Margaret Skoch of Cleveland felt a jumble of emotions as the day to leave for college neared. She was thrilled to be attending her dream school, Notre Dame University, but anxious about leaving home.
And then there was her mental health. Skoch had been diagnosed with obsessive-compulsive disorder, depression and anxiety in high school. Although she was feeling confident and healthy, she worried her symptoms might return.
That worry turned into a full-blown panic attack her first night in her dorm. It was the beginning of a rough few months.
“I was really homesick. I called home every day crying,” recalled Skoch, now a junior. “It was bizarre because I was so happy to be in this place that I loved and at the same time sometimes miserable.”
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Due to better mental health care and campus services, more young adults with a mental health diagnosis are attending college than ever. According to a 2013 survey, 88 percent of college counseling directors reported a steady increase in students arriving on campus already on psychiatric medication.
But with strategies crafted in advance and monitored from afar, teens with a mental illness can thrive in college and beyond.
Students who have been diagnosed with mental illness should know what they’ll need to maintain their recovery – before they leave for college, said David Spano, UNC Charlotte’s associate vice chancellor for health programs and services and director of the counseling center.
“Some students make the mistake of believing that, because they feel better, they can discontinue treatment after starting college,” he said. “The stress of college can sometimes exacerbate or reactivate old symptoms.” (And for some students, he said, a gap year experience may be a good option to consider before heading off to college.)
He also suggests students talk to their mental health counselors at home about continuing therapy in college. Questions to ask include: Is it sufficient to have sessions during breaks? Can we talk by phone between sessions? Should I seek out a counselor at school?
“One of the biggest markers of success in college is an ability to self-advocate,” said Melinda Harper, associate professor of psychology at Queens University of Charlotte and a licensed clinical psychologist with Charlotte Psychotherapy and Consultation Group.
“I ask my teens to do two things during their first four weeks in college,” Harper said. “I ask them to stop by the campus student health center – just to get familiar with it and pick up a pamphlet with their phone number. And I ask them to stop by the office of disability or academic tutoring office” to seek possible accommodations.
Ideally, students and their parents will make those visits together during move-in and orientation. If not, students should take the initiative.
“Take responsibility; know what your diagnosis is,” Harper said. “Be prepared to advocate for yourself.”
Parents should encourage their child to make use of those support services.
“Counseling and mental health treatment work best when students voluntarily choose it, Spano said. “Gentle, loving encouragement (from parents) is much more effective than mandates or ultimatums.”
He added: “After a student turns 18, parents cannot (legally) know whether a student attends counseling or the content of counseling sessions unless the student gives written permission.”
Improving a child’s organizational and study skills should be a priority, said Rick Auger, a professor in the department of counseling and student personnel at Minnesota State University.
“For almost all mental health issues, organization is so critical, especially ADHD, anxiety and autism spectrum disorder,” he said. “Binders, folders, assignment planners – all those things are helpful getting students into the habit of being organized.”
Parents who have been advocates, cheerleaders and anchors in their children’s lives must nurture independence in the months leading to college. Parents shouldn’t be afraid to let a child fail – modestly, according to Auger. It’s time to be a coach rather than a problem solver, he explained.
“Ask, ‘How are you going to go about solving this?' Start with small, low-stakes problems. That’s where kids grow in confidence and self-advocacy.”
Parents are likely to have freshman jitters right along with the child. Staying in regular touch can help both, but the terms of communication should be worked out beforehand, suggested Lauren Freise of San Francisco, a sophomore at Boston College who has battled depression and anxiety.
“While a parent understandably may want to ask their child how they are doing or steer a conversation toward their mental illness, sometimes just sending a text with a picture of where they are and a blurb about what they are doing will really make their kid’s day and lets them know that their mom or dad are thinking about them,” Freise said.
If you’re lucky, you might get a photo back.
Correspondent Page Leggett contributed.
▪ “Transition Year”: The Jed Foundation and the American Psychiatric Foundation teamed up to produce this guide to help students and parents prepare for college. jedfoundation.org.
▪ Active Minds supports about 400 student-led, campus-based chapters that provide students with programming to educate others about mental health, connect students to resources and reduce stigma toward mental illness. activeminds.org
▪ NAMI on Campus: There are about 90 NAMI on Campus clubs so far. These student-led organizations support fellow students, raise mental health awareness and promote mental health services. nami.org/Get-Involved/NAMI-on-Campus