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Each year students across the country apply to and matriculate at universities. After arriving on campus, these newly minted freshmen unpack, settle into dorm rooms and meet new classmates. No doubt, as they said good-bye to their parents, they were dutifully reminded to study hard, eat well and make sure to get enough sleep. However, neither students nor parents likely paid much attention to their school’s mental health services. Indeed, in deciding which college to attend, mental health services likely never crossed the minds of must parents and students.
And why should it? College students setting off on their own for the first time are generally young, healthy and feel invulnerable. While this may be true for most types of illness, it’s not the case for mental disorders.
The college years and experience closely coincide with the onset of many mental disorders in young people (including anxiety disorders, eating disorders, depression, psychoses and substance abuse). In fact, research conducted by the National Alliance on Mental Illness on mental health on college campuses shows that:
- One in four young adults between the ages of 18 and 24 develop a diagnosable mental disorder.
- Forty percent of students with diagnosable mental conditions do not seek help.
- Eighty percent feel overwhelmed by their responsibilities.
- Fifty percent have been so anxious they struggled in school.
In the course of my career, I have seen many young patients whose education and lives were derailed by the onset of mental illness that was not adequately managed while in college. In the worst cases, it leads to suicide or irreparable damage.
The unfortunately reality is that most schools are ill-prepared to meet the needs of their students and lack adequate, much less optimal, services. Witness the increased frequency of on-campus physical and sexual violence, as well as the rise in high risk and self-harmful behaviors. In addition, the number of student clients of campus counseling centers who are taking psychotropic medication is nearly 25%.
The most common form of treatment provided by student health services is crisis counseling and psychotherapy. However, to provide the requisite evaluative and treatment services, universities must employ and provide student access to trained personnel, including psychiatrists, psychologists and social workers in adequate numbers.
University administrators have been slow to accept the responsibility of providing comprehensive and state of the art mental health services to students. This is partly due to cost, but also to liability. However, today more and more institutions appreciate the need to provide for the mental health needs of students and support them while they continue in school.
Similarly, students and parents must acknowledge the possibility that mental health care might be needed in the course their college education, and make learning about it a priority. Both parents and students should look for the following when evaluating student mental health services:
- Credentials (psychiatrist, psychologist, social worker) of the director of the service
- Number and composition of the staff
- Relationship of student service to the university’s medical school and department of psychiatry
- University policy toward managing mental illness in students.
Attention to mental health care should be a new criterion for evaluating colleges, just as the quality of its information technology facilities and other services are now a top priority. Knowing such services are available will provide a family with greater peace of mind but also could be life changing or saving.
Dr. Jeffrey Lieberman, former president of the American Psychiatric Association, is chair of psychiatry at Columbia University and New York Presbyterian Hospital, and the author of Shrinks, The Untold Story of Psychiatry.
