The Deteriorating Mental Health of U.S. College Students: Part II
How college and university leaders can build a culture of mental wellness across campus
Higher education, ideally, leads to knowledge, fulfillment, an expanded worldview, and increased opportunities later in life. Unfortunately, it can also lead to stress, pressure, time management challenges, financial worries and mental health strain. These days, many students are unable to experience the good without the bad.
Suicide is the second-leading cause of death among college students. More than forty percent of students reported feeling “so depressed they had difficulty functioning.” About one in five students has engaged in non-suicidal self-injury, like cutting. Millions more suffer from milder forms of depression and anxiety that still affect their self-esteem, their emotional well-being, their physical health, their education and their future careers.
The mental health crisis among students is becoming more and more dire. “Student mental health concerns have escalated over the last 10 years,” states a 2019 report from the American Council on Education (ACE). For college and university leaders, the crisis is escalating in priority as well as scope.
About 75 percent of 400 top university executives surveyed reported hearing about anxiety and depression the most frequently among mental health issues, the report found, with 23 percent of presidents saying suicide was one of the top problems on campus.
More than 80 percent of presidents say that, as a result, mental health is more of a priority on campus than it was three years ago, according to the report, and that it is becoming more personal to them as the years go on. ACE found that 29 percent of all the presidents received reports of students with mental health issues once a week or more, and 42 percent reported hearing about these problems at least a few times every month.
These reports are being taken seriously. Presidents are allocating more funding and more resources to addressing student mental health problems than in the past, with 72 percent reporting they spent more money on mental health initiatives in 2019 than they did three years prior.
“We know that poor mental health hinders student academic success,” said Hollie Chessman of ACE. “I think it’s important that mental health and well-being be a campuswide priority, and it is for a lot of college presidents.”
“The issues facing students have become more complex and time-consuming for faculty and staff to address,” one president said. “It also involves multiple staff (student services, counseling, security, external resources, safety, legal) to develop a comprehensive plan to address.”
When asked what action they would take first with unlimited resources to dedicate to student mental health on their campus, 58 percent of college and university presidents said they would hire additional staff to augment their counseling services.
More than one in five said they would invest in more enhanced resources or programs. “We are currently working to improve our early alert system for at-risk students to improve retention and persistence,” one reported. “As a result of this initiative, students requiring mental health services may be identified and we need to have proper training services in place for their well-being.”
In the absence of anything approaching unlimited resources, however, how should college and university presidents address growing mental health concerns on campus? “Including student mental health as part of strategic plans is an important step,” writes Higher Ed Today. “However, many institutions continue to face issues fully meeting student concerns. As one president said, ‘Our strategic plan and efforts are all about the students, yet we still struggle to meet their mental health needs.’”
At a time when resources and finances are already stretched thin, there are ways college and university leaders can create a culture of wellness, transparency and action that encourages students to seek help when they need it.
Five steps toward a mental wellness-focused campus culture
- Identify students at risk
In 2018, UCLA began offering all incoming students a free online screening for depression. “More than 2,700 students have opted in, and counselors have followed up with more than 250 who were identified as being at risk for severe depression, exhibiting manic behavior or having suicidal thoughts,” says a TIME Magazine article.
Early identification is key, but that identification absolutely must be followed by action, in the form of resources or treatment. Otherwise, not only exacerbate a student’s condition, but could leave an institution at risk of legal action as well.
In 2018, a suit was filed against the Massachusetts Institute of Technology (MIT) following a student suicide. The court ruled in favor of the institution, two of its professors, and an assistant dean, but said that “a college may have a legal duty to take ‘reasonable measures’ to ‘prevent a student’s suicide,’” says Peter McDonough, vice president and general counsel at ACE. “This duty, which also extends to faculty and staff members personally, exists in two contexts where there is ‘actual knowledge’: (1) of a prior suicide attempt that occurred while the student was enrolled at the university or just before matriculation, or (2) of a student’s ‘stated plans or intentions’ to commit suicide, i.e., more than suicidal ideation.’”
