College students are struggling. Are schools doing enough to help?

I just returned from a law school graduation at the shockingly beautiful Cornell campus. Once known as a pressure cooker, where six students committed suicide in the 2009-2010 academic year, Cornell looks like it is working to prevent more tragedy. Bright, inviting signs for mental health help and non-judgmental support are pasted on bathroom stalls and along the walkways.

As COVID turns the world into a place of greater loss and fear, colleges are facing a mental health crisis. In a February 2021 survey by the American Council on Education, 73% of college presidents identified student mental health as a pressing issue on campus — in many cases, the most pressing issue. Presidents of two-year and public four-year colleges were more likely than their private-school counterparts to voice strong concerns about the psychological and emotional wellbeing of students. 

Troubling as the data is, it comes as no surprise to mental health experts familiar with campus life today. 

“Students are arriving to college campuses with increasingly complex mental health, substance use, financial, and other challenges which may interfere with their academic success and quality of life,” said Dr. Doris Cimini, a psychologist and director of the Center for Behavioral Health Promotion and Applied Research at the State University of New York at Albany School of Education. 

It’s also not surprising to therapists like me who treat teens and young adults in private practice, or to parents like me who have kids in college or recent graduates.

With nearly 20 million young people attending colleges and universities nationwide, these institutions are “important potential ‘safety nets’ to protect young adult mental health,” according a 2021 report by the National Academy of Medicine. Like Cornell, many schools are trying. But efforts are inconsistent. 

One of my children went to a public college that had “wellness” as the theme of the dorms. My other child attended a private Ivy that capped free therapy at five sessions. After that, students were on their own.  

Aside from the alarming mental health trends and two years of disruptions due to COVID, the obvious strain is the inherent vulnerability of this age group. Campus mental health is a critical investment at an urgent time. It’s going to take more than adding a few therapists, or, for that matter, tacking up mental health posters, to provide the support that young people need.

How we got here

In the years leading up to the pandemic, college students were already showing inordinate stress.  

One of my clients left school because of a break-up. Another wanted twice-weekly sessions because she had stopped doing her work or forgotten how to study altogether, and she would lose her scholarship if she dropped a single class. Another client told me she had a nightmare that her entire family was shot to death. Still another had a free dorm room for summer — but no food.

And then there was the Georgetown law student who stepped into my office and asked me to stroke her hair to comfort her. I had never met her before! 

When we left young people who were already under pressure alone in their rooms for two years, what did we think would happen? About 40% of Cornell students reported feeling dysfunctional for a week or more because of depression and anxiety, according to the campus newspaper. 

A one-to-one intervention can be expertly timed, but how do we take care of a whole cohort? It obviously doesn’t help that anxious and depressed students at many colleges now have longer wait times for help.

On the blog of Higher Ed Today, Kate Wolfe-Lyga and Marcus Hotaling outline important policy solutions. These include training all faculty and staff to become suicide-prevention gatekeepers, developing agreements with community-based agencies to supplement services provided by campus counseling centers, creating a guide that directs students to supportive resources, and including a crisis contact on student ID cards. These last two ideas are so straightforward, it’s hard to believe they’re not standard. 

But one of my clients called me, crying, because she couldn’t even find the campus counseling center. (“Look on a map!” I said. But she was too upset.)

Best practices

What some colleges do well is free, brief therapy. Much can be accomplished in 10 sessions, especially if mental health professionals are trained in short-term therapy.  The structure is good for teens and young adults, and it gets them back on track. 

But after those sessions, students often are left to fend for themselves. Finding therapy and psychiatry is difficult at best. And it’s often impossible for students facing financial or social barriers: young people who are undocumented, LGBTQ, food insecure or underinsured.

The National Academy of Medicine report highlights model programs at schools around the country. University of Puget Sound expanded access to naloxone beyond the health service, to speed up the response to opioid overdoses. Virginia Commonwealth University created a syllabus to develop life skills and encourage students to be proactive about seeking help. Cornell Minds Matter, a student mental health advocacy group, provides free weekly Feel Good Friday sessions, events called Dining With Diverse Minds, and Random Acts of Kindness activities, to forge social connections.

Peer-to-peer mentorship programs and 24-hour student-run crisis hotlines, such as the model at SUNY Albany, are measurable winners. Wellness workshops can serve as a balm and give students a sense of belonging that has been all too elusive these past few years. Faculty can model self-care and wellbeing and encourage similar behaviors among students, for example, by taking lunch away from the phone and computer. Schools should also facilitate connections with professors, advisors and others who can offer support. Drop-in services are crucial.

Making a serious investment in college mental health comes down to prevention, wellness, accessibility, relevant programming and community outreach.

In a recent New York Times essay, Jonathan Malesic, who teaches at Southern Methodist University, reminds us of a tenet of social work: “Meet them where they are.”  My clients are beset with fears of failure, loneliness, debt, war, guns, climate change and health. By meeting them where they are, these topics and fears are put out in the open, destigmatized and given meaning.  

At the end of my young adult support group on Zoom every month we show our pets, because it’s that important. A beloved dog, cat or bird can reduce your blood pressure, not to mention alleviate loneliness and boredom and provide comfort. I write letters for emotional support animals all the time. Although my generation had struggles growing up too, we did not lose two years of our lives to utter dread and a flatline of boredom and social isolation.

According to the American Psychological Association, “It looks like COVID is here to stay, so from an operational perspective, psychological services in higher education will need to be extremely flexible.” Services should be available and affordable to students from the minute they step on campus until they get diplomas — all students, not just privileged kids who have the means to pay for help when resources on campus fall short. Our country needs young people to thrive.

But our systems of delivery are slow. More money, time, attention and openness can create the space for more therapists to meet the skyrocketing demand. Where is government leadership on such things? 

At Cornell Law School graduation, the sun was shining and the students seemed hopeful. Their speaker said, “Don’t be afraid to ask the hard questions.”

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