Mental Health Issues and the University Student

1. Crisis on the College Campus?

College is becoming an aspiration for more and more of America’s youth. Nearly half of American 18- to 24-year-olds are enrolled in college at least part-time. With the rise of information technology and an increasingly global economy, higher education is also becoming more of a necessity for success. Although many of us look back fondly on our “bright college years,” for growing numbers of students, this is a tumultuous and difficult time. In addition to many normal developmental milestones that can cause emotional challenges, psychiatric disorders often first emerge during these years. “Record Levels of Stress Found in College Freshmen,” trumpeted a headline in the New York Times in 2011.1 Continuing a trend that has been noted since the 1990s, college students were reporting the lowest levels of emotional health in 25 years. This particular finding relied on data from over 200,000 incoming first-year students at four-year colleges across the United States who participated in “The American Freshman: National Norms Fall 2010,” the largest and longest-running survey of American college students.2 The numbers have since remained about the same. In the past decade, many other studies have raised similar concerns about the emotional and mental well-being of students. And it’s not just “stress”—depression, anxiety, substance abuse, eating disorders , and other psychiatric issues seem to be on the rise in this population. Chapter 1 Crisis on the College Campus? 4  The Student in Context: The Interdependent Campus Part of the explanation may be that we are getting better at identifying these problems earlier and offering help sooner. More children and adolescents than ever before are receiving effective treatment in high school or earlier for anxiety , depression, and other problems, allowing them to successfully enter college . Some researchers speculate that the trend toward “helicopter parenting,” in which parents overmanage every detail of their child’s life before college, leads to children whom college deans have called “crispies” or “teacups”—so burned out that they can’t engage meaningfully in college life, or so fragile that they break at the first sign of challenge. Admissions officers from selective universities have been speaking out against the craze that pressures families and adolescents to go to extremes in trying to achieve, in order to get into certain colleges. Marilee Jones, a former dean of admissions at the Massachusetts Institute of Technology, teamed up with an adolescent medicine specialist to write the book Less Stress, More Success; both authors are concerned that the pressure placed on kids to get into college is actually making them sick. Regardless of the reasons, those of us who work in college counseling centers can attest to the growing numbers of students we see, as well as to some increase in the complexity and severity of the kinds of problems students bring in. In the most recent National Survey of College Counseling Center Directors, over 90% of directors agreed that the trend toward greater numbers of students with severe psychological problems continues. Increasingly problematic, in the opinion of these directors, are “psychiatric medication issues” and “crisis issues requiring immediate response.”3 And indeed in the last decade, university communities have been buffeted by some emergencies so severe that their effects have reverberated far beyond the campus gates. Each year of the new millennium seems to bring another high-profile campus tragedy, highlighting unmet mental health needs among college students. There are clusters of suicides, such as the three within a five-week period at New York University in fall 2003, followed by three more that academic year, or the six over a few months in 2009–2010 at Cornell. There have been campus shootings, most notoriously at Virginia Tech in 2007, in which 33 people were massacred, and many others were injured. Sometimes the disasters involve enrolled students; at other times, the perpetrator is a student who was recently dismissed. In retrospect, there were often warning signs of mental distress but a lack of clarity about how best to respond. Jared Loughner, who in January 2011 shot Representative Gabrielle Gifford and 19 others, killing 6, had been suspended from Pima Community College after displaying behavior that was Crisis on the College Campus?  5 disturbing enough that he was mandated to get a psychological evaluation before he could return to school.4 However, there was no system in place to ensure that he got treatment, and it...