September 29, 2025 • 21 mins
Explores the diverse mental health challenges faced by university students, distinguishing college experiences from those of non-attending peers. It examines various conditions like anxiety, depression, substance abuse, eating disorders, and psychosis, along with their impact on academic performance and social life. The source also addresses the unique difficulties of specific student populations, including international students, LGBTQ+ individuals, those with disabilities, and non-traditional students, offering insights into assessment, treatment modalities, and the evolving role of mental health professionals on campus. Ultimately, it emphasizes the critical window of opportunity that the college years present for early intervention and positive life trajectory changes.
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You can listen and download our episodes for free on more than 10 different platforms:
https://linktr.ee/book_shelter
Get the Book now from Amazon:
https://www.amazon.com/Mental-Health-Issues-University-Student/dp/1421412381?&linkCode=ll1&tag=cvthunderx-20&linkId=d2759e7ae0cd7b1218c5b154ff328bfe&language=en_US&ref_=as_li_ss_tl
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome you to the deep dive. Today, we're embarking on
really a crucial exploration into a topic that touches the
lives of so many young people, the evolving landscape of
mental health for university students.
Speaker 2 (00:13):
That's right. We're pulling insights from the book Mental Health
Issues and the University Student and really distilling the most
important knowledge to help you understand the unique challenges and
also the opportunities for well being on campuses today.
Speaker 1 (00:26):
Yeah, what's truly fascinating, I think is how much this
landscape has transformed, you know, from historical approaches to the
really nuanced issues students navigate right now exactly. Our mission
for you is simple to cut through the complexity and
give you a comprehensive yet concise understanding of this vital area.
Think of it as your shortcut to being incredibly well
(00:47):
informed on a subject that's well more relevant than ever.
Speaker 2 (00:52):
So let's unpack this indeed, and it's worth just quickly
noting that while we'll discuss some case examples, these are
really composite illustrations based on common patterns we see in
clinical practice, not actual patients, So names details are all fictitious.
Speaker 1 (01:07):
That's a really important point. Okay, so let's look at
how campus mental health support has well changed over time.
For decades, university counseling centers, they largely focused on career
guidance and developmental.
Speaker 2 (01:20):
Needs, right, kind of vocational stuff exactly.
Speaker 1 (01:23):
But after World War Two, say, by the nineteen fifties,
there was this growing recognition that mental well being needed
a much broader focus.
Speaker 2 (01:31):
Yeah, and if we connect this to the bigger picture,
doctor Dana Farnsworth was really a pioneer here. He articulated
the crucial role of psychiatrists on campus, not just treating illness,
but integrating mental well being through educational and importantly preventive services.
Speaker 1 (01:45):
So weaving it into the community fabric.
Speaker 2 (01:46):
That was the vision, Yeah, to weave mental health into
the very fabric of the university community. But making that
vision a reality has been a slow and often pretty
uneven process.
Speaker 1 (01:58):
But then something you know, really pivotal happened, particularly I
think in the wake of high profile tragedies like the
one of Virginia Tech. Unfortunately, we saw this rapid shift.
Colleges started forming threat assessment teams and there were even
laws mandating them in states like Virginia and Illinois.
Speaker 2 (02:15):
Right, and while those teams are important for immediate risk management,
the broader insight here is that they often don't address
the systemic issue, you know, the underfunding, the limited resources
for the kind of mental health care students desperately need.
Speaker 1 (02:30):
So it's like a band aid.
Speaker 2 (02:31):
Sometimes it can feel like that. Yeah, a band aid,
when maybe a deeper structural change is what's really required.
Speaker 1 (02:37):
Okay, this rais is a really interesting question. Are college
students facing different mental health issues than their peers? Yeah,
you know this is the same age, but not in
university And the.
Speaker 2 (02:47):
Answer, maybe surprisingly is yes in some key areas. So
while approximately half of all eighteen to twenty four year
olds have a psychiatric disorder in any given year, which
is a huge statistic in itself a profound national challenge,
wow happen? Yeah, college students show a significantly higher rate
of alcohol use disorders, but interestingly, they also have lower
(03:08):
rates of personality disorders and bipolar disorders.
Speaker 1 (03:10):
Okay, that is interesting, But here's where it gets well disturbing.
Despite these high rates, college students are actually less likely
to get treatment for alcohol or drug addictions. That's a
major gap, a huge gap, and even with more counseling
centers appearing on campuses. Surveys show most students identified as
(03:30):
potentially depressed or suicidal are just well, they're not engaged
in any kind of treatment.
Speaker 2 (03:35):
It truly is a gap. And these difficulties they often
go unnoticed by the wider campus community, yet they profoundly
affect students' lives, right. I mean, when you ask students
what impedes their academic performance, they consistently point to stress.
That's number one, okay, followed closely by sleep difficulties, then
things like internet use, computer games, depression, anxiety, and alcohol.
(03:56):
So it's a whole constellation of factors, absolutely, and the
impact isn't just academic. It's insidious. Psychological problems can make
it hard to form friendships, they can lead to housing conflicts,
and they significantly contribute to delayed graduation or even students
dropping out altogether.
Speaker 1 (04:14):
And you might wonder just how prevalent these struggles really are. Well,
the numbers are pretty stark. Most students report feeling overwhelmed
at least once in a year. Nearly half felt so
depressed it was difficult to function. And get this, almost
one in ten seriously considered suicide.
Speaker 2 (04:31):
That's incredibly sobering, it really is.
Speaker 1 (04:34):
And what's more, among students who are using college counseling centers,
twenty four percent are now taking psychotropic medications. Yeah, you know,
medication is affecting brain function for mental health conditions. That's
a huge jump from just nine percent back in nineteen
ninety four.
