Picture a morning when your alarm goes off, and you realize that you have a hectic day ahead with midterms, assignments and work after classes. You don't want to get up. But that's not really a choice. You finally drag yourself out of bed, but even moving feels tough, like you're carrying a big load. The sun shining through your window doesn't cheer you up. Breakfast doesn't taste good, and chatting with your loved ones feels far away. Going to class feels like a never-ending journey. On top of all that, you have a pile of academic work to do, a part-time job to juggle, and you're still not sure what you want to do with your future. Even though you're surrounded by family, friends, and classmates, you feel totally alone, like you're separated from them.

This is the reality for many students battling depression while everyone else seems caught up in the whirlwind of college life. Depression is defined as a common mental disorder, which “involves a depressed mood or loss of pleasure or interest in activities for a long period of time” (World Health Organization (WHO), 2023, p. 1). According to the WHO (2023), depression is the leading cause of disability worldwide and is a major contributor to the overall global burden of disease.

Globally,  an estimated 5% of adults suffer from depression (WHO, 2023). Moreover, women are affected by depression more than men (WHO, 2023). Regardless of age and gender, when a person is depressed, the disorder can affect his or her life in many ways. Some common symptoms are poor concentration, feelings of excessive guilt or low self-worth, hopelessness about the future, thoughts of dying or suicide, disrupted sleep, changes in appetite or weight, and feeling very tired or low energy (WHO, 2023). Depending on the individual, a depressive episode can be categorized as mild, moderate or severe (WHO, 2023). The more severe the episode is, the greater impact it will have on an individual’s functioning. Furthermore, because of these symptoms, some people may use drugs or alcohol to improve their well-being, which can make depression and other health issues worse (Substance Abuse and Mental Health Services Administration (SAMHSA), 2023). It is possible that people may experience both mental health and substance use disorders at the same time, which are considered co-occurring disorders (SAMHSA, 2023).

There is a critical need to examine the influence depression has on college students. According to the National Institute of Mental Health (2023), an estimated 14.5 million U.S. adults, ages 18-25, had at least one major depressive episode in 2021. Indeed, this age group typically experiences significant life transitions that may cause stress and anxiety: in one research study, Beiter et al. (2015) found that the areas that caused students most concern was "pressure to succeed, post-graduation plans, financial concerns, quality of sleep, relationship with friends, relationship with family, overall health, body image, and self-esteem” (p. 93). For example, the pressure to succeed academically and the expectations of their parents and other adults can be overwhelming, especially those who are struggling to keep up with their coursework or decide their course of study. College students may also feel pressure to fit in with their peers. The sense of belonging can be especially challenging for students who do not speak English as their first language or who have family/caregiving responsibilities (Bowe, 2023).

Moreover, 71.26% reported that their stress/anxiety levels increased during the COVID-19 pandemic (Wang et al., 2022). Indeed, COVID-19 significantly exacerbated college students' probability of struggling with depression (Haikalis et al., 2022). In addition to COVID-19, the political unrest and systematic racism and inequality that escalated in mid-2020 may also be contributing to this uptick in mental illness. In a 2022 study, U.S. college students stated that 48.14% suffered from moderate to severe depression, 38.48% experienced moderate to severe anxiety, and 18.04% had suicidal thoughts (Wang et al., 2022).

In severe cases, depression can lead to students dropping out of college. Even more drastically, according to a 2021–2022 survey of students across 133 U.S. college campuses, 44% of students reported symptoms of depression and 15% reported seriously considering suicide in the past year (Bowe, 2023). Although these statistics are staggering, positive research illustrates that more students now report having one more or more therapy or counseling sessions in a one-year time frame (Cook, 2023). For example, between 2020 and 2022, the number of students who participated in counseling or therapy increased from 30 to 37% (Cook, 2023). Higher education institutions increasingly recognize the need for college students to receive timely medical care instead of waiting for an appointment at the clinic.

The sun shining through your window doesn't cheer you up. Breakfast doesn't taste good, and chatting with your loved ones feels far away. Going to class feels like a never-ending journey.

Particularly in light of a shortage of licensed professionals, campuses must now rethink their approach to health services (Abrams, 2022) turning to remote resources—telehealth, a crisis hotline, or mental health apps (e.g., Talkspace, Headspace, Happify)– to support student demand. Given the dramatic impact that depression has on college students, a health campaign for New York City College of Technology (City Tech) students may be critical to raising awareness about mental disorders and its influence on academic performance. Between January and June 2024, my proposed health communication campaign would raise awareness about depression, providing support for City Tech students who may be struggling with this mental disorder. By the end of the campaign, an estimated 80% of City Tech students (including all levels) should know where to find resources for mental health support at the university. 

