Students and Mental Health

[adel9216]

Hello,

I have spoken with one of my professors in a seminar I took when I was a master's students. And she mentionned that her undergrads are more stressed than they ever have been in her entire career, and that it is getting worse. Is it something that you have noticed as well? Is this a trend?

Just at my uni, there has been 4 statements from the Principal about suicides by students in this year alone...

Considering that I want to teach (and that I probably will during my PhD), it is something of great concern to me.

[polly_mer]

https://www.insidehighered.com/news/2019/08/12/college-presidents-prioritizing-mental-health-more-previous-years-new-study-finds has additional links to research on student mental health.

[Hegemony]

I think in a way the situation is better — the stressed students are still in college, rather than just dropped out.  They have more support (even if that support remains spotty and imperfect), and therefore get further in their education.  That means we will see more students in our classes who are having significant struggles.  Not to say that the world isn't stressful for young people and for all of us.  But back when I went through the system, many decades ago, I knew a whole lot of students who were also in very stressful situations.  The difference is that there was less understanding of such factors, and many fewer resources.  So largely they just sank under the weight of it all.

[Bede the Vulnerable]

What Hegemony said. 

I've been advising students, as well as teaching them, for 24 years now, and every year I walk one or two directly to the Counseling Center, since I'm worried about them harming themselves.

I'm not sure that students are becoming more fragile--which is the common narrative.  My sense is that we have the "irony" of psychotropic medication at work here.  Students who would previously have been unable to attend college--and especially "high-pressure" colleges--are able, with medication, to do well in HS.  This despite what would previously have been incapacitating mental health issues.  Thus, we are getting more kiddos who come into college with anxiety disorders, severe depression, ADHD, etc.  Should it be any surprise that they manifest more "issues" when they arrive?

What I've noticed as well:  A disturbing number of students take themselves off of their meds when they get to college.  I've talked to students who have done this.  I can't give any good answer as to why they make that decision, other than that some with depression think that their illness was situational:  Things will "be different now." Which would be equivalent to my having taken myself off of my anti-seizure meds when I took my new position.  Like my epilepsy, these things don't just go away with a change of circumstance and scenery.

[downer]

Plenty of of anxiety and depression is situational. I completely understand the desire to go off meds. But it needs to be done very carefully. With close supervision.

[Bede the Vulnerable]

Plenty of of anxiety and depression is situational. I completely understand the desire to go off meds. But it needs to be done very carefully. With close supervision.

My concern is that most students--in my experience--make the decision to quit meds without professional consultation.  Even if--say--depression is situational, quitting cold turkey is likely to result in a crash.  In addition, teenagers can be poor judges of what will and what won't change as a result of going away to college. 

[downer]

On the other hand, if the students are also engaging in binge drinking when they arrive in college, as seems quite likely, it may be better to be off the meds, even if it is cold turkey. They are not going to be doing well anyway, but at least they won't get the drug interactions. Then they will crash out, maybe drop out, or else return a little wiser.

[Puget]

I'm heavily involved in this topic through my research as well as some direct service/teaching work.

The rate of demand for college counseling center services has been increasing 5x greater than increases in enrollment in the US. The reasons for this are complex--  Some of it is what Hegemony said-- students who previously weren't making it to college at all are now able to attend, so rates of mental health problems in college students look more like the general population in that age range. Another chunk is increased self-advocacy and decreased stigma, so students are using services more and talking more openly about their struggles. I hope we can all agree these are good things. But on top of that there really does seem to be a population-level increase in anxiety and depression (based on epidemiological research). The reasons for this are no doubt complex, but stress is a major risk factor, and their are certainly ways in which the world is a more stressful place for many young people today.

[adel9216]

Plenty of of anxiety and depression is situational. I completely understand the desire to go off meds. But it needs to be done very carefully. With close supervision.

I agree. There are negative side-effects to these medications. All of that needs to be monitored and discussed with a health professional (i.e psychiatrist).

And yes, someone with a mental health issue can do just fine in academia or university. Full disclosure: I am one of them. Despite having bad days where I feel more sad, I thrive in university settings. It actually helps me to stay sane as strange as it may sound. I truly love what I am doing, I feel like I am made for it and like I have found a purpose and my calling. so it helps me when things get more difficult on a personal level. But I'm one of the lucky ones. My mental health struggles do not impact my productivity most of the time.

[adel9216]

I'm heavily involved in this topic through my research as well as some direct service/teaching work.

The rate of demand for college counseling center services has been increasing 5x greater than increases in enrollment in the US. The reasons for this are complex--  Some of it is what Hegemony said-- students who previously weren't making it to college at all are now able to attend, so rates of mental health problems in college students look more like the general population in that age range. Another chunk is increased self-advocacy and decreased stigma, so students are using services more and talking more openly about their struggles. I hope we can all agree these are good things. But on top of that there really does seem to be a population-level increase in anxiety and depression (based on epidemiological research). The reasons for this are no doubt complex, but stress is a major risk factor, and their are certainly ways in which the world is a more stressful place for many young people today.

