Tuesday, December 21, 2010

College Students and Mental Health

A story in the New York Times this week highlighted the fact that many students on campus are seeking mental health services and sometimes overwhelming the system.  This article touched on some of the reasons that colleges seem to dealing with a great deal of psychological and psychiatric issues in addition to the usual mono, strep throat and exhaustion that are the more mundane problems they see.

Just a year ago the Journal of Adolescent Health published a review article of the research to date about this very subject.  Some interesting findings include:

  • 17% of students in a national survey of 26 colleges and universities (the Healthy Minds Study) met the screening criteria for depression.
  • increases in help-seeking behavior (rather than increases in mental illness) contribute to the perceived rise in mental health problems among college students 
  • there is an increase in severity of problems presenting to student health services.  The researchers attribute this to the fact that more students with more severe (and often previously diagnosed and treated) mental health problems are applying to, being accepted at and matriculating in colleges.  Increased access during adolescence and improved outcomes with current medications make it more likely that students will be able to function.
  • In spite of this studies show a high prevalence of untreated mental illness.  Only 24% of those diagnosed with depression were receiving treatment. 
  • financial constraints are rarely a barrier to care for college students since at least the first encounters are covered by student health insurance.
  • Improved faculty, staff and student training will be necessary to steer suffering students toward help and prevent tragedies.
Sometimes, student health and the resources they bring to bear at college are not enough. Many young adult patients come home each year and need to re-group, find treatment, start medication, gain weight or simply make a new start.   In New York City, Columbia Presbyterian has an excellent program for college students who have been asked to take or have decided to take a medical/psychiatric leave.  Called the Columbia College Student program it is group based and problem oriented, allowing like minded students to have a place where they can learn new skills and support each other during their transition back to health.

Colleges are in a uniquely effective position to detect, diagnose, treat, and refer students for treatment of mental health disorders, many of which emerge during exactly these years of late adolescence.  Although there is much work to be done, many innovative programs and initiatives are being studied in hopes of creating a better safety net.

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