that we can provide students with more than just reference help is an idea over half a century old. David K. Maxfield (1954) coined the term "counselor librarianship" to describe his empathetic approach, advising "in the best libraries the chief emphasis has always been placed...upon the patron as an individual person. That is to say, it has been placed upon the satisfying of his total individual needs (insofar as a library can satisfy them); both those needs he expresses freely, and those he is not able to communicate, or, in fact may not even be fully conscious of." Libraries can play a key role in filling the need for student mental health and wellness support.

How Can Libraries Support Student Mental Health and Wellness?

Late-Night Study Support

At Memorial University Libraries, two branches, the Queen Elizabeth II (QEII) on the St. John's Campus and the Grenfell library on the Corner Brook Campus, have both undertaken initiatives to address mental health issues students may be experiencing. In an attempt to help decrease anxiety levels during the particularly stressful end of semesters, both have introduced new services and programs aimed at supporting student wellness. In 2008, the Grenfell library began offering extended hours during the last three weekends of the semester, remaining open until 2:00 am on Friday, Saturday and Sunday evenings.3 Branded as "Late-Night Hours", the library also offers free coffee, tea, and a hot chocolate station-complete with toppings like minimarshmallows-on those evenings along with healthy snacks, like popcorn. The QEII library, by partnering with the library's cafe, were also able to offer a limited number of free coffees for students. Popular with students, the snacks provide them with an opportunity to get up from their seat, take a break, interact with their peers, and relax, even if only for a few much-needed moments (see Figure 3).

Breathe: Meditation in the Library

In 2010, the Grenfell library began a partnership with Student Services, meeting regularly with the Recreation and Wellness Co-ordinator. The Student Services department was similarly interested in ways to reduce student stress and at the same time recognized that the library was one of the main places where students spent time, particularly at the end of the semesters. Student Services is also able to apply for funding opportunities which the library may not necessarily be able to access. Partnering with other departments is a great way to increase the programming libraries offer, and contributes to a campus-wide culture of wellness support. Our first joint program provided free yoga sessions in the library (see Figure 4). "Yoga has been found to modify stress response and a person's attitude towards stress, while improving self-confidence, increasing one's sense of well-being, and creating feelings of relaxation and calmness" (Rizzolo, Zipp, Stiskal, & Simpkins, 2009). The sessions are offered repeatedly at the end of semesters. They are scheduled just before the library officially opens, so additional stress isn't added to students wishing to study. Student Services arranges for the yoga instructor (and attends to any insurance issues), provides mats, and provides pamphlets on wellness and time management. The Grenfell library secured sponsorship for the events from a local business so they could provide healthy snacks, like fruit, and a gift certificate to give away.

In addition, the Grenfell library has offered free sessions on mindfulness, led by an expert faculty member. Mindfulness teaches moment to moment awareness through purposefully paying attention to the present experience. Two recent reviews of the literature on the effects of mindfulness concluded that it reduces stress, anxiety, and depression (Regehr, Glancy, & Pitts, 2013; Khoury, Manoj, Rush, & Fournier, 2015).

"Paws" and Relax: Pet Therapy in the Library

Both branches also support wellness by offering pet therapy sessions towards the end of each semester. During the 2012-2013 academic year, both libraries contacted their local St. John Ambulance Therapy Dog program, which arranged to send volunteers and their dogs to the libraries. The program, which began in 1992, ensures volunteers complete an application process and a criminal record check, successfully participate in an evaluation, and provide documents indicating all required vaccinations are current (St. John Ambulance, n.d.). Dogs are evaluated to make certain they are accepting of strangers, sit calmly while being petted, sit/stay on command, and react well to other dogs or distractions. Animal-assisted activities (AAA) have been used therapeutically with hospital patients, autistic children, the elderly, veterans, and in prisons, and there is abundant research suggesting that animals can exert a calming, beneficial effect on people, lowering blood pressure and reducing anxiety and stress (Chandler, 2012; Fine, 2010; Wilkes, 2009). Research done on the effects of pet therapy on the stress levels of university students specifically (Crump & Derting, 2015; Adamle, Riley, & Carlson, 2009; Somervill, Kruglikova, Robertson, Hanson, & Maclin, 2008) suggests that AAA can benefit students by reducing feelings of stress and anxiety. Most recently, Crump and Derting (2015) found "animal-assisted activities were associated with a significant decrease in psychological stress and...AAA could provide an inexpensive approach to alleviating psychological stress in students" (p. 575). Many students who have relocated to attend university experience homesickness (Denovan & Macaskill, 2013) including missing their family pets. At Memorial, like most campuses, students are not permitted to have pets in residence. The libraries' pet therapy programs may be their only opportunity to interact with animals.