Speaker 2 (04:47):
Yeah, that signals a fundamental shift, doesn't it. And the
severity and the complexity of issues that counselors are encountering now.
But you know, this also highlights the immen's opportunity universities
have for early intervention. The college years are this unique
window really to alter the trajectory of an illness and
quite literally a student's entire life.
Speaker 1 (05:08):
Okay, let's shift our focus a bit. Let's talk about
the changing demographics on campus, because that introduces entirely new
mental health consideration. For example, many more students are openly
identifying as gay, lesbian, bisexual, or transgender.
Speaker 2 (05:22):
Now much more visibility.
Speaker 1 (05:24):
Yeah, the average age for starting the coming out process,
it dropped from like nineteen twenty three in the eighties
to just sixteen by twenty eleven. Wow. But even with
increased societ acceptance, students from underrepresented groups, They still face
more challenges bullying, discrimination, and that's often amplified by social media.
Speaker 2 (05:43):
Absolutely, consider a case like Bruce's composite example. Remember his
deep struggle with his attraction to men stems from his background.
Son of an evangelical Christian minister. He lives in fear
of family and community disapproval.
Speaker 1 (05:56):
That sounds incredibly difficult.
Speaker 2 (05:58):
It is, and for mental health profess it's critical to
understand that so called reparative therapy trying to change someone's orientation,
is unethical and harmful. The goal isn't change, it's integration,
helping students like Bruce integrate their sexual orientation and their
religious beliefs, providing a safe, non judgmental space for discussion,
(06:19):
for exploration.
Speaker 1 (06:20):
Okay, integration not change. That makes sense. And what about
gender identity.
Speaker 2 (06:24):
Well, awareness there is still evolving even among professionals. Terms
like cisgender by a gender, gender queer. These describe how
individuals identify with or diverge from the gender they were
assigned at birth. They're becoming more common, but transgender students
like Allen, another composite example, who actually resorted to buying
testosterone online after a suicide attempt. They face significant discrimination
(06:47):
and psychological distress. Oh wow, Yeah, so this requires clinicians
to be familiar with the WPATH standards of care. These
emphasize informed consent and comprehensive screening, recognizing that you know,
mandatory psychotherapy before underfirming hormones can actually be counterproductive sometimes.
Speaker 1 (07:02):
Got it? Okay, what about international students? They face unique
pressures too.
Speaker 2 (07:07):
Right, Definitely beyond the obvious acculturation stresses adjusting to a
new culture. Their visa status is well inextricably linked to
their student status.
Speaker 1 (07:20):
Uh so they can't just drop courses.
Speaker 2 (07:22):
Exactly or take time off without potentially jeopardizing their ability
to stay in the US. And the data shows they're
significantly more likely to be hospitalized for psychiatric reasons, use
crisis services, and present with suicidal ideation, grief, and loneliness.
Speaker 1 (07:38):
That's a heavy burden, it is.
Speaker 2 (07:40):
Take Lie, a composite Chinese international graduate student. She initially
experienced fatigue anxiety attacks, but believed it was purely a
physical ailment. This illustrates how mental illness can be far
more stigmatized for many international students, leading to reluctance maybe
to take psychotropic medications, so they might prefer different approaches
often Yeah, they prefer more direct counseling styles and can
(08:02):
benefit greatly from complementary treatments like yoga or mindfulness, which
are actually quite popular. Then there's a Jeet from India, again,
a composite initially presented as love lorn after his professor
noticed him falling behind. But his behavior stalking stimulant use,
was really out of step with cultural norms, suggesting an
underlying mood disorder.
Speaker 1 (08:23):
So the initial presentation wasn't the full story, not at all.
Speaker 2 (08:26):
It really underscores the need for collateral information, talking to peers,
maybe family if possible, when working with international students to
truly understand their context.
Speaker 1 (08:35):
Makes sense. What other demographic shifts are impacting student mental health?
Speaker 2 (08:39):
Well, Another significant one is the rise of older students.
Over forty percent of university students are now over twenty.
Speaker 1 (08:45):
Five forty percent Yeah.
Speaker 2 (08:47):
And specifically post nine to eleven thanks to the GI Bill,
student veterans have surged onto campuses. They often bring with
them high rates of PTSD, depressions, suicide risk, and substance
abuse stemming from combat exposure.
Speaker 1 (08:59):
Right Like Arcis, the veteran example in the book feels detached,
struggles to focus exactly.
Speaker 2 (09:05):
He might be dealing with a traumatic brain injury a
TBI from an explosion during his service. Understanding both military
culture and campus culture is absolutely essential for effectively supporting them.
Speaker 1 (09:17):
Okay, and finally, students with disabilities.
Speaker 2 (09:20):
Their numbers have doubled, but a key shift happens in college.
The responsibility for advocating for services moves from the institution
like in high school, to the individual student.
Speaker 1 (09:31):
Ah, that's a big change.
Speaker 2 (09:33):
It is they face additional developmental demands, and studies show
they have higher rates of substance use and risky sexual
behaviors too. Esther the example with an anxiety disorder and
a physical disability, Her story really highlights how physical and
emotional challenges intersect with social experiences, creating this unique set
of pressures.
Speaker 1 (09:52):
Okay, so that covers a lot of the demographic shifts. Now,
let's maybe zoom in on some specific mental health challenges
that affect students really profoundly.
Speaker 2 (10:00):
IDEA. First, sleep problems we mentioned them earlier. They are
second only to stress as an academic impediment. Dave, the
biracial sophomore example, struggles with insomnia. Why erratic schedules. Alcohol
use energy drinks.
Speaker 1 (10:14):
Ah, energy drinks, They're everywhere exploded.
