1 in 3 college students seek help with mental health. Here's what schools are doing

When she was younger, Josie Roth leaned on her mother as symptoms of anxiety and depression emerged from the shadows.

Her family and friends were supportive, but their support wasn't enough on its own. They weren't trained to help her handle mental health issues that could feel all-consuming at times.

So, at 14, she started seeing a therapist. After leaving the comfort of home for college at Vanderbilt University, Roth turned to the campus counseling center for therapy.

Roth said her stress radiated from pressure to excel academically, participate in large social gatherings and deal with a tight budget. Turning to therapy, she developed coping strategies to address her needs, avoid panic attacks and fight off irrational worries.

She isn't alone. According to a study released earlier this month, about 1 in 3 U.S. college students sought mental health treatment in 2017. That's up from 1 in 5 just 10 years ago.

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The dramatic jump in demand has forced schools across the country to overhaul their offerings. In many cases, the progress on college campuses lagged behind similar efforts in other sectors.

"Unfortunately higher education, which is usually cutting edge, is behind the eight ball on this," said Nance Roy, the chief clinical officer at The Jed Foundation, a nonprofit that supports campus efforts to improve mental health services. "Colleges are just catching up."

There is a sea change in mental health care, and experts agreed many of the changes could be positive, especially for young adults.

Advances in medication in the last decade opened doors for people whose mental illnesses might have kept them from attending college. And a surge of programming on and off campus helped reduce the stigma surrounding mental health treatment, meaning some students who would have kept their problems secret in the past now feel comfortable speaking out.

“The good news is, in part, that students are more willing to come forward," Roy said. "The challenge is meeting the need."

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Vanderbilt, UT and MTSU among local colleges grappling with the challenge

Tennessee college leaders said they watched the national trend play out on their campuses to dramatic effect, reshaping their work and requiring them to stretch beyond traditional service models.

In several interviews, they cast the change in dramatic terms.

“I’ve been in the business more than 30 years, and one of the biggest shifts in higher education from my perspective in student affairs is the change in how students need and use counseling," said Debra Sells, vice president for student affairs at Middle Tennessee State University. “They come here really expecting to have access to really great support services."

Driven by the need "to provide much, much better care," Vanderbilt Chancellor Nicholas S. Zeppos made mental health a priority at his university in the last couple of years.

In 2016, he asked a panel of campus leaders to take stock of what needed to be done. They released a series of recommendations in March, calling on the university to ramp up services and to invest more in the scientific research of mental illnesses.

As a result, Vanderbilt made a $10 million investment, through the university's brain institute, to research mental illness and develop new treatments.

Zeppos said Vanderbilt has added offerings to provide “a much more holistic approach” for students. The university launched a new student care hub in July giving students one destination for a wide spectrum of treatment options, from crisis response and counseling to preventative measures, including meditation and yoga.

Student leaders like Roth, the Vanderbilt senior, are pivotal in the process, spearheading their own programming and pushing the administration to deal with complaints, including long wait times at the counseling center.

A student government committee on health and wellness supports peer-led efforts, including programing that encourages fraternity and sorority members, as well as students in other groups, to discuss mental health.

“A lot of students, including my friends, weren't really aware of the resources available," Roth said. “I realized there’s probably groups of people on campus who don’t have those people they can go to to talk about it.”

Zeppos repeatedly stressed the importance of getting to those pockets of students — as well as training professors and staff — to push past discomfort and help one another.

“These struggles are the very reason people can’t lift themselves off a chair, off a bed and seek help,” he said. “They can be successful if we are their partner in providing the best care.

“That’s just a big thing to take on."

Paul McAnear, director of the student counseling center at the University of Tennessee's flagship campus in Knoxville, said the rapid influx of students seeking care probably didn't reflect a new wave of mental illness. Instead, he said, it shed light on a crisis that had been overlooked for years.

Since he started at UT in 2010, the number of students seeking care has nearly doubled. By January, UT will expand its counseling staff to 14, but he estimated the university is still four staffers short of covering the need.

“We just didn’t know how much need there was out there until we started asking students to come in,” he said. “For every staff increase we had an increase in demand."

Advances in college access brought students with new challenges to campus

The latest generation of college students brings some challenges that are unique. McAnear said an increase in the availability of financial aid and other support has made it possible for homeless students to come to campus.

Until recently, students with problems of that magnitude were unheard of in his office.

“I don’t think people have a clue what some students are dealing with on a day-to-day basis while they’re going to college," McAnear said. “In previous generations those students didn’t go to college."

Roy agreed advancing treatment was one of several factors contributing to the increase in need.

She also said social media and “a bombardment” of increasingly acrimonious internet content had created “a perfect storm that increases anxiety levels” among young people coming of age in an era of constant stimulation. Colleges also have seen anxiety overtake depression as the top reason students ask for help.

And some students, Roy said, arrive on campus after sheltered childhoods that left them “ill equipped” to handle day-to-day disappointments.

“We don’t teach them how to deal with difficult feelings,” Roy said.

As a result, she said, it was incumbent on campuses to offer a wide range of offerings to help students develop more emotional grit. 

“Students (must) feel that there’s no wrong door to walk through in order to get support,” she said.

Staff members like McAnear have tried to get ahead of the swell by partnering with other offices to create more preventative entry points for students, like emotional support dogs during exam weeks and online self-help offerings.

Roth, the Vanderbilt student, said she's hopeful colleges will continue to expand their offerings and that families will encourage students to consider therapy or other treatment options.

“It’s actually very hard work," she said. "But if you’re trying to make your life better, it can help."

Reach Adam Tamburin at atamburin@tennessean.com or 615-726-5986 and on Twitter @tamburintweets.

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