Pet therapy has proved popular with students, with over 250 attending the first pet therapy session at the QEII. Librarians received much positive verbal feedback during the event. Students shared stories about their own dogs and their excitement to return home and see their pets during the breaks. Some said their pets acted as a calming influence and expressed happiness at having a chance to interact with an animal on campus. The Grenfell library has since introduced guinea pigs-another popular choice for pet therapy-in addition to the dogs (see Figure 5). In one study on the effects of a classroom-based AAA program with guinea pigs on the social functioning of students, participants demonstrated significant increases in social skills and decreases in problem behaviours (O'Haire, McKenzie, McCune, & Slaughter, 2013).

Micro-Breaks

Another strategy that may be effective in improving mental health is taking "micro-breaks." Micro-breaks are defined as "short, informal breaks which can occur spontaneously throughout the day possibly in response to waning attention and are less than several minutes in length (Lee, Williams, Sargent, Williams, & Johnson, 2015).

Maintaining focus on a particular task, for example studying for an exam or writing a paper, requires mental effort and is difficult to sustain for long periods of time (Sarter, Givens, & Bruno, 2001). Traditionally, much of the research on taking breaks has been on the ergonomic and physical health benefits. More recently, studies have been done on whether taking frequent, short breaks to focus on something else is beneficial for cognitive function, attention and fatigue reduction (Hannes, Brailsford, & Parker, 2014; Lee et al., 2015). Lee et al. (2015) had university students take a break from an assigned task and found that after viewing a green roof scene, boosts in attention could occur after as little as 40 seconds of viewing the scene.

Both branches introduced de-stressing stations during exam periods with stress-busting activities encouraging a much needed micro-break. The stress-busters include items such as stress balls, small toys like Slinkies and yo-yos, colouring books and crayons, playdough, toy swords, and other items (see Figure 6). Whimsical items were selected as humour can help reduce stress as well. According to Rizzolo et al. (2009) "the use of humour to help reduce stress has received increased attention by both health care providers and the general public because of its psychological and physiological benefits." Students could borrow any of the items, essentially on an honour system, and were encouraged to return them when they were done. At both libraries, colouring was a student favourite. Colouring has been proven effective at reducing anxiety amongst undergraduates (Van der Vennet & Serice, 2012; Curry & Kasser, 2005). The Grenfell library also began a collection of board games in 2014 that could be checked out for two days.

Fun activities and micro-breaks provide healthy, positive coping mechanisms for relieving stress. Stress and anxiety are frequently associated with negative coping behaviours amongst students, such as smoking, binge drinking, drug use, unhealthy eating, and unsafe sexual behaviour (Stecker, 2004; Hudd, Dumlao, & Erdmann-Sager, 2000; Zaleski, Levey-Thors, & Schiaffino, 1998). Deasy, Coughlan, Pironom, Jourdan, & Mannix-McNamara (2014) discovered in their interview with higher education students, a tendency towards escape or avoidance of stressful experiences; "They did this through substance use, comfort eating, isolation and denial. Students used substances such as alcohol, tobacco and cannabis to cope...Comfort eating was common...Isolation from others and extra time spent sleeping were means of coping for some" (p. 13). As Zaleski, Levey-Thors, and Schiaffino (1998) noted, how students chose to cope with the challenges of transitioning to university could be either positive or negative "setting the stage for either health opportunities or health risks" (p. 127). Encouraging students to choose positive, healthy ways of dealing with stress will promote a campus culture of wellness.