- Make wellness everyone’s responsibility
Just over one in 10 presidents surveyed mentioned professional development for current faculty and staff. “I would broaden the range of people who could help students by [providing] proper training rather than staffing up the counseling center,” one president responded.
Every campus leader should be doing this. All faculty, staff and students should be able to recognize the warning signs of depression and have resources available for themselves and students at risk of hurting themselves or others, dropping out of school, or experiencing a mental health episode.
This approach makes sense, given the breadth of the problem and the lack of dedicated staff at most schools. Right now, most presidents (approximately 92 percent) depend primarily on the vice president for student affairs to be responsible for mental health initiatives, but some depend on the campus police chief or the university’s legal counsel, most of whom are unlikely to have been trained in addressing mental health concerns.
It is especially important to “promote emotional health awareness among those who interact with students the most: the gatekeepers, such as residence hall staff, academic advisors, faculty, and even fellow students,” says Higher Ed Today. “It also is vital for these people to be able to recognize and refer a student who might be in distress.”
Some institutions are providing Mental Health First Aid training for their entire campus: faculty, staff, and students.
“One example of an innovative program is called I CARE at the University of Pennsylvania,” says Higher Ed Today. “I CARE is an interactive gatekeeper training for students, faculty, and staff that builds a caring community with the skills and resources needed to intervene with student stress, distress, and crisis. The initiative includes information, discussion, and experiential exercises that focus on understanding mental health beliefs and biases, engaging in self-care, and other relevant areas.”
The chances that your students will even come into contact with, let alone have a conversation with, your VP of student affairs, police chief or legal counsel is very slim. Preparing those who do have regular contact with students – like instructors, counselors and other students – with the skills they need to identify students at risk and guide them toward treatment has a much higher chance of success.
- Publicly reduce stigma
“Some students who need help may be reluctant or unsure of how to seek it out,” says Higher Ed Today. “Obstacles to help-seeking include lack of awareness of mental health services, skepticism about the effectiveness of treatment, prejudices associated with mental illness, and uncertainty about costs or insurance coverage.”
Time Magazine profiled Nelly Spigner, who arrived at the University of Richmond in 2014 as a Division I soccer player and aspiring surgeon. “‘I was running myself so thin trying to be the best college student,’” Spigner said. “‘It almost seems like they’re setting you up to fail because of the sheer amount of work and amount of classes you have to take at the same time, and how you’re also expected to do so much.’”
“At first, Spigner hesitated to seek help at the university’s counseling center, which was conspicuously located in the psychology building, separate from the health center. ‘No one wanted to be seen going up to that office,’” she said.
No students should feel ashamed of getting treatment for their mental health or talking to an expert about their problems. Campus-wide communication initiatives that make it easier for students to connect with the resources they need are a great way of reducing stigma and increasing access at the same time.
Individual faculty and staff can work wonders on this initiative as well. “For example, Chan Thai, a professor from the Department of Communication [at Santa Clara University] uses class assignments to have students develop stigma-reduction campaigns and increase help-seeking behavior,” says Higher Ed Today. “The course teaches students how to develop a strategic campaign plan, implement the campaign, and evaluate the effectiveness of the campaign.”
- Provide students with self-care tools
Along those lines, it is recommended to give students the ability to take first steps toward dealing with their mental health individually. Today’s college students expect access to everything they need at their fingertips – literally. Giving them access to digital mental health resources they can access on their laptops or smartphone means a group who is unlikely to admit mental distress to a faculty or staff member is still able to get help in their own way.
In addition to adding 12 mental health clinicians to its staff in the 2016-2017 academic year, says Time, “The Ohio State University also launched a counseling mobile app that allows students to make an appointment, access breathing exercises, listen to a playlist designed to cheer them up, and contact the clinic in case of an emergency.”
Similarly, Northwestern University developed an app for students, called Breathe, that supports healthy living and stress management by providing guided meditations and breathing practices to help deal with stress; reduce the negative impact on mind, body, and spirit; decrease perfectionism and self-criticism; and enhance confidence and well-being.
