Mental Health Concerns on the Rise for College Students

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Like thousands of students across the continent, tomorrow I’ll be heading back to school. For me this will (hopefully!) be for the very last time, as I enter my final pre-doctoral residency for my PhD. in Counselling Psychology. In light of the work I'll be doing, which is primarily at a university counselling center, a study published online this summer in the Journal of Adolescent Psychology tugs at my mind. The study (1) looked at data from two large U.S. datasets, which surveyed undergraduate students from across the country between 2007-2018. Findings concluded that serious mental health concerns - like suicidal thinking, severe depression, and self-harm behaviours - more than doubled among college students during this time. The authors indicated their belief that this rate of increase is "alarming," and I'd have to say I agree. This statistic certainly makes me question why this trend is occurring and, more importantly, what college mental health professionals can do about it.

In regards to my first question - the why - the authors noted that most increases in mood, anxiety, and suicide-related outcomes occurred after 2013. In an interview published in Reuters Health, co-author Jean Twenge, a psychology professor at San Diego State University, observed that this date correlated with the surge in social media and smartphone use among young people. Twenge, who has been researching generational differences for over 25 years, coining the term iGen for those born between 1995-2012 (and writing a book of the same name), wrote the following excerpt in an article in The Atlantic that went viral in 2017:

"It’s not an exaggeration to describe iGen as being on the brink of the worst mental-health crisis in decades. Much of this deterioration can be traced to their phones."

I'm notoriously passionate about the potential harm of social media and technology - particularly in young people. I cringe a little inside every time I see a family at the park, each person's nose buried in their own individual device of choice. Because I am a millennial and not an iGen, my childhood and adolescence was largely devoid of technology in the ever-present way that characterizes it today (not to say my adult-self hasn't struggled with the perils of social media). However, as the mother to a one-year-old born in the digital era, and as a counselling psychologist who will be working primarily with iGens in the coming year, this upward trend in mental health concerns really, really concerns me.

Needless to say, Twenge's claims, well, speak to me. But I have to check myself to make sure my gut reaction isn't overshadowing a more balanced perspective on this issue. Indeed, is it really as simple as "blaming" social media? Amy Orben, a social media psychologist at the University of Cambridge, offered a fantastic critique of a different (but related) article from Twenge and her colleagues, entitled “Increases in depressive symptoms, suicide-related outcomes, and suicide rates among U.S. adolescents after 2010 and links to increased new media screen time.” After re-running parts of the analyses on a more recent dataset, Orben found no strong evidence for the article's claims. In fact, she wrote that the links between social media and technology use with depressive symptoms are "so weak and inconsistent they could be artefacts of statistical error." Recently, Orben and her colleagues published an article in the Proceedings of the National Academy of Sciences (2) where they argued that social media's effects on young people is nuanced and context-dependent, and is not, by itself, a strong predictor of life satisfaction.

So where does that leave mental health professionals working with iGens? I still don't think we can ignore technology use (indeed, I'm sure most of my clients will have their phones tucked safely beside them in session). However, I think it's more important to explore the how than the what. By this I mean how is the technology being used? Not all screen-time is created equal, and limiting screen-time isn't the answer - especially in a digital age where so many things rely on, are made more convenient by, and, yes, can be enhanced by our screens (e.g. FaceTiming with long-distance relatives for international students is invaluable). But if a student is sleeping with their phone under their pillow, scrolling Instagram in lieu of sleep, and falling into the rabbit hole of social comparison games then, yes, we have a problem. We also need to explore the context. When working with mental health concerns, it's not particularly helpful to pinpoint one specific "cause;" indeed, although technology use may play a part in a person's symptoms of anxiety or depression, there are undoubtably other factors at play. We need to look at what else is going on in the client's world - both challenges and protective factors - to support that person in a holistic, well-rounded way.

Ultimately, our approach to mental health issues needs to be turned inside out. Although individual factors are undoubtably at play in a person's mental health, and some of these factors might include the ways in which that person uses and responds to social media and technology, mental health issues are largely a systemic issue. As such, college counselling centers can play a major role in combatting stigma, making their services accessible and visible, providing culturally-competent care, and increasing mental health supports for students in a variety of settings. All posts for another day, and things I will be advocating for in the year to come.