Cover Story

In recent years, a string of tragedies has shone the spotlight on the mental health of students on campus: a murder-suicide at Harvard, the death of an MIT freshman from alcohol poisoning, six student suicides within three months at Michigan State University.

But those are only the high-profile incidents. At campuses across the country, more undergraduate and graduate students are reporting depression, substance abuse, eating disorders, learning disabilities and, most commonly, problems adapting to college life.

"Our counseling center has treated 13 percent of the student population this year--more students in one year than ever in our history," reports Colgate University Counseling Center Director Mark Thompson, PhD, adding that centers around the country are also witnessing "an increase in clinical demand."

No one knows for sure whether that upsurge is due to more mental health problems among today's students or whether today's students are more likely to seek psychological services because there is less stigma associated with mental illness. Experts say it could be a combination of both.

But the good news is that campuses are increasingly recognizing that mental health is a critical factor in students' academic success, giving it attention psychologists only dreamed about a generation ago. More schools are beefing up their counseling centers and emphasizing mental health through innovative programs aimed at helping students before serious problems emerge.

Though the system is far from perfect--the demand still exceeds the amount of services available and some campuses don't have the resources to do more--faculty agree that academe has come a long way in preventing and treating student mental health problems.

"It's impossible to find and meet every need," says Mark Reed, MD, head of Dartmouth College's counseling center. "But there are good things happening in campuses nationwide."

It takes a campus

New data document the growth of campus counseling centers. According to the National Survey of Counseling Center Directors, 21.1 percent of centers gained new counselors since 1996, while only 8.1 percent lost staff members. (The increase in college enrollment increased 11 percent in that same period.)

Many centers say they are hard-pressed to meet the mental health needs of their entire student population. Indeed, 62.7 percent of counseling center directors in the national survey report concern about the growing demand for services when their resources are not increasing.

But meeting the mental health needs of a campus is not as simple as hiring more counseling staff. More campus administrators now understand that all of a school's mental health issues cannot fall solely on counseling centers' shoulders.

"It's got to be a collaborative effort," says Martha Christiansen, PhD, counseling center director at Arizona State University. Like at many schools, the university's counseling center works with university administrators, faculty, student-life offices and residential life offices. "For the most part, it works well," she says.

Such collaborations are resulting in better outreach to students. Some of the more innovative programs include:

  • Offering a "De-Stress Fest." Every semester, Metro State College of Denver offers "The De-Stress Fest," a day where the student lounge is transformed into a haven for unwinding and learning self-care. "Together with the student health center, we invite massage therapists, aromatherapists, acupuncturists, biofeedback technicians, nutritionists, touch therapists and Tai Chi specialists who provide nontraditional techniques of stress reduction," says Gail Bruce-Sanford, PhD, director of the school's counseling center.

The center also sets up a "relaxation booth" where students sit in comfortable chairs and listen to soothing music. "Hundreds of students attend," says Bruce-Sanford. "We utilize this opportunity to present information on the array of services we (offer) on a variety of mental health topics such depression, anxiety, stress management and single parenting."

  • Rewarding good ideas. At Harvard, the administration boosted student involvement by offering a $1,500 prize to students who had the best ideas to increase awareness of mental health issues on campus. Three awards were granted: one plan sought to improve Web-based mental health information, another called for a public education campaign and the third asked for resources in each dorm to educate students on a range of issues, from rape prevention to CPR classes.

  • Staving off mental health problems among students with disabilities. With a significant portion of counseling centers reporting an increase of students with diagnosed learning disabilities and mental illness, part of the counseling center's mission is to ensure these students aren't unduly penalized. At Dartmouth, the school's counseling center works closely with the Disabilities Office to meet the needs of students with learning disabilities.

"Over the past five years, I have noticed more students taking more time on exams if they have depression, or taking a reduced course load with a financial break if their treatment requires a great time commitment," says Mark Reed of Dartmouth's counseling center.

Last spring, Reed and college counselors from all over New England organized a conference about assisting students with mental health problems and making sure they get the most out of their college experience. The students who attended spoke about the initial shame of registering with a disability, but then being glad to have taken advantage of the extra resources that were once only available to those with physical illnesses.

  • Finding the students where they live.The nine psychologists at the Boston University (BU) Counseling Center routinely deliver presentations in dorms on how to help friends with problems. Often they find that students who attend these sessions later seek help for themselves. They also train student resident advisers in all topics, from spotting signs of depression and suicidal tendencies to helping victims of sexual assault and approaching someone with an eating disorder.

  • Wooing students with an MTV-style approach. Also at BU, during summer orientation, freshman students view an attention-grabbing, multimedia presentation with music and images about the issues they may encounter in college--from disagreements with roommates to identity crises--and how the Counseling Center can help. "To engage the generation grown up on MTV, we tailor it to them," explains Leah Fygetakis, PhD, director of the BU Counseling Center.

  • Partnering with student groups. At Colgate, the counseling center is working to reduce incidents of sexual assault and stalking by joining forces with a student group called "The Sexual Crisis Resource Center" to sponsor Sexual Violence Awareness Week. Collaborating with student groups, the center encourages students with relationship or violence issues to make appointments there.

  • Expanding faculty involvement. At Florida Memorial College, Woodrow Wilson, PhD, runs an "Absent Professor Workshop Series." When a faculty member is out, Wilson and his staff members present a topic that's relevant to the class and mental health.

"For example, we talk about 'speech anxiety' in a communication class," he explains. "We also take time to talk about counseling and the stigma associated with receiving help, give examples of how a few problems would be treated and pass out business cards and brochures."

Wilson believes the program helps students connect with counseling center staff, which in turn reduces the stigma of making an appointment. "On average, a presentation to a class of about 25 students will result in about three coming in for services at the counseling center," he says.

Helping students find themselves

Regardless of the approach to reaching students, counseling center staff, students and faculty alike are continuing their push for expanded and improved mental health services on campus, and counseling is becoming a more valued service on campus.

"No matter what the concern or disorder, recovery is about developing a sense of self," says Charles Ducey, PhD, director of Harvard's Bureau of Study Counsel. "This is the great thing counseling does--it helps a student find him- or herself as an individual, separate from family demands, peer pressures or internalized critical voices or expectations that don't fit the reality of students' feelings, ideals and talents."