Thursday, August 30, 2007

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 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.


Jay Croft said...

Wow! That was a long post, but it points out an important aspect of college life.

Thank you.

Sarge Charlie said...

This is interesting Shela, I was especially interested in your father. You see it took the old sarge 35 years to accept the fact that he had a problem. When I did the VA was there to help me, they called it shell shocked in your fathers day, after Vietnam the named it PTSD, same thing, different war.

By the way, your son will be fine.

Marion said...

Another great post. It seems to me the repercussions of war on family life are long reaching. My father had PTSD after the second WW and was also hospitalized.

My mother moved on with the rest of us, and I never saw him again until my thirties. He had been treated at that point.

And my daughter carried on his legacy of depression...a different kind than his, but depression...until she died, after a suicide attempt.

Thank you for this post.

Sheila said...

Yes, Jay, I know I was long winded but I'm glad you agree it's an important part of college life we sometimes overlook.

Thanks Sarge. Well, it's better later than never. It's encouraging to see you say that the VA was there for you. I, on the other hand, have some criticisms, but I really don't know the whole picture of my dad's illness and treatment. We were estranged until shortly before he died. Working as a VA hospital volunteer was, ironically, one of my first jobs. I thank you and all the veterans who will carry many inner scars until the day they leave this green earth. It was a tremendous personal sacrifice and one I believe many would not hesitate to make again.

There is a great sadness when I read about your daughter and her struggle with depression and the suicide. If we could only protect our children from the troubles life can bring. If only we could wrap our arms around them and say, "I'll protect you dear one." It's a great sadness I would wish on no parent. Like your father and you, I grew apart from my father and out of touch with his daily life. I never knew if he was correctly diagnosed or not but he lived a hermit's life and only opened the door a little bit here and there with selected people when absolutely necessary. If one parent reads your words and my long post and the advice from these experts and recognizes a danger signal in a child before it's too late, then I will rest only a little easier for I know the troubles and demons are still lurking and will strike another family all too soon.

Marsha said...

Thank you Shelia, this was very educational.

Miss Trashahassee said...


I wish this post could be seen by the parents of all college-age children, as required reading.

Miss T

Joe said...

Once again you have written an exceptional post. I hope many people read it. College is often viewed as a care free time for adolescents to "sow their wild oats" before settling down to adulthood and responsibilities, but for many the stress is too much to handle. I remember talking more than one friend through some very rough times in college - times when their parents chose to write things off as "just a phase" or worse yet, ignore the situation all together. I wish both my own parents, and the parents of my friends would have had something like this to read and guide them.

Thansk for the post

Sheila said...

While many parents themselves went through the home-to-college transition, I think it's a lot more intense these days. Heck, life itself is more intense in my opinion. I really hadn't given this issue a huge amount of thought until all hell breaking loose at Virginia Tech. If you noticed, yesterday, the independent commission studying the university's response found critical lapses in judgment, especially during the time between the initial murders and the mass attack.

The one thing I did take away from the incident was that I wanted my son to go to a small college where I hoped he wouldn't become lost in a sea of students. Maybe that's not any better, but in my mind I feel that it is.

I, along with other, have made fun of the helicopter parent. And if you've read my posts, you know I could fit in that category. I hover but do not, I hope, go overboard with intruding into my son's life. I'm attempting to find the balance while leaving myself available to help if need be.

I don't want to be too alarmist, but I do think we parents can't depend on others in our students' lives to pick up on trouble should it arise in quite the way we possibly can.

Don said...

Sheila, thanks for an interesting and informative post on a topic a lot of people still feel queasy talking about, if they talk about it at all. And thank goodness treatment of mental illness has progressed beyond performing lobotomies such as JFK’s father, I believe, had done to one of JFK’s sisters.

Bob said...

Thanks for visiting our blog. You have a very professional looking blog here and are an excellent writer! I am enjoying your posts.

Best wishes to you this morning!

Jay Croft said...

Small or large?

Our older daughter spent her first two years at Western Maryland College (which is not in Western Maryland at all; it is the only college named for a railroad. It is now called McDaniel College). Then she transferred to the University of Maryland which, of course, is a large school. She lived at home.

Our younger daughter made the theological jump from a Quaker boarding high school to a Roman Catholic college (Trinity, in DC). For college, she lived at home.

Both are small facilities, and this was right for her.

Palm Springs Savant said...

Sheila- this was GREAT. I think its a great topic to cover. People think college kids have four years of partying and thats it. I knew two fellow students in college at SUNY StonyBrook who were depressed. I was able to refer one of them to a counsellor, but the other one ended up dropping out after becoming an alcoholic. ::sigh::

It was nice to hear your voice on the call! I think your comments were excellent. Congratulations

Sheila said...