Finally, this campaign also aims for a 20% increase in City Tech students seeking help for depression, whether from the Counseling Service Center, doctor appointments, mental health apps, or other resources. These objectives are critical to measuring the campaign’s success. In subsequent sections of this report, I provide details about how the campaign was created. Additionally, I discuss a potential dissemination and evaluation plan for this City Tech health campaign.

The City Tech Student Body and the Formative Research Plan

City Tech is a highly diverse college with a student body from a variety of different countries. With an average age of 21 years, the school’s students variously identify as  Hispanic (34%), African American (28%), Asian (21%), and White (11%) Additionally, 4% of our students are classifiable as non-resident “aliens.” Additionally, students who attend City Tech are not just New York City residents. The school has many students from other parts of New York State, other U.S. states, and even from around the world. ​​Among the New York City boroughs, 43.0% of students call Brooklyn their home, 24.6% are from Queens, 9.6% from Manhattan, 7.6% from Staten Island, and 2.7% from the Bronx. Furthermore, 2.6% of students come from various regions of New York State. In one particularly interesting demographic statistic, nearly half of the students, 46%, were born in different countries – specifically, 133 of them!

This diverse group of students faces a variety of challenges while in college. For some, attending college is students’ first exposure to the so called  “real world,” which can create immense uncertainty. Other students are faced with unstructured time, greater demands of academic work, new friendships, greater range of values and morals, and a greater complexity of time-management responsibilities. City Tech students might either attend classes full-time (64%), part-time (36%), with many balancing study and work, even working multiple jobs to support themselves. As a result, they may be only pursuing their degree part-time. All these stressors can contribute to mental health problems, such as depression. According to the Suicide Prevention Resource Center, (SPRC), depression is connected to lower grade point averages in students. Sometimes, depression can even lead to a person deciding to stop going to school (SPRC, 2023).

Despite these critical resources, general awareness of the university’s support for mental health issues is scarce. To be fair, the City Tech Counseling Service Center created an Instagram account in July 2023 to disseminate messages about its resources.  That said, mental health among college students has been a health concern long before 2023. In light of this longstanding lack of communication about depression and other mental health issues at City Tech, a health communication campaign would help to reduce the stigma associated with depression and encourage City Tech students to seek help if they are struggling. This tailored health campaign would present information about depression that is easy to read, ensuring that all students know where to receive mental health care.

Conducting this campaign requires a survey instrument to collect information from City Tech students:their perspectives on depression, their awareness of the issue, barriers to seeking help, and suggestions for how to improve mental health support on campus. This survey instrument would include all students, regardless of their race, ethnicity, gender, age, or disability status. Moreover, I disseminated these questions via Google Forms, since it is easy to use and the majority of students have taken a Google survey before. See Appendix A for the entire survey.

Once I developed the survey, I conducted a pilot test, sending the survey to a small group of City Tech students. The participants’ responses helped me to identify their knowledge gaps about depression as well as resources on campus. Later, this allowed me to construct insightful and effective health messages for City Tech students.

The Formative Research Results

A health communication campaign survey was distributed to gather information from City Tech students. Twenty students provided feedback about their knowledge, experience, and perception of depression and their preferences for health campaign messages. Further, there was a diverse group of respondents in terms of age, race, ethnicity, gender, and course load. In terms of age distribution, a majority of respondents fell within the 21-25 age (55%). This was followed by 18-20 year olds at 30%, and 26-30 year olds at 15%. Racially, Black /African Americans represented the largest group at 40%, followed by Asians at 25%, Caucasians slash whites at 20%, and individuals identifying with multiple races  at 10%. No respondents identified as American Indian/Alaskan Native or Native Hawaiian/Pacific Islander. 80% identified as Not Hispanic or Latino, while 20% identified as Hispanic or Latino. The response pool displayed a balanced gender distribution, with 50% identifying as male and 50% as female. Finally, the majority of respondents, or 65%, reported taking courses amounting to 10-15 credits this semester. Meanwhile, smaller percentages took courses amounting to 18-21 credits (15%), 16 to 18 credits (15%), and 6-9 credits (5%).

