Prevention Profiles: Take Five - Dr. Kevin Kruger (President and CEO of NASPA)

Rich Lucey: Hi, this is Rich Lucey in the Drug Enforcement Administration's Community Outreach and Prevention Support Section, and I welcome you to this episode of our podcast series "Prevention Profiles: Take Five."

I am pleased that today's guest is Kevin Kruger who is the President and CEO of NASPA, and I'll tell you a little bit about that organization and him right now before I formally introduce Kevin.

So Dr. Kevin Kruger draws on more than 40 years of experience in higher education.

Since 2012 he has served as President and CEO for NASPA Student Affairs Administrators in Higher Education.

Prior to his role as President, he worked for 18 years as the Associate Executive Director and served as the Chief Operating Officer and Chief Financial Officer for NASPA.

He has held a range of Student Affairs positions at Southern Methodist University and the University of Maryland.

Dr. Kruger has published and presented nationally on trends in higher education, student success, degree completion strategies for low income and first generation students, and change management and leadership in higher education.

He is the proud father of two children, one a college senior and the other a first year student.

With that, Kevin, welcome to the podcast.

Dr. Kevin Kruger: Thanks, Rich, good to be here.

Lucey: Absolutely.

And I'm excited to have you today.

Throughout my entire federal career, Department of Education, previously Health & Human Services and now Department of Justice, I've had the pleasure of working with you and your staff at NASPA in various ways, and I'm sure we'll probably get into that a little bit.

So it's great to have you here on the podcast.

There's a question I didn't formally put down but I do have to ask you.

So as a dad (I mentioned you're the father of two children) is it interesting to be in the field that you're in and then also see your children in that environment and how they're affected by higher education?

Kruger: Yeah, it's been an interesting sort of maybe case study because I've been at this work for 40 years from everything from the college choice process to the way they're experiencing their college experience as a student.

It's been interesting to sort of see it from a different lens.

A couple of quick anecdotes.

I think any family that's had a child go through the college search process, you realize there's an element of chaos to it, chaos.

I decided to let them choose their own journey and not intervene too much and learned a lot about what they pay attention to, what they read, how they are making their decisions, the importance of the campus visit, the importance of the tour leader who is doing the first tour, all those kinds of things.

But I think more importantly I think what is, what it's tapped me into is as a father and a parent of college students, I know the really exciting, energizing things that take place as a college student but also know some of the pitfalls.

And so I've been able to just engage both of kids in conversations about their life outside the classroom.

And with my daughter engage with questions around issues that we know exist for adolescent girls, and that is a lot of issues around anxiety and depression, and so really kind of hit those head on.

And for my son I believe about the way adolescent boys struggle with organization in particular and then the exposure to what is our topic today, exposure to substances, alcohol in particular and other issues that allow me again to have a fairly frank and open conversation with both of them about these issues as they progress.

So it's been a learning experience for all three of us.

I have chosen not to be a helicopter parent.

I always felt like it would be a little embarrassing for the NASPA President to be sitting in some of the spaces that many parents sit in so I tend to do this a little bit from afar.

But it has certainly been a learning experience and one that sort of matches up against my own understanding of what we know takes place on college campuses.

Lucey: Well, it definitely gives you a different lens in order to look at this issue.

So appreciate you sharing that experience with us.

So I'm going to jump right into the first of our five formal questions.

So in your time as President and CEO of NASPA and as I mentioned that's been since 2012, how has the focus on drug misuse issues on campus either changed or stayed the same among Student Affairs administrators?

Kruger: I think there are elements of it that have stayed the same.

I think if you sort of look historically over the last 20 or 30 years, you can see this sort of thread of work around prevention.

And we kind of knew that prevention was a really critical tool in the process of how we would address substance abuse on campus.

We have that paired with; you know, policies and enforcement obviously is important, but that to really see substantive change in the behavior of students, particularly around the dangerous use of alcohol or other substances, we knew that prevention was going to be really critical.

So I don't think that thread has changed, but I think what has changed is that we know more today than we did
even 10 years ago.

I think the science around substance abuse and the kinds of interventions that can make a difference in the student population has really improved thanks to the work of some great researchers out there.