- Partner with external health resources
In 2016, TIME magazine reported, “the Center for Collegiate Mental Health found that, on average, universities have increased resources devoted to rapid-access services – including walk-in appointments and crisis treatment for students demonstrating signs of distress – since 2010 in response to rising demand from students. But long-term treatment services, including recurring appointments and specialized counseling, decreased on average during that time period. ‘That means that students will be able to get that first appointment when they’re in high distress, but they may not be able to get ongoing treatment after the fact.’”
Because many colleges and universities struggle to provide students with mental health treatments at a regular cadence beyond a crisis, “College students facing anxiety may find that the resources offered by mental health clinics outside their campus community provide the most effective treatment for their conditions,” says Stress.org. “The resources include consulting with mental health practitioners operating in public health facilities and in private offices.”
“Demand for mental health services for college students is increasing at a time when scarce resources make it nearly impossible for schools to hire sufficient counselors to meet the demand, says USA Today. “The result is students having to wait weeks before a counselor is available, or once treatment starts, students may be limited to a set number of sessions with the counselor.”
Whether students are on campus or attending classes virtually, college and university executives can use their leadership to implement comprehensive, systemic, accessible initiatives to improve student mental health, increase access to necessary resources and reduce incidents of crisis. By sharing the responsibility for every student’s wellbeing, you can lead your faculty and staff away from shame and stress and toward a culture of wellness, self esteem and success.
Throughout 2020, Career College Central will continue to examine the mental wellbeing of college students, focusing specifically on how institutions can provide systemic support and resources, how counsellors can better understand their most at-risk students, and how students themselves can take steps to support their mental wellness.
Sidebar: Addressing the unique mental health challenges of nontraditional students
A couple years ago, The National Center for Education Statistics estimated 7.6 million college students to be 25 years and older. As students who did not transition directly from high school into higher education, their life experiences and mental health needs are unique.
“Some are returning to college after decades of working or raising a family, which can be daunting. College can be quite an adjustment as they get used to being a student again,” says Higher Ed Today. “They tend to see themselves as more serious and focused than traditional-age students and may struggle to relate to them. Additionally, some post-traditional learners may be older than their professors or instructors. These students may also worry about being behind the curve with technology—especially when they look at the 18-year-old sitting next to them, who seems so technologically adept”
A study in the Journal of American College Health found that nontraditional students scored significantly higher on life stress, anxiety, and depression than traditional students.
Additionally, in the ACE survey referenced earlier, presidents at public two-year colleges, which enroll proportionally larger percentages of nontraditional students, were twice as likely to hear about housing insecurity than presidents at other types of institutions.
So assuming nontraditional students have unique mental health concerns – and often the increased life stresses to back them up, how can college and university leadership prepare to address their needs?
- Do not assume that because post-traditional learners are adults that they have the agency to seek help for mental health or recognize when they need it.
- Listen carefully to post-traditional learners’ needs and struggles and validate their concerns as they juggle multiple roles and responsibilities outside of being a student.
- Consider modifying hours of services and programs to cater to the evening and weekend times that post-traditional learners are on campus.
- Use your on-campus counseling centers, CARE team, or behavioral intervention teams to follow up with students in need of services.
- Invite counseling center staff to provide consultative meetings or trainings for faculty and staff who interact with post-traditional students on identifying and intervening in high-risk cases or dealing with a student resistant to services.
- If you have a counseling center, consider providing support groups for post-traditional students, which can help them develop a better sense of belonging and reduce their stress levels.
- Offer a variety of workshops at varying times on topics related to adult learners, such as managing stress, parenting, sharpening study skills, and succeeding in college while balancing multiple responsibilities.
- Be prepared with professional mental health resources to make referrals as needed, including to mental health crisis lines.
- Try to avoid problem-solving for students who do not ask for it. Discuss options and allow them to make their own decisions.
“It is important that post-traditional learners feel supported by and connected to campus resources. These students are often expected to adjust their own lives and schedules to campus life and services,” says Higher Ed Today. “But it is equally important that campus administrators make adjustments in campus services and culture to accommodate this growing group of students and their unique needs.”
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