Thank you for your input. Yes, at my previous university, I went to a TA training and they showed us stats about requests for accomodations for mental health reasons, and it was a huuuuuge increase in the last 10 years. Probably for the reasons you are describing.

[mahagonny]

On the other hand, if the students are also engaging in binge drinking when they arrive in college, as seems quite likely, it may be better to be off the meds, even if it is cold turkey. They are not going to be doing well anyway, but at least they won't get the drug interactions. Then they will crash out, maybe drop out, or else return a little wiser.

Alcohol will make you get violently ill (and who knows, maybe even dead?)
in much smaller amounts if you're on nortriptyline or doxepin. But with almost any SSRI or dopamine-receptor medication, alcohol will prevent the drug from doing what it needs to do. Some students will go off prozac or celexa because they are in a relationship and don't want trouble with impotence.

I'm not sure that students are becoming more fragile--which is the common narrative.  My sense is that we have the "irony" of psychotropic medication at work here.  Students who would previously have been unable to attend college--and especially "high-pressure" colleges--are able, with medication, to do well in HS.  This despite what would previously have been incapacitating mental health issues.  Thus, we are getting more kiddos who come into college with anxiety disorders, severe depression, ADHD, etc.  Should it be any surprise that they manifest more "issues" when they arrive?

The meek shall inherit the earth.

[mahagonny]

Paradoxical (worsening depression) reactions to SSRI's are the most likely among young patients. The good doctor watches them like a hawk during the first month.

[the-tenure-track-prof]

I teach Master`s level students in a mental health profession and the rate of students in my class who report mental health problems including official diagnoses of serious mental illness is rather high. In the class that I teach there are students with a broad range of mental disorders such as bipolar disorder without medication, plenty of PTSD cases, a number of major depression disorders with medication, plenty of anxiety disorders, OCD and my favorite is one student with complex PTSD and borderline personality disorder and I suspect but this is not a confirmed diagonsis one psychopath. What I wonder about is that these students talked about their mental health issues in their class presentations that each student was supposed to present in my class (they were required to present a mental disorder and evidence-based treatment) and each one of the students in the list above talked in front of the class that they have the mental disorder that they are presenting!. I was concerned especially that the class is not the right frame to handle mental illness and I cant intervene unless a student asks for assistance. I am reconsidering to revise the requirement of class presentations in future classes to prevent a situation where a student presents his mental health condition in a classroom setting. I wonder if anyone else faced similar situations like this with students?

[Puget]

I teach Master`s level students in a mental health profession and the rate of students in my class who report mental health problems including official diagnoses of serious mental illness is rather high. In the class that I teach there are students with a broad range of mental disorders such as bipolar disorder without medication, plenty of PTSD cases, a number of major depression disorders with medication, plenty of anxiety disorders, OCD and my favorite is one student with complex PTSD and borderline personality disorder and I suspect but this is not a confirmed diagonsis one psychopath. What I wonder about is that these students talked about their mental health issues in their class presentations that each student was supposed to present in my class (they were required to present a mental disorder and evidence-based treatment) and each one of the students in the list above talked in front of the class that they have the mental disorder that they are presenting!. I was concerned especially that the class is not the right frame to handle mental illness and I cant intervene unless a student asks for assistance. I am reconsidering to revise the requirement of class presentations in future classes to prevent a situation where a student presents his mental health condition in a classroom setting. I wonder if anyone else faced similar situations like this with students?

If these are masters level students in mental health profession, it sounds like it is well past time for a serious discussion with them about appropriate professional boundaries. While I'm glad stigma has diminished, a class in a professional program is not an appropriate place for self-disclosure. If you don't talk with them about this now, how are they going to act with real clients?

[the-tenure-track-prof]

You are correct and I agree that it was unprofessional behavior to self expose oneself during a professional presentation and as a new faculty in my first semester teaching this class I was caught by surprise. I taught in similar graduate programs in other universities and I`ve never faced this kind of situation before.
While statistics show that mental illness is prevalent among graduate students in mental health professions at the universities (a colleague of mine actually just published an article about this issue), it is still an actual problem to deal with in the classroom and I have to find a way on how to address it. Since I am new at this university, I don't know what is the norm to talk about this issue and how often do students do that in-class presentations.
This coming semester I teach an online course for graduate students so I will not meet them. I am considering to talk to my mentor about this before I consider to address this issue.


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If these are masters level students in mental health profession, it sounds like it is well past time for a serious discussion with them about appropriate professional boundaries. While I'm glad stigma has diminished, a class in a professional program is not an appropriate place for self-disclosure. If you don't talk with them about this now, how are they going to act with real clients?
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