Choosing a College When Mental Health Is an Issue

Choosing a college is always a difficult task. Sure, for some people it may be basically like looking for the best four-year sleep-away camp with alcohol, but that doesn’t change the fact that college represents a critical transition in a young person’s development. College offers the first chance for a clean break between the person you were for eighteen years and the person you want to become; college is when you step away from your parents and your childhood friends, and take a crack at being a grown-up.

And unfortunately for those of us with mental illness, this can mean a spike in symptoms at the worst time imaginable.

If you’re a graduating high school student with a mental disability (or the parent of one), I strongly recommend researching the academic and social climates and the mental health resources and accommodations available at each of the schools you’re considering. I suspect that, had I done more research, I might not have wound up at the college I chose. It had a reputation for being academically intense, something I valued, but in retrospect there were a number of signs that the school emphasized academic achievement over wellness. I remember a shirt I saw in the school bookstore during my visit to the college: “Work. Friends. Sleep. Choose two.” And during an initial orientation meeting, the Dean of Students required the freshman class to repeat this mantra: “No matter what you say or do to me, I am still a worthwhile person.” It seemed kind of quirky and charming at the time, but looking back, I should have asked: “What exactly are you people planning on saying and doing to me? Why will I need to remind myself I’m not worthless?”

Fortunately, you can do research that may help you make a good choice – much of this research can be done anonymously, either online or via a telephone call to a college’s Dean of Students Office or Health Services office, or through a campus visit. Below, I describe some features to look for in your college choice. This is certainly not an all-inclusive list, but provides some indicators that may suggest that a college is conscious of and responsive to the mental health wellness of its students.

One of the most important, yet often difficult to measure, characteristics of a school is the balance in its academic and social climates. Finding a reasonable equilibrium between academic rigor and social/athletic outlets is critical to maintaining mental wellness in college. A mental illness can make socialization unusually difficult, so it might be worth looking at schools that give you multiple opportunities for making friends as a freshman - perhaps look for one with an extensive orientation program, or one that offers housing with multiple roommates. Certainly, having a variety of extracurricular activities that interest you is important. It’s also worth thinking about the size of the school. Small schools can be nurturing and facilitate closer friendships, but can become claustrophobic; larger schools may have more diverse social opportunities (as well as more extensive psychological services), but risk being impersonal.

The quality of the psychological services offered at the school is clearly of critical importance. Find out whether the school has a Counseling and Psychological Services (sometimes referred to as “CAPS”) office or its equivalent, with therapists and at least one psychiatrist to address medication requirements, preferably on-campus and under the auspices of college health services or administration. (If these aren’t available, ask if there’s an off-campus facility with a relationship with the school. Check if it’s easy to access and if it’s covered by student healthcare or your family health insurance). Ideally, the CAPS office should offer, at a minimum, psychotherapy treatment, psychiatric consultation, and eating disorder assessment and treatment.

And if you think you might need to make use of these services as a student, there are some questions that it might be prudent to ask:

• What are the lead times for scheduling an evaluation and a routine therapy session?
• Are there limits on the number of sessions, or fees?
• How does the school maintain confidentiality?
• And, perhaps most importantly, what is the office’s emergency response procedure, both during open hours and after hours? (If a school doesn’t have a 24-hr. response line, they should be able to direct you to a local hospital or mental health center that can provide care.)

You can also look for a variety of additional programs and services that may indicate that a college or university is responsive to mental health issues. A school with accommodations such a WellnessCenter, that offers classes in yoga and meditation, or possible access to therapy pets on campus, is clearly invested in the wellness of its students. Health Centers and Wellness Centers can support mentally disabled students in many ways: by training their faculty, staff and peer leaders in suicide prevention; by offering health programs on subjects such as drinking, stress management and healthy relationships; and by assembling a Behavioral Intervention team with representatives from the campus Health Center, Counseling, Disability Services, and the Dean’s Office.

You may want to get in touch with the school’s Disability Services Office. Schools can be surprisingly flexible and supportive in accommodating disabled students, provided you go through the proper channels. Disability Services should have defined programs and procedures for academic and testing accommodations, and should tell you up front what information they’ll share with faculty and staff. Although instructors are usually understanding about accommodations for mental disability, be sure you know who to go to for backup if you find an unsympathetic professor. Many schools have housing set aside for special needs students, so be sure to ask about housing arrangements – it might be beneficial to have a dorm room close to the health center, for instance.

Finally, see if the college or university has an established Peer Counseling organization, such as those offered by Active Minds and NAMI. A good peer counseling group might offer regular meetings and support groups for students, both those personally affected by mental illness and those who want to support their peers. They can also educate students and challenge the stigma of mental illness. I had a terrific experience with my school’s peer counseling group. It was empowering to be able to stand with other students and speak up about issues I’d been silent about for so long; and I made a number of friends who were not only passionate about issues surrounding mental health, but also uniquely supportive and understanding when I was struggling with my disorder.

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An Imperfect World Shouldn’t Mean Imperfect Health

I can’t emphasize this enough: college is tough for everyone and particularly for those challenged with a mental health disability. But if you plan ahead and get a good support network in place, there’s a good chance that years 18 through 21 can be better than all the others leading up to them.

Image: ©iStockphoto.com/callistox

Copyright, Fletcher Wortmann, 2013.

Author of Triggered: A Memoir of Obsessive-Compulsive Disorder (St. Martin’s Press), named one of Booklist’s “Top 10 Science & Health Books of 2012”

Read my Psychology Today blog: Triggered