Speaker 2 (10:17):
About thirty four percent of eighteen twenty four year olds
regularly consume them, and get this, a quarter combine them
with alcohol.
Speaker 1 (10:23):
Yeah, that sounds risky.
Speaker 2 (10:24):
It is so a key insight here for helping students
like Dave is teaching something called constructive worry, like writing
down worries and potential solutions before bed, along with of course,
consistent sleep hygiene practices.
Speaker 1 (10:36):
Constructive worry. I like that. Okay? What about substance abuse,
always a big topic on campus?
Speaker 2 (10:41):
Huge alcohol obviously is ubiquitous. Binge drinking effects about two
in five students ruin five.
Speaker 1 (10:47):
Yeah.
Speaker 2 (10:48):
One the example of the Hispanic male wanting to rush
a fraternity he binges but minimizes the consequences. He thinks, oh,
everyone drinks this much.
Speaker 1 (10:56):
Right? That normalization exactly.
Speaker 2 (10:58):
It highlights a common lack of insight. So for emerging adults,
harm reduction strategies and motivational interviewing are often more effective
than pushing strict abstinence models right away, meeting them where
they are.
Speaker 1 (11:09):
Okay, harm reduction? What about marijuana?
Speaker 2 (11:12):
That's the most commonly used illicit drug well drug after alcohol.
Rosa the law student example, She attributes her attention and
memory problems to stress, not cannabis, but.
Speaker 1 (11:23):
The cannabis could be playing a role, very.
Speaker 2 (11:26):
Likely, especially since cannabis potency has significantly increased over the years,
and withdrawal symptoms like irritability or sleep problems can actually
mimic stress, which makes diagnosis tricky. Right, and with legalization expanding,
we're likely to see more students using it, often unaware
of the potential long term impact on cognitive function, on motivation.
Speaker 1 (11:47):
And then there are stimulants Adderall.
Speaker 2 (11:49):
Riddlin Susan the economics major using her boyfriend's adderall to study,
or Tom the engineering student thinking he might have undiagnosed
ADHD in considering self treating.
Speaker 1 (11:59):
OH common is that using them non medically.
Speaker 2 (12:01):
Estimates are between seven to fifteen percent of students use
stimulants non medically, mostly trying to boost academic performance. But
there are risks, serious risks anxiety mania, addiction. There's that
tragic example in the book of a pre med student's
suicide linked directly to adderall addiction. It's a very stark reminder.
Speaker 1 (12:21):
Definitely okay, moving away from substances. Loneliness and relationships. That's
another big.
Speaker 2 (12:28):
Area, right, absolutely, the whole hookup culture. It's an ambiguous term, right,
could mean anything from kissing to intercourse. Sure, it's widespread,
often overshadowing traditional dating, and alcohol is frequently involved, which
increases risks like non consensual encounters or regretting the experience later.
Speaker 1 (12:46):
But do students actually prefer that?
Speaker 2 (12:48):
Well, here's the surprising insight. Most students, especially women, actually
say they prefer traditional dating.
Speaker 1 (12:53):
Interesting.
Speaker 2 (12:54):
And then there's the loneliness aspect. Jason the example who
feels like a social failure. He highlights something called social hopelessness.
Speaker 1 (13:01):
Social hopelessness, Yeah.
Speaker 2 (13:02):
It's the specific fear of never fitting in, never finding intimacy,
and it's shown to be a powerful predictor of suicide
among college students, more so than general hopelessness.
Speaker 1 (13:13):
Wow, that's specific and potent. And social media doesn't always help.
Speaker 2 (13:17):
Ironically. Know, while it seems to connect people, about fourteen
percent of students report it actually increases their feelings of isolation.
Seeing everyone else's curated highlight reel can make you feel worse.
Speaker 1 (13:29):
Yeah, I can see that. Okay, what about perfectionism that's
often seen as a good thing, driving excellence.
Speaker 2 (13:35):
It can be, but it often crosses a line into
being psychologically damaging. Jenny the valedictorian example, she struggles with
these incredibly unrealistic expectations. She even interprets a Bible verse
as meaning she can't tolerate any mediocrity in herself, which
leads to immense suffering.
Speaker 1 (13:52):
Oh dear.
Speaker 2 (13:52):
And similarly, fang Wi the international student example, she dismisses
her very real acculturation stress, viewing anything less than top
grades is complete failure. This self critical perfectionism. It's linked
to psychological and academic difficulties across different cultures. It's a
broad issue.
Speaker 1 (14:08):
Okay, and anxiety you mentioned that's huge in counseling centers.
Speaker 2 (14:11):
It's the most commonly cited concern. Yeah. Mike the medical
student example suffers from generalized anxiety disorder constant dread, physical
symptoms severely affecting as studies. Or Louise the popular cheerleader example,
who hides her bisexuality that creates significant anxiety around her
social interactions. It shows how hiding core aspects of your
(14:32):
identity can really feel anxiety, and also that anxiety disorders
can manifest differently depending on factors like sexual orientation right.
Speaker 1 (14:40):
And anxiety isn't just gad right, there's OCD exactly.
Speaker 2 (14:43):
The obsessive compulsive spectrum symptoms like excessive concern with things
being just so, or intrusive thoughts, maybe repetitive behaviors like counting.
These can be signs of OCD itself or related disorders
like body dysmorphic disorder, trichotilomania that's hair pulling like a
li VIA's case, or pathological skin picking. Panic attacks are
also common and tragically. The college years are a high
(15:06):
risk period for traumatic experiences. Sexual assault causes the greatest
incidents of PTSD among students.
Speaker 1 (15:13):
That's devastating, which leads us naturally to depression.
