Increasing mental health needs

We learned many things from the COVID pandemic including what didn't work in various systems and supply changes on which we depended. Health and wellness is an area that was exacerbated by the isolation of months of shut-downs where personal interaction was replaced by a mass movement to virtual communication and meetings. The Healthy Minds study found that the number of students in some form of therapy is at an all time high with 44% reporting signs of depression, 37% reporting anxiety, and 15% indicating suicidal thoughts. The 2023-24 assessment of students' mental health reflected slight improvement. Loneliness may be a common element across multiple types of mental health concerns. Mental health crises often goes unrecognized by peers and research has found that parents often had no clue that their children were struggling. Students seeking counseling help is a good sign but questions remain about the cause of rising needs.

The heightened awareness of both physical and mental health needs has reinforced the importance of providing a broader array of wellness interventions in higher education and community settings. Complicating the issue of addressing depression among students, research has found that those who identify as depressed cope less well than those who have similar symptoms but don't see themselves as depressed. Counseling support contributes to student persistence but being employed, family support, and extracurricular involvement can also help. Student affairs administrators have been at the forefront in responding to this need and getting ahead of the problem in ways that contribute to student success is essential.

Mental health is current students' top stressor and the soaring numbers related to anxiety disorder is one of the more prominent examples of unmet need. A close friend when I was a graduate student at CSU was a hilarious and talented student in veterinary medicine. He worked summer orientation with me and was selected as a resident assistant in my building. While serving as a resident assistant, he started coming to my apartment during the middle of the night, just wanting to be with me. All I knew to do was leave my door open to respond to his needs. When my company ceased to help, he went to the health center where he was prescribed medication. Unfortunately, medication ultimately seemed to exaggerate his symptoms. He withdrew from CSU to return home, broken by his inability to pursue his dream of becoming a vet.

Years later I began struggling with being able to sleep at night and I started having fearful thoughts that were almost obsessive. Immersed in frustration, I remembered my former friend and colleague and recognized the similarity between what I was experiencing and what caused him to leave his studies. I tracked him down to ask for his help. He immediately recognized my symptoms as similar to his own, symptoms that in the meantime had drawn him to pursue a doctorate in psychology with a research focus on anxiety disorder. To this day, I credit my friend and colleague with throwing me a life-line, one which prevented a deeper crash and offered hope (and success) in managing anxiety disorder throughout the rest of my adult life.

Anxiety disorder has now emerged as the most common mental health need, and stress is a strong deterrent for some students to even attempt pursuing a higher education. Estimates are that 34% of undergraduate students have some degree of anxiety disorder, a condition that appears to have been exacerbated by the COVID pandemic and perhaps the advance of technology that drives many young people deeply into isolation. The isolation and reduced interaction with others has been hypothesized as increasing the prevalence of anxiety disorder. Researchers have found that 64% of those who have dropped out of college had mental health-related reasons, 45% of which had no accommodation and 50% had limited access to mental health services. The impact of this in disrupted educational and personal life is unmeasurable. And, the cost of college drop-outs to institutions justifies the researchers' call that colleges must do more to address mental health needs.

Disruption of education and life certainly require attention and support in higher education. Yet, some counselors warn that including predictable youthful stress and anxiety as indicative of mental health decline is a mistake. Inside Higher Education's interview of three mental health professionals highlighted that students' mental health and needs are sometimes better addressed by paying more attention to life skills and helping students acquire adversity management mindsets. One said, "Not every student on campus needs direct clinical care, but they all can benefit from a culture of caring and compassion." Trauma among students is another condition that may be more effectively addressed in a time-limited and practical way, rather than introducing deeper diagnosis and longer treatment. Campus environment conditions such as trust & transparency, peer support & belonging, and cultural humility & critically engaging difference can systemically respond to the trauma felt by a variety of students.

Addressing the increased prevalence of mental health complications requires more than just adding counselors. The 2023 Depression on College Campuses conference shed light on central challenges that require attention. Providing triage to determine what type of support students need may release some of the pressure for counseling. Some institutions resorted to out-sourcing counseling due to budget restrictions in the face of rising demand. Relying on external providers neglects the role of community, which can at least partially address students' needs through connective, supportive, and positive environments for all. The University of Maryland teaches emotional regulation in a 1-credit course to provide a tool for those students who elect to take the course. Other campuses are redefining the the role of counseling and replacing previous Directors who have perhaps been slow to change their models. Creating campus spaces that foster different types of student engagement is a trend on other campuses.

With college mental health counselors reporting concern about their ability to address students' needs, finding other ways to respond is critical. Faculty are first to see evidence of students in crisis, but training and support is required to increase their effectiveness. Four out of ten students say that faculty are central to addressing stress, with primary sources being exams and pressure to do well. Faculty can contribute to increased student success including being more flexible about deadlines, teaching strategies, and attendance/participation. Even strategies using virtual reality are being adopted to train and to reach broader numbers of students in need.

The creativity of faculty who integrate practicable mental health skills in regular courses would do a lot to improve the campus climate. Encouraging resilience is an important part of a positive climate but it must not minimize the suffering experienced by those struggling with mental health. Officials at the University of New England say, "Messages of strength, resilience and the expectation of positive outcomes must extend beyond college counseling services to all aspects of the student experience" and well-coordinated networks of support should be a dependable dimension of the student experience.

One of the most critical questions is how well prepared are students to face the reality of living and working after graduation, a challenge captured in a Harvard graduate's reflections. A survey of graduates ages 22 to 28 determined that 51% needed mental health support in the last year with variations in types of problems and a disparity of impact for men and women. One of the most interesting findings was that peer relationships (57%) and extracurriculars (51%) were most helpful in preparing them for their past-graduate experience.

My previous blog post on Health and Well-being in Higher Education addresses the variety of challenges related to the mental health needs of students, a phenomenon that is complicated and requires a comprehensive response. I'm thankful that educators are now understanding the need for greater mental health services and a more wholistic approach to it, a commitment that is reinforced by my personal experience and the professional role I played as a university administrator for over 40 years.