More than one in 10 students sought counseling at college and university counseling centers in the 2008–09 school year, the highest proportion ever found in a long-running survey. Even more disturbing are center directors’ reports that students are showing more serious psychological problems, including severe depression, anxiety and suicidal ideation.

The results come from the 2009 National Survey of Counseling Center Directors. Last year’s survey queried 302 counseling centers at institutions representing 2.6 million undergraduate and graduate students.

One possible reason for the increase is the growing number of students who, before the widespread prescribing of psychiatric medications, wouldn’t have been able to attend college, says survey director Robert Gallagher, PhD, of the University of Pittsburgh.

“It’s a good news story in one sense because a lot of students come now who couldn’t come in the past,” he says. “At the same time, a lot of students either go off their medications or the medications don’t [continue to] work.”

Other directors tie the increase in counseling demands to the easing of the stigma for seeking therapy, the exposure to drugs, alcohol and sex at younger ages before teens can psychologically handle the problems associated with sex and substance use, and, paradoxically for some students, overprotective parents who sheltered them from life’s stresses, Gallagher says.

The survey also found that:

  • About 48 percent of students seen in campus counseling centers have severe psychological problems, a slight drop from last year’s 49 percent. Almost 56 percent of center directors reported that over the past five years, they’ve seen an increase in self-hurting behaviors, such as cutting or hair pulling to reduce anxiety.

  • More than 100 student suicides were reported in the survey, and only 19 percent of these students had been seen in counseling centers.

APA’s Education Government Relations Office has advocated for the creation and continuation of federal programs designed to meet the mental and behavioral health needs of college students, through the Garrett Lee Smith Memorial Act Campus Suicide Prevention program, and the Mental Health on Campus Improvement Act.

Center directors say they are responding to the increase in severe psychological problems and heavier demand for counseling by training faculty and resident advisers to spot students in trouble and make early referrals by schooling counselors to conduct brief psychotherapy and by adding staff. Directors are also holding depression screening days and last year referred 2,400 students for follow-up counseling.

Overall, directors reported that they’d like to do more outreach and workshops, but the needs of individual clients have them running from one serious case to another, keeping them fully occupied and too often, overextended.

“It used to take until the beginning of October before counseling schedules were full, now they’re filled the first week of the season,” Gallagher says.

—C. Munsey