Speaker 2 (15:16):
Yes, Jamal, the African American sophomore example, experiences chronic depression
academic decline. His case highlights the increased risk and often
under utilization of services among minority students and first generation students. Marissa,
after a breakup, experiences severe depression, and Todd after being
rejected by fraternities, falls into isolation and increased drinking. These
(15:39):
stories really underscore how difficult life events can trigger or
worsen underlying depression.
Speaker 1 (15:44):
And diagnosis can be tricky.
Speaker 2 (15:46):
It can be especially because the brain is still maturing
into the mid twenties. Sometimes emotional volatility might resolve over time.
And while medication is often very beneficial, students frequently hesitate.
They worry about personality changes or dependents.
Speaker 1 (16:00):
Yeah, those are common concerns.
Speaker 2 (16:02):
Absolutely, and finally, disordered eating rates for conditions like anarexia
and bolimia are notably higher among college students than the
general population. Nicole the example, who after a breakup develops binging,
excessive exercise and also self injury or NSSI. There are
useful screening tools like the Scoff questionnaire, just five simple
(16:23):
questions that can quickly help identify potential eating.
Speaker 1 (16:26):
Disorders, and early intervention is key.
Speaker 2 (16:28):
There critical absolutely critical to prevent these conditions from becoming
chronic and much harder to treat.
Speaker 1 (16:34):
Okay wow. So, given this incredibly complex landscape of challenges,
what does this all mean for how universities can actually
support their students effectively?
Speaker 2 (16:44):
Well, the role of mental health professionals, particularly psychiatrists, in
college settings has certainly expanded, or at least the need
for it has. The principles from the community mental health movement,
you know, community based services, prevention, early identification, evidence based treatment,
cultural sense. They're all incredibly relevant here, but resource constraints
(17:04):
often limit things like traditional long term psychotherapy. So adopting
a psychotherapeutic stance, even during brief medication management visits, becomes crucial.
It's about building that connection, providing a space for discussion,
even if it's sharp.
Speaker 1 (17:19):
So it's about the quality of the interaction, not just
the length. What stands out to you When we look
back at all these challenges and examples the stories of
Dave wan Nicole, it seems clear a one size fits
all approach just won't work.
Speaker 2 (17:32):
Precisely, establishing a strong therapeutic alliance, that trusting relationship is
absolutely fundamental, especially with students who might be reluctant, maybe
hesitant to discuss their issues or consider medication due to
cultural beliefs, financial worries, or fear of side effects.
Speaker 1 (17:49):
So flexibility is key.
Speaker 2 (17:50):
Flexibility and creativity, yeah, considering complementary approaches like yoga or
mindfulness meditation groups. These are increasingly popular, especially as we
mentioned with Internet students, and they can provide vital support
beyond just the traditional therapy room.
Speaker 1 (18:04):
Okay, and when things escalate, when the stakes are high,
how do universities navigate crisis intervention? You mentioned the threat
assessment teams earlier.
Speaker 2 (18:12):
Right, Those high profile tragedies definitely spurred the creation of
behavioral intervention teams or bits to identify students of concern.
But there's this really delicate balance you have to strike
between individual rights, privacy, confidentiality, and community safety.
Speaker 1 (18:31):
It sounds like a tightrope walk.
Speaker 2 (18:32):
It really is. Overreactions can cause significant harm, like the
example of Baba Femei, the international student facing cultural misunderstandings,
who got locked out of his dorm because of a
perceived but maybe misinterpreted threat that can cause significant emotional harm.
Speaker 1 (18:48):
Yeah, that sounds counterproductive, exactly.
Speaker 2 (18:50):
The key has to be matching the intervention to the
actual level of risk, not just reacting out of anxiety
with overly punitive or restrictive responses.
Speaker 1 (18:58):
That makes so much sense. We want to protect students,
of course, but also empower them and avoid exacerbating their distress.
Speaker 2 (19:05):
Exactly, right, And that comes back to the opportunity here.
The college years offer this unparalleled window. Students arrive generally
with resilience and hope, even if they're carrying past traumas
or vulnerabilities. It really is a crossroads where effective, compassionate
interventions can truly alter the trajectory of their lives for
the better.
Speaker 1 (19:25):
And is there good news? Is the field moving forward?
Speaker 2 (19:28):
I think so yes. The isolation that college mental health
professionals sometimes felt is diminishing. There's growing research, thankfully, there
is increased psychiatric staffing in some centers, although resources are
still a major issue overall. But there's a clear movement
towards identifying and sharing best practices.
Speaker 1 (19:46):
So collaboration is increasing.
Speaker 2 (19:48):
Yes, definitely, This collaborative effort signals a much more promising
path forward. Ultimately, by providing a really comprehensive range of services,
focusing strongly on prevention and empowering students themselves to recogn
problems and seek help without shame, we move towards not
just healthier universities, but actually healthier future communities for everyone.
Speaker 1 (20:07):
What an incredibly insightful deep dive this has been. It's
so clear that understanding this evolving landscape of mental health
on campus, it isn't just about treating illness, is it.
It's about fostering an environment where every single student can
truly thrive.
Speaker 2 (20:23):
Meeting them where they are, Yeah.
Speaker 1 (20:24):
Meeting them where they are, recognizing their unique journeys and
providing that tailored support.
Speaker 2 (20:29):
And this discussion, I think it truly underscores the immense
potential for positive intervention during these formative years. The support
students get or don't get at this crucial juncture can
genuinely shape their entire lives. It's a profound responsibility and opportunity.
Speaker 1 (20:45):
So as you reflect on everything we've discussed today, maybe
consider how can recognizing these really nuanced challenges help you
better support the students in your life, or perhaps even
deepen your own understanding of mental well being in this
rapidly changing world. What's maybe one small step you might take,
sparked by this conversation to contribute to a more supportive
(21:05):
environment around you.
