The Campus Crisis
By PsychologyToday.com; Last Reviewed: 16 Jun 2005
By Hara Estroff Marano
The severity of mental health problems on college campuses has been rising dramatically since 1988—one year into the Prozac era. But it has also been a time of other major shifts, in the culture at large and the character of colleges.
Everyone, for example, has had to adapt to incessant technological change. And there’s the economy, stupid: job outsourcing is so real a pressure that students hyperventilate at the mere thought of having to commit to a major lest their chosen field evaporate before their diplomas are dry. Also, diversity makes special demands on students’ social skills just when no one is at home to teach them to the children anymore.
Small wonder, then, that young ones are showing signs of psychological distress. But are college students today fundamentally different from college students of other times? Experts point to many reasons why today’s kids are besieging campus-counselling centers.
• Adolescence begins earlier and lasts longer. Kids live in a far more complex world than their parents did and they are exposed to a lot of stuff before they have the cognitive and emotional faculties to deal with it. For example, they no longer have to discover their sexuality; it’s thrown at them from the time they can sit in front of a television screen or pass a billboard while safely strapped into the family car.
• Kids are growing up unbuffered from stress. They live in fractured families, leading to greater instability in their psychological lives. It’s hard to focus and to define yourself if the ground is always shifting beneath your feet.
• Psychopathology is showing its true face. Colleges are seeing the natural prevalence of mental health disorders, for most of which the peak age of onset is late adolescence. The average age of onset of bipolar disorder, for example, is now 19, down from 32 a generation ago. Serious mental health conditions have been there all along. But a generation ago, affected students were seldom diagnosed and treated—because viable treatments were not available—and didn’t make it to college. If they did they either dropped out or hid themselves.
• The Prozac payoff is still high. Many more students than ever arrive on campus with significant mental health problems. That’s in fact good news. "They are living up to their potential because of treatments that weren’t available a generation ago," says Hyman. The advent of relatively safe and effective antidepressants has encouraged early diagnosis and care, enabling students to stay in the academic system and function well enough to handle the tasks of higher education.
• College also stimulates the Prozac rebellion. Of course, late adolescence being what it is, and college not being home, there are those students undergoing treatment for a condition who deliberately go off their meds. Some do it to engage in drinking. But many erroneously believe that now that they are out of the house, where problems first arose, their troubles should be over. It may take a while, but they eventually start slipping back into symptoms.
• College creates and exposes vulnerability. "The level of stress on campus is so high now that it brings out anxiety and depression," reports Linda K. Hellmich, Ph.D., associate director of counselling at Minnesota’s 1,800-student Carleton College. "The worst offender is poor sleep hygiene. There is a climate of sleep deprivation; students think they can pull several all-nighters without psychological consequence." Students at the elite liberal arts college "don’t compete for grades," she reports, "they compete over who is more stressed out. It’s a badge of honor to say you’ve been up for several days straight."
• The high cost of college is a major stressor. It’s caused parents and students to focus on elite colleges and the whole admission process with unprecedented seriousness and competitiveness from an early age. You’ve heard all the jokes about parents pushing their kids to get into the right kindergarten so they’re on track for success. But mounting pressure on achievement can also be viewed as a reaction to real-world stresses—an attempt to see that the children have choices as job markets shift and evolve.
• There have always been troubled students on campus. It’s just that in previous generations disappeared from campus. Today, with the cost of college so high, schools can’t afford to sacrifice a tuition-generating space. And parents have too much of an investment at stake. They don’t want their children taking time off to get stabilized first.
• Diversity exposes a lack of social skills. The increasing diversity of college populations puts a burden on students that many are not prepared for. Yes, it’s exciting to encounter people from all different cultures, says Christine Mullis, a recent Duke graduate. "But it puts more stress on negotiating differences. Different groups of students bring different ideas of how to make relationships work." As a result, there is a widespread failure of relationships—between the sexes, the races, ethnic groups—that is a big contributor to unhappiness on campus.
• Decision-making skills are nil. Mullis sees "lots of kids who are unhappy because they are making bad decisions. One girl, for example, was miserable because she was sleeping with 40 different guys a month. Then she goes to her parents, says she’s depressed and winds up getting medication for her unhappiness without learning how to make better decisions." College does not provide close-enough models of successful adult behaviour, Mullis adds. Nor is campus peer culture a help; it’s just too competitive. She says students even compete over their eating disorders. She considers eating disorders a "huge problem that is impossible to eradicate because they are a way for people to impose control in an out-of-control environment."
• There are few cultural outlets for anger and anxiety. A generation ago there were huge movements of social change students could throw themselves into. Today students are more inward-focused. The self is seen as the primary arena for action. Says Virginia’s Federman, "that leads to things like self-cutting as a form of protest."
• Build it and they will come. Sophisticated services are attractive. "Once in college, people recognize that treatments are available," says Hyman. "And there is a whole new generation that is not averse to psychotherapy." The diminishing stigma of mental health problems makes it more socially acceptable to disclose and seek treatment—an attitude today’s students will hopefully carry into their post-college life.
• It’s the last best chance of whole-person care. An ailing health care system has displaced the burden of mental health care onto colleges. In many schools, physical and mental health care are carefully integrated. Morton M. Silverman, M.D., associate professor of psychiatry at the University of Chicago and director of the National Suicide Prevention Center, sees that as part of the attractiveness of student health centers. "Compared to the real world, college offers more comprehensive health care," says Silverman, formerly head of counseling at Chicago. "Chances are students will not get the same level of care after they graduate."