And I think that has been, filtered down to the practice itself.

So I think in that regard we're, I think we're just smarter and more focused about some of those prevention efforts.

But what hasn't changed is just an understanding that for many students, substance abuse can be a pathway to some really both psychosocial challenges but also academic challenges.

I think in looking at some of the research that Amelia Arria has done at the University of Maryland, sort of looking at the impact of both increase for example in cannabis use or alcohol use and the impact that that has on
academic performance.

One thing that has changed in the academy over the last 20 years and really in some cases over the last 5 or 7 years has been a very focused effort at college universities across the country to look at student success.
That's a concept that we now articulate fairly regularly.

But student success can mean a lot of different things.

One of them certainly is measured against the outcomes of how we commonly think about in terms of degree progress and persistence and completion.

And so we look at all kinds of barriers to that degree progress, persistence and completion.

And what we know is students who are struggling with substance abuse, it has a direct impact on them attending class and time of study, time attending class, absence from class and ultimately can result in higher degrees of attrition or dropping out of college.

So we care about this both from a population level in terms of preparing students to be functioning adults and managing some of these psychosocial issues.

We also know it has dramatic effects and direct effects on the academic performance.

So we think about that as well.

So I think that focus I think is maybe a little bit more articulated.

We even hear people talking about sort of an ROI kind of analysis about how some of this works.

So the dollars you put into prevention and education can actually result in downstream retention of tuition dollars of students staying in class, in college more consistently.

So I think that kind of analysis I think has changed, and I think we'll see even more of that as budgets are in tighter.

So we begin looking at those outcomes as really key issues.

One last thing I would say is that, using cannabis as an example, I think that certainly is a place where we've seen a lot of evolution from it being the criminalization of cannabis and the way policies were enacted on campus.

I think now with the evolving landscape of cannabis, both availability and legality, I think that's also changing the way we approach this on campus.

And we certainly have more headwinds as we try to help students understand some of the negative impact of cannabis use, particularly excessive cannabis use on sort of brain development and against those academic performance issues.

So I think that; we are one part of the world and the society so we are subject also to the evolution of those changes.

Again an example would be the opiate crisis that America is facing right now.

And while that has not found its way heavily onto the college campus, it is touching the college campus in terms of the communities that we touch.

It's certainly affecting the families of some of our students, and in some cases the students themselves.

And not to name a college, but there was a university this week, this very week that had, has had a number of deaths on campus, some related to suicide but a number of them related to drug overdoses.

And so I think it's a reminder that our students aren't immune from this and one that requires a lot of diligent attention.

Lucey: Yeah, I think that what you've mentioned on this issue of what's changed or not is certainly the issue of substance misuse at large has not changed.

That's been an issue on college campuses for decades if not centuries.

But like you said, just even in the last 10 years what we know from prevention science and how much it's evolved and how we approach substance misuse prevention and the strategies that we look to employ.

And I like what you said about the opiate crisis, that you know, it really.

I guess I would like to think that most college campuses do not exist within a vacuum.

I know that sometimes if there's a crisis, there is that sense that they become insular.

But you know, campuses really are a part of the community.

That's the whole idea.

We've been trying to spread that word that the campuses are indeed connected to families and communities, and so they need to be part of what's going on in the larger community as far as substance misuse prevention goes.

Kruger: Yeah, because Rich, I think it's easy to look at; you might look at a data point, a national data point and see that number of students who are experiencing some sort of opiate addiction issue and you might think that number is fairly low.

It might suggest that we can just turn our attention elsewhere.

But I think, I think the real point here is not just the students themselves.

It's that community.

And so these students are living in that community.

They're interacting in the community.

So even more important to have the educational efforts that we have in place.

And again I think some of the states where we know we have very, very high opiate use in the community, again the potential impact on families and the focus and concentration around students is important to consider.

So it's clearly a public health issue we're dealing with right now in America, and I think that to think that college students are kind of immune from it is, would be foolish.

And I think we need to be diligent about any signs in our college community, that attitudes around that are changing in a way that would increase usage.

We already know that students have a sense of self-immunity about things.

So if it's not opiates itself, there's certainly other substances.