Student Response

Surveys

Both libraries surveyed students to gather feedback about their wellness initiatives. In 2012, 194 students attending the pet therapy sessions at the QEII Library completed informal paper questionnaires to assist in evaluating the program. 89% agreed that they found the program "very useful and helped reduce my stress levels" (see Figure 7). Success was also evident in that 99% of students who participated indicated that they wanted to see the program continue during exam times. One survey question asked what else would help them de-stress, in an effort to obtain suggestions for additional activities. The responses reinforced how much the students enjoyed the pet therapy, as the majority suggested "more dogs," more frequent pet therapy sessions throughout the semester, or additional animals such as puppies or kittens.

In 2014, an online survey of the 1200 undergraduate students on Grenfell Campus was conducted, from which 132 responses were received. When asked to what extent they felt each of the programs supported students during the end of the semester by reducing stress levels, the majority of students responded "greatly" for late-night hours (52%), free coffee, tea, and snacks (60%), and therapy dogs (51%); "somewhat" (29%) for yoga; and "somewhat" (27%) or "very much" (27%) for the de-stressing station (see Figure 8).

When asked to select which of the wellness initiatives was their favourite, the free coffee, tea, and snacks was the clear favourite (38%), followed by the therapy dogs (23%), and late-night hours (21%) (see Figure 9). We also asked students why they may have not participated in the library's wellness initiatives. Out of 14 responses, the main reasons given for why they could not participate was that they were too busy (50%) or it conflicted with their schedule (43%). Only 3 students responded that it was because they were not interested, and only one student responded that it was because they did not feel it had any benefit for them (see Figure 10).

The survey garnered many positive comments from students. One student commented, "the library does a great job at helping students managing stress. I loved it when the coloring pages and crayons were there. Relieved some stress and brought me back to my childhood." Another commented, "keep doing what you are doing now. It really helps!" Out of the 48 comments received, 16 indicated that students wanted more of the wellness initiatives, specifically more extended hours, making coffee and tea available throughout the semester, and additional pet therapy days. "Coffee!! more coffee, and not just late in the night but all day or in the afternoon" and "free snacks all the time" were typical comments. One student suggested, "stress reduction all during the semester to help students create healthy habits." Another said, "start Late Night Hours earlier and during midterms."

Both the QEII and Grenfell library surveys suggest that the initiatives had a positive effect on student wellness. Students believed that the initiatives contributed to reducing their stress levels. The survey also indicates a need for wellness support not just at the end of the semester, but throughout the academic year.

Social Media Response

In addition to the surveys, both libraries received a tremendous positive response to their initiatives through social media. Students on the St. John's Campus were tweeting about the St. John Ambulance therapy dogs visit with the hashtag "#puppyroom", the free coffee, and the de-stressing station (see Figure 11). Some students even used social media to gloat to friends attending other universities or to lament that such programs were not offered when they had been a student at Memorial University. The QEII library's tweets about the therapy dogs received the highest number of clicks, replies, mentions, and retweets, representing a significant increase in the number of interactions with students via Twitter.4

The Grenfell library's pet therapy post was one of their most popular Instagram posts. Both libraries' Facebook posts about pet therapy received the most reach (over 30,000 for the QEII) and some of the highest numbers of likes, comments, and shares of any of their posts.5 One student commented on a Grenfell library Facebook post, "Therapy guinea pigs have to be the best mental health aid I've ever heard of. 10/10." The social media statistics reflect the power that a popular event can have on increasing engagement with users. Though anecdotal, the social media response was similar to our survey results; students felt that these initiatives were effective at reducing stress and supporting their wellbeing.

Unexpected Media Exposure

The various wellness initiatives had the unexpecteded secondary effect of turning out to be a great promotional opportunity for the libraries by garnering positive exposure on campus and in local media. The QEII library's pet therapy program was featured in the university's Gazette. Both libraries have been featured on local radio (CBC and VOCM). The Grenfell library's pet therapy also made the province-wide television news and the local newspaper (see Figure 12). Positive exposure in the media helps communicate the value of libraries to the broader community.

