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While much of the country is preoccupied with the “March Madness” of the NCAA basketball tournament, many high school seniors anxiously await the results of their college entrance applications. Their emotions will fluctuate wildly as they await their fate to be decided and learn where they will enter college in the fall. Their choices in which universities to apply to mirrors their aspirations and self-image, as well as those of their parents, and will indelibly influence their future.
In deciding where to apply and which college to attend, students weigh numerous factors, including the quality of faculty and curriculum, appearance of the campus, prestige and reputation of the university, cost and availability of financial aid, the nature of the social life, and caliber of the sports teams. However, the one area that students and their parents will likely fail to take into account is the quality of the school’s mental health services—an omission that could have serious consequences in the years ahead.
Why should access to quality mental health services matter when students are deciding on college? The simple answer is that the college years and student experience are closely aligned with the onset of mental disorders in young people. Depression, schizophrenia, bipolar anxiety, eating and substance use disorders all commonly develop in adolescence and young adulthood. When you combine this with the stresses of today’s college environment, you have a substantial population at high risk for mental illness that may need mental health care during the period of their college education.
This is borne out by the fact that approximately 30 percent of matriculating college students are taking psychotropic medications. College entails circumstances and experiences that many students will encounter for the first time—being away from home and independence from parents, rigorous academic demands, exposure to recreational drugs and alcohol, as well as sexual freedom. This novel and challenging environment is complicated by the increased frequency of on campus physical and sexual violence as well as the rising occurrence of self-harmful behaviors and suicide.
Unfortunately, most schools are ill prepared to meet the manifest needs of their students and lack adequate, much less optimal services. Instead, they react to individual crises or clusters of incidents when they occur rather than addressing the problem fully and proactively. Recent examples of this include the spate of binge drinking (causing occasional deaths) being reported among college students and the alarming frequency of sexual assault and rape on campuses (such as reported [falsely or otherwise] in the Rolling Stone article about the University of Virginia).
In these instances universities were again caught unprepared. Historically, healthcare was not central to the mission of institutions of higher education. As student health services evolved, mental health was an afterthought and somewhat reluctantly incorporated into their repertoire of services. However, universities are unsure and ambivalent of how much responsibility they should assume for the young charges in their care. In addition, many parents are wary of educational institutions taking over the health care of their children. Consequently, university administrators find themselves in a no-win situation.
Nevertheless, I would advise universities to take a proactive approach to student mental health and establish state of the art comprehensive youth mental health services. Adopting this strategy is the right thing to do, and it will mitigate the risk to students and the institution and more than make up the costs of providing these services.
For their part, students and their parents must be open to the possibility that they might need mental health services sometime during college and often urgently. For this reason, they would be well advised to include the quality and availability of mental health services along with traditional considerations as they decide on the college of their choice.