NASPA has sent a lot of time with a coalition around the diversion of ADHD medication for example, which again for the average person might think, well, you know, it's prescribed.

It's legal.

What's the big deal?

But every week I get a news digest of cases of students who have overdosed on ADHD medication or misused it to the point that they've been hospitalized or in some cases some experienced death.

The procurity sometimes students have to design new party drug experiences, and so the combination of ADHD and Red Bull and alcohol and other kinds of concoctions, it [inaudible 13:04] we have a huge educational lift every
single semester when we have a new group of students coming in.

This is one; you mentioned we've been doing this for decades.

I think the work never stops because what we know about brain science is that adolescents are in that period of brain development where they're still developing, and the part of the brain that's the slowest to develop is that
risk taking, risk reward part of the brain.

And so we see that really frankly every day in student behavior.

So it requires a real long-term, ongoing commitment every semester.

Every time we get a new group of students, we're reinforcing message that we've had with students who may not have embraced that into their own behavior.

Lucey: So I want to segue onto our second question sticking in the Student Affairs arena here.

So what are your thoughts on how we as a field can transcend this idea of alcohol and drug misuse from being a Student Affairs issue to a broader institutional issue?

Kruger: Well, I would say that there's a lot of intersection here between of course alcohol and drug abuse issues and the larger constellation of mental health issues that we're dealing with on college campuses.

And so as we think about the approaches we're taking in general, I think we're seeing a very clear shift in how campuses are addressing this.

We know conclusively that just downstream clinical interventions are not going to be enough, that we have to work on the intervention side.

And when we think about working on the intervention side, we have to think then about all the ways in which we, the campus and individuals on the campus touch students.

So not just the counseling center but for example I think there's a huge need to engage faculty in this process.

Faculty see students more than any other sector of the institution.

They see them every day.

And it's a little bit of an overgeneralization but too far the faculty feel ill equipped and in some cases intimidated to deal with the complexity of some of these issues we're addressing here.

And so getting faculty to kind of understand what is their role.

What can they do?

When they see a student for example who perhaps has been performing at a high level early in the class and then suddenly their behavior changes.

They may be missing class or coming late to class or falling asleep during class, or their grades went from being a "B" plus to a "D" minus.

Something's happening with that student.

And so we're really encouraging campuses to engage in faculty development programs.

It doesn't put them in a clinical role but puts them into a role of engaging students in normal conversation about what's going on in their lives so that if there's something that's not, that's tripping up for them, whether that be a mental health issue or anxiety, depression or substance abuse issue, that the faculty member can guide them to some support.

This sort of it takes a village approach I think is really what's going to be required to make a dent in these issues that a campus is really struggling with.

So I think that's one component of it.

We need to think more broadly about how we help the broader community interact with students around the places where they're struggling.

The second thing is we've also learned of course a lot about; I think we've see campuses think differently about not allowing efforts like this to be siloed.

So it's not just the health educator who's in the health center who is managing or dealing with some of the substance abuse issues on campus but to think more broadly on how that intersects with recreation and wellness and the counseling center.

And so we're seeing that kind of an evolution of units within the campus that are, that have a wellness function to them that are addressing all this range of issues and looking at multiple departments in a broader effort on campus than just Student Affairs.

And I think that's going to be really critical as we think about the long-term solutions.

We know.

We get criticized a lot for silos and in some cases there's a good reason for it because people have expertise, and their expertise comes from years of study and education.

So we're not asking people to play some of these wider clinical roles, but we do think that a broader audience of folks engaged with this is helpful.

And again I think to reinforce faculty and really play a critical role.

I think that's a place where we have been less effective than in other places.

Lucey: Yeah, I recently had the opportunity to speak before a group of college presidents in a state that we're both familiar with, New York, and through their state system of universities.

And one of the questions I was asked by one of the presidents was, What can we do to help our faculty members?

And I said from my perspective I think the best thing that you can do to help your faculty members is make sure they're aware of the resources that are available on campus.

This is an ideal opportunity for Student Affairs to work with Academic Affairs, the health center and Academic Affairs, because just as you said they're seeing students probably more than any other stakeholder on campus.

And we're not asking them to be the prevention/intervention treatment specialists.

But if they know where to point the student, that's the best thing they could possibly do.