Challenges

Despite the success of the wellness initiatives, there are certain challenges to consider before undertaking similar programs. One issue, particularly with pet therapy, is space. Even therapy dogs aren't always quiet, and some students may have allergies or phobias.6 This was evident in a Grenfell student's comment in response to the survey, "The dogs were a good idea, but the venue probably wasn't the greatest, seeing how dogs tend to bark sometimes the library seems a bit too quiet for them." Both libraries attempted to address this issue by keeping the animals contained in one area of the library, such as a study room, and scheduling additional cleaning directly following the pet therapy sessions to make sure any pet hair was removed. Space was also an issue when deciding where to locate the de-stressing stations; finding the right balance between a space visible and accessible enough, but also located where it won't disturb anyone can be a challenge. One Grenfell student also commented, "I wish that the destressing station with the toys were in the back of the library, not in the middle where everyone is studying."

Having the animals in a specific space with sufficient signage alerting students about where and when they would be in the library, allowed any students who wished to avoid the animals to do so. Neither library received any specific complaints about the pet therapy due to allergy or phobia issues. However, keeping the animals in one specific area inadvertently caused another issue: it limited how many students could participate at a time. Both libraries experienced long lines of students waiting to visit with the animals (see Figure 13) as they proved more popular than anticipated. In the Grenfell library survey, one student commented, "I liked the idea of the therapy dogs, but I wish there were more provided. Two really were not enough." As a result, arrangements have been made to increase the number of therapy animals, as well as increasing the number of sessions offered to meet the demand.

Having sufficient staff to assist with pet therapy is also a consideration. For example, a staff member was required to meet the volunteers to assist them in locating the library on a large campus, and staff need to be present during the sessions to supervise the student and animal interactions. The Grenfell library's partnership with Student Services also proved helpful in this instance. Student Services staff were in contact with the volunteers, met them and brought them to the library, and were present during the sessions. Libraries also need a budget for wellness initiatives. Some of the expenses we incurred were the yoga instructor's fee; small thank-you gifts and parking costs for the St. John Ambulance volunteers; items for the de-stressing stations; and supplying free coffee, tea, hot chocolate, and snacks. This again, is another instance where partnering with other departments within your institution can help. The Grenfell library's partnership with Student Services meant that expenses associated with the St. John Ambulance volunteers, yoga, and stress-busters were covered by their budget.

Another challenge, common to all library programming, is advertising. How do you ensure that students know about your wellness initiatives? The QEII survey asked students how they had heard about the pet therapy program. The majority, 47%, indicated they had heard about the event from a friend. Over 50% of the students had heard about the event through Twitter or Facebook, and only 13% had viewed the event details on the library website (see Figure 14).

In the Grenfell library survey, 36% of students indicated that they had not participated in one or more of the stress reduction initiatives because they "did not know about it." (see Figure 9). This was despite the library advertising through social media, print posters, ads on the campus-wide closed circuit TVs, emailing students directly, Messenger (the Grenfell Campus email newsletter), the library website, and certain initiatives-like pet therapy and the board game collection-being featured in local media, including radio, newspapers, and local television. The fact that some students were still unaware of the programming was frustrating, but it remains unclear what additional means of communicating with students could have been pursued.

Conclusion/Discussion

Student mental health and wellness is a major issue for Canadian universities, with student stress and anxiety on the rise. University administrators are becoming increasingly aware of the importance of addressing the issue of student mental health. Evidence suggests that stress and anxiety have a negative impact on academic success and are associated with negative coping behaviours, such as smoking, binge drinking, drug use, unhealthy eating habits, and unsafe sexual behaviour which can have adverse health effects. The wellness initiatives at the Grenfell and QEII libraries are very popular with students. Through both informal and formal feedback, students indicated that these initiatives are effective at reducing stress and contributing to student wellness. Students report feeling less stressed after participating in various programs, with extended hours, free caffeine and snacks, and pet therapy clearly being the most popular initiatives overall. Yoga, mindfulness, pet therapy, and micro-breaks provide students with healthy, positive coping mechanisms for relieving stress. These initiatives also allow the libraries to engage users in unexpected ways through social media and serve as an unintentional but useful way to promote the library to the university and broader community.