The participants unanimously acknowledged depression’s prevalence amongst college students. Moreover, every respondent demonstrated a clear understanding of depression as a mental health condition causing sadness, hopelessness, and disinterest in formerly enjoyable activities. Furthermore, all respondents agreed that, with accurate treatment, most people with depression can recover and live full ,productive lives. Lastly, when asked to identify unhelpful approaches when supporting friends or family members struggling with depression, nearly three-quarters of respondents correctly identified the response, “Telling him or her to isolate his or herself from others.” Overall, the majority of respondents answered these questions correctly.

As for questions regarding depression-related messaging at City Tech, 100% of respondents reported never encountering any health campaign about depression at City Tech. Somewhat alarmingly,70% (n=14) of participants expressed uncertainty about where to seek help for depression within the City Tech community. Clearly, this result reveals a need for greater awareness of on campus mental health resources.

When asked to describe beneficial information about depression and mental health, respondents provided a range of valuable insights. They variously expressed curiosity about the prevalence of depression, methods that prevent the escalation of depression, strategies to overcome existing depression and anxiety, and allies who might assist them in  their mental health challenges. Furthermore, respondents emphasized the need for accessible, remote service. Respondents also expressed interest in learning about the symptoms of depression, both in oneself and in others.

All respondents agreed that, with accurate treatment, most people with depression can recover and live full, productive lives.

Finally, when asked about their aesthetic preferences for health campaign messaging, students gravitated towards materials with large fonts and impactful images; bright and engaging colors; relatable stories; and motivational phrases.

Overall, the survey results suggest that City Tech students are generally not aware of the resources available for dealing with depression or where to seek help. In light of student responses, my health communication campaign will aim to heighten awareness of depression’s symptoms, causes, and remedies: where City Tech students can seek help, how they can support friends and family members facing depression, and how they can develop coping strategies for mental health struggles. Furthermore, the message will include images, bright colors, large fonts, relatable stories, and motivational phrases, emphasizing positive and empowering language to encourage students to take action. Ideally, this campaign will help spark an urgently needed conversation on campus.

Taking respondents’ feedback into consideration, I designed the following two messaging templates for this health campaign.  After creating these posters, I intended to test these messages with City Tech students in order to receive another round of feedback.

Revisions to Health Communication Messages Prior to Round 2 of Testing

Prior to testing the health campaign messages with more City Tech students, I sought the perspective of a trusted health communication expert. This expert suggested revisions to punctuation, font size, titles, and the kind of information displayed. For example, she suggested including the Counseling Center's URL, as well as a clear invitation to ”CONTACT US." She also suggested changing the background color so that the graphics wouldn't blend in. After revising accordingly, we disseminated the below posters in the second round of testing.

Revisions to Health Communication Messages Prior to Round 2 of Testing

Prior to testing the health campaign messages with more City Tech students, I sought the perspective of a trusted health communication expert. This expert suggested revisions to punctuation, font size, titles, and the kind of information displayed. For example, she suggested including the Counseling Center's URL, as well as a  clear invitation to ”CONTACT US." She also suggested changing the background color so that the graphics wouldn't blend in. After revising accordingly, we disseminated the below posters in the second round of testing.

Revisions after Testing the Health Communication Message among City Tech Students

A second survey was disseminated to City Tech students soliciting respondents’ feedback about the specific messages.( See Appendix B for the entire survey.) Our 14 survey responses revealed that a majority considered the messages to be effective at encouraging City Tech students to seek out services for depression. Regarding the first health communication message, "Free Counseling for Depression at City Tech," respondents described the content as capturing their attention, was informative, and displayed empathy. For example, one respondent wrote, “My reaction to this message is feeling safe, knowing that there is someone that is willing to help me deal with my mental health. The first image to the right really stands out to me. It’s implying that I am not alone. There is someone who can help you get up.” Another respondent commented, “This poster is welcoming and nonjudgmental, there is no shame in reaching out…is helpful for someone who does struggle with mental health.”

Additionally, the survey asked respondents what they did and did not like about the advertisement to help improve its efficacy. While both messages received positive feedback, there are areas for improvement. Regarding the first message, participants recommended larger fonts, more vibrant colors, and broader messaging encompassing all mental health concerns. For example, one wrote, “While the message was informative, the small font size made it difficult to read.” Meanwhile, another respondent said, “The background felt plain and could benefit from more vibrant colors to grab attention.” This emphasizes the importance of visual appeal. Lastly, a respondent noted, “While depression is a major concern, focusing solely on it might exclude students struggling with other mental health challenges.” This indicates a need to make the message more inclusive, so that it encompasses a wider range of mental conditions.