Kruger: One other thing, Rich, that I think is emerging is that we're seeing a lot more psychological, psychosocial stress for graduate students.

And we tend to think about this as an 18-22-year-old issue, undergraduates.

But they went on, the same generation, a cohort went from being an undergrad to now a grad student.

And the graduate school life does not have any of the kind of wraparound support services that exist for the undergraduate.

There may be a graduate student Student Services person, but we know our grad students are struggling from both a health standpoint and a substance standpoint.

We know that stress; it's a very high stress environment.

Even suicide ideation is actually higher for grad students than it is for undergrads.

So I think campuses also need to kind of understand that student behavior, student issues evolve from the undergrad to the graduate space, a little more invisible, but we need to be attentive to them as well.

And so for example, as you know, almost every campus has some kind of behavioral assessment team, care team.

I've been talking more to campuses that are having their law school Student Services person, business school, so you know there are all these Student Service folks that join the care team once every three weeks to discuss challenges they're having with grad students.

I think it's important to expand our view of this because that's a little bit of an invisible population that I think is one we need to pay more attention to.

Lucey: Totally agree.

So as I move onto our third question I want to zero in a little bit on presidents and other senior administrators.

From your perspective, what do you see as the essential skills that presidents and senior administrators need to possess to be effective in providing the campus leadership that's needed around prevention efforts?

Kruger: Well, this is a really good question because I don't think that from a presidential standpoint that this is enough of a priority for college presidents.

We have come to understand and you have in your work as well that leadership makes a tremendous difference into how staff and resources are deployed and how some of these efforts are deployed across the campus.

And I think about places where college presidents have made for example alcohol misuse and abuse an issue.

They've seen some remarkable results.

And I think that we could use more of that kind of visible, outspoken leadership.

It accomplishes several things.

One is it sends a clear message to students about what's valued and what kind of community they are.

It sends a message to staff who are working in this space that their work is valued and important.

And I also think that it then trickles down to the allocation resources because if you're really thinking about a comprehensive effort, a prevention effort, then it's going to take some dedicated resources to do that.

And so that kind of leadership and prioritization I think makes some of that possible.

So I think it's critical.

And I know we've learned over the years that one of the key elements to a successful prevention effort in this space absolutely requires that kind of leadership.

I think that the challenge is there for Vice-Presidents of Student Affairs as well, but probably a little less so.

I think that certainly given the roles that Vice-Presidents of Student Affairs are playing today, they're much more acutely aware of some of the wider range of issues I think of students, psychological and health overall.

Now I'd say we're probably a little bit probably skewed on the mental health side today.

We just completed our survey of Vice-Presidents of Student Affairs asking them what the top issues are that they're dealing with, and mental health issues is ten times higher than the other issue rated on campus.

So that, I think that while that is clearly critical, I think it's also important that our Student Affairs leaders understand some of the core issues around alcohol and drug abuse and mental health, and think about prevention efforts that are not just focused on some of the clinical mental health issues but also look at those wider range of prevention issues.

So I think that's something.

The leadership issue I think is critically important.

I will say that, and again mental health has caught the attention of college presidents so that's a good thing.

About 80% of college presidents in the ACE survey that was done this year believe that mental health is a bigger issue today than it was three years ago.

And I think about the same percentage are putting more resources into that.

So I think that that is a positive thing, but I think we also need to broaden the conversation to not be just simply mental health but a wider range of issues that are affecting students' psychosocial development.

Lucey: So I liked what you said about a college president needing to be visible and outspoken.

And I hearken back to my time when I worked at the Department of Education, and we used to have our national meeting, our national conference each year and we had a college president who shall remain nameless who was a plenary speaker and came in and spoke about her campus' devotion to this issue and all the different things they did on campus.

And she spoke for a good 20-25 minutes with, from not one single note.

And I was in awe watching her because that said to me one, she absolutely did her homework and was totally prepared to give that speech, but it also what was a little bit more important for me was that she really knew her campus and what they were doing on this issue, and that was just an act of just devotion to this issue that to this day has stuck with me about what a president can do.

Kruger: Yeah, we so need more presidents like that.

And this is not a knock on presidents.

