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Thirty-five thousand counseling appointments were scheduled at Ohio State University in the 2016 to 2017 school year. This is more than double the number of appointments—15,000 —that were made during the 2006 to 2007 academic year. 

Like Ohio State, colleges and universities across the country are gearing up for an ever-increasing student demand for mental health services, primarily reflecting overwhelming stress, anxiety, and depression

According to psychologist Jean Twenge, writing in The Atlantic, this increase is due largely to what she calls the iGen, those born between 1995 and 2012, and possessed by their smartphones and social media. Although the iPhone was  introduced only in 2007, a survey in 2017 shows that three out of four American teens own one.

Twenge points out that the rates of teenage depression and suicide have skyrocketed since 2011. The arrival of the smartphone has radically changed every aspect of teenage life, from social interactions to mental health. Only about 56 percent of high school seniors in 2015 went out on dates; among Boomers and Gen Xers, the number was about 85 percent. The allure of independence, so powerful in previous generations, holds less sway with teenagers today, who are less likely to leave the house without their parents. While nearly all seniors used to have a driver’s license, today one doesn’t bother, since “Mom and Dad are such good chauffeurs there’s no urgent need to drive.”

A portrait of iGen teens is emerging as a lonely, unhappy, sleep-deprived, dislocated, and depressed generation that uses a social media device before bed, sleeps with it, and reaches for the device upon awakening. As those in iGen spend less time with their friends face-to-face, they increasingly lack the social skills, decision-making skills, and resilience needed as future adults. Although GenX stretched adolescence beyond all previous limits, Twenge believes the iGen presents a seismic change from previous generations. If her diagnosis is right, this radical shift will require a corresponding change in how colleges and universities address their incoming cohorts.

The current approach to mental disorders is based on a medical model, which provides categories of diagnostic criteria for mental illness based upon symptoms.  A more recent approach is PsychResilience Training (PRT), which recognizes the enormous pressures placed upon college students. PRT abandoned the medical model in favor of an educational model focused on prevention. By focusing upon two key attributes for mental health, PRT provides a self-empowering learning approach that helps students be better prepared to deal with the disappointments and setbacks that often lead to the onset of mental disorders. 

The first attribute is being one’s own person—taking responsibility for one’s decisions based upon probable outcomes and corresponding consequences. The inability to make one’s own decisions is the result of relying on an embedded voice of authority figures carried over from childhood. Students decide if they want to be their own persons or continue having others making decisions for them.

PRT postulates that we have two rational voices—our own voice and the embedded voice of authority figures from childhood, e.g., “You must look before crossing the street,” “You need to follow directions,” “ You have to do your homework.” The embedded voice is often mistaken for our own voice, but it is recognizable when we tell ourselves “I have to do this,” “I need to do that,” “I must do the other,” etc. Have-to’s are imperatives, and they offer no choice.

Early have-to’s become habits of mind, controlling our emotional life with “either/or” value judgments: good or bad, right or wrong, moral or immoral.  We begin to screen out our honest emotions—to hide them not just from others but even from ourselves. We become anxious about inadvertently revealing our true feelings.  Suppressing this anxiety leads to stress, anxiety, and a multitude of self-destructive behaviors.

We can recognize our own voice with its use of want-to’s, like-to’s, and wish-to’s.  Want-to’s provide the freedom of changing our minds. Want-to’s don’t necessarily dispel all have-to’s as without merit, since our own voice can independently determine the merit based upon our own self-interest. Want-to’s place us in charge of our lives.

Students who refuse to let go of have-to’s must default to embedded or outside authority to make decisions for them. Submitting to authority, however, can lead to powerlessness, anxiety, and depression. It’s difficult to feel good about ourselves when someone else is pulling the strings and we are only reacting.

Students can empower themselves by listening to the number of “I have-to’s” and “I need-to’s” they hear while talking to themselves compared to the number of “I want-to’s” and “I’d like-to’s” they hear. They can become their own persons by changing their have-to’s to want-to’s. “I have to study to get good grades” can become “I want to study to get good grades.” And “I have to exercise to stay healthy” can become “I want to exercise because I want to stay healthy.”

According to PRT, students don’t have to excel in everything they do. They don’t have to join cliques or that group. They don’t have to lose weight or dress in the latest fad. They don’t have to go to that party or event this weekend. They may want to do these things. But, they don’t—ever—have to. They always have a choice as long as they are willing to accept the consequences—in short, taking personal responsibility for their own decisions.

Admittedly, PRT is an enormous undertaking with developmentally arrested 18-year-olds. Even mindfulness, which relieves stress from ruminating about negative events that have happened or fretting about what might happen, requires an ongoing effort and steadfast commitment. Unfortunately, it doesn’t increase teenage social skills or decision-making skills.               

While colleges and universities can rightly claim to be educational communities, not therapeutic communities, they are stuck with an outmoded medical model of mental illness that provides individual counseling sessions at enormous costs. It may be time for colleges and universities to adopt an educational model based upon small group participation, whereby students not only can learn social skills but learn to take greater responsibility for their own mental health.

A PowerPoint presentation including contents of this blog is available to educators free of charge for classroom use by contacting mace@psychresilience.com

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