Speaker 2 (21:07):
That's a great question to ponder, because the conversation around
mental health it's continuously evolving, isn't it, And so too
must our understanding and our approaches. There is always more
to learn, always more we can do to connect the
dots and help create more compassionate, more supportive communities.
Speaker 1 (21:23):
Well said, and that's our deep dive for today. Join
us next time for another journey into being well informed
Welcome you to the deep dive. Today, we're embarking on
really a crucial exploration into a topic that touches the
lives of so many young people, the evolving landscape of
mental health for university students.
Speaker 2 (00:13):
That's right. We're pulling insights from the book Mental Health
Issues and the University Student and really distilling the most
important knowledge to help you understand the unique challenges and
also the opportunities for well being on campuses today.
Speaker 1 (00:26):
Yeah, what's truly fascinating, I think is how much this
landscape has transformed, you know, from historical approaches to the
really nuanced issues students navigate right now exactly. Our mission
for you is simple to cut through the complexity and
give you a comprehensive yet concise understanding of this vital area.
Think of it as your shortcut to being incredibly well
(00:47):
informed on a subject that's well more relevant than ever.
Speaker 2 (00:52):
So let's unpack this indeed, and it's worth just quickly
noting that while we'll discuss some case examples, these are
really composite illustrations based on common patterns we see in
clinical practice, not actual patients, So names details are all fictitious.
Speaker 1 (01:07):
That's a really important point. Okay, so let's look at
how campus mental health support has well changed over time.
For decades, university counseling centers, they largely focused on career
guidance and developmental.
Speaker 2 (01:20):
Needs, right, kind of vocational stuff exactly.
Speaker 1 (01:23):
But after World War Two, say, by the nineteen fifties,
there was this growing recognition that mental well being needed
a much broader focus.
Speaker 2 (01:31):
Yeah, and if we connect this to the bigger picture,
doctor Dana Farnsworth was really a pioneer here. He articulated
the crucial role of psychiatrists on campus, not just treating illness,
but integrating mental well being through educational and importantly preventive services.
Speaker 1 (01:45):
So weaving it into the community fabric.
Speaker 2 (01:46):
That was the vision, Yeah, to weave mental health into
the very fabric of the university community. But making that
vision a reality has been a slow and often pretty
uneven process.
Speaker 1 (01:58):
But then something you know, really pivotal happened, particularly I
think in the wake of high profile tragedies like the
one of Virginia Tech. Unfortunately, we saw this rapid shift.
Colleges started forming threat assessment teams and there were even
laws mandating them in states like Virginia and Illinois.
Speaker 2 (02:15):
Right, and while those teams are important for immediate risk management,
the broader insight here is that they often don't address
the systemic issue, you know, the underfunding, the limited resources
for the kind of mental health care students desperately need.
Speaker 1 (02:30):
So it's like a band aid.
Speaker 2 (02:31):
Sometimes it can feel like that. Yeah, a band aid,
when maybe a deeper structural change is what's really required.
Speaker 1 (02:37):
Okay, this rais is a really interesting question. Are college
students facing different mental health issues than their peers? Yeah,
you know this is the same age, but not in
university And the.
Speaker 2 (02:47):
Answer, maybe surprisingly is yes in some key areas. So
while approximately half of all eighteen to twenty four year
olds have a psychiatric disorder in any given year, which
is a huge statistic in itself a profound national challenge,
wow happen? Yeah, college students show a significantly higher rate
of alcohol use disorders, but interestingly, they also have lower
(03:08):
rates of personality disorders and bipolar disorders.
Speaker 1 (03:10):
Okay, that is interesting, But here's where it gets well disturbing.
Despite these high rates, college students are actually less likely
to get treatment for alcohol or drug addictions. That's a
major gap, a huge gap, and even with more counseling
centers appearing on campuses. Surveys show most students identified as
(03:30):
potentially depressed or suicidal are just well, they're not engaged
in any kind of treatment.
Speaker 2 (03:35):
It truly is a gap. And these difficulties they often
go unnoticed by the wider campus community, yet they profoundly
affect students' lives, right. I mean, when you ask students
what impedes their academic performance, they consistently point to stress.
That's number one, okay, followed closely by sleep difficulties, then
things like internet use, computer games, depression, anxiety, and alcohol.
(03:56):
So it's a whole constellation of factors, absolutely, and the
impact isn't just academic. It's insidious. Psychological problems can make
it hard to form friendships, they can lead to housing conflicts,
and they significantly contribute to delayed graduation or even students
dropping out altogether.
Speaker 1 (04:14):
And you might wonder just how prevalent these struggles really are. Well,
the numbers are pretty stark. Most students report feeling overwhelmed
at least once in a year. Nearly half felt so
depressed it was difficult to function. And get this, almost
one in ten seriously considered suicide.
Speaker 2 (04:31):
That's incredibly sobering, it really is.
Speaker 1 (04:34):
And what's more, among students who are using college counseling centers,
twenty four percent are now taking psychotropic medications. Yeah, you know,
medication is affecting brain function for mental health conditions. That's
a huge jump from just nine percent back in nineteen
ninety four.
Speaker 2 (04:47):
Yeah, that signals a fundamental shift, doesn't it. And the
severity and the complexity of issues that counselors are encountering now.
But you know, this also highlights the immen's opportunity universities
have for early intervention. The college years are this unique
window really to alter the trajectory of an illness and
quite literally a student's entire life.
Speaker 1 (05:08):
Okay, let's shift our focus a bit. Let's talk about
the changing demographics on campus, because that introduces entirely new
mental health consideration. For example, many more students are openly
identifying as gay, lesbian, bisexual, or transgender.
