As an adjunct professor teaching English to community college students, one of my standard assignments in composition classes was asking students to write a straightforward narrative essay. When these neatly-typed, two-page papers were handed in, that’s when I really got to know my students by more than just the names listed on my roster.
Some of the stories that touched me the most: a young man who became homeless; a couple recovering from heroin abuse and living in the guy’s parents’ basement; a young woman grappling with coming out; a student recovering from eating disorders; a mom whose baby daughter had just been molested; and the student whose prescription painkiller and alcohol problem resulted in an overdose.
Time and again, my students would share their struggles in essays and during class discussions. Some also told me what they were dealing with in private conversations – in hopes that I could help pull them out of their profound distress. And I did try to do so, as best I could.
It was especially frustrating, though, for those students who clearly needed a lot more than just someone to listen. The college I taught at offered few on-campus resources, and students often had too little money to pay for other help for serious mental health troubles, including addiction. What I thought at the time was a deficit in mental health services specific to our campus, I soon learned is actually a widespread problem across the entire college and university system – from community colleges to large universities. In the U.S., we’ve been facing what’s been called a “growing mental health crisis on college campuses” by The American Psychological Association. It’s a problem that has been affecting colleges and students for some time, and it almost certainly won’t let up soon. “Over the last 10 years, we’ve seen an ever-growing number of students coming to campus with mental health and substance use history,” says Nance Roy, EdD, clinical associate professor in the department of psychiatry at the Yale School of Medicine and clinical director of The JED Foundation.
Severe Mental Health Problems on the Rise
According to the 2014 National Survey of Campus Counseling Centers (NSCCC), which looked at 275 both two- and four-year schools, 94% of campus counseling center directors said they were continuing to see more students with severe psychological problems. Of students seen by counselors in 2014, 52% had severe psychological problems, a significant jump from 44% in 2013, according to the NSCCC. Directors reported seeing more students coming to campus dealing with:
- Anxiety disorders
- Crises requiring an immediate response
- Psychiatric medication issues
- Clinical depression
- Learning disabilities
- Sexual assault on campus
- Self-injury issues (such as cutting to relieve anxiety)
- Problems related to earlier sexual abuse
Similar findings can be seen in the 2013-2014 Association for University and College Counseling Center Directors report, which canvassed nearly 500 counseling center directors. That report showed that anxiety continues to be the topmost and growing concern among college students (47% said this), followed by depression (40%), relationship issues (34%), thoughts of suicide (18%), self-injury (12%) and alcohol abuse (9%).
A recent seven-year study of over 43,000 students published in the Journal of American College Health showed that some schools have characteristics associated with worse mental health. Institutions that grant doctorate degrees, public institutions, schools with a large enrollment, nonresidential colleges (i.e., commuter schools), colleges that rank as less competitive and those with lower graduation rates all were associated with students who had worse mental health.
Why Students Need to Get Help
Getting a handle on depression, anxiety, ADHD, bipolar disorder, substance abuse or another mental health issue is important for anyone, but perhaps especially so for college students. According to the 2014 NSCCC, 64% of students who used the counseling center said sessions helped their academic performance and 65% said counseling even kept them in school. “Having a mental health professional available is very important to students’ mental health and overall well-being as well as academic success,” stresses Amy M. Lenhart, LPC, president of the American College Counseling Association and author of the 2014 American College Counseling Association Survey of Community College Counseling.
On campus, many college students feel overwhelmed, lonely and hugely stressed, Dr. Roy says. “First-year [students] are leaving home for the first time and leaving their group of friends and maybe a significant partner,” she explains. “When they get to campus, they are not with a ready-made friend group unless they’re part of an athletic team.” Social media may pour salt in the wound if they see other students posting about all their new friends, activities and parties (even if those posts don’t fully reflect reality). Commuter students may have to juggle work and family and “often are not feeling part of the college community,” Roy adds. Attending a mega-sized school may also make it tough to develop a feeling of connection. “It’s much easier to develop community on small campuses,” acknowledges Roy, “than when you have a 40,000-student campus. Bigger campuses are harder to navigate and the ability to develop a sense of community and belonging is challenging.”
