Last fall, a couple on the West Coast nervously sent their daughter off to school in the Midwest. The 18-year-old had anxiety and depression and had spent much of the previous two years in remote learning, which made her parents wonder whether she would be better off attending a local school. But, her mother said, “she had her heart set on going away for college.”
The mother had found a therapist for her daughter to see, but it didn’t work out. “I think she met with the therapist once, and it’s like, ‘Well, it didn’t really click, but I’m fine. I’m fine,’ ” her mother said. (She and the other parents spoke on the condition of anonymity to discuss sensitive issues.)
Except she wasn’t fine. Soon her mother was answering calls in the middle of the night. “It’s really, really hard to be … 2,000 miles away … and have your daughter calling at midnight — sobbing, crying and having a panic attack,” she said. She would sometimes stay on the line until her daughter was calm enough to fall asleep.
At one point, the mother called the school asking for someone to check in on her daughter. The school suggested her daughter go to a hospital. Instead, she and her husband flew their freshman home for a visit. Their daughter made it through the semester, but the family decided she wouldn’t go back in the spring.
Mental health issues among children and adults have been rising for years. Pre-pandemic data from the Center for Collegiate Mental Health showed that the number of students seeking mental health services nationally increased at more than five times the rate of enrollment. The result: Counseling centers have shifted to “short-term crisis support and rising caseloads of clinicians, which are both associated with reduced treatment and less effective care,” the center noted in its 2021 report.
“Most counseling centers are saying that they see more students every year come through, and that’s why they’re changing some of their service models, because we can’t do individual therapy weekly anymore,” said Becca Smith, director of counseling at Berry College in Georgia and president of the American College Counseling Association. Smith added that many counseling centers established stepped care, a triage system that could decide when a student can go to group therapy or a support group instead of individual therapy.
In addition to mental health issues, students must cope with the “newfound freedom” of college, one mother said. “There’s a lack of structure beyond a class schedule. There’s really odd sleep cycles, which definitely affect your mental health. Or alcohol.”
On top of that, many current students spent significant amounts of high school learning remotely, which has made the transition more difficult academically and socially.
These factors combined have left families charting their own paths, with often distressing outcomes.
“Given the current situation — increasing numbers of students with mental health concerns that may have been exacerbated by the pandemic, along with the inability of college counseling centers being able to keep up with demand — it is important that parents and students take steps to manage the transition to college,” Smith said.
Know before you go
Brett Scofield, a psychologist and CCMH’s executive director, suggests parents and students research what kind of mental health services a school offers and what the limits are — for example, how many counseling sessions a school will provide.
The size of the school can make a difference in the level of care, Scofield added. According to data from CCMH, standardized caseloads for counselors rise along with enrollment.
Ask about average wait times for therapy. One mother said her daughter signed up in August, didn’t have an intake appointment until late October, and was only given one therapy appointment before winter break. Meanwhile, the student’s therapist at home had gone on maternity leave. “So she had nobody for a while,” her mom said.
“If you already know that your student has a mental health or physical health concern, and will need continued care, it is important to set that up before the student arrives on campus,” said Nance Roy, chief clinical officer of The Jed Foundation (JED), a nonprofit that works with high schools and colleges to strengthen their mental health services.
Finding out that a school doesn’t offer adequate services for your child “doesn’t mean that institution would not be a good fit,” Scofield said. You may be able to make arrangements for your child to continue seeing their therapist through teletherapy, if state laws allow it, or find a therapist off campus.
Understand your student’s privacy rights
The federal Family Educational Rights and Privacy Act generally protects the privacy of a student’s treatment records, unless that student is a threat to themselves or others. “If a student is seeing a therapist on campus, that information cannot be shared with parents unless the student expressly gives permission or in the case of an emergency,” said Roy, who is also an assistant professor of psychiatry in the Yale University School of Medicine.
For that reason, parents should have a conversation with their student before they go to college about whether the student is willing to sign a release of confidential information, Roy said, adding that parents should be aware of who the student has listed as their emergency contact.
While a school cannot give a parent privileged information, a parent can contact a school at any time to share information with a therapist or ask the counseling center or dean of students to check on a student.
Check in with your kid — appropriately
Don’t focus your conversations on grades or whether your student is taking care of themselves. “It’s probably not helpful to be calling your child every day or texting and emailing them and saying, ‘Are you okay?’ ” Roy said. “You can glean a lot of information about how someone is doing just in regular conversation.” If you think they are at risk or in danger, ask directly if they are having thoughts of suicide and notify the campus if so.
One sophomore who struggled during his freshman year with undiagnosed attention-deficit/hyperactivity disorder echoed this advice. “If my dad … was, like, badgering me … I’m not going to be as willing to open up and be like, ‘Yeah, well, actually, I didn’t do too well on this test because this was going on,’ ” he said.
Make your support clear
Smith said students are often reluctant to let their parents know when they are having difficulties. “They’re really afraid the parents are going to be upset or stressed,” she said. “And a lot of times, we find the opposite.”
After their daughter withdrew from school, the West Coast parents sent her to an intensive therapy program. She received a diagnosis of obsessive-compulsive disorder and started new medication. The treatment allowed her to return to the same school this fall, where she’s seeing an off-campus therapist and doing a better job of taking care of herself. “She definitely struggles from time to time, but she also absolutely loves it,” her mother said.
When she recently asked her daughter what made the greatest difference in getting through that tough first semester, her daughter said it was “knowing that no matter what happened, she had our unconditional love and support. So, if things went bad, she needed to come home, she needed to transfer schools, she failed out of school, she knew that she could tell us and it would all be okay.”
As the college sophomore with ADHD put it: “It’s always good to just have ringing in your head, ‘I’m going to do this, but I know at least I have people behind me, if something goes wrong for some reason.’ ”