Illustration by Tim Cook
Just as leaves begin falling from the trees, a fresh crop of students arrives on college campuses. Along with excitement and anticipation — and lots of stuff for their dorm rooms — they bring with them questions relating to their new lives: What if I don’t like the food? What happens if my roommate is a jerk? Will my professors be nice?
Here’s another question that both students and parents should ask: What support for mental health does the college provide?
A Growing Need
The Center for Collegiate Mental Health, located at The Pennsylvania State University, works with more than 700 college and university counseling centers and supportive organizations to provide accurate information about the mental health of college students across the nation. CCMH has found that between fall 2009 and spring 2015, visits to college counseling centers increased 30% to 40%. Additionally, from 2012 to 2019, student self-reported anxiety and depression had been rising steadily.
Then came the pandemic.
Data gathered by CCMH during the fall semesters of 2020 and 2021 shows increases in virtually every category the organization tracks: depression, generalized anxiety, academic distress, eating issues, family distress and overall distress. Social anxiety rates dipped in fall 2020 — perhaps because many students were not attending classes or were doing so from home — only to increase in fall 2021.
This spring, Fortune magazine commissioned a Harris poll to compare the mental health of college students with postgraduate adults. The survey showed students had nearly double the rates of elevated stress and anxiety as those over the age of 25, as well as significantly more depression, a decline in overall mental health, and a higher number of suicidal thoughts or ideations.
A study focusing on Generation Z from the Walton Family Foundation and Murmuration, released in June, showed that teens and young adults ages 15-25 are nearly twice as likely to face depression and feelings of hopelessness when compared to older individuals.
Finding Help
Dr. Jihad Aziz, executive director of university counseling at Virginia Commonwealth University, says more students are asking about mental health services when they come to campus for orientation.
“We like to get them connected early,” he says. “Some may think, ‘I don’t need therapy anymore,’ but then they realize later they might need some support.”
VCU has 17 full-time counselors, as well as interns in both counseling and social work, plus postdoctoral fellows. Services include individual therapy sessions and group sessions, and students may schedule 50-minute appointments at the campus Resilience Lab to develop strategies for finding specific ways to manage their stressors.
To provide additional services to its more than 28,000 enrolled students, VCU, along with Virginia Tech and James Madison University, recently partnered with telehealth provider TimelyMD, one of several businesses that offer online treatment options. Offering online appointments increases the number of therapists available to students.
Students can select from a range of virtual care options from licensed counselors and mental health providers. Twelve scheduled counseling visits are available at no cost for each student throughout the year, and TimelyMD provides a 24/7 TalkNow service for students who need to speak with someone immediately.
At Randolph-Macon College, which has approximately 1,500 undergraduate students, the counseling staff includes three full-time counselors, one of whom is always available for after-hours emergencies. Like VCU, R-MC also has a telehealth partner, Uwill, which offers 24/7 telephone support, as well as individual counseling.
“We have a very extensive emergency management team,” says Dr. Grant Azdell, R-MC’s dean of students.
Azdell says R-MC saw a marked increase in the number of students seeking assistance during the pandemic. “For the first time in my 13 years on campus, there was a waiting list [for counseling visits],” he says. “That’s what prompted us to look at online consultations. With Uwill, the waiting list went away immediately.”
R-MC also has trained student “wellness advisors,” who work with a member of the counseling staff to create programs for students and make mental health an easy topic to discuss. “We try to normalize that process of seeking help,” Azdell says.
At Virginia Union University, telehealth and in-person counseling is available through the school’s partnership with the Capital Area Health Network, which operates a clinic on the historically Black college’s campus. Additionally, VUU has a PantherSafe app that students can download to their phones for 24/7 support.
“Any time a student comes in for physical services, they can be referred to a network of therapists,” says Dr. Deborah Martin, VUU’s dean of students, adding that the school, which is affiliated with American Baptist Churches USA, also offers pastoral counseling through the campus ministry office. “A lot of students find that to be equally helpful,” she says.
Martin notes that because of VUU’s small size — roughly 1,200 undergraduates — the “circle of support” is different.
“People know your name [here],” she says. “If a professor doesn’t see you in class for a few days, they’re going to reach out. I get emails all the time. Everybody feels they are responsible and involved.”
The Whole Student
R-MC’s Azdell says students and parents need to think about how best to use all the services available on campus. Some schools place counseling services within the student health department, while others have separate counseling offices. HIPAA releases signed for parent access to medical information do not apply to psychotherapy notes.
“Unless I have a written release from a student, I don’t discuss that [the student] is even within counseling,” Azdell says. “If there’s an emergency situation where a student discloses potential for harm to self or others, and I have to involve law enforcement or an outside agency, I call the parent, and I tell the student I need to involve their parents.”
R-MC doesn’t impose a limit on the number of counseling sessions a student may attend. This releases students from feeling as though they have to use a set number of meetings.
“The meter’s not ticking, so they self-regulate,” Azdell says. “They can walk away and reengage the relationship down the road when they need to. That’s something really helpful to learn as young adults.”
VCU’s Aziz says families should look for ways in which students are supported on campus beyond counseling services.
“What’s happening in classrooms, in organizations? What are the cultural things in place to support well-being?” he asks. “We have to make this holistic.”
At VCU, Aziz says, most professors will include information in their course syllabi about where students can go for support. Resident advisors, who live in the dorms, also receive training, as do peer educators through the recreation and well-being department, known as RecWell.
“Students listen to other students, but the reality is that well-being is a university responsibility,” Aziz notes. “Students are bombarded with social media and lots of information. There’s so much information about so much tragedy. It used to be that when you went to college, you got away from that, but we’re so connected [through technology] that we can’t get away.”
VUU’s Martin says colleges must find ways to adapt to meet students where they are now.
“For most freshmen, their high school journey was in a pandemic,” she says. “Part of our responsibility is to teach them what they may have not gotten in high school, like social skills. And we realize that learners are different, so we hope to provide various platforms for everybody to participate.”
VUU uses surveys to gauge the needs of students, Martin says, adding that she tries to keep her “ear to the ground” through conversations with professors and students so she can get a feel for the campus mood.
“Temperature checks can be very difficult,” she notes, “but I think we do a pretty decent job trying to measure the needs of our students.”
Martin says one good outcome of the pandemic is an openness around mental health, noting that students appear more willing to seek out services.
“Sometimes, [discussing] mental health can be taboo in the Black community, and we see so many examples of situations where lives are lost or people don’t see the signs that someone is experiencing a mental health episode or issue,” she says. “I think we’re seeing a shift in how people are viewing mental health. That is healthy.
“This generation is a different generation,” she adds. “They are very independent. They have a voice, and they’re not afraid of using their voice. They’re not afraid to do what they want to do.”
VCU’s Aziz agrees that the stigma once attached to therapy seems to have decreased, and having more options makes it possible for students to find the help they need in ways that make sense to them. He says affinity offices on campus — for multicultural, international and military students — have resources, and students using public bathrooms can see messages about resources on “Stall Street” journals, which are posted on the back of stall doors.
“We try to figure out how to reach people in different ways, to let them know of our services and support,” he says. “We try to be thoughtful about how to connect.”
R-MC’s Azdell says college is a good time for young adults to begin the practice of taking their mental health as seriously as their physical health, noting that regular mental “tuneups” are akin to taking a car in for regular maintenance and service.
Bottom line, he says: “Learning good, healthy behaviors in college is really important for adult life.”
