Ill-equipped college students flood counseling centers

By Katie Kerwin McCrimmon

Six students in crisis flooded the counseling center on the first day of school this fall at the University of Colorado Colorado Springs.

Last year, the number of UCCS students who needed emergency or crisis counseling tripled over the year before. And the director of the campus counseling center says the number of students seeking care has been steadily rising along with the student population in recent years.

In Boulder at CU, the number of students seeking counseling has been steadily climbing for eight years and last year the schools psychological and counseling services center treated or reached out to more than 15,000 students and faculty. The upward trend is the same at Colorado State University in Fort Collins. In the fiscal year that started in the summer of 2009, CSU counselors served about 8 percent of the student body. That jumped the next two years to about 13 percent. And this year from July 1 through the first week of school, the counseling center served 740 students or 18.6 percent more students than during the same period last year.

Theyre bursting at the seams already, said Janelle Patrias, coordinator for mental health initiatives for the CSU Health Network, where student fees of about $39 per semester cover the first five individual counseling sessions, behavioral health workshops and some drug and alcohol prevention programs. Fees have inched up to keep pace with demand.

Since prevention is critical, CSU has launched a program this fall to have counselors work directly with students recently released from psychiatric hospitals. It is believed to be the first such program in the nation.

Aurora theater shooting suspect James Holmes started accumulating weapons as he was flailing in an elite neuroscience graduate program at the University of Colorado Denver. His apparent mental health struggles have highlighted concerns about students under stress, although most suffer with mild depression or anxiety, and never become violent.

A nationwide trend

Nonetheless, at other Colorado campuses and universities across the country, deans, researchers and behavioral health experts have been seeing spikes in recent years in visits to counselors and mental health facilities. Incoming students are arriving in poor emotional health aggravated by academic and financial pressures.

Scholars Arthur Levine and Diane R. Dean tapped scores of interviews and surveyed more than 5,000 students at 270 colleges and universities for their new book, Generation on a Tightrope, A Portrait of Todays College Student. They found that students are stressed about school, worried about future job prospects, abusing alcohol more than ever and have been coddled so much by their parents that many may not be equipped to handle adult pressures.

There are more stressors in students lives, said Dean, associate professor of higher education administration and policy at Illinois State University. Whats compounding it at the same time is that theyve been raised in such a way that theyre less prepared than ever to deal with it.

She and Levine spend an entire chapter documenting parents who range from helicopters (who hover), stealth protectors (who swoop in) and lawnmowers (who mow down anyone in their students way). Some parents communicate from afar with their young adult children multiple times a day and intervene on everything from academics to disciplinary hearings. Some have even pestered university officials to wake their students up for class.

The message to students from their parents is, Youre not capable. I will do it for you. Theyre not developing appropriate social skills or coping mechanisms. This is the generation that was never allowed to skin their knees. Everybody gets a trophy and nobody ever fails, Dean said.

Theyre used to being over-rewarded and applauded for what prior generations would have seen as average.

Spike in university students seeking counseling

Colorado State University

  • 2009/10: 2051 students, about 8.2 percent of students
  • 2010/11: 3416 students, about 13 percent of students
  • 2011/12: 3606 students, about 13.5 percent of students
  • 2012/13: From July 1 to Aug. 31, 740 students, 18.6 percent increase over same period in previous year.
Source: CSU

University of Colorado Colorado Springs

  • 2008/09: 492 students served, about 6.1 percent of students
  • 2009/10: 481, about 5.7 percent of students
  • 2010/11: 701, about 8 percent of students
  • 2011/12: 739, about 8 percent of students

Source: UCCS

Deans research and surveys from the American College Health Associationhave found that 75 percent of students reported experiencing stress; nearly half said they were dealing with anxiety; and 25 percent said they had been depressed in the last year.

The causes for the angst vary. The sour economy has added pressure to students who are taking on more debt and working more hours to pay for their degrees. No longer is college merely a time to ponder the meaning of life, take basket-weaving and excel in the art of partying. Facing a bleak post-college job outlook and the prospect of boomeranging back to their parents basements after college, students feel pressure to earn degrees that will bring high-paying jobs.

Stigma easing

In the past, stigma about mental health ailments may have prevented some students from seeking psychological counseling. Experts see it as a sign of maturity that many students now are asking for help.

We see it as a positive that young people are being identified earlier and are receiving more adequate treatment for any mental health disorder, said Patrias, CSUs mental health coordinator. They are able to come to school whereas in years past, with the onset of disease, many werent able to manage their disease and go to school.

The Americans with Disabilities Act requires schools to accommodate students with both physical and mental ailments.

Patrias says parents are more connected to their students than ever before, but she doesnt see it as a negative. She believes its helpful to have them keeping tabs on their students mental health.

She is not certain why CSUs rates of students seeking counseling are so much higher than those of comparable universities . National surveys from the Association for University and College Counseling Center Directorshave found that similar-sized four-year universities would typically see about 5 percent of students seeking their services whereas CSUs mental health system is serving about 13 percent of its students.

