American University mental health facilities strained

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Spigner is one of a rapidly growing number of college students seeking mental health treatment on campuses facing an unprecedented demand for counseling services. Between 2009 and 2015, the number of students visiting counseling centers increased by about 30% on average, while enrollment grew by less than 6%, the Center for Collegiate Mental Health found in a 2015 report. Students seeking help are increasingly likely to have attempted suicide or engaged in self-harm, the center found. In spring 2017, nearly 40% of college students said they had felt so depressed in the prior year that it was difficult for them to function, and 61% of students said they had “felt overwhelming anxiety” in the same time period, according to an American College Health Association survey of more than 63,000 students at 92 schools

As midterms begin in March, students’ workload intensifies, the wait time for treatment at counseling centers grows longer, and students who are still struggling to adjust to college consider not returning after the spring or summer breaks. To prevent students from burning out and dropping out, colleges across the country — where health centers might once have left meaningful care to outside providers — are experimenting with new measures. For the first time last fall, UCLA offered 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.

As colleges try to meet the growing demand, some students are slipping through the cracks due to long waits for treatment and a lasting stigma associated with mental health issues. Even if students ask for and receive help, not all cases can be treated on campus. Many private-sector treatment programs are stepping in to fill that gap, at least for families who can afford steep fees that may rise above $10,000 and may not be covered by health insurance. But especially in rural areas, where options for off-campus care are limited, universities are feeling pressure to do more.

At the start of every school year, Anne Marie Albano, director of the Columbia University Clinic for Anxiety and Related Disorders (CUCARD), says she’s inundated with texts and phone calls from students who struggle with the transition to college life. “Elementary and high school is so much about right or wrong,” she says. “You get the right answer or you don’t, and there’s lots of rules and lots of structure. Now that [life is] more free-floating, there’s anxiety.”

That’s perhaps why, for many students, mental health issues creep up for the first time when they start college. (The average age of onset for many mental health issues, including depression and bipolar disorder, is the early 20s.)

A spokesperson for Rensselaer says the university’s counseling center launched a triage model last year in an effort to eliminate long wait times caused by rising demand, assigning a clinician to provide same-day care to students presenting signs of distress and coordinate appropriate follow-up treatment based on the student’s needs.

Some students delay seeing a counselor because they question whether their situation is serious enough to warrant it.

Counselors point out that college students tend to have better access to mental health care than the average adult because counseling centers are close to where they live, and appointments are available at little to no cost. But without enough funding to meet the rising demand, many students are still left without the treatment they need, says Ben Locke, Penn State’s counseling director and head of the Center for Collegiate Mental Health.

The center’s 2016 report 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.

More than 40% of college counseling centers hired more staff members during the 2015-16 school year, according to the most recent annual survey by the Association for University and College Counseling Center Directors.

As anxiety and depression among college students soars, universities in Connecticut and nationally are expanding their mental health counseling, even offering courses that address mental well-being.

A new national report from the Center for Collegiate Mental Health at Penn State found that anxiety and depression were the top concerns of students seeking counseling services, and that self-harm behaviors have risen for the seventh year in a row. In another survey, 57 percent of directors of college counseling services said the severity of student mental health concerns increased between 2015 and 2016. And according to a National College Health Assessment survey, 9.1 percent of college students reported being diagnosed in the last year with a psychiatric condition.

“We have seen an increase this fall compared to last fall of almost 30 percent in students requesting to be seen by our counseling service,” said Kerry Patton, director of health and wellness at Quinnipiac University. Over the last few years, anxiety has surpassed depression as the most common reason students at Quinnipiac are seeking counseling services.

Mental illness can be especially challenging for college students, who are suddenly on their own and often far away from their support system of family and friends. It can affect not only their well-being and their social life, but their academics. According to the NCHA study, 24 percent of students reported that anxiety affected their academic performance, leading to a lower grade on an exam or project or for the entire course, or receiving an incomplete or dropping the course completely.

Mental health experts have pointed to a number of factors that may be causing the uptick in mental health issues, with social media use and overprotective parenting high on the list.

“There is a theory that the amount of time students are spending with technology and reduced amount of time with peers hanging out has increased the amount of anxiety they’re experiencing,” said said Elizabeth J. Cracco, the director of counseling and mental health services at the University of Connecticut. Social anxiety is the top type of anxiety that UConn students report.

“Social media has become another way of being excluded,” said Peter Chlebogiannis, a student at Quinnipiac, who formed a National Alliance of Mental Illness club on campus. “Students struggle because they feel socially obligated to go out and post pictures of themselves on Instagram, and that pressure can be intense.

Experts are also finding that in general students are less resilient than past generations. They are less able to cope with disappointments, manage stressors like the workload, or cope with change. Compounding that problem are the increasing academic pressures.
“There’s a lot of pressure at the university level to perform at their best, to compete in an environment where so many other kids are perceived as being smarter or having greater opportunities than them,” said Marc Brackett, director of the Yale Center for Emotional Intelligence. “The juxtaposition of the pressure to succeed, which seems to be greater and greater, coupled with being socially isolated because of technology, is hurting students.”

For the students who do seek help, many colleges do not have enough resources to handle the caseload. About 42 percent of college counseling center directors say they increased the number of full-time staff between 2015 and 2016. Still many centers don’t offer psychiatric services on campus. According to the survey, only 64 percent said they did, up from 55 percent the year before. The majority of directors said their number of psychiatric hours available for students did not meet the needs of students.
“We’re always able to address emergencies, but sometimes that could cause wait lists for non-emergencies,” says Quinnipiac’s Patton. Wait time could be up to two weeks.