The second poster, “Join a student club at City Tech,” also received positive feedback for its welcoming tone and content. However, respondents requested more details about specific clubs and their benefits, as well as more information about  office hours for the Center For Student Life And Development. For example, one participants commented, “The message felt welcoming and encouraging, but I didn't find specific details about the clubs offered.” Meanwhile, another respondent wrote, “While the club meeting times were mentioned, they seem inaccessible for students with busy schedules.” These responses suggest a need to expand office hours, perhaps offering alternative meeting times that cater to diverse student needs.To be clear, the campaign cannot control such policies; nonetheless, the campaign has yielded insight that can be shared with the Center.

Overall, most people liked the design of the posters, the use of color and images, and the clear and concise messages. From a survey question,  “Do you think City Tech students will read this message?”, 69.2% of City Tech students said that they would read the health communication message. Despite the above suggestions for improvement, the survey indicates that students now have a clearer understanding of where to go not only for mental health support but also for making friends and joining clubs.

Using the feedback from the second survey, the messages were further revised. The newly updated health campaign messages follow.

The Health Communication Campaign’s Proposed Dissemination Plan

Using the above messaging templates, I propose a semester-long health campaign at City Tech. The short timeline will allow for a dedicated focus on mental health, particularly depression, while remaining within a manageable timeframe for evaluation. The target audience for this health campaign would be all City Tech students regardless of their academic year or enrollment status.  The campaign would inform students about depression, its potential effects, and available resources at City Tech; more broadly, it would help reduce stigma,by normalizing conversations about depression and highlighting the availability of support systems. By raising awareness, reducing stigma, and promoting help-seeking, this campaign can significantly improve the well-being of the student population, enabling them to thrive both academically and personally.

To create a successful and effective health campaign at City Tech, organizers should collaborate with a variety of stakeholders at City Tech, including the Student Life Development Center, Student Wellness Center, Counseling Services Center, Student Clubs, and City Tech Faculty. Student and health/wellness centers will be crucial partners as they have the ability to promote this health campaign on their websites. The high volume of traffic on these websites means that this health campaign will be seen by a variety of students, perhaps even potential future students Furthermore, spreading campaign messages through email, newsletters, and/or events will help reach students directly. Finally, the health campaign should appear on university-wide platforms, like Blackboard and CUNY First.

Additionally, City Tech faculty could play an important role in the campaign, emailing monthly campaign messages to the students enrolled in their courses and incorporating the messaging into their syllabi. Because all City Tech faculty review their syllabi on the first day of school with their students, these course policies can provoke discussion of  the resources available  for those struggling with mental health. Lastly, organizers could share hard copies of the health campaign in high trafffic physical spaces, like the library, study areas, and elevators to maximize visibility. Having a variety of communication mediums would ensure regular exposure to the health campaign throughout the semester, which could increase its effectiveness.

To assess the campaign's effectiveness, organizers should implement a pre- and post-survey design. Faculty will distribute a brief survey to students via email and Blackboard before and after the campaign (e.g., the first and twelfth weeks of the semester). Offering extra credit for survey completion may motivate student participation. Additionally, the faculty might send the students reminders about completing the survey, to elicit additional responses; the survey would be open for two weeks, with access to the survey expiring after those two weeks have passed. Organizers could then compare the results to the initial campaign goals to evaluate if the health campaign was or was not effective.

This survey feedback may, in turn, lead organizers to once more revise the campaign messages, testing them with a small group of students to ensure that they are more effective than the previous ones. Unlike the survey, a focus group would allow organizers to ask follow-up questions. Subsequently, the revised messages could be disseminated through the same communication channels as the original health campaign. Ideally, this campaign would continue beyond the one semester, allowing the focus group-tested messages to have a stronger impact. Indeed, I envision this campaign evolving into a permanent resource for City Tech students, promoting a healthier and more supportive campus environment.

Overall, the goal of this health campaign is not only to raise awareness, but also to create a community at City Tech where mental health is openly discussed, support is readily available, and students are empowered to prioritize their well-being. By working together, using diverse communication channels, and continuously adapting, we can create a supportive and welcoming place. This health campaign could launch our campus community into an era of support and resilience, where students can thrive academically, personally, and emotionally.

Depression is a silent struggle that often goes unnoticed, masked by smiles and superficial interactions. But behind closed doors, it's a constant battle against the darkness within. If you or someone you know is experiencing similar feelings, know that you're not alone. There is help available, whether it's through reaching out to a trusted friend, reaching out to resources on the campus such as the counseling center, or the students club. Your journey may be tough, but there is hope and support waiting for you.