Test minds, but tend them too

October 15, 2004

Today's students are suffering a mental health crisis. Richard Kadison demands more understanding and action from the universities

The number of college students with serious mental health problems has grown dramatically in recent years. From 1988 to 2001, the likelihood of depression has doubled, suicidal thoughts tripled and sexual assaults quadrupled, one US study discovered.

The situation appears much the same in the UK. Analysing data from national surveys, the Nuffield Foundation found that the percentage of adolescents suffering from emotional problems such as anxiety and depression had risen continuously between 1974 and 1999.

These are our children and our future. If we don't address this problem, the consequences will be dire. In the US, 44 per cent of students report feeling depressed to the point that they can't function, and almost 10 per cent report thinking seriously about suicide. Another 44 per cent engage in binge drinking and, despite massive funding for educational programmes, there has been no improvement in the past decade.

Counselling centres around the US report being busier than ever dealing with more severe problems. This is frightening. A college student today has a nearly one in two chance of developing a serious mental health problem.

There has always been stigma attached to mental health problems. In the US, this is complicated by rising numbers of international students and first-generation immigrants whose cultural taboos mean seeking care can be tantamount to disgracing the family. This very vulnerable group is also dealing with a new academic environment, culture and language.

Economic factors play a role. The cost of education in the US has increased at more than double the rate of increase in income. When the economy is bad, there is more stress on students and their families. More mental health resources and support are therefore required at a time when colleges have tighter budgets.

The improved availability of effective antidepressants has allowed many students who otherwise would have been too debilitated to attend college.

They, in turn, require more counselling resources.

The attack on the World Trade Center and the war in Iraq have added to the stress that college students face, bringing to the surface all the trauma, loss, and uncertainty that has occurred in their own lives. Students are also sleeping less.

If the mental health crisis is to be turned around, colleges, from the top down and bottom up, must recognise that emotional and physical wellbeing is part of the educational mission and can affect academic success dramatically. Universities must provide resources for education and assessment. Students can play a key role - young people are most receptive to their peers who can help with education and reduce stigma. In fact, the entire community, including parents, needs to be educated about the symptoms of serious problems and how to make referrals.

When college students are in distress, there is a "window of opportunity" to get them into care. There must be an adequately staffed system to allow rapid access to medication and therapy. The good news is that these problems are highly treatable. The bad news is that many universities don't have the resources to do this.

As we send our children off to college, we must stay in contact with them and demand that universities provide for both their emotional and intellectual development.

Richard Kadison is chief of mental health services at Harvard University.

His book College of the Overwhelmed: The Campus Mental Health Crisis and What to Do about It is published by Wiley later this month (£16.99).

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