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Thursday, November 20, 2014

Mental Health on Campus


There have been a lot of conversations lately on my campus and others about mental health.  And to be perfectly honest?  I'm concerned.

We've seen some pretty awful things happen on college campuses recently.  The shootings at FSU and in Santa Barbara.  The man who opened fire with a handgun in a building at Seattle Pacific University, killing one and injuring two others. These events, and the stories of students who have harmed themselves instead of harming others, demand both that we rethink the role of the campus in cultivating and supporting mental health and well-being, but that we also take seriously our own limitations in doing so.

Walking the fine line between caring for students and appearing punitive is complicated, though.

On the one hand, we need to take care of students for whom college triggers or exacerbates mental illness.  We know that the instances of depression and anxiety among college students are higher than ever.  According to the American College Health Association's 2013 national survey, over 30 percent of college students reported feeling "so depressed that it was difficult to function" at some time over the past year. Over 50 percent felt "overwhelming anxiety."  Eighty-four percent felt "overwhelmed by all they had to do."  And yet only 10 percent were diagnosed with/treated for depression, and 15 percent diagnosed with/treated for anxiety. A 2011 National Alliance on Mental Illness study of college students diagnosed with mental health conditions found that more than half of the students with mental health conditions who dropped out of school didn't access campus-based support services.  We need to make it acceptable to seek help for mental illness (at all stages) instead of hiding because they fear being seen as weak or stigmatized, and we need to educate our communities better to recognize the warning signs.  I wish that someone had recognized what was happening with Elliot Rodgers, and done something for him before it was too late for him, and for others.  While the police who did the welfare check on Rodgers certainly missed the boat, so did so many others who had contact with him on a regular basis, who might have been able to catch this before tragedy became the inevitable outcome.

On the other hand, we need to be able to talk openly and honestly about the fact that colleges are not equipped to handle students who require intensive care.  Students where I work have been worried about the fact that the college may ask them to leave if they are a threat to themselves and the community, and they worry that we won't allow them to come back.  Though there have been stories about students being bullied into withdrawing, my experience has been of staff and faculty members looking out for students--we do the best we can with extensions and accommodations first if situations haven't reached a crisis level--and realizing that we are limited in our ability to provide support.  We can't exclude students with any disabilities--mental or otherwise--from pursuing their educations.  But if they are not in a position to balance both treatment (which can be a full time job, and then some) and the rigors of college work, we have to help them to be realistic, and to allow themselves the time and space to be well enough to return and be successful.  Mental health problems also have real ripple effects for the community that need to be considered; if a student is suicidal, and a roommate is (rightfully) concerned, how will that roommate focus on her work?  I worked with a student last semester who was in an intensive outpatient program, and (understandably) fell behind in his classes.  As I arranged extension after extension with his professors, I worried about the additional psychological weight of his accumulating academic responsibilities.  At every point, I tried to keep the door open so that he could leave without being judged.  I let him know that what he was trying to do was challenging, and that his first priority needed to be his own well-being.  In the end, he made it through that semester, but at the expense of the fall; it had been too much.

We also need to rethink the way we cultivate wellness.  I work at a place where the pressure to perform is extreme: our community includes of some of the highest-achieving students from around the country and the world and some of the most well-known scholars in their fields.  Even in co-curricular circles, students take themselves very seriously; many of our athletes and artists and dancers might as well be professionals, and students who arrive with an amateur interest in, say, dance, often have their hopes dashed when they are rejected from some of the prestigious dance companies on campus, which aren't even affiliated with the dance department.  The unfortunate culture of effortless perfection is strong here.  As someone who was pushed from an early age to achieve, and who later pushed herself, listening to the voices in my head that told me I'd never be good enough, I know exactly where these students are coming from.  What I didn't have was the additional pressure of feeling that everyone else around me had it all together, because I went to a large state school.  That came later, perhaps in graduate school, and the effects were very real, even though I had four more years of experience on my side.

Worse, many of them report being socialized to think that being this busy and overcommitted is normal, or even desirable; that they're somehow flawed for not being able to handle it; and that attentiveness to wellness and downtime is an undesirable feature in a successful student/professional/adult.  While some of it is chemical, I think that some of it is also environmental.  The competition and pressure starts early, with our own children, who we know are also--as a generation--overscheduled and overcommitted.  How many of us really opt out?