Our experience uncovered a few areas where further research is needed. Undergraduates were the main audience and primary focus of our surveys. An oversight is that we did not ask students to identify themselves as either undergraduate or graduate students and therefore we do not have any data on how many graduate students may have attended our wellness programs. Now that the National College Health Assessment includes data on graduate student health, in future there will be data on whether graduate students are also experiencing an increase in mental health issues. This is a significant area for further study. With students experiencing increasing mental health issues, it is also recommended that library staff may benefit from formal training in identifying students who may need to be referred to counselling or health services. How such services could be best incorporated into the library's services or programming is also an ideal area for further study.

Partnering with other departments within your institution, as well as organizations outside the university, to promote a campus-wide culture of wellness is recommended. Other departments, such as on-campus food service providers, Student Services, counselling or health services, student unions, as well as community or government organizations have access to funding opportunities which the library may not. Partnerships are an excellent way to increase the programming libraries offer. However, libraries need to consider the importance of wellness support when it comes to their own budgets, so allocating funds specifically for wellness initiatives is recommended. Libraries have an important role to play in the creation of a campus culture supportive of student wellness. Wellness support is an extension of the services traditionally offered by libraries to aid in learning and research. It is another way of contributing to student success. Libraries are where the students are, particularly during the end of semesters and exam periods when workloads and stress levels are at their highest. This gives libraries a unique opportunity to provide users with programs and services that may reduce the anxiety and stress that research shows numerous Canadian university students are experiencing.

Footnote

1 One significant difference between the two surveys is that the National College Health Assessment includes graduate students, whereas the earlier Canadian Campus Survey does not.

2 Based on the Grenfell library usage statistics.

3 Regular semester hours are normally until 6:00 pm on Friday, 8:00 pm Saturday, and 10:00 pm Sunday. On weeknights the library remains open until midnight.

4 According to Twitter, a "mention" is a tweet that contains another user's @username.

5 According to Facebook Insights, reach is the number of people who have seen a post. A post counts as reaching someone when it's shown in News Feed. Figures are for the first 28 days after a post was created and include people viewing post on desktop and mobile.

6 The University's Environmental Health and Safety Department did not object to the visits, as therapy and service animals are permitted on campus.

References

References

Adamle, K., Riley, T., & Carlson, T. (2009). Evaluating college student interest in pet therapy. Journal of American College Health, 57(5), 545-548.

Adlaf, E.M., Demers, A., & Gliksman, L. (Eds.). (2005). Canadian campus survey 2004. Toronto, ON: Centre for Mental Addiction and Mental Health.

American College Health Association. (2013). National college health assessment Canadian reference group executive summary spring 2013. Hanover, NH: American College Health Association.

Andrews, B., & Wilding, J. M. (2004). The relation of depression and anxiety to lifestress and achievement in students. British Journal of Psychology, 95(4), 509-522.

Barron, L. (2014). 'If a brain is troubled, it doesn't learn': Student health survey reveals stress and anxiety as primary academic impacts. Gazette, 26(13), 1, 3.

Chandler, C. K. (2012). Animal assisted therapy in counseling. New York, NY: Routledge.

Crump, C., & Derting, T. L. (2015). Effects of pet therapy on the psychological and physiological stress levels of first-year female undergraduates. North American Journal of Psychology, 17(3), 575-590.

Curry, N. & Kasser, T. (2005). Can coloring mandalas reduce anxiety? Art Therapy: Journal of the American Art Therapy Association, 22(2), 81-85.

Deasy, C., Coughlan, B., Pironom, J., Jourdan, D., Mannix-McNamara, P. (2014). Psychological distress and coping amongst higher education students: A mixed method enquiry. PLOS One, 9(12), 1-23.

Denovan, A., & Macaskill, A. (2013). An interpretative phenomenological analysis of stress and coping in first year undergraduates. British Educational Research Journal, 39(6), 1002-1024.

Fine, A. H. (Ed.). (2010). Handbook on animal-assisted therapy: Theoretical foundations and guidelines for practice (3rd ed.). Amsterdam, Netherlands: Academic Press.

Hanlon, C. (2012, Summer). State of mind: Addressing mental health issues on university campuses. University Manager.

Hannes, Z., Brailsford, H. A., & Parker, S. L. (2014). Micro-breaks matter: A diary study on the effects of energy management strategies on occupational well-being. Journal of Vocational Behavior, 85(3), 287-297.

