During the past decade or so, the Massachusetts Institute of Technology has experienced a spate of students who have jumped to their deaths. In 2000 Colgate University endured a drunken-driving crash that resulted in the deaths of four students. In 2001 the prestigious university for the deaf, Gallaudet University, was the scene of one student’s murdering another. Then in January of this year, the Appalachian School of Law found itself being stormed by a failed student who then allegedly proceeded to kill the dean, a professor, and another student.
What is going on at American colleges? Where are those campuses that used to offer young adults, at least for a few short years of their lives, soothing ivy-covered brick walls and a chance to have some fun between tests and term papers?
Gone, perhaps? For today, many colleges appear to be more cauldrons of mental perturbation and emotional turmoil than legendary ivory towers.
First, many types of mental health dilemmas appear to be besetting today’s college students. Mark Reed, M.D., director of counseling and human development at Dartmouth College Health Service, gave Psychiatric News a rundown:
"The most common issue we see students for is mood disorders, followed by general developmental issues—relationships, intimacy, identity, independence, family issues, plans for the future. Next come anxiety disorders—social phobias, obsessive-compulsive disorder, posttraumatic stress disorder, and general anxiety disorder. We also see many students with eating disorders and substance abuse disorders. And as is common in all areas of mental health, many of our students deal with more than one issue or disorder."
Jackie Ayers, Ph.D., director of mental health services at the University of Florida and immediate past president of the American College Health Association, provided Psychiatric News with a similar litany: "Some of the most common mental health problems we see on our campus these days are depression, stress/anxiety disorders, relationship issues, alcohol and drug use, sleep difficulties, eating disorder problems, learning disability (ADD/ADHD), sexual assault/abuse, obsessive-compulsive disorder, grief and loss issues."
Second, one college mental health difficulty—depression—appears to be widespread today. The American College Health Association in Baltimore surveyed college students’ mental and physical health in spring 2000. It was called the National College Health Assessment and included data from over 16,000 students at 20 public colleges or universities and at eight private colleges or universities from throughout the United States. The assessment revealed that 10 percent of all students surveyed had been diagnosed with depression and that anywhere from 1 to 10 times during the 1999-2000 school year, they experienced mental health problems (see chart).
This scenario also applies to students at one of America’s most prestigious universities—Harvard, according to Richard Kadison, M.D., chief of the Mental Health Service at Harvard’s Health Services.
"Depression is probably the most common mental health problem that college students face these days," Kadison said.
So, if depression is so common among college students, what about suicide? As David Shaffer, M.D., a professor of psychiatry at Columbia University and past president of the American Foundation for Suicide Prevention, told Psychiatric News, "The only systematic study done on suicidal behavior on college campuses is the special survey done by the Centers for Disease Control and Prevention, which was only done once, so that there are no data for change over time. However, as the rate of suicide has been declining for both 15- to 19-year-olds and 20- to 24-year-olds over the past decade, it would be reasonable to assume that the rate [on college campuses] has been declining rather than rising."
Still, one can hardly dispute the fact that even a few college suicides constitute terrible tragedies—that the suicide of even one student is a devastating loss.
What’s more, there is reason to believe that certain types of mental health problems besides suicide are increasing on college campuses. For instance, from 1999 to 2000 liquor arrests on college campuses were up 4 percent, drug arrests were up 10 percent, and murders were up 45 percent, according to statistics released by the U.S. Department of Education in December 2001. More undergraduate and graduate students across the country are reporting depression, substance abuse, and eating disorders than was formerly the case, according to an article in the September 8, 2001, Monitor on Psychology. The numbers of college students with major depression or anxiety have shot up sharply during the past five years, according to an article in the October 3, 2001, Chronicle of Higher Education.
The increase in such problems may explain, at least in part, the perceived upswing in the number of students seeking help. "We are seeing more students than we used to see," Peter Reich, M.D., director of mental health at the Massachusetts Institute of Technology and head of the Group for the Advancement of Psychiatry’s College Students Committee, told Psychiatric News. "In fact, all the services that I know of in the United States are seeing larger numbers of students than they used to see."
Another factor affecting college students’ mental health is stress. In fall 1999 researchers from the University of California at Los Angeles polled freshmen on campuses around the United States as to how stressed they felt. Thirty percent said that they felt overwhelmed by what they had to do.
A similar survey conducted in 1985 showed that only 16 percent of freshmen felt this way. And one reason a number of college students feel stressed, Reed explained, is that "there is pressure from a very early age to get into the best kindergarten. Children are specializing in activities at a very early age so that they can excel. That pressure persists through high school to get into the best college possible. When you look at students’ resumes and personal statements, it is stunning what they have accomplished by the time they graduate high school, but you sometimes wonder at what cost? That overwork continues in college. It is not uncommon for two students who want to get together for breakfast to pull out their palm pilots and work fairly hard to find a date."
Moreover, college students’ mental health troubles appear to be more serious than they used to be. "In speaking to colleagues at other college counseling centers," Reed said, "most report a 35 percent increase in psychiatric hospitalizations over the last five years."
At Dartmouth alone, he added, "We have about 50 students a year now taking leave for psychiatric reasons. In 1995-96, it was 18 maybe."
"I meet with a lot of other directors of college health services and talk with them," Kadison said. "I think there is a general sense that we are seeing much sicker people in college now, we are hospitalizing more people, and people are demanding more attentive psychotherapy services."
Students seeking mental health care at the University of Florida, Ayers said, "are bringing with them increasingly complex, severe mental health problems."
As Morton Silverman, M.D., director of student mental health at the University of Chicago, put it during an interview: "More individuals with a history of mental health problems are attending colleges. So they are coming to us with their problems; it is not that they are developing them when they are here."
Yet this trend is actually positive because it indicates that stigma is decreasing; that more young people with mental illness are receiving treatment in high school and earlier; and that earlier treatment in turn is allowing them to perform closer to their potential and to gain acceptance into competitive colleges.
At Dartmouth, for instance, Reed pointed out, "We are seeing more and more students who have had psychiatric hospitalization prior to coming to college. We are also getting calls from families before students decide to attend Dartmouth to ask about our mental health resources and to make sure that their children will receive good care."
The situation is similar at Harvard, Kadison attested: "We have some students with schizophrenia, but what I think we are seeing a lot more of are bipolar patients. They are on combinations of five or six medications. That keeps them stable enough to function, and since many bipolar people are very creative and intelligent, that allows them to function well enough to make it in school."
More information about the American College Health Association’s spring 2000 National College Health Assessment is available by contacting ACHA Research Director Victor Leino, Ph.D., by phone at (410) 859-1500, ext. 239, or by e-mail at email@example.com. The U.S. Department of Education’s December 2001 statistics on changes in crime on American college campuses from 1999 to 2000 can be found at www.ed.gov/offices/OPE/PPI/security.html. ▪