Students don't want to take time off, but they also don't realize that not taking time off could result in poor grades from not being able to catch up, or worse.  Then, they worry that if they do take time off, that the institution will ask them to offer up some evidence that a treating professional thinks they can come back without being a risk to themselves and others.   If you're already experiencing severe depression and anxiety, it's a lot harder to think this sort of thing through rationally.

I don't think we should encourage our young people to be mediocre.  I think that all students deserve to be challenged to achieve their potential; after all, that's how we get leaders and innovators.  But I think that we need to do a better job of teaching them (and modeling) balance, speaking openly about mental illness, reminding them that no one expects perfection, that we need to judge ourselves by what we learn, not by what we earn.  In the end, no one cares whether you got an A or a B or even a C on your English term paper.  They care that you turn out to be a decent human being who makes a contribution to the world, in whatever way you are called to do, to the best of your ability.

Did you ever take time off in college?  What is your experience of mental illness, or of expectations of perfection, on campus?

4 comments:

  1. I have nothing intelligent to say here. But I am so grateful for this post. Most of my students in one of my courses (writing, of course) has mentioned or written about anxiety and other mental health issues this semester. Not to the point that I'm seriously worried about any of them. But it's something I think about, as the slip between writing and therapy is quick, esp. for those young ones.

    And my own attempt at therapy at 20--for what was probably mild anxiety--failed horribly because she wasn't able to see HOW REAL my worrying about not getting into Harvard/Yale/U Chicago/etc was. A different sort of student, I suppose, than what she was used to dealing with. MOre the sort that you see on a daily basis...

    Anyway. Thank you for this.

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  2. Great post. We started and RESP for our daughter the week after she was born, because it is one of my hopes that she will grow up and have a great post-secondary experience somewhere, as I (mostly) did. This post made me think about what sort of campus I would like her to go to, in an ideal world!

    Assuming the quality of education is sound, I would also look for:

    1) on campus services for mental/physical health
    2) a sense of community where students look out for each other

    Other than that, I wonder if a key to college students' mental health is reminding them that although the college years are important and something that will shape them, they aren't everything. There is a whole world/lifetime of experience waiting for them outside of college.

    For my experience, I definitely had my perfectionist side, and I got very good at being a college student for my first degree. A lot of my life learning however happened when I had to step away from all that in the "real" world. When I went back for 2nd degree, I did have an anxiety episode and was advised to access counselling on campus, which I did, and which was a very good experience. I learned that it was OK to admit that I needed help and that showing vulnerability can be the key to developing strength and resiliency.

    Finally, this quote from your post really says it all:

    "In the end, no one cares whether you got an A or a B or even a C on your English term paper. They care that you turn out to be a decent human being who makes a contribution to the world, in whatever way you are called to do, to the best of your ability."

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  3. I teach at a very different kind of university, but I see the same thing: students that are overwhelmed and completely unable to cope with the (ordinary) challenges that they are experiencing. I don't remember things being like that when I was a student, and it makes me really wonder what is happening in our society. It is also my experience that the school health system is very poorly equipped to deal with serious mental health issues, and that students are very reluctant to leave school to focus on their treatment. At my school, this often results of a whole semester of F's, since the student refuses to withdraw, but cannot finish their work. It is really awful to watch, and I don't know how to help.

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  4. Long time reader, first time commenter.

    Your post is something I've been thinking about a lot with my students. I've worked both a small liberal arts college and now at a small public university (will be teaching at the large main campus this winter). In all cases, I've been very mindful of the mental health of my students as how they are doing is directly correlated with how well they will do with my courses. You bring up a lot of very good points here. The first being that we do need to create a culture where resources are available to students and where both faculty and staff can readily recognize the signs in order to help those who are in trouble. But your other point about how there needs to be recognition that sometimes breaks from projected paths are needed in order to give helps the help they need is equally important (and something most aren't willing to talk about). I had students who are struggling so much and yet would not withdraw even as they were failing every one of their courses. I've had students who were struggling with balancing all their different responsibilities who refused to reassess and drop anything. All because they had it in their heads that by doing anything differently, they would somehow screw up their life plan. It hurts as an educator to be in situations where you feel like the only option is to watch them crash and burn. Yes, we need to accommodate students. But I don't feel there's really a way to also communicate when accommodation isn't working and, thus, the plan in place needs to be modified. Sometimes against the desires of the students.

    Thanks for this post. It's an important one.

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