This is a complex job.

Lucey: Absolutely.

Kruger: Frankly I think one of the opportunities we face is I think for the Vice-Presidents of Student Affairs and the Affairs Division is to help the President and other leaders on the cabinet understand the importance of these issues and what it really means in terms of, again back to him.

So a subject that everybody can wrap their head around is student success.

What does it mean for degree persistence, completion?

Not just what does it mean for the incidence you might find on Monday morning after, you know, a weekend of partying but the academic and personal impact that these issues have on students?

And I'll get this a little bit wrong, but I know Jason Kilmer talks about as he thinks about the population of students who mostly, largely underage students for drinking, and he kind of breaks them into two groups.

One group will engage in underage drinking and in some cases drinking to excess quantities and then graduate and then go back, and then sort of go into sort of a normal behavior of alcohol use for an adult.

But he really worries about this alcohol disorder that starts in college for the other half and then continues on to their work life and then prevents them from being successful in their jobs, et cetera.

He's more articulate about it than I am obviously, but I think, you know, for us also to understand and for college presidents to understand, this isn't just a weekend party issue.

This is an issue that can affect the students' ability to get a successful job, to thrive in that job, to be a successful alumni for that college or university.

So it has a lot of downstream impact as well.

And I think maybe that's an argument that we could strengthen with college presidents.

Lucey: Absolutely.

My fourth question references the strategies conference.

NASPA has become a leader in our field through the annual strategies conference.

I've been honored to be on the planning committee for that conference for several years helping to co-sponsor it through different agencies I worked for.

And while the strategies conference provides excellent information and skills development for prevention professionals, it seems that we're seeing relatively slower progress in the development and the testing of evidence-based practices and strategies through research and maybe scholarship.

Do you see NASPA having a role in helping to advance the research around drug misuse prevention and if so, what might that role be?

Kruger: Well, I think yes.

I'm not, I mean this is the observation you make.

Rich, I think one of our goals of course is to create that kind of practitioner scholar model that exists in the same space.

And so obviously we have a fair amount of practitioners who come to the strategies conference.

I know you know as being on the committee that we also try to elevate and give a space for some of the research that's coming out in a variety of places in higher and elevate that so that we can, that can drive some of the practice.

I think that our whole field, practice to theory, theory to practice cycle and I think we have benefitted from that.

So I think the biggest thing we can do is create spaces for that research to be disseminated and discussed and tested with a practitioner audience.

I think the place where I think we probably struggle as a field is that the sources of funding for this kind of research have kind of dried up.

Lucey: Agreed.

Kruger: And as you know that there was a time when the federal government was fairly involved in this space, and I think that was a really positive development.

And so now you're really looking at more pockets of academic programs where this research is valued and we have scholars advancing this research.

So I think that that is a gap for us in this field for sure.

And I think you're asking a good challenging question for me as where we can work and where can NASPA play a larger role.

And I think that we could certainly be a little more of a driver in either sponsoring or finding sources of funding for emerging scholars and researchers in this space.

It's probably a good conversation for us to engage in with particularly as we see younger researchers and younger scholars who are coming up who have not established themselves.

To find some, even some modest resources to advance some new research in this area I think would be really productive.

And I think we are fortunate in our field to have 175 to 200 graduate preparation programs.

Many of them are [inaudible 30:36].

So we have, we also have emerging scholars who are coming up who perhaps could identify this as a research agenda.

So maybe some things we also could do in working with our graduate faculty and our graduate programs to identify some of the places where this could be, this could be applied.

Although my guess is that these aren't the programs where we're going to see this kind of science that we're going to need at least.

So it probably involves partnering with some different types of institutions that have this kind of research interest.

But I think it's; I think your observation is a good one.

We'll continue to provide space at the strategies conference for research because I think it's important.

But we need more, right?

We need more as we learn more and so that we don't get sort of stagnant in the ways in which we are linking research to practice.

Lucey: And I feel I want to clarify just a little bit that first of all, thank you.

The strategies conference absolutely does bring together practitioners and researchers in the same space which is really helpful for the field.

I think that the challenge goes beyond just the college setting.

Unfortunately sometimes the research is lagging behind the need.