Delighted you could visit. I always leave a comment when I discover someone new I like.

I guess your daughters illustrate that one size doesn't fit all. I think a small college is perfect for Scottie. But maybe no matter what the size, we will all find our place. Or not. I can't remember if you told me before, but did your daughter attend the same Quaker school that the Clinton's daughter did?

Did you listen? I am impressed and you deserve the reader of the week award. Depression is not to be treated lightly. I'm glad your friend listened to you. The other one--it's really hard to get some people to realize they need help.

Jay Croft said...

Same school? Nope! We couldn't afford that one, nor would she have been accepted on our income level.

I forget its name, but it's a few blocks north of the Washington Cathedral. One of the most exclusive and snobbish schools in the DC area.

Sarge Charlie said...

I like your thought about the blog, a public personal diary, that is good, maybe the loss of personal family history will come to an end because we blog, it is a new era.

Naomi said...

Great post Sheila about a subject that even today, many people find difficult to talk about. This post should be required reading for all parents with kids at college. Thank goodness we have come so far and progressed so much further now in the treatment of mental illness.

Sheila said...

I was surprised to see the rise of electroshock therapy again, but I remember now that Kitty Dukakis wrote a book about her treatment and was a strong supporter of it. No, I hope we won't see a return to the use of lobotomies again any time soon. I still remember Tennessee Williams' play and Gore Vidal's screenplay, Suddenly Last Summer.

I'll bet Washington D.C. is the capital of snobbery as well.

Yes, the blog is a powerful way to communicate and touch others. Rev. Jay can tell you a thing or two about how the power and persistence of a deaf blogger at Gallaudet University helped end the presidency of the university before it even began. I blogged a lot about that last year too. So, now not only is it personal for me, it is a way to get on my soapbox.

You are so right about this being a difficult subject. I was happy to be a part of the call and was impressed with the forthright manner of the young man who had struggled in college. Recognizing the alcohol and drug connection with mental illness at an early age would save many lives. Self-medication is so destructive and it shouldn't be because with therapy and/or medications, lives can be fulfilling again.

Dirty Butter said...

OH MY! I'm reading your post as we watch a tape of Night Line about Cho, the killer at VT, and how he got lost at such a large school. Very chilling.

Jay Croft said...

It was actually a number of bloggers and V-loggers, plus various coalitions that changed the picture at Gallaudet a year ago.

These blogs and v-logs kept the attention of thousands of people around the world, keeping up the pressure on the Board of Trustees and the retiring president (who had the chutzpah to request the BoT to name a major building for him, even before he was out the door.)

An interesting incident last April at Gallaudet. I gave a presentation in the religion class I told you about previously. The professor was, six months previously, a strong supporter of the president elect. In the class in April was one of the student leaders in the protest. The two were getting along just fine. Both had put aside their "agendas" to pursue the higher agenda of education.

Barrett Laurie said...

I so wish I had come across your blog 5 years ago. I attempted suicide on my 20 birthday. After almost five years of therapy to get to where I can talk about it! I actually was planning on writing an article about depression and my experience on my birthday, as a way to document my progress. If you don't mind, I may trackback a link to your article. You have a great site, and I look forward to more great posts!

Sheila said...

I didn't see that on Nightline but I was going to see the VT report which, I believe, goes much further into specifics regarding the student's past than we've heard from most media.

Thanks, Jay, for the Gallaudet update. It just goes to show that raising a ruckus can accomplish a goal.

Barrett Laurie,
Please write that article if you are up to sharing. I'm happy you are still here. Link away.

I remember when my older son was in upper elementary school, a 14 year old neighbor boy took his own life. It rocked the community. We all asked ourselves, "What should we have noticed earlier?" I write about this so that maybe one person will notice and help a fragile young person get treatment and know that life may be difficult but that it can become meaningful again too.

Janey Loree said...

Hi Shiela! Thanks for the words of encouragement on my Mustang 'n' Cowboys blog!!

Barrett Laurie said...

Thank you for the kind words! The last five years have been a long road! I posted that article today and I reference your post! Bless you, Sheila!

Sheila said...

I know you'll miss the guys and this is a big transition for you. Thanks for visiting again.

I read the post. I am so sorry you suffered this pain but thankfully, you were rescued. You have so much more living to do and with posts like this one, you will go on to help another person realize that life has more to offer than death.

John said...

There is a crisis out there, and parents and students need to recognize the problems of being depressed, and that there is something that can and should be done to cope with these disorders. The book is very well written, and easy to read. I feel this book should be read by every parent and every student so they can recognize the signs of depression, and get the help they need. It is a wake-up call, and a real contribtion to mental health.

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Sheila said...

I absolutely agree. There is such a large percent of students facing this issue, but I feel there is much suffering in silence as Szbabo points out.