College or Bust? Understanding Your College Student's Mental Health

An interview with Christine Triano, LCSW

After months of preparation and the college essentials are jammed in the back of car, your high school grad is off to their first year of college. You might be experiencing the swirl of emotions and expectations typical of a parent sending their child off on their first step toward adulthood. But what happens when your student doesn’t make it through their first year or even semester? According to some sources, 35 percent of first year college students will drop out during their first year. The Bill and Melinda Gates foundation reports that a majority of these students drop out due to the cost of going to school. But what about the mental health of our first-year college students? According to the National Alliance on Mental Health, 50% of college students reported their mental health as below average or poor.

There is no doubt that the transition from high school to college is a difficult one. As therapists we are seeing clients who are struggling to make this transition. We work with others who have returned home experiencing feelings of shame and guilt for not performing to the real or perceived expectations of their family and friends. Students are left asking questions of themselves and working through the feelings on their own. Many times, parents are left with questions about how to help their children who are in uncharted college territory. I have turned to a seasoned colleague who has years of experience working with this exact population. Christine Triano is a licensed clinical social worker and the Director of Mental Health at the Center for Connection in Pasadena. Here is a question and answer session vis-à-vis parents of college-age students.

Christine, how can we know if our student is really struggling with mental health issues or if it’s just laziness or homesickness?

Homesickness is a normal part of the college experience, and likely a feeling your child has already experienced at summer camp or travel away from family. It’s a hard feeling, but one that is also tolerable and should resolve with time and engagement with others and by participating in enjoyable activities.

A mental health issue does not simply pass, but rather continues to come up and, untreated, likely worsen. One way to look at any issue is to ask, is this significantly impairing my child’s ability to function? Questions to assess this might include: Are they making it to class? Getting their work done on time? Maintaining a regular schedule? Getting enough sleep? Spending time with peers? How’s their self-care (e.g. hygiene, nutrition, personal chores)? Major challenges in any of these areas may signal that there is a mental health issue at play.

How do I prepare my student for the independence of college life?

There are two fundamental forms of preparedness for leaving home. The first is cultivating the skills necessary for independent living. I can’t tell you how many freshmen I met while working as a college mental health counselor who had never grocery shopped or done a load of laundry. Think about leaving home for the first time to live away from your family in a totally new setting, surrounded by strangers, including one or more you have to share a room with. Then add the academic pressures and logistical demands of mastering a college schedule. It’s a lot. Now, add the fact that you need to put money on your laundry card, make sure you have a bottle of Tide, and separate your whites from your colors. It is a small task that can become that one extra drop that makes a student’s bucket overflow.

So, how to help your teen be better prepared in this regard? This one is relatively simple, but means starting now (or yesterday!). I strongly believe all kids should have chores. Even a 5-year-old can help set the table, or put their clothes in the hamper. Beginning in high school, I often share with parents that they are not helping their child grow by doing things for them they are capable of doing themselves. My own children, both teens themselves, have heard this time and again. Of course, there are exceptions. When my recent high school graduate was studying for finals, I happily threw in a couple of loads of laundry for him. But, in general, I think it’s great to look at this as adding tools to their self-care toolkit. This includes tasks like: laundry, changing their sheets, cleaning the bathroom, preparing some simple meals, and making a basic grocery store run. For older teens, making their own appointments for haircuts or the doctor is also great practice. If they drive, I would add basic car maintenance too.

The second form of preparedness is more about emotional readiness. A Harris Poll of college freshmen found that a full 60% stated they wished they had gotten more help with emotional preparation for college, defined as “the ability to take care of oneself, adapt to new environments, control negative emotions or behavior and build positive relationships.” Studies have shown us that such preparedness is a major factor for students’ success during their first year at college. I would also add that play and balance are major contributing factors for cultivating resilience.

At the Center for Connection, we often talk about the foundation for this kind of resilience in terms of having the ability to self-regulate. Anxiety, depression, panic, stress, isolation, or withdrawal, by contrast, are all forms of being in a state of dysregulation. One way to approach this is by asking yourself if you are scaffolding your child up toward greater resilience. This may mean encouraging them to email a teacher or to set up a meeting at school on their own, allowing them to plan how to spend their time when there are competing social and academic demands, and generally letting them experiment with taking risks (within reason) and possibly failing. In general, if you can standby with support and empathy, rather than intervening or otherwise performing those amazing contortions of body and spirit designed to prevent your child from experiencing disappointment, loss, or discomfort, then you are on the right path.

