I'm fine. It's fine. Never mind.

The stressful climate on campus

College can be the most exciting time in our lives, and for many it is. For traditional college students, typically aged 18-24, and for adult students, it means entering a time of heavy transition in our lives.

Attending school and being away from our caregivers for the first time offers us incredible freedom, allowing space for authentic self-discovery. This may include discovering sexual orientation and identity, entering romantic relationships, making lifestyle choices, reviewing academic and career options, and adding to our social circle. Additionally, as adult students, we may be juggling the demands of work and family our younger classmates are not.

Completing schoolwork, finding love with raging hormones, discovering ourselves, and planning how to structure our lives become everyday challenges (Pedrelli et.al., 2015). Navigating these decisions all at once creates stress and introduces the use of coping mechanisms to process our feelings. This often becomes overwhelming, and a lack of access to mental health services puts us in a perfect storm of risky behavior.

To relieve stress, we may choose to binge drink, engage in sexual behavior which may lead to sexual assaults, develop eating disorders by undereating or overeating, engage in drug use, or self-harm. These are just a few of the unhealthy coping mechanisms we participate in, and it is at an all-time high.

The availability of alcohol surpasses access to mental health services, and close to one-fifth of college students exhibit behaviors of an alcohol use disorder (AUD). The main characteristic of an AUD, binge drinking, is defined as 4 drinks for women and 5 drinks for men in the time of two hours. Motor vehicle accidents by intoxicated drivers are one of the leading causes of death for college students.

The numbers

College campuses are struggling to keep up with the demands of their student's mental health needs. The mental health crisis on college campuses is staggering; 2-3 college students die by suicide every day (Shrinking it Down, 2017). Young adults who identify as LGBTQIA+ are at an even greater risk of suicide. We can stop this in its tracks. Free and unlimited access to mental health services has the potential to shift our community with dramatic results.

Providers understand mental health disorders and assist us in processing our stress while facilitating the task of sorting out and navigating our journey. Offering students mental health services right on campus frees them from a host of accessibility barriers including transportation off-campus, affordability, and time constraints.

Detecting disorders such as ADHD, OCD, bipolar disorder, depression, addiction, abuse, PTSD, eating disorders, and anxiety is another large part of their role. It is estimated that 75% of us ultimately identifying with a mental health disorder will have our first onset by age 25 without receiving adequate treatment. When mental health disorders go undetected or untreated, it creates more complications for the patient, leading to one of the main causes of responding with unhealthy coping behaviors.

How does this impact me?

You may be wondering what this has to do with you. The mental health of college students is a community-wide concern because better mental health can result in less drinking and vandalism, more community involvement, and healthier adult choices about how to conduct our lives. When we enter the community without learning how to properly cope with the stress life brings, it becomes everyone’s problem.

The dysfunctional behavior and practices of community members are something everyone we encounter is obligated to manage. Imagine graduating from college with better mental health than when you began. Imagine what kind of power this would give our workforce, and our community.

Let’s look at some common unhealthy coping mechanisms, what causes them, and some potential outcomes. If we are stressed about grades, or family problems, or are depressed about a romantic relationship, we are going to seek relief. We may choose to drink alcohol in excess, possibly leading to promiscuity or sexual assault. Being a survivor of an assault, managing an unplanned pregnancy, or contracting an STI/STD changes our path drastically. The responsibility of a child may prevent us from finishing our education or create an inability to work, possibly forcing us to rely on government assistance to prevent food and housing insecurities. The consequences of these outcomes have the potential to change our entire life.

If we experience the passing of a loved one or are exposed to trauma, for example, we may find ourselves unable to cope with the changes. Facilitating the grieving process offers a much greater opportunity to learn the coping skills we need and moves the healing process forward. This allows an opportunity to live a healthy lifestyle with less depression, addiction, and various other negative outcomes.

Students are not getting the support they need.

A study found a direct link between perceived stress and self-esteem to be a main contributing factor fostering unhealthy coping, which can lead to poor academic performance. The Center for Collegiate Mental Health (CCMH) reported that 76% of on-campus mental health facilities had to reduce the number of visits for non-crisis patients due to the demand for overall services (Rakow and Eells, 2019). In the 2016 National Survey of College Counseling Services, 94% of Counseling and Psychological Services center directors reported severe psychological problems are increasing on campus. Mental health services are five times more in demand than the rate of enrolment growth.

This is not about irresponsible decision-making but about implementing healthy coping skills. Mental health disorders have the potential to invade our thoughts, with a likelihood of disrupting our quality of life. Our behavior impacts everyone in our lives, and we may not even recognize it. Being unaware of our actions puts unintended negativity into others’ lives and will ultimately come back to us as part of the cycle. Healthy coping and confidence with communication on an individual level are predictors of better overall mental health than GPA (Byrd and McKinney, 2012).

Why it is not difficult

We have an opportunity to reallocate the same funds going into recovery, to preventative programs. Offering low- or no-cost mental health services may be the best place to start. It may seem like a burden at first, and slowly there will be a reduction in alternate programs as the therapy offers us irreplaceable healing, shifting us to healthy behaviors.

