When College Shopping, Don't Forget About Mental Health

Learn to recognize how committed schools are to student mental health.

Posted Sep 03, 2015

Photo purchased from iStockphoto, used with permission.
Source: Photo purchased from iStockphoto, used with permission.

When scouting colleges, hopeful students and their families are sure to give weight to the student/teacher ratio, the quality of the classes, the extracurricular activities, the look of the campus and the school vibe. But there’s one offering that isn’t always factored into the equation: mental health.

It should be. How well a school responds to its students’ mental health needs can be literally lifesaving, and that’s not just for the students already dealing with concerns such as anxiety, depression, bipolar disorder and substance abuse. Many mental health issues first emerge in early adulthood, and college — with its stresses, competition and disconnect from familiar support networks — can leave even the most seemingly together student struggling to cope.

Because budgets are always tight and not every school prioritizes mental health help, the quality of campus wellness programs can vary dramatically. That means its crucial to know what you can expect before you start sending off those college applications. Otherwise, you might be in the midst of a crisis when you find out you’re essentially on your own.

While there’s no single clearinghouse to compare college mental health programs, there are questions you can ask and things to look for that can help give a sense of how committed the schools on your wish list are to student mental health. For example:

  • Does the campus have a dedicated counseling and psychological services program? Most do. If yours does not, be clear on what you can expect if you’re in need.
  • Campuses are required by federal law to make accommodations for students with disabilities, and that includes mental health disabilities. Check with the campus office for disability services to make sure they are following the letter of the law and to get a sense of what you might expect. For example, if you have bipolar disorder, major depression or an anxiety disorder and you find yourself unable to take a test because you need to seek treatment, could you reschedule the test without academic penalty?
  • What is the mental health staff-to-student ratio? The International Association of Counseling Services recommends one full-time employee to each 1,000 to 1,500 students. Most schools, however, fall somewhere in the 1 to 1,600 range. The fewer workers, of course, the more likely you are to wait for services and the less time there is to devote to those with severe issues.
  • If you have to take time off from school to deal with a mental health issue, will you be able to return? Sadly, some schools show students the door. After a Yale University student committed suicide after saying she feared she wouldn’t be allowed to return if she took the time for new medication to take effect, the school amended its policies to allow leaves of absence.
  • Are sober services available? Students who need help maintaining their recovery from drugs or alcohol should have options such as sober dorms and sober support groups. Students who find themselves getting into trouble as they are immersed in the party culture of college should find it easy to access help before problems spiral out of control.
  • How easy is it to find help and information? Ask how the college gets the word out about its mental health services. If you are pointed to a website, check it out to see if it’s clear and easy to navigate.
  • Can you walk in and get help? Or is there a waiting list? Time is of the essence with mental health issues, but many schools are short-staffed and overwhelmed with demand.
  • Are all services offered on campus? If some or all are offered off campus, how easy is it for students to get there? At some schools, freshmen are forbidden to have cars so transportation options matter. Students might also be less likely to continue with treatment if it’s tough to access.
  • Are support groups available? A mix of student-sponsored support groups and college-sponsored groups for issues such as addiction recovery, eating disorders and anxiety disorders is a good sign that both the administration and the student body are engaged.
  • What’s the procedure if a student is in crisis? Is help available 24/7? Waiting until “normal business hours” can be deadly for those struggling with suicidal thoughts.
  • What costs are associated with treatment? Is the student expected to use their own insurance or are some or all services considered part of the university offerings?
  • What are the treatment limits? For example, about 40% of the schools that responded to the 2014 Center for Collegiate Mental Health annual report have an annual psychotherapy limit of a dozen sessions.
  • Are there any mental health perks? The connection between exercise and emotional wellness has caused some schools to offer free gym access, for example. Some schools offer workshops and classes designed to help students learn to deal with the stresses of college life.
  • What services are integrated with counseling? Some mental health programs will go beyond the basics and include things such as career services, drug and alcohol treatment, and health services.
  • What’s the process for identifying a student in emotional trouble and getting them help? Because HIPAA laws restrict information about those 18 and older, ask how family members can be kept in the loop.

It’s also enlightening to find out what organizations and programs the college is affiliated with. There are many groups working hard to improve the quality of student mental health. Association with some of these isn’t a guarantee of superiority, but it is a sign that the school is serious about student mental health and welcoming to those who wish to promote it.

Among them are:

  • The Jed Foundation. This nonprofit works to protect the emotional well-being of teens and college students through a variety of avenues, including The Jed and Clinton Foundation Health Matters Campus Program. This campaign helps colleges establish comprehensive offerings designed to promote mental health, reduce substance abuse and prevent suicide. Those who meet the standards are allowed to carry The Campus Program membership seal. See the list of schools that have made the grade.
  • Active Minds. Founded by a University of Pennsylvania student after the suicide of her brother, Active Minds helps fight the stigma surrounding mental illness and encourages those in need to reach out for help. If the school you’re considering has a student chapter, it’s one more place to turn for support.
  • The International Association of Counseling Services. This professional group helps sets standards that promote quality mental health care. If your school is affiliated, it’s a sign that certain quality levels are being aimed for and hopefully met.

Taken together, the information you gather can give you a sense of how supportive your school will be if your emotional well-being suffers. And for those convinced that the quality of the football team will be of more importance to them than the quality of the college’s mental health services, consider these statistics compiled by the Jed Foundation:

  • More than half of college students reported experiencing overwhelming anxiety in the past year.
  • About a third reported finding it difficult to function because they felt so depressed.
  • About 8% reported seriously considering suicide.

Clearly, college can come with challenges to mental health. Strong and accessible campus care offerings can act as a vital counterweight to that reality.

David Sack, MD, is board certified in psychiatry, addiction psychiatry and addiction medicine. He writes a blog about addiction and is Chief Medical Officer of Elements Behavioral Health, a network of mental health and addiction treatment centers that includes a young adult relapse program at The Recovery Place and Promises young adult rehab.