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. Enrolling in college courses means entering a time of heavy transition and change. The majority of college students actively enrolled in courses range from ages 18-24, and there are also many adult students who choose to participate in later years.

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 expanding our social circle. Adult students may also encounter these challenges while juggling the demands of work and family, while younger classmates may not.

Completing schoolwork, discovering ourselves, managing sexual health with raging hormones, and creating structure in our lives become everyday challenges (Pedrelli et.al., 2015). Navigating these decisions all at once creates stress and tests our ability to cope with a seemingly unending trail of pressure. This is overwhelming and thus forces us to activate our learned coping mechanisms to process feelings and results in action. When we don't have healthy outlets coupled with a lack of access to mental health services, we find ourselves in a perfect storm of risky behavior.

Binge drinking and engaging in sexual behavior may temporarily relieve stress and also have a strong possibility of leading to sexual assaults. Surviving a sexual assault and facing all the typical daily stress puts even more pressure on students, and they may develop eating disorders by undereating or overeating, engaging in drug use, or self-harming. These are just a few of the unhealthy coping mechanisms we participate in, and it is at an all-time high.

Alcohol consumption is on the rise, and close to one-fifth of college students exhibit behaviors of an alcohol use disorder (AUD). An alcohol use disorder recognized as binge drinking is defined as 4 drinks for women and 5 drinks for men in the time of 2 hours. With so many drinks in so little time, one of the deadliest statistics recorded is the leading cause of death among college students is motor vehicle accidents by intoxicated drivers. The availability of alcohol surpasses access to mental health services on many campuses.

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, and we have the ability to stop it in its tracks. Free and unlimited access to mental health services has the potential to stop the 2-3 daily college students who die by suicide (Shrinking it Down, 2017), and that number is higher for young adults who identify as LGBTQIA+. This has the potential to shift our community with dramatic results.

With the assistance of mental health professionals, students can better understand their disorders and more effectively process their daily stress. We've all been in a position where we need help sorting out what is right in front of us and guidance to navigate 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 can be the missing puzzle pieces in a student's life. It is estimated that 75% of us ultimately identifying with a mental health disorder will have our first onset by age 25, and most of us will not receive an intervention, diagnosis, or proper treatment. This creates exponential complications for them, and other members of the community. Mental health counseling explores the causes and management of these conditions and introduces the use of healthy coping mechanisms, which prevent risky and dangerous 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 actions of those around us become something we all have to manage. Whether it's recovering from an assault, grieving a loved one, or caring for a family member who is struggling with addiction, it affects the entire community in one way or another. Turning this around and offering free and unlimited mental health can offer students the ability to create a future like no other. Imagine what kind of wonderful transformation healthy and confident young adults could offer our workforce and our community.

Let’s look at some common unhealthy coping mechanisms and how they translate to real-world examples. Getting a bad grade, a family argument, or dealing with a breakup leads to seeking emotional relief. Maybe we decide to numb with alcohol and we are sexually assaulted. Survivor an assault needs healing from the trauma, and maybe it leads to an unplanned pregnancy or contracting an STI or STD. Any of the events alone changes our path drastically any combination could result in dropping out. 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 lives.

Surviving and managing PTSD symptoms or grieving a loved one requires active coping. If we haven't learned them, we can use them, and the support of a mental health professional expedites this process. Once we gain the tools, we have a much greater chance of managing healthy relationships, making better choices when dealing with depression, and recognizing burnout.

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. Although it may seem like alternate programs will slowly decrease as therapy offers irreplaceable healing and shifts 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 that 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.
• Under the Affordable Care Act and the Mental Health Parity and Addiction Equity Act of 2008, large-group and individual health plans are required to cover mental health as a benefit. This makes colleges that require students to pay for mental health treatment more financially accessible.

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 small changes that lead to big results.

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. An added bonus of offering internships to social work students is we have a much easier time connecting with a peer 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 strengthening and maintaining mental health, not a weakness. Just as our bodies need nutrition and exercise to maintain health, our mind needs support and flexibility 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/