Campus Mental Health Front and Center

Note: Revolution Health, the folks at a new online health resource founded by AOL co-founder Steve Case, noticed my incessant blabbering about college and invited me to join in on a bloggers’ conference call about campus mental health issues. While not strictly a health blogger by nature, I was intrigued since I have a college freshman son. I’m passing along what I found out and hope that if you are a college student, or know or love one, you’ll keep this advice in mind. And check out the new Website http://www.revolutionhealth.com for I think you’ll find a wealth of good information there and at the special section devoted to college life. Also, you can listen to the hour-long discussion.

I often ask myself when son calls, “How’s he REALLY doing?” and “Would he tell me if he wasn’t handling life or school very well?” So, like many parents whose young adult child has left the nest, I wonder, "How life’s treating my son?" Since I went to the parents’ orientation I learned his campus has plenty of resources at the counseling center and even an informal “watchdog” group, which follows students who have been identified by their professors as perhaps students who might be struggling. But parents must remain connected despite the distance and the push on the part of students to enjoy this “great moment of freedom.”

A little personal background: I watched for years as my father lived out a mostly troubled life after he returned from serving in World War II. He went from VA hospital to VA hospital and from job to job. My aunt tells me that until he left home at 16 to join the Marines, he was fine. However, by the time I came along, and he had moved our little family back to Alabama, that was no longer the case. One of the earliest memories I have is of a visit to Bryce Hospital, down a long tree-lined avenue to a stark, white-columned building. The memory stops at the door and fails to unveil just what led up to my father being placed in the state mental hospital.

Back then, people would whisper, “He had a nervous breakdown.” That’s how people explained mental illness with its secretive and mysterious disappearances. No one went away for treatment or to rehab. These were still the days of electroshock to wipe away the mind’s demons. And even though electroshock therapy has managed to shed some of the stigma (can anyone forget 1975’s One Flew Over the Cuckoo’s Nest?), today it is used for cases of severe depression and in a different manner from the days after Italian Ugo Cerletti developed the idea in 1938.

So, I was happy to participate in the call. Expert number one: Ross Szabo, Director of Youth Outreach for the National Mental Health Awareness Campaign, went to college with a bipolar diagnosis and found self-medication with alcohol didn’t work for long. Dr. Mark Smaller, Ph.D, the second expert, is a practicing psychotherapist and Director of Analytic Service to Adolescents Project as well as Director of the Neuro-Psychoanalysis Foundation in New York and London, a graduate of the University of Chicago and on the faculty at Chicago's Institute For Psychoanalysis. There were four of us bloggers (Lena from Sex and the Ivy, Therese of Beliefnet, John, me) and the moderator, Dr. Val Jones.

Szabo’s story is compelling. In January of his senior year in high school, he tried to take his life. By the following fall, he was a freshman at American University turning to alcohol to self-medicate the pain. He ended up in the hospital getting his stomach pumped from alcohol poisoning and suffered a “massive relapse.” He withdrew from college but returned and graduated in 2002 with a degree in psychology. Today, Szabo is a motivational speaker on college campuses, reaching thousands of at-risk students with his message and efforts to remove the stigma from mental illness. He has a book coming out this fall called Behind Happy Faces. His advice for students: Have a plan. Research the college and know what the counseling center has to offer. Talk it over with your current doctor if you are under care and have a plan. Stay away from drugs and alcohol. Develop a healthy lifestyle. Have a system. Sleep. Know what’s going to work.

Dr. Smaller emphasizes that going to college for the first time is a “huge transition.” This is the time “vulnerable spots in someone’s personality” may surface. According to Dr. Smaller, “Parents and students can be in denial about the intensity of this transition.” “Some students will immerse themselves in studying for awhile” and this will work. But he stresses parents should know the warning signs that may distinguish normal angst from a full-blown depression. Here they are: trouble sleeping (not sleeping intensifies any mood), eating too much or too little, social isolation, lack of concentration and a disconnect.

How do you encourage students to seek help?
Szabo says students hear a lot about alcohol at orientation but not much about mental health. He wishes colleges would “take the model on alcohol education and apply it to mental health” and add a dose of peer-to-peer contact. “Treat it as a health issue. Students may fail to seek help because of issues of trust or self-hatred Szabo says. Other excuses may be no time. But he urges them to realize the need to move beyond this attitude.

Parents must stay connected to their kids during this initial period of freedom. Visit the school if signs of distress appear. Let them know they can call. Szabo says parents don’t know what to say and that emotions are hard for many to talk about with their kids. Parents may be “frightened and just sitting down and having a conversation is alien,”he says.

With students who come to college with mental health issues already, parents have to emphasize the nature of the transition and have a “very frank discussion” with their students. Dr. Smaller says he often stays in touch with his patients and will schedule a visit at Thanksgiving just to touch base. Szabo says it boils down to “Is that student going to be cooperative?” He says that the student may come to realize, “You know I didn’t choose this problem, and I am going to have to follow treatment.” Being compliant is a hard problem. Parents must focus on health in these situations and say, “If you stick with the treatment, you’ll be able to stay in college.”

So What Do You Do If You Think A Student Needs Help?
Friends and family can do a few things if they think a student needs help, but they can’t “fix” their friend or child according to Szabo. He says one way to break through the isolation and fear of going for help is to say, “I’ll go with you to counseling. I’ll sit in the waiting room and we can talk afterward.” According to him, “15-24 year olds have the lowest rate of seeking help.”Another suggestion is to compare the brain to another part of the body. If you had a broken arm or diabetes, you likely wouldn’t hesitate to seek help. It’s a “fight with their mind,” adds Dr. Smaller. Remind the student that with time and treatment, things will improve.

Depression’s classic warning signs according to Dr. Smaller: sleep issues, lack of concentration, hopelessness, the attitude that things aren’t going to get better. Parents, if you hear this from your son or daughter, take heed.