Graduation: classically peppered by parties, gifts, and champagne toasts to the happy memories of university life.
Not all the seniors donning their caps and gowns during this year’s commencement season will be leaving behind four years of joy and wonder, however. Far from it. For tens of thousands, the college experience has been marred by crippling stress—enough so that many campuses have been overwhelmed by demand for mental health services.
The situation has been acute enough to prompt expensive policy changes. California, cash-strapped as it may be, recently proposed a bill that would set up funding streams for mental health services for students at all of the state’s public colleges. And the University of California system recently committed millions of dollars to expanding its student mental health budget, including the hiring of more psychologists, psychiatrists, and case managers, in response to student complaints of inadequate counseling resources. The UC schools join dozens of other universities, coast to coast, staggering under the same weight.
The number of appointments made at counseling centers has grown at more than seven times the rate of institutional enrollment. One might wonder whether college students across the US are suddenly having some sort of breakdown. In fact, the trouble starts much earlier than that. Anxiety and depression in America’s high-school-aged teenagers have climbed to astronomical levels; it makes sense that these patterns of unhappiness stretch, and oftentimes amplify, during college, when many students taste life for the first time away from family and familiar surroundings.
A nascent push for mental health reform at the college-age level began in the aftermath of the 2007 Virginia Tech shooting, when a 23-year-old senior with a history of mental illness murdered 32 people on campus before killing himself. In the years since, the focus on mental-health services on campus has grown—but far too slowly to keep pace with demand.
Take a look at the numbers: In 2014, the American College Health Association found more than 50% of students had felt “overwhelming anxiety” in the previous 12 months; in 2013, almost all the college mental health directors surveyed by the National College Counseling Association said they’d seen a recent increase in students with serious psychological problems at their schools; and Pennsylvania State University’s latest national report (pdf) on collegiate mental health reveals the number of appointments made at counseling centers has grown at more than seven times the rate of institutional enrollment.
It’s that last figure that might just be the most troubling—because if mental illnesses are on the rise at American universities, so are the failures of school systems to successfully address them.
“You can’t expect to meet all the demand”
Earlier this year, a rattling report from a University of Wisconsin higher-education research lab found only 12% of US community colleges have a psychiatrist or other licensed provider on hand to help students in need of mental-health services.
Four-year institutions might have more resources, but it doesn’t mean they’re fully equipped to meet needs. Schools including the University of Missouri, the University of Pennsylvania, and Swarthmore College have seen unprecedented demand for psychological services; many are running up long wait-lists for counseling sessions. Importantly, it’s not a US-specific trend. Universities in the UK and other countries also are struggling to meet record-high counseling requests.
At some schools, like Brown University, the answer has been to expand the counseling staff. And at a recent conference on collegiate mental wellness hosted at the University of Michigan, educators and psychology experts discussed the viability of crowdsourcing mental health resources with mobile apps and other technology.
Yet it may not ever be enough.
“As we go on increasing services, we hope more students will come to them, which means we’ll have to increase services,” says Unab Khan, medical director of Brown’s health services. Still, without knowing exactly how much support will be needed, the supply of resources available on campus “lags a little behind demand—you can’t expect to meet all the demand,” she says.
Feeling the strain
Former Yale University student Rachel Williams helped focus the debate over the ability of campuses to handle students’ mental health issues with an essay she penned in the Yale Daily News in 2014, titled “We Just Can’t Have You Here,” about her traumatic experience with the school’s mental health system. She recalled admitting episodes of self-harm to a student counselor, then being locked into an emergency ward against her will and all but forced by Yale’s psychiatrists to withdraw from the school.
Williams’ essay ripped through classrooms and dormitories, prompting students to hold forums, write to administrators, and bare their personal battles. Stories came spilling out from campuses beyond Yale’s, from Princeton University and the University of California at Santa Barbara, among other institutions that allegedly forced out mentally ill students, treated them with hostility, or simply didn’t have the resources to serve them.
Responding to the backlash over Williams’ experience as well as the 2015 suicide of Luchang Wang, a 20-year-old student who referenced the school’s withdrawal and readmission policies in her suicide note, Yale last year announced a series of reforms to its counseling services, including plans to hire additional psychologists, psychiatrists, and clinical social workers. But that’s just one school.
Pointing fingers everywhere, nowhere
For all of the destigmatization surrounding basic mental-health services like regular counseling, accounts of punitive actions taken against students with more complicated needs has, in some cases, amplified unease. That’s fostered deep distrust—essentially a “chilling effect,” says Darcy Gruttadaro, advocacy director of the National Alliance on Mental Illness.
“That’s absolutely wrong,” Gruttadaro says. “Schools need to be extremely careful about the message they send. It’s a sign of strength when a student comes forward because it means they’re interested in getting better.”
But while having better mental health infrastructure directly benefits students, and even boosts schools’ graduation rates, there’s a lingering debate: What role does—or should—a university have in a student’s personal life anyway?
Daniel Eisenberg, a professor of health management and policy at the University of Michigan professor and a co-author of the Wisconsin study on mental health at US community colleges, suggests a highly practical—not moral—approach to the question of responsibility. Eisenberg tells Quartz:
“The lens I like to bring to this question is from my background in economics. Rather than thinking about it as a responsibility or not, I find it more helpful to think—does this make sense for society? It makes sense to provide mental health services at least on some basic level through campuses, because campuses are integrated communities that have so many ways of identifying people who might benefit from these services [and other places are not]. It’s a more efficient, high-value way of delivering the service.”
With American campuses shaken this past year by a wave of controversies over free speech and political correctness, critics are broadly accusing schools of coddling their students, of being overly sensitive to even the smallest of complaints. Some say this indulgent attitude has spilled over to mental health, and that perhaps students have learned to rely on institutional crutches for their concerns rather than sorting out problems themselves.
But maybe the role for schools in the mental well-being of their students is as Eisenberg suggests: a matter of economic efficiency.
Colleges may have not an obligation, but rather a golden and pressing opportunity, to better the lives of young people they send off into the world.