Speaker 2 (05:22):
Now much more visibility.
Speaker 1 (05:24):
Yeah, the average age for starting the coming out process,
it dropped from like nineteen twenty three in the eighties
to just sixteen by twenty eleven. Wow. But even with
increased societ acceptance, students from underrepresented groups, They still face
more challenges bullying, discrimination, and that's often amplified by social media.
Speaker 2 (05:43):
Absolutely, consider a case like Bruce's composite example. Remember his
deep struggle with his attraction to men stems from his background.
Son of an evangelical Christian minister. He lives in fear
of family and community disapproval.
Speaker 1 (05:56):
That sounds incredibly difficult.
Speaker 2 (05:58):
It is, and for mental health profess it's critical to
understand that so called reparative therapy trying to change someone's orientation,
is unethical and harmful. The goal isn't change, it's integration,
helping students like Bruce integrate their sexual orientation and their
religious beliefs, providing a safe, non judgmental space for discussion,
(06:19):
for exploration.
Speaker 1 (06:20):
Okay, integration not change. That makes sense. And what about
gender identity.
Speaker 2 (06:24):
Well, awareness there is still evolving even among professionals. Terms
like cisgender by a gender, gender queer. These describe how
individuals identify with or diverge from the gender they were
assigned at birth. They're becoming more common, but transgender students
like Allen, another composite example, who actually resorted to buying
testosterone online after a suicide attempt. They face significant discrimination
(06:47):
and psychological distress. Oh wow, Yeah, so this requires clinicians
to be familiar with the WPATH standards of care. These
emphasize informed consent and comprehensive screening, recognizing that you know,
mandatory psychotherapy before underfirming hormones can actually be counterproductive sometimes.
Speaker 1 (07:02):
Got it? Okay, what about international students? They face unique
pressures too.
Speaker 2 (07:07):
Right, Definitely beyond the obvious acculturation stresses adjusting to a
new culture. Their visa status is well inextricably linked to
their student status.
Speaker 1 (07:20):
Uh so they can't just drop courses.
Speaker 2 (07:22):
Exactly or take time off without potentially jeopardizing their ability
to stay in the US. And the data shows they're
significantly more likely to be hospitalized for psychiatric reasons, use
crisis services, and present with suicidal ideation, grief, and loneliness.
Speaker 1 (07:38):
That's a heavy burden, it is.
Speaker 2 (07:40):
Take Lie, a composite Chinese international graduate student. She initially
experienced fatigue anxiety attacks, but believed it was purely a
physical ailment. This illustrates how mental illness can be far
more stigmatized for many international students, leading to reluctance maybe
to take psychotropic medications, so they might prefer different approaches
often Yeah, they prefer more direct counseling styles and can
(08:02):
benefit greatly from complementary treatments like yoga or mindfulness, which
are actually quite popular. Then there's a Jeet from India, again,
a composite initially presented as love lorn after his professor
noticed him falling behind. But his behavior stalking stimulant use,
was really out of step with cultural norms, suggesting an
underlying mood disorder.
Speaker 1 (08:23):
So the initial presentation wasn't the full story, not at all.
Speaker 2 (08:26):
It really underscores the need for collateral information, talking to peers,
maybe family if possible, when working with international students to
truly understand their context.
Speaker 1 (08:35):
Makes sense. What other demographic shifts are impacting student mental health?
Speaker 2 (08:39):
Well, Another significant one is the rise of older students.
Over forty percent of university students are now over twenty.
Speaker 1 (08:45):
Five forty percent Yeah.
Speaker 2 (08:47):
And specifically post nine to eleven thanks to the GI Bill,
student veterans have surged onto campuses. They often bring with
them high rates of PTSD, depressions, suicide risk, and substance
abuse stemming from combat exposure.
Speaker 1 (08:59):
Right Like Arcis, the veteran example in the book feels detached,
struggles to focus exactly.
Speaker 2 (09:05):
He might be dealing with a traumatic brain injury a
TBI from an explosion during his service. Understanding both military
culture and campus culture is absolutely essential for effectively supporting them.
Speaker 1 (09:17):
Okay, and finally, students with disabilities.
Speaker 2 (09:20):
Their numbers have doubled, but a key shift happens in college.
The responsibility for advocating for services moves from the institution
like in high school, to the individual student.
Speaker 1 (09:31):
Ah, that's a big change.
Speaker 2 (09:33):
It is they face additional developmental demands, and studies show
they have higher rates of substance use and risky sexual
behaviors too. Esther the example with an anxiety disorder and
a physical disability, Her story really highlights how physical and
emotional challenges intersect with social experiences, creating this unique set
of pressures.
Speaker 1 (09:52):
Okay, so that covers a lot of the demographic shifts. Now,
let's maybe zoom in on some specific mental health challenges
that affect students really profoundly.
Speaker 2 (10:00):
IDEA. First, sleep problems we mentioned them earlier. They are
second only to stress as an academic impediment. Dave, the
biracial sophomore example, struggles with insomnia. Why erratic schedules. Alcohol
use energy drinks.
Speaker 1 (10:14):
Ah, energy drinks, They're everywhere exploded.
Speaker 2 (10:17):
About thirty four percent of eighteen twenty four year olds
regularly consume them, and get this, a quarter combine them
with alcohol.
Speaker 1 (10:23):
Yeah, that sounds risky.
Speaker 2 (10:24):
It is so a key insight here for helping students
like Dave is teaching something called constructive worry, like writing
down worries and potential solutions before bed, along with of course,
consistent sleep hygiene practices.
Speaker 1 (10:36):
Constructive worry. I like that. Okay? What about substance abuse,
always a big topic on campus?
