The Mental Health Enigma: One Size Does Not Fit All (Part I)

By Wendy Fischman

The state of mental health on college campuses has become a major topic of conversation. In recent months, media outlets ranging from The Chronicle of Higher Education to Foreign Affairs have featured stories about how campuses have been inundated with reports of students’ personal problems.

When we began our study of higher education in 2012, we detected traces of concern from participants on our two pilot campuses; but soon thereafter, nearly every participant across the eight other schools—including students, faculty, administrators, parents and trustees—acknowledged a mental health problem. Indeed, the majority of individuals participating in our study indicated that mental health was the biggest problem on campus, and that was in comparison to other well-known problems, such as academic dishonesty, alcohol and substance abuse, peer relationships, and safety. Among students, our largest constituency, both mental health and safety—described as violence and sexual misconduct—are the overwhelming choices. In this and in succeeding blogs, I discuss our own preliminary findings about mental health in higher education.

By now, we are prepared to hear ample discussion of mental health on any campus that we visit. Indeed, we’d be surprised if we didn’t! However, we have also learned that the prevalence of mental health concerns across disparate campuses, with varying student populations of all kinds, needs closer examination.

To begin with, we might have expected to hear about more about stress and anxiety from first year students. After all, they are onboarding to college—and so they have to deal with academic pressure from an unfamiliar environment, the experience of attending large lectures with hundreds of other students, the challenge of forging social connections with peers.

Surprisingly, though, we find that an even greater percentage of graduating than first year students designate mental health as the biggest concern on campus. Moreover, the challenge occurs across the range of campuses. According to our data, mental health is an equally big concern whether students are on residential or non-residential campuses, and whether they attend highly selective or non-selective schools. When we began our study of higher education, we did not intend to be writing about mental health issues. But this is a topic that we can’t ignore, especially when it distracts students from engaging with academic and other aspects of campus life.

Although the concern about mental health, broadly speaking, is equally strong across various kinds of campuses, interesting and important differences are associated with the more and less selective schools, and residential vs. non-residential campuses. (And we note that in our study, more selective schools are residential; less selective schools are not; hence these factors are confounded.) These differences provide useful insight, while also complexifying the general issue. In unraveling the enigma of mental health issues across disparate college campuses, “one size does not fit all.”

  • Students encounter different problems.

As described by adults on campus, there are some discernible patterns in the kinds of problems students experience. Students at the more selective campuses tend to seek support for issues relating to maintaining a high standard of academic work, balancing academics with campus activities, and handling complicated peer relationships. The more selective institutions in our study (primarily residential), are often comprised of more affluent students, as well as more financial aid for those who are in need. In contrast, students at the less selective campuses tend to seek help to deal with traumatic family situations and balancing academic work with paid work. Their limited time on campus can prevent these students from connecting with peers.

These different causes of stress lead to different kinds of recommendations. At more selective campuses, mental health professionals believe that students need to develop more resilience when confronting academic imperfection and vulnerabilities exposed by relationships with peers and adults. Their counterparts at less selective schools report that the students that they see exhibit plenty of resilience, but need help developing meaningful relationships with others. Put differently: perhaps as a result of navigating traumatic situations and/or finding ways to make the financial ends meet, students at less selective schools can handle “imperfection” and “failure;” but they need to feel more comfortable confiding in and relying on others.

For students in both settings, living apart from parents is described as an important factor in mental health, but plays out in different ways. Students at more selective and residential campuses—those who may be accustomed to daily familial support—find that balancing personal needs (laundry, cooking, shopping) away from parents for the first time is stressful. But students at less selective and non-residential campuses—those who may not have not been raised by their own parents, or who are the first in their families to go to college—find the separation difficult in another way. According to one mental health director, “first gen” students have a hard time talking with parents who don’t have an understanding of the value of higher education, especially when not directly linked to a job or financial outcome that will support the family.

  • Students seek help (or don’t) in different ways.

According to mental health providers at the more selective schools, students tend to take the initiative in seeking help. At the less selective schools, fewer students go to the mental health center on their own. More often, students are referred to mental health services by faculty and student life administrators who observe suffering in some way.

There are a few possible reasons for these differences. First, the more selective campuses have stand alone, independent centers, with little to no connection to other departments on campus. They are labelled and recognized as such. At the less selective campuses, mental health services are more closely tied to other administrative and programmatic departments, such as academic advising, tutoring, and inclusion and diversity offices. Accordingly they may well be less distinctive. Second, on the whole, the less selective campuses are bigger campuses, those in which mental health services may not be as widely known. On smaller campuses, as the saying goes, “everyone knows everything.”

A third consideration: Knowledge about and connection to individuals who can help may be closely connected to the larger concept of belonging, whose three varieties are described in an earlier blog. If students feel a sense of belonging to academics, to peers, and/ or to the institution as a whole, the likelihood is high that they would have a faculty member or advisor, a friend, or awareness of centers on campus, where they might seek help. Those who feel alienated may not know to whom or where to turn. On an initial analysis, at the less selective schools in our sample it appears that higher percentages of students feel alienated from academics, peers, and/or the institution.

Regardless of size, type, or availability and accessibility of mental health services, students who tell us about seeking help complain that there are not enough services or counselors. Students lament long waits (weeks) to be seen or a limited number of sessions per academic year. In an earlier blog, we reflect on whether campuses should ramp up mental health services or help students become “hardier” by using techniques on their own—for example, those learned from cognitive behavioral therapy.

  • Mental health providers have different goals for students.

Though all mental health providers and directors clearly want to help students overcome personal issues, they tend to have different goals for students.

For those students at the more selective campuses who struggle with academic pressure, stress about jobs and careers, and/or problems from being overscheduled, mental health professionals hope that students will focus on these problems. But they also prompt students to investigate larger questions about their place in the world and how they might eventually contribute to a larger society. One mental health director states, “I would like [students] to leave with the sense that they are not the center of the universe.” In other words, the goal is for students to focus on contributing to a wider society, not just harping on their own personal challenges and achievements.

With respect to students at less selective campuses who come for help with trauma (losing a parent, fear of safety), the focus is on helping students become stable and productive—going to class, completing work, and staying in school.  As described earlier, these students tend to be more resilient based on what they have already gone through; but in the words of, one director, “when they fall apart, they fall apart.” The clinicians’ emphasis is clearly on helping individuals cope with the particular challenge being faced—learning humility or engaging in public service are left for another day.

In future writings, we expect to take a closer look at other topics relating to mental health: for example, particular words used by students to describe “mental health” challenges (even if they aren’t their own challenges); correlation of students’ preoccupation of mental health with other key concepts of our study, such as mental models, “higher education capital,” called HEDCAP (formerly LASCAP for liberal arts and sciences capital), and belonging; and the range of approaches to mental health carried out across schools in our study.

© 2019 Wendy Fischman and Howard Gardner

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