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Mental illness growing concern on campuses

Garret Condon The Hartford Courant

When Aimee Belisle of Woonsocket, R.I., was a freshman at Bentley College in Waltham, Mass., she thought that crying herself to sleep every night was normal. She became moody and began skipping meals. By her junior year, she was cutting herself. That’s when a college friend took her – carried her – to the college counseling center.

There, she was linked up with one-on-one talk therapy, and a psychiatrist retained by the college prescribed the anti-depressant Paxil. Although Belisle had setbacks along the way, she said the treatment for depression turned her life around. She graduated in 2002 and became an advocate for depression screening. She made her battle part of her successful bid to become Miss Rhode Island 2004.

The reason she resisted getting treatment earlier in her college career, Belisle said, is that she thought that “depression is for older people.” But depression, anxiety, sleep disorders, eating disorders and even suicide are very much part of college life these days, and experts in the field speak of the “college mental health crisis.” The American Medical Association, prompted by the American Psychiatric Association, agreed this year to undertake a study of the problem.

Nearly half of college students in a recent survey reported that at some point in time they were so depressed that they could not function. Nearly 15 percent of college students reported that they had been diagnosed with depression. About 10 percent reported that they had considered suicide at least once. There are more than 1,100 suicides on college campuses each year, making it the second-leading cause of death, after accidents, among students.

And although stress has always been a part of collegiate life, there is evidence the burden of mental illness has gotten worse in recent years. Dr. Richard Kadison, chief of the Mental Health Service at Harvard University Health Services and co-author of “College of the Overwhelmed: The Campus Mental Health Crisis and What To Do About It,” cites a 2003 study done at Kansas State University looking at student mental health complaints from 1988 and 2001. In that period, the number of students who had contemplated suicide or had serious depression doubled. The number seeking help for sexual assault quadrupled.

Michael Kurland, director of student health services at the University of Connecticut in Storrs, said it’s a nationwide issue. “This is a problem that virtually all campuses are facing,” he said. The psychiatric illnesses diagnosed at college counseling centers include anxiety disorders, depression, eating disorders and substance abuse. Major psychiatric disorders like schizophrenia, although much less common, typically first surface during the college years.

Experts keeping tabs on the campus mind-set say that whether someone is in college or not, the 18-to-24 age range represents one of life’s most jarring transitions: the beginning of adulthood.

“It is the first time you’re away from home for most people,” Belisle said. “And it’s a lot harder than people may think.”

Many students, faced with a sudden surplus of freedom, engage in risky behavior.

Kurland said they also are often under tremendous financial strain because of the cost of a college education, and that the pressure to compete and be perfect is very high.

Psychologist Randolph Lee, director of the counseling center and associate professor of psychology at Trinity College, has been on the job for 36 years. He believes that daily life is speeding up in general and that, paradoxically, many students are poorly equipped to deal with the added stress because they’ve been overprotected by their still-hovering parents.

Students “have a harder time dealing with the roadblocks when they come up – they’re kind of flummoxed,” Lee said. “We do have to let our kids go, and we have to let them screw up.” At the same time, he acknowledges that students now graduate into a post-9/11 world of homeland insecurity and economic uncertainty. “There are more consequences to screwing up now,” he said.

Dorm living often is laced with drugs and alcohol, which tend to worsen mental health problems. Psychologist Michelle Williams, director of clinical training for doctoral psychology students at the University of Connecticut, said that “substance abuse is alarmingly high for college students.”

And colleges are welcoming many more students already diagnosed with emotional or developmental problems than in the past, said Dr. David Fassler of Burlington, Vt., co-chairman of the American Psychiatric Association’s Presidential Task Force on Mental Health on College Campuses.

“There are kids going to college today who would never have made it that far in previous generations,” Fassler said. Such students “made it through high school with a lot of external support. Some do quite well in college, but often need a team to help provide continuing support and assistance.” A student with Asperger’s Syndrome, for example, might have the intellect for college, he said, but need help with interpersonal relations, which can be especially difficult for people with that diagnosis.

Whether students are already diagnosed with emotional difficulties or suddenly need help, they must deal with the shame that continues to shadow mental illness.

“It can be pretty stigmatizing for a college student, if this is really the first time they’re starting to experience these kinds of issues, to seek therapy or take medication,” Williams said.

She said that colleges are increasingly using freshman orientation to introduce students to on-campus mental health resources – and to academic resources as well. Students with identified disabilities, for example, can seek certain accommodations such as extra time for exams.

Kadison said that parents would do well to ask about mental health services, wellness programs and on-campus mental health advocacy groups when considering colleges.

The wise choice of a college, itself, can ward off many potential mental health problems, Fassler said. “Some kids can go to a huge state university and they do great,” he said. “Other kids are just overwhelmed and lost in the same environment.”

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