Beyond Stress: College students increasingly seek on-campus counseling
August 17, 2004
Young and bubbly, Jessica Parker, 26, easily fits in with other dorm students at Nova Southeastern University in Davie. The only difference is that, in addition to living there, she also carries a crisis cell phone and keeps office hours.
Parker, who is studying for her doctorate in clinical psychology at Nova, is a counselor in residence, a year-old position at Nova created to reach out to the increasing number of students who need mental health counseling.
"I see students for everything -- stress, time management and study skills all the way up to suicide, depression and schizophrenia," Parker says. "I'm on call all the time, 365 days a year. It's taxing, but it's very, very needed. You'd be amazed. There's such an increase in students seeking out services, especially those on psychotropic medication."
Colleges in South Florida and around the nation are reporting increasing numbers of students seeking counseling for psychological problems. One in 10 college students has been diagnosed with some type of mental illness, according to the American College Health Association. The group recently reported that an estimated 38 percent of college students say they have trouble functioning because of severe depression. That's much higher than the 10 percent of adult Americans with a depressive disorder, according to the National Institute of Mental Health.
The emotional health problems of today's college students can be severe and complex. A study of 13,000 college students seeking psychological counsel at Kansas State University between 1989 and 2001 found that the percentage of suicidal students had doubled in that time, as did the number of students taking psychiatric medication. Other problems included stress, anxiety, learning disabilities, family issues, grief and sexual assault.
Social and clinical psychologists debate the reasons for the high demand for counseling. One theory is that a better arsenal of medicines, earlier diagnosis and a lessening of the mental illness stigma make more students willing to seek treatment. Another is the increased awareness of mental health issues and improved treatment options. Many students are already on psychotropic drugs when they enroll in college. There's also the reality that the college years coincide with the onset of many mental disorders, including depression, bipolar disorder and schizophrenia.
Family issues can play a big part, too. The high divorce rate and shrinking size of the American family create stressors that didn't exist for many college kids 10 or 20 years ago.
"There's a lot of pressure when you're the only child or there are only two kids in the family," says Malcolm Kahn, a clinical psychologist who directs the University of Miami's counseling center, which saw the number of students seeking help more than double between 1990 and 2002, from 467 to 964 students.
UM's center has five psychologists, one full-time counselor, a part-time social worker, two consulting psychiatrists and three interns working on their doctorates who meet with students.
"Kids come to college with a lot of parental expectations on their shoulders," Kahn says. "Even the fact that many of these students have never had to share a room before becomes an issue."
Regardless of the theories, the bottom line is this: Many parents may fondly remember college as a good time, but for today's students it can be a period of confusion and pain. The difference is that now one can easily find help on campus.
"What gets them in the door is that the problems start to impact their grades," says Cheryl Nowell, director of counseling and psychological services at Florida International University, which has a center on each of its two Miami-Dade County campuses and experiences a 10 percent to 15 percent increase in clients every year.
"Relationship problems are very big, so are depression and anxiety," Nowell says. "Usually it's a combination. Maybe they're having difficulty with a relationship and they're starting to feel depressed or they have academic problems and they're stressed out. We primarily have commuter students and many of them work. They get overloaded."
As the bulk of students head back to school late this month, colleges are bracing for even more increasing demands from a freshman class fresh with mental health needs.
"Anxiety is a big problem among our students, so is depression and adjustment disorders related to leaving home and making transitions," says Roxanne Bamond, assistant director of student counseling at Nova. "Students need to give themselves time to adjust. People who move down, leave home and start college think they shouldn't be grieving or crying because they've been looking forward to this for four years. They have to be patient with themselves and reach out."
A student counseling center manned by at least one full-time psychologist has become as common today on college campuses as a student health center or a career guidance office. Schools typically offer 10 to 15 one-on-one counseling sessions for free, but may increase the number if a student seems particularly needy.
A small but growing number of colleges have 24-hour mental health hotlines. Many are developing forgiveness policies that make it easier for students who take a semester off for mental health reasons to return without re-applying.
The variety of services keeps growing each year with student demand. A sampling:
[*]At FIU, one of the most popular services is counseling for couples. Students also can attend workshops on conflict resolution and anger management, or take an online test on the school's website to see if they might be suffering from depression. The school's two centers also test for learning disabilities.
[*]At UM, about eight different group counseling sessions meet each year to discuss family conflict, sexual identity and body image, among other issues. A part-time psychologist is available to counsel students suffering from binge drinking and other substance abuse problems. During student orientation week, there are even group sessions for parents having separation anxiety.
[*]Therapy groups at the University of Florida cover such topics as eating disorders, trauma recovery, relationships and stress management. Lunch sessions, with free food from Subway, are held for groups of 20 throughout the school year on issues that affect specific groups, such as lesbian-gay-transgender students, international students and women of color.
A Counselor Among Us
Some counseling centers help train residence assistants, or RAs, the older students who live in dorms and offer advice and supervision to undergraduates. But Nova Southeastern is the only South Florida school with a mental health counselor living among students. Nova counselors feel a dorm-based counselor makes it easier for students to seek help.
"There is still a stigma attached to going to counseling," says Parker, the live-in counselor.
"Part of what I try to do is help students recognize that counselors are not perfect people who sit around to judge you," Parker says. 'I live with them, eat in the cafeteria with them. I'm an adjunct professor and they see me in the library studying. I'm not much older than they are. They see me as a typical person who is friendly; it's not like going to see a therapist. They look at me and think, `She seems nice. My friend says she can help. Let me go see her.' "
At FIU, where 11 psychologists and one clinical social worker staff the counseling centers, Nowell, the director, says the stigma of seeking counseling is "fading, but it's still there."
"It's something we continually struggle with and fight against," Nowell says. "That's why we try to do a lot of intervention and workshops where we go into classrooms and talk to student organizations."
Some therapists think more students are seeking help on campus because stronger psychotropic drugs are enabling people to attend college who could not have done so before. As a result, more and more schools are dispensing medications. On one FIU campus, a pharmacy and a student counseling center share the same building .
"More people are taking psychiatric medications at very early ages and they come to college, says Kahn at UM, which doesn't dispense medication unless a student is in counseling. "Research shows that the best form of treatment for depression is psychotherapy and a combination of anti-depressant medication."
Jamie Funderburk, a licensed psychologist at UF's counseling center, considers it a positive sign that more medicated students are making it to college.
"There wasn't awareness before for them to get help so now it means more access to college for more people," Funderburk says. "It might have been really hard to get there before if you had multiple stressors going on in your life. Now we're more representative of the general population. They're coming to college and making it more diverse, even if it does present more of a challenge."