Hudd, S. S., Dumlao, J., & Erdmann-Sager, D. (2000). Stress at college: Effects of health habits, health status and self-esteem. College Student Journal, 34(2), 217-227.

Khoury, B., Manoj S., Rush, S. E., & Fournier, C. (2015). Mindfulness-based stress reduction for healthy individuals: A meta-analysis. Journal of Psychosomatic Research, 78(6), 519-528.

Klein, K., & Boals, A. (2001). Expressive writing can increase working memory capacity. Journal of Experimental Psychology: General, 130, 520-533.

Lee, K. E., Williams, K. J. H., Sargent, L. D., Williams, N. S. G., & Johnson, K. A. (2015). 40-second green roof views sustain attention: The role of micro-breaks in attention restoration. Journal of Environmental Psychology, 42, 182-189.

Lumley, M. A., Provenzano, K. M., & Harris, K. R. (2003). Stress management through written emotional disclosure improves academic performance among college students with physical symptoms. Journal of Educational Psychology, 95(3), 641-649.

Lunau, K. (2012, September 5). The mental health crisis on campus: Canadian students feel hopeless, depressed, even suicidal. Maclean's.

Maxfield, D.K. (1954). Counseling librarianship: A new departure. University of Illinois Library School, Occasional Papers, (38), 1-42.

Misra, R., McKean, M., West, S., & Russo, T. (2000). Academic stress of college students: Comparison of student and faculty perceptions. College Student Journal, 34(2), 236-245.

O'Haire, M. E., McKenzie, S. J., McCune, S., & Slaughter, V. (2013). Effects of animal-assisted activities with guinea pigs in the primary school classroom. Anthrozoos, 26(3), 445-458.

Owen, J.J., Tao, K., & Rodolfa, E. (2006). Distressed and distressing students: Creating a campus community of care. In S.A. Benton & S.L. Benton (Eds.), College student mental health: Effective services and strategies across campus (pp. 15-34). Washington, DC: National Association of Student Personnel Administrators.

Owen, J.J. & Rodolfa, E. (2009). Prevention through connection: Creating a campus climate of care. Planning for Higher Education, 37(2), 26-33.

Queen's University Principal's Commission on Mental Health. (2012, November). Student mental health and wellness: Framework and recommendations for a comprehensive strategy. Kingston, ON: Queen's University.

Regehr, C., Glancy, D., & Pitts, A. (2013). Interventions to reduce stress in university students: A Review and meta-analysis. Journal of Affective Disorders, 148, 1-11.

Rizzolo, D., Zipp, G. P., Stiskal, D., & Simpkins, S. (2009). Stress management strategies for students: The immediate effects of yoga, humor, and reading on stress. Journal of College Teaching & Learning, 6(8), 79-88.

Sarter, M., Givens, B., & Bruno, J.P. (2001). The cognitive neuroscience of sustained attention: where top-down meets bottom-up. Brain Research Reviews, 35(2), 146-160.

Somervill, J. W., Kruglikova, Y. A., Robertson, R. L., Hanson, L. M., & Maclin, O. H. (2008). Physiological responses by college students to a dog and a cat: implications for pet therapy. North American Journal of Psychology, 10(3), 519- 528.

Stecker, T. (2004). Well-being in an academic environment. Medical Education, 38(5), 465-478.

St. John Ambulance. (n.d.). Therapy dog program.

Stoliker, B. E., & Lafreniere, K. D. (2015). The influence of perceived stress, loneliness, and learning burnout on university students' educational experience. College Student Journal, 49(1), 146-160.

Van der Vennet, R., & Serice, S. (2012). Can coloring mandalas reduce anxiety? A replication study. Art Therapy: Journal of the American Art Therapy Association, 29(2), 87-92.

Wilkes, J. K. (2009). The role of companion animals in counseling and psychology: Discovering their use in the therapeutic process. Springfield, IL: Charles C. Thomas.

Zaleski, E. H., Levey-Thors, C., & Schiaffino, K. M. (1998). Coping mechanisms, stress, social support and health problems in college students. Applied Developmental Science, 2(3), 127-137.