And that's just, that's just probably the case for what research is at times.

It just takes time to test the theories and such.

So I mean if you were to look at all the different quote unquote lists of effective programs, they really haven't changed much over the last decade or so.

I think that's where my question was coming from I think.

Kruger: I think it's a good question.

I think, you know, I think the other observation I'd have is that some of the research that we now see coming that gets sort of, kind of disseminated and talked about is also coming from the for profit sector.

And so not that that's not or it can't be a source of research, but we also, we need to ensure the kind of rigor of some of the findings that are getting disseminated from the for profit sector and ensure that they can stand up to good research principles.

Lucey: So moving on to our last question and I'll allude back to something you said earlier in the interview with substance abuse, for some not really enough of a priority for college presidents.

And that's because they have so many things being put on their radar screens with so many possible hot topics related to health and wellness that presidents and other senior level administrators must contend with.

I'll ask you in our last question for our listeners who are primarily prevention practitioners.

I don't know how many college presidents we get tuning in for each episode.

But what advice do you have for the program staff to help keep the issue of drug misuse and drug misuse prevention a priority for senior level administrators?

Kruger: I think that one, one strategy or tactic that can be reinforced is either initiating or reinforcing coalitions that exist on campus.

I think virtually every campus has a kind of a constellation of individuals who either have expertise or interest for whom this issue intersects the work that they do.

I think the more people involved in the conversation the more, I think the more knowledge and awareness is raised and I think the more attention you potentially can get for the folks who are actually driving the resources and that kind of thing.

So I think that's one thing that comes to mind.

Almost every campus and community state does some kind of professional development around a variety of topics.

So you might have the Student Affairs Division in the state of Maine might do something, or there might be sort of statewide meetings, very low cost driving kinds of things.

I think there's an opportunity there for to ensure, to work with your colleagues to identify something you're doing on your campus or a nuance of the issue or the challenge or some experiences you've had with students and think about sharing that at professional development events.

I think that's another space we can, that that can happen.

I think the other thing I would raise is that where there is good research and where we have good practices bedded in that is evidence-based, bedded in science, we may think that that is widely known across the field of higher education but it's not.

So there are a lot of assumptions that practitioners make and leaders make based on, you know, well intended, an understanding of the problem or perhaps an [inaudible 35:41] an older understanding of the problem.

So I think ensuring that your own campus has access to some of the most current thinking that is available nationwide I think would be another really clear strategy, and not assuming that everybody understands the whole range of the current practice and theory to practice approaches that are being used on campus.

So I think that would be.

And almost every campus is sort of vulnerable to wanting to be the best at what it does.

And so when there is a good practice, sort of best practice, but when there's a good and effective practice that's being led somewhere with some results that have been positive, kind of sharing that within your own campus community I think can also help advance the work that you're doing as well.

I think that that's another piece of it.

I think the other thing I would just say is that sometimes you have to build your own reward structures, own reward structures in so work with your teams about identifying students or student organizations or peer groups or things that have been really excelling on your campus.

Find a way to get that into the reward structure that occurs within every institution so that you can raise the visibility of some of the good work that's being done within your own campus that maybe, where some of the campus leaders may not be aware of that.

Lucey: Absolutely.

That's a very good takeaway message and really good advice for our listeners.

And as we come to the conclusion of the interview, Kevin, I want to thank you for your perspective on many different fronts.

This was not just focused on Student Affairs.

Obviously that's certainly where your focus is many times.

But I hope that the breadth of the questions and our conversation today took a little bit of a broader approach as well.

So I just want to say thank you for joining us on the interview.

And DEA, I can speak on our agency's behalf, looks forward to our continued relationship with NASPA as we continue to work on this issue.

Kruger: Great.

I enjoyed the conversation and I appreciate the dialogue.

I think it just reinforces, Rich, how critical these issues are for our nation and for the students who are at our institutions, something that we should remain focused on and diligent about.

This really is about graduating successful, healthy, full functioning adults is going to make our society better.

So it's a really important thing for us to focus on.

Lucey: Absolutely agree.

So again, Kevin, thank you so much.

And to our listeners for tuning in to this episode of Prevention Profiles: Take Five, I thank you for listening and I wish you a great day.