Colorado has disproportionately high suicide and depression rates, a challenge that faces behavioral health experts working with people of all ages.

University counselors at various Colorado universities think rates of usage may be on the rise partly because they are getting better at reaching out to students who may need help. At CSU, counselors make presentations for all students at summer orientation and let them know how to find help. They will see students the same day they walk in for care.

At CU in Boulder, Karen Raforth, director of counseling and psychological services, has gotten creative with her outreach efforts, conducting stress workshops, holding office hours in strategic buildings far from the counseling center to reduce stigma, hiring therapists who speak nine languages and reaching out to one of the toughest groups to penetrate, international students.

Photo by Glenn J. Asakawa.

International students dont get stressed

Raforth recently attended a reception for international students. She introduced herself and was careful not to use words like depression or mental health.

I run the counseling center. You might run into me, she said to one student, introducing herself.

We dont get stressed, the student informed her.

Raforth said thats a typical reaction. So, she talks instead about cultural issues and urges the students to seek her out if theyre having challenges adjusting to life in the U.S.

CU also offers programs tailored specifically to veterans, students of color and students who are gay, lesbian, bisexual and transgender (GLBT).

While Boulder seems like a tolerant place, Raforth says surveys show African American and GLBT students are among those who report being least satisfied on campus.

It only takes one person to ruin your day, she said.

The chief complaints among all students relate to depression, academic pressures, relationship problems and fear of disappointing parents.

We hear I flunked my exam. My girlfriend threw me out. My parents are getting a divorce. I got my first F, Raforth says.

When the economy started tanking in 2008 and 2009, Raforth said she heard more students voice fears about money.

It was abrupt for many folks. Economic stress can take a toll on the entire family. It closes down your options, she said.

Some students never wanted to be at a particular campus in the first place and came only because they had no other option.

Substance abuse a problem

These days, its more common to hear about students who are having difficulty taking care of themselves. Few get enough sleep, eat a healthy diet and get enough exercise. Substance abuse is rampant and aggravates mental health woes.

Counselors see demands for their help ebb and flow throughout the academic year. The beginning of the year can either be a honeymoon or a time for homesickness. Demand rises again during midterms, eases around the holidays when the students head home and peaks again during spring midterms.

Photo by Casey A. Cass.

Exam times at the end of each semester bring in severely depressed students.

Its make or break time. A lot of the students who come in then are in serious trouble. Theyre at the end of their rope. Its knotted and their hanging on. The ones we see then probably should have been in here by midterms. Theyre a mess, fewer in number but more worrisome cases, Raforth said.

Whats clear is that students have excellent access to same-day, low-cost care. In Boulder, there is no charge to see a mental health counselor. The visits are covered through student fees. At CSU, students can get care at either the medical clinic or the counseling center. Behavioral health experts staff both location and all students seeking medical care are also screened for mental health concerns.

In Colorado Springs, students pay for care on a sliding scale. Student fees at the fast-growing university dont cover mental health visits.

Dr. Benek Altayli, the director of UCCSs counseling center, said shes never turned anyone away, but studies show students are more invested in their care if theyre responsible for a co-pay. Sometimes she has charged as little as 25 cents per session.

Her center cares for students based on the urgency of their issue. They provide psychotherapy to individuals and groups for traditional relationship issues, depression and anxiety.

If someone says, My world is falling apart. I cant take it anymore. Im thinking about hurting myself. Im going to drop out of school today, then theres a crisis going on and they cant wait, Altayli said.

If students are at risk for harming themselves or others, counselors will see them immediately. If theyre in no imminent danger, but facing a crisis, therapists will see the student within 48 hours. Both the emergency and crisis calls are the ones that rose at such a fast clip last year and could rise again judging by demand as school began in late August.

The complaints at the beginning of the year indicated utter disarray: Im not ready to be here. I dont have money to buy books. My living arrangements are not what I want. My parents are not being supportive.

Sometimes the particular concern a student voices may not be the most crucial part of their visit. Rather, she said its fundamental that a student who feels out of control steps up and asks someone for help.

The data shows that students are more stressed out. Period, Altayli said.

Students ill-prepared for independence

She agrees with Diane Dean, co-author of Generation on a Tightrope, that coddling parents have not prepared their young people for independence.

Students dont just wake up one day and now theyre adults. Its important throughout high school to pay attention to training the child to become independent, to teach them how to balance a checkbook and show them that using a credit card does not mean you have unlimited resources, she said.

She has parents who call her and say they think their student needs to be seen at the counseling center. Or parents will want to know how counseling is going and therapists must explain that by law they cannot confirm that a student is a client.

Taking over their lives is not healthy and helpful, she said. We have some parents who want to take over everything. They call administration, records, the dean of students or if theyre sick, the health center. They want to do everything for their child.

But, its vital for young people to learn to advocate for themselves and to ask for help if they need it, Altayli said.

Dean said its clear that universities are going to need to continue strengthening their programs for students in crisis.

These instances of mental health issues are not going to diminish. Were anticipating more students coming with more complex problems, she said. Its an important issue for public health and safety.