Speaker 2 (10:41):
Huge alcohol obviously is ubiquitous. Binge drinking effects about two
in five students ruin five.
Speaker 1 (10:47):
Yeah.
Speaker 2 (10:48):
One the example of the Hispanic male wanting to rush
a fraternity he binges but minimizes the consequences. He thinks, oh,
everyone drinks this much.
Speaker 1 (10:56):
Right? That normalization exactly.
Speaker 2 (10:58):
It highlights a common lack of insight. So for emerging adults,
harm reduction strategies and motivational interviewing are often more effective
than pushing strict abstinence models right away, meeting them where
they are.
Speaker 1 (11:09):
Okay, harm reduction? What about marijuana?
Speaker 2 (11:12):
That's the most commonly used illicit drug well drug after alcohol.
Rosa the law student example, She attributes her attention and
memory problems to stress, not cannabis, but.
Speaker 1 (11:23):
The cannabis could be playing a role, very.
Speaker 2 (11:26):
Likely, especially since cannabis potency has significantly increased over the years,
and withdrawal symptoms like irritability or sleep problems can actually
mimic stress, which makes diagnosis tricky. Right, and with legalization expanding,
we're likely to see more students using it, often unaware
of the potential long term impact on cognitive function, on motivation.
Speaker 1 (11:47):
And then there are stimulants Adderall.
Speaker 2 (11:49):
Riddlin Susan the economics major using her boyfriend's adderall to study,
or Tom the engineering student thinking he might have undiagnosed
ADHD in considering self treating.
Speaker 1 (11:59):
OH common is that using them non medically.
Speaker 2 (12:01):
Estimates are between seven to fifteen percent of students use
stimulants non medically, mostly trying to boost academic performance. But
there are risks, serious risks anxiety mania, addiction. There's that
tragic example in the book of a pre med student's
suicide linked directly to adderall addiction. It's a very stark reminder.
Speaker 1 (12:21):
Definitely okay, moving away from substances. Loneliness and relationships. That's
another big.
Speaker 2 (12:28):
Area, right, absolutely, the whole hookup culture. It's an ambiguous term, right,
could mean anything from kissing to intercourse. Sure, it's widespread,
often overshadowing traditional dating, and alcohol is frequently involved, which
increases risks like non consensual encounters or regretting the experience later.
Speaker 1 (12:46):
But do students actually prefer that?
Speaker 2 (12:48):
Well, here's the surprising insight. Most students, especially women, actually
say they prefer traditional dating.
Speaker 1 (12:53):
Interesting.
Speaker 2 (12:54):
And then there's the loneliness aspect. Jason the example who
feels like a social failure. He highlights something called social hopelessness.
Speaker 1 (13:01):
Social hopelessness, Yeah.
Speaker 2 (13:02):
It's the specific fear of never fitting in, never finding intimacy,
and it's shown to be a powerful predictor of suicide
among college students, more so than general hopelessness.
Speaker 1 (13:13):
Wow, that's specific and potent. And social media doesn't always help.
Speaker 2 (13:17):
Ironically. Know, while it seems to connect people, about fourteen
percent of students report it actually increases their feelings of isolation.
Seeing everyone else's curated highlight reel can make you feel worse.
Speaker 1 (13:29):
Yeah, I can see that. Okay, what about perfectionism that's
often seen as a good thing, driving excellence.
Speaker 2 (13:35):
It can be, but it often crosses a line into
being psychologically damaging. Jenny the valedictorian example, she struggles with
these incredibly unrealistic expectations. She even interprets a Bible verse
as meaning she can't tolerate any mediocrity in herself, which
leads to immense suffering.
Speaker 1 (13:52):
Oh dear.
Speaker 2 (13:52):
And similarly, fang Wi the international student example, she dismisses
her very real acculturation stress, viewing anything less than top
grades is complete failure. This self critical perfectionism. It's linked
to psychological and academic difficulties across different cultures. It's a
broad issue.
Speaker 1 (14:08):
Okay, and anxiety you mentioned that's huge in counseling centers.
Speaker 2 (14:11):
It's the most commonly cited concern. Yeah. Mike the medical
student example suffers from generalized anxiety disorder constant dread, physical
symptoms severely affecting as studies. Or Louise the popular cheerleader example,
who hides her bisexuality that creates significant anxiety around her
social interactions. It shows how hiding core aspects of your
(14:32):
identity can really feel anxiety, and also that anxiety disorders
can manifest differently depending on factors like sexual orientation right.
Speaker 1 (14:40):
And anxiety isn't just gad right, there's OCD exactly.
Speaker 2 (14:43):
The obsessive compulsive spectrum symptoms like excessive concern with things
being just so, or intrusive thoughts, maybe repetitive behaviors like counting.
These can be signs of OCD itself or related disorders
like body dysmorphic disorder, trichotilomania that's hair pulling like a
li VIA's case, or pathological skin picking. Panic attacks are
also common and tragically. The college years are a high
(15:06):
risk period for traumatic experiences. Sexual assault causes the greatest
incidents of PTSD among students.
Speaker 1 (15:13):
That's devastating, which leads us naturally to depression.
Speaker 2 (15:16):
Yes, Jamal, the African American sophomore example, experiences chronic depression
academic decline. His case highlights the increased risk and often
under utilization of services among minority students and first generation students. Marissa,
after a breakup, experiences severe depression, and Todd after being
rejected by fraternities, falls into isolation and increased drinking. These
(15:39):
stories really underscore how difficult life events can trigger or
worsen underlying depression.
Speaker 1 (15:44):
And diagnosis can be tricky.