Addressing mental health problems is a matter of campus safety as well. Many schools, after all, have had to face crisis situations in recent years, including campus shootings (such as those at Umpqua Community College, in western Oregon, this week, and at Virginia Tech and Santa Monica College in recent years) and suicides (like one this spring at Yale University and overdoses such as one involving 10 students and two others on Wesleyan University’s campus this year).
Overtaxed Resources, Especially at Community Colleges
Most schools have either a college counseling center (or sometimes just a student health center) to serve students’ emotional needs. “[These centers] are really meant to serve students in brief psychotherapy,” though, notes Roy. “Their mission was never meant to be community mental health clinics.” She also notes that part of the increased demand on counseling centers is owing to the fact that more students with psychological issues, from depression to ADHD, are benefitting from psychiatric medications that have made it possible for them to go to college. In addition, today there’s less stigma associated with asking for help and accessing services, she says.
Because of growing need for counseling centers, about one-third of schools have had to put limits on how long a student can get mental health services and a small minority charge a fee ($20 is the mean rate), according to the 2014 NSCCC survey (most don’t charge students at all, though). Another 43% of schools offer no limits on how many times a student can visit but do encourage short-term therapy and will make referrals to an outside provider, at which time a student’s private insurance, if he or she has it, would pick up the tab. Twenty-eight percent of college counseling centers surveyed said they’re dedicated to seeing students as long as it takes.
Centers are, for the most part, thinly staffed; the average ratio is one counselor for every 2,081 students, although ratios improve when two-year schools are taken out of the equation. “The overall picture for mental health at community colleges is similar [to four-year institutions],” says Lenhart, meaning that rates of depression, anxiety and other problems are much the same regardless of the school. “[But] one of the major differences is that community colleges do not have psychiatric services on campus as many four-year schools do.” Just 7% of two-year schools offer on-campus access to a psychiatrist, compared to 58% of four-year institutions. Counselors at the community-college level also have to wear more hats, even including academic advising and serving on college committees. “This compromises their ability to effectively be there for students’ mental health needs,” explains Lenhart, adding that these schools may use untrained workers to fill counseling and advising needs.
Some colleges have responded to the growing mental health needs on campus by expanding counseling hours, hiring part-time counselors, offering tele-psychology and adding online modules to help students learn better emotional self-care. In addition, 55% say they’ve expanded their referral network, according to the NSCCC. So if a student reaches the campus’ counseling session limit (usually three to 12 per academic year, says Roy) or needs a psychiatrist to prescribe a medication, a school may refer him or her to local outside providers.
More colleges are also taking an “all hands on deck” approach. A majority (64%, according to the 2014 NSCCC) are now doing more to train faculty and staff members to talk to students in need so that the college counseling center isn’t solely responsible for ensuring the emotional well-being of the student body. College employees are learning how to make referrals on campus or to community resources when a student needs support.
“We will never be able to offer all the mental health services for all the people who need it for as long as they need it,” concedes Roy. But with more members of the college community trained in how to engage students and where to direct them for resources, students should have more places to turn when they do need support. “They’re going to be people to talk to like their faculty, their coach, someone in residential life,” she adds.
As we close our interview, Roy reiterates that students today are grappling with some tough issues, contrary to the perception that college is a blast for everyone. I relay the kinds of struggles my own students dealt with and shared with me. She assures me their troubles were the same as those dealt with at community colleges, small colleges and big universities alike, all across the country.
I learned a lot teaching college, including how to support students who so desperately needed someone to listen. And when their problems went beyond simply giving someone an encouraging talk, I’d sit down with them and make some calls to on- or off-campus community services. Perhaps the greatest lesson I learned, though, was that a student’s GPA doesn’t matter very much unless and until a student is able to handle all that real life puts in his or her path.
SAMSHA’s Suicide Prevention Lifeline: 1 (800) 273-TALK