Mental health issues in college on the rise

An increasing number of college students are arriving on campus with psychological issues or developing problems once they're in school, psychologist Sharon Kirkland-Gordon, PhD, told participants at APA's 2013 Education Leadership Conference.

And college counseling centers are evolving to meet those changing needs, said Kirkland-Gordon, who directs the University of Maryland's Counseling Center. Counseling centers got their start in the mid-1940s, with faculty advising students with academic problems, she said. The movement took off after World War II, with centers providing educational and vocational counseling to the influx of veterans arriving on campus. Centers then added personal counseling to the services offered and began to see increasingly complex cases.

"The good news? Students are coming in, they're bringing other students in and faculty and staff are walking students over to the center," said Kirkland-Gordon. "The bad news? It's hard to keep up with the numbers of students coming in." The result is long waiting lists and referrals to community providers, she said.

Several best practices could help solve the problem, said Kirkland-Gordon. Because more students are arriving at college already on medications, mental health prevention and intervention efforts need to start in high school, for example. She also recommended that centers hire more staff to handle increased demand, train faculty and staff how to recognize students in distress and what to do, enlist student groups to help with social media campaigns, create wellness and coping programs and establish medical leave policies that include mental health.

Some students are more vulnerable than others, such as veterans, active duty military members and members of the National Guard and reserves, said psychologist Paula Domenici, PhD. Domenici directs civilian training programs at the Center for Deployment Psychology, which was established through advocacy efforts by APA's Education Directorate.

As soldiers come home from Iraq and Afghanistan, the number of student veterans on campuses will continue to grow, said Domenici. And those students may be at elevated risk of suicide, she warned.

It's not just physical and psychological injuries that explain this heightened risk, said Domenici, explaining that student veterans may also suffer from "moral injuries" in which their moral codes or ethical values have been transgressed. Add to that academic and social issues, such as being unable to relate to the content of English 101 after returning from a combat zone or being a 24-year-old Marine with three tours of duty assigned to a residence hall full of 18-year-olds, she said. On top of that, there's a stigma against seeking help in the military. Plus, she said, those who have been in the military are familiar with weapons and may have lower fear of pain and death than their non-military counterparts.

"We need to be vigilant about this special niche of students on our campuses," said Domenici. "They deserve our providing them with services that fit their unique needs."

This is just the kind of information university administrators need to hear, said Louise A. Douce, PhD, special assistant to the vice president of student life at the Ohio State University.

Psychologists and others should use specific arguments to make the case about why college mental health services are so important, said Douce. For one thing, institutions' images suffer when there's a student suicide or violent event. More important, addressing mental health needs produces a very high return on investment, she said.

"There's very good literature that suggests that seeing someone in a counseling center affects retention," she said. "You can make the case that the less energy you have to spend on feeling safe or being healthy, the more you have for the academic mission."

Bringing attention to such arguments is the purpose of a new partnership among APA, Student Affairs Administrators in Higher Education (NASPA) and the American Council on Education.

As part of the White House's national conversation on mental health, the three partners are now collaborating on a report that will give college and university presidents as well as the president and his cabinet ideas about how best to respond to the growing mental health needs of college students, said Brian Sponsler, EdD, NASPA's vice president for research and policy. The partners plan to complete the report by March.

"We're trying to elevate the good work that's happening," Sponsler said.

— Rebecca A. Clay