Speaker 2 (15:46):
It can be especially because the brain is still maturing
into the mid twenties. Sometimes emotional volatility might resolve over time.
And while medication is often very beneficial, students frequently hesitate.
They worry about personality changes or dependents.
Speaker 1 (16:00):
Yeah, those are common concerns.
Speaker 2 (16:02):
Absolutely, and finally, disordered eating rates for conditions like anarexia
and bolimia are notably higher among college students than the
general population. Nicole the example, who after a breakup develops binging,
excessive exercise and also self injury or NSSI. There are
useful screening tools like the Scoff questionnaire, just five simple
(16:23):
questions that can quickly help identify potential eating.
Speaker 1 (16:26):
Disorders, and early intervention is key.
Speaker 2 (16:28):
There critical absolutely critical to prevent these conditions from becoming
chronic and much harder to treat.
Speaker 1 (16:34):
Okay wow. So, given this incredibly complex landscape of challenges,
what does this all mean for how universities can actually
support their students effectively?
Speaker 2 (16:44):
Well, the role of mental health professionals, particularly psychiatrists, in
college settings has certainly expanded, or at least the need
for it has. The principles from the community mental health movement,
you know, community based services, prevention, early identification, evidence based treatment,
cultural sense. They're all incredibly relevant here, but resource constraints
(17:04):
often limit things like traditional long term psychotherapy. So adopting
a psychotherapeutic stance, even during brief medication management visits, becomes crucial.
It's about building that connection, providing a space for discussion,
even if it's sharp.
Speaker 1 (17:19):
So it's about the quality of the interaction, not just
the length. What stands out to you When we look
back at all these challenges and examples the stories of
Dave wan Nicole, it seems clear a one size fits
all approach just won't work.
Speaker 2 (17:32):
Precisely, establishing a strong therapeutic alliance, that trusting relationship is
absolutely fundamental, especially with students who might be reluctant, maybe
hesitant to discuss their issues or consider medication due to
cultural beliefs, financial worries, or fear of side effects.
Speaker 1 (17:49):
So flexibility is key.
Speaker 2 (17:50):
Flexibility and creativity, yeah, considering complementary approaches like yoga or
mindfulness meditation groups. These are increasingly popular, especially as we
mentioned with Internet students, and they can provide vital support
beyond just the traditional therapy room.
Speaker 1 (18:04):
Okay, and when things escalate, when the stakes are high,
how do universities navigate crisis intervention? You mentioned the threat
assessment teams earlier.
Speaker 2 (18:12):
Right, Those high profile tragedies definitely spurred the creation of
behavioral intervention teams or bits to identify students of concern.
But there's this really delicate balance you have to strike
between individual rights, privacy, confidentiality, and community safety.
Speaker 1 (18:31):
It sounds like a tightrope walk.
Speaker 2 (18:32):
It really is. Overreactions can cause significant harm, like the
example of Baba Femei, the international student facing cultural misunderstandings,
who got locked out of his dorm because of a
perceived but maybe misinterpreted threat that can cause significant emotional harm.
Speaker 1 (18:48):
Yeah, that sounds counterproductive, exactly.
Speaker 2 (18:50):
The key has to be matching the intervention to the
actual level of risk, not just reacting out of anxiety
with overly punitive or restrictive responses.
Speaker 1 (18:58):
That makes so much sense. We want to protect students,
of course, but also empower them and avoid exacerbating their distress.
Speaker 2 (19:05):
Exactly, right, And that comes back to the opportunity here.
The college years offer this unparalleled window. Students arrive generally
with resilience and hope, even if they're carrying past traumas
or vulnerabilities. It really is a crossroads where effective, compassionate
interventions can truly alter the trajectory of their lives for
the better.
Speaker 1 (19:25):
And is there good news? Is the field moving forward?
Speaker 2 (19:28):
I think so yes. The isolation that college mental health
professionals sometimes felt is diminishing. There's growing research, thankfully, there
is increased psychiatric staffing in some centers, although resources are
still a major issue overall. But there's a clear movement
towards identifying and sharing best practices.
Speaker 1 (19:46):
So collaboration is increasing.
Speaker 2 (19:48):
Yes, definitely, This collaborative effort signals a much more promising
path forward. Ultimately, by providing a really comprehensive range of services,
focusing strongly on prevention and empowering students themselves to recogn
problems and seek help without shame, we move towards not
just healthier universities, but actually healthier future communities for everyone.
Speaker 1 (20:07):
What an incredibly insightful deep dive this has been. It's
so clear that understanding this evolving landscape of mental health
on campus, it isn't just about treating illness, is it.
It's about fostering an environment where every single student can
truly thrive.
Speaker 2 (20:23):
Meeting them where they are, Yeah.
Speaker 1 (20:24):
Meeting them where they are, recognizing their unique journeys and
providing that tailored support.
Speaker 2 (20:29):
And this discussion, I think it truly underscores the immense
potential for positive intervention during these formative years. The support
students get or don't get at this crucial juncture can
genuinely shape their entire lives. It's a profound responsibility and opportunity.
Speaker 1 (20:45):
So as you reflect on everything we've discussed today, maybe
consider how can recognizing these really nuanced challenges help you
better support the students in your life, or perhaps even
deepen your own understanding of mental well being in this
rapidly changing world. What's maybe one small step you might take,
sparked by this conversation to contribute to a more supportive
(21:05):
environment around you.
Speaker 2 (21:07):
That's a great question to ponder, because the conversation around
mental health it's continuously evolving, isn't it, And so too
must our understanding and our approaches. There is always more
to learn, always more we can do to connect the
dots and help create more compassionate, more supportive communities.
Speaker 1 (21:23):
Well said, and that's our deep dive for today. Join
us next time for another journey into being well informed
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