I know my student has mental health issues, what can I do to ensure he/she is safe and healthy at school?

College campuses are acutely aware that students are experiencing record-levels of mental health challenges, with counseling centers facing increasing, and in some settings, overwhelming demand for services. The fact is, almost one thirdof students meet criteria for an anxiety or depressive illness during their college experience and many do not get or seek the help they need. It’s important not to be afraid to explore what’s really going on. It’s not unusual for a young adult to try and work things out on their own, or to be reluctant to worry parents back home. If you have concerns or a sense that your child is really struggling, start with some open-ended questions or maybe be sharing a memory of your own college experience when things were hard. Let them know that their well-being is more important than their GPA and that you are there to offer support, without judgment. If you suspect they feel overwhelmed, you may want to gently offer to investigate options on campus, such as “I know the counseling center is available to all students, would it be helpful if I checked into how you go about making an appointment?” Keeping your own fears and concerns in check is important here. Even with college-age students, as parents our emotional state still has a big impact on our kids. We can help by being mindful that our own worries don’t amplify our child’s distress.

My student just told me they want to take a year off, what should I do?

First, breathe. Then, investigate, without leaping to assumptions. If your child is coming to you with such a pronouncement, it very likely was not arrived at lightly or easy to share. Maybe they are just feeling overwhelmed and need to vent. In that case, it may be more a question of exploring what kinds of support they need that they may be lacking. If it’s more serious, the first step should be to assess whether your child is in crisis. If so, it’s always important to seek help immediately. There are lots of reasons students decide to take a break. In many other parts of the world, it’s common for young people to take a gap year before heading off to four-years of college. The reasons for this are many, including gaining life skills, seeing new places, discovering what they’re interested in, volunteering, earning some money, and learning more about themselves.

I have worked with students who muscled through their first year or two of school, despite the growing burden of untreated, or undertreated, anxiety, depression, trauma or other mental health issues. In my experience of working with such young people, there is also often an element of confusion about their identity rooted in not having a sense of their authentic self. Teens today face enormous pressure, oftentimes internalized, to be “perfect.” I am regularly impressed by the drive I see in high-schoolers, juggling AP classes, sports, extra-curriculars and schedules that make me tired just to hear about. The one thing that can be missed in this drive to get into a good college or university, however, can be time to reflect on their true values, hopes, dreams, and passions. Once away at school, it can make it even harder to form meaningful connections with others when it’s hard to be yourself, or if you’re not even quite sure who that self is.

All of these factors can lead to that call where the idea of taking a year off is proposed. Getting to the degree is important, but so is arriving at college graduation with the mental and emotional well-being, life skills, and maturity to succeed after college. Would your student benefit from a year to focus on cultivating these qualities? What are the options for your family, and how can you come to an agreement about what the year will look like? I’ve worked with students home for a semester or a year, some of whom have done intensive therapy for most of that time, others who combined treatment with getting a job or taking classes nearby, and yet others who created plans involving travel and volunteerism after a restorative period home. All schools have a procedure for requesting medical leave, which applies to mental as well as physical health. There are some details to work out, but with a simple request and sometimes a letter from a mental health professional, the process can be initiated to give your student the time they need to get well.

Christine, you gave the readers great words of wisdom, anecdotes, and practical advice we can implement tonight! In some cases, the decision to go to college is expected and the discussion around the kitchen table usually focuses on tuition, deciding on a major, and where to live. While bedding and books are essential parts of going to college, you can equip your child with a tool belt stocked with resilience, self-care, and self-advocacy tools to ease their transition into Independence University. Experiment with giving your child space to be responsible for making an appointment, completing a chore, or advocating for themselves, and except some speed bumps along the way; mistakes and failures are moments of learning. By the way, the loads of laundry they bring home on the weekends are their way of saying, “I still need you.” — OMH