• The Garrett Lee Smith Act (2004-2007) offered $82 million to address suicide on college campuses. This program was one of the first of its kind and was successful in providing a boost to mental health on campuses.
• Mental Health in Schools Act of 2015 fights to revise eligibility requirements making it easier for campuses to receive funding for trauma and mental illness treatment.
• Saving Our Next Generation Act proposes directing the United States Department of Health and Human Services to allow eligible colleges access to grants which would provide resources in full for mental health assessments and care for students.
• Americans with Disabilities Act allows legal protection and services to those with a mental health condition by defining it as a valid health condition. College students can register their condition with their school to receive services.
• Large-group and individual health plans are required to cover mental health as a benefit through The Affordable Care Act and The Mental Health Parity and Addiction Equity Act of 2008. For colleges requiring payment from students for mental health treatment, this allows more financial accessibility.

Successful funding programs create an opportunity to break the cycle by redirecting resources into proper diagnosis, treatment, and prevention. Understanding the pattern is the first step in making a drastic change.

What we need on campus

Therapists on staff should start at a 1:1000 ratio to students (International Association of Counseling Services (IACS)). Some staff should remain stationed in the facility for in-person meetings while adding evening and weekend hours. If the patient can't get to the facility, go to them. Meet somewhere on campus, in a dorm building, or in a vacant classroom. If the patient is too overwhelmed or depressed to get out of bed, our virtual world puts us at an advantage by making mental health sessions just a click away. Around-the-clock on-demand virtual sessions and a 24-hour crisis line are critical.

Introduce therapists with specialized capabilities such as ADHD, Autism, LGBTQIA+, trauma-informed, OCD, sexual abuse, and adult students. Offering group sessions softens the stigma around therapy by showing the community that therapy is the simple act of talking. Allowing social work graduate students from local programs an opportunity to help their fellow community members is one of the best solutions. This is a win-win situation. This frees up space in the budget and offers much-needed experience and college credit for social work students. We have a much easier time connecting with someone we can relate to.

Talk about it.

We're easily caught in the trap of the stigma placed on receiving mental health services, and we all have an opportunity to lead the way by setting the example of seeking therapy ourselves. Therapy is about maintaining mental health, not a sign of weakness. Just as our bodies need nutrition and exercise to maintain health, our mind needs support to navigate the common stresses of everyday life.

Support for crisis situations

The suicide and crisis lifeline - 988lifeline.org

LGBTQ crisis hotline - thetrevorproject.org

LBGT National Help Center - lgbthotline.org

Helping a friend in need - nimh.nih.gov/health/topics/suicide-prevention

Crisis text line-text HOME to 741741 - crisistextline.org

Crisis hotline - 211lifeline.org

Dating abuse helpline - loveisrespect.org

Domestic violence hotline - thehotline.org

Sexual assault - rainn.org

Find a therapist - psychologytoday.com/us

References

Blanco, C., MD, PhD; Okuda, M., MD; Wright, C., BS; Hasin, D. S., PhD; Grant, B. F., PhD; Liu, S., MS; Olfson, M., MD, MPH (2008). Mental Health of College Students and Their Non–College-Attending Peers. American Medical Association, 65:12. DOI: 10.1001/archpsyc.65.12.1429

Braithwaite, S. R, Delevi R., & Fincham, F. D. 2010. Romantic Relationships and the Physical and Mental Health of College Students. Journal of the International Association of Relationship Research. Personal Relationships, 17.1: 1–12. https://doi.org/10.1111/j.1475-6811.2010.01248.x

Byrd, D. R., MS; McKinney, K. J. PhD (2012). Individual, Interpersonal, and Institutional Level Factors Associated With the Mental Health of College Students. Journal of American College Health. 60:3.

Liu, C. H., Stevens, C., Wong, S. H. M., Yasui, M. & Chen, J. A. (2018). The prevalence and predictors of mental health diagnoses and suicide among U.S. college students: Implications for addressing disparities in service use. Wiley Periodicals, Inc. Depress Anxiety. 2019;36:8–17. Wileyonlinelibrary.com/journal/da. DOI: 10.1002/da.22830

Long, M. A. (2018). Policy Brief on Mental Health on U.S. College Campuses. RhetTech Journal. Volume 1 (2018-2019). https://www.jmu.edu/wrtc/students/undergraduate/rhet-tech-volume-1.shtml

Pedrelli, P., Nyer, M., Yeung, A., Zulauf, C., & Wilens, T. (2015). College Students: Mental Health Problems and Treatment Considerations. Acad Psychiatry. October 2015; 39(5): 503–511. doi:10.1007/s40596-014-0205-9

Rakow, D. A., and Eells, G. T. (2019). Nature Rx: Improving College-Student Mental Health. Cornell University Press. ProQuest Ebook Central, http://ebookcentral.proquest.com/lib/brockport/detail.action?docID=5750328

Shrinking it Down Podcast. (2017, February 7). The College Mental Health Crisis: A call for cultural change – part 2. The Clay Center for Young Healthy Minds. https://www.mghclaycenter.org/parenting-concerns/college-mental-health-crisis-call-cultural-change-part-2/

Westefeld , J. S., PhD, Homaifar B., PhD, Spotts, J., BA, Furr, S., PhD, Range, L., PhD, & Werth, J. L., Jr., PhD (2005). Perceptions Concerning College Student Suicide: Data from Four Universities. The American Association of Suicidology. Suicide and Life-Threatening Behavior 35(6) December 2005. DOI: 10.1521/suli.2005.35.6.640

Wood, M. (2012). The State of Mental Health on College Campuses. Inquiry: The Journal of the Virginia Community Colleges. 2012;17:1. https://commons.vccs.edu/inquiry/vol17/iss1/1/