Families and Mental Health Issues in College

Two experts offer guidance to students and parents getting set for freshman year of college

By: Alison Murtagh

IN RECENT YEARS, colleges have seen a concerning increase in mental health issues such as anxiety and depression among students – and that was before the coronavirus pandemic disrupted campus life and threw the future into doubt.

In "The Stressed Years of Their Lives," family psychologist B. Janet Hibbs and University of Pennsylvania psychiatrist Dr. Anthony L. Rostain – both parents of college graduates – examine the challenges many students, parents and schools are facing and offer insights about what kinds of counseling and other services to look for when considering colleges. This interview has been edited for length and clarity.

Is there a mental health crisis on college campuses?

Rostain: There is strong evidence of a legitimate and significant rise in levels of stress, distress and mental health disorders in college students over the last two decades. In part that's a reflection of the success we've had in identifying kids with issues, treating them and helping them adjust and adapt to the transition from high school to college.

While college campus resources are being stretched, there are really good new programs that colleges are developing to expand students' capacity to be resilient in the face of stress. I'm not here to say the sky is falling; I'm here to say, yes, there's a crisis, but I think that everyone's eyes are now open to this, and people are talking about it and trying to handle it.

What can families do early on to help students prepare for changes to come?

Hibbs: Parents tend to be over-involved, and they're anxious. They'll do everything they can to kind of catch their kids before they fall, so kids don't have enough practice in some of the social-emotional maturity development. Instead of promoting childhood autonomy, which is really a parent's job, they're exerting more parental control because they're scared.

Rostain: We talk in the book about social and emotional readiness. I think that practicing these skills is key: being able to take responsibility, practice self-management, handle social relationships and learn to exercise self-control. Developing the ability to cope with frustration, handling risk and at the same time being open and accepting, and also seeking help when you need it

For parents, what are some warning signs of problems?

Rostain: Differences in mood where the individual may be developing depression – they withdraw from their usual activities, they start to not sleep well, they are less engaged in their normal pursuits, they stop socializing as much. There's also concern about excessive alcohol or substance use.

Hibbs: About one-quarter of kids who arrive on college campus today have already been treated for or diagnosed with a mental health problem. The most common is anxiety, followed by depression. One of the good things about Gen Z is they are more open to seeking help, and they show a reduced negative stigma about mental health problems, with greater willingness to get treatment. Mental health literacy helps parents and kids be more alert and aware that this is treatable.

So how should parents respond if their child reports being anxious or depressed?

Hibbs: Listen. Don't judge them for telling you.

Rostain: Normalize to the best extent possible – sometimes life is difficult. Make it clear to kids that these things are not untreatable.

What role can friends and peer support play? Do peer counselors or advisers help?

Hibbs: Basically, if social life fails, college fails. A key role of friends is to help individuals stay motivated and to encourage them to devote time and effort to learning.

It's actually been shown that kids who graduate on time usually graduate in a friend group, and kids who don't graduate on time have somehow lost social connection or they drop out – literally or figuratively.

The other research on connection suggests that having an adult mentor or adviser who actually knows what you're doing and is invested in you is also a key to helping young people succeed.

Can you give an example of an action to take in the face of a challenge?

Hibbs: Destructive perfectionism is something that very high-achieving kids often experience in college because they haven't had that much practice with failure. And by "failure," we can mean a lower grade than they thought they'd get.

In our book, we talk about how a student's anxiety – constant pressure, constant striving – turned into a suicidal intent one evening after she'd been drinking. She came to see me in therapy, and after that we gradually involved her family in terms of the things she felt like she couldn't tell them before and things that made her feel like "I'm disappointing people."

Through this process, she became more self-accepting, which is a key component of social-emotional maturity. She was able to tolerate her faults and mistakes while dealing with setbacks without feeling too ashamed.

What parting advice would you give students and parents preparing for that first year of college?

Rostain: Take time to make friends, but also spend time getting to know your teachers and getting connected to clubs. Whatever you're excited about, give yourself a chance to explore those things.

Hibbs: (A parent) can try to reassure them that I'm not going to call you every week, asking "How's this class going? How's that class going?" They don't need a checkup all the time. Have a conversation.

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