By Dr. Micaela Wexler
As a family psychiatrist, I have noticed this is the time of the semester when college students first face mental health challenges. These can include issues like homesickness, anxiety about exams, alcohol abuse, difficulty with focus and concentration, romantic break ups, roommate conflicts, insomnia and time management challenges. Though these are common, and not considered serious, they can interfere with a student’s progress. These issues are easily treated, and should be addressed by students and the people in charge of supporting them.
The mental stress that is part of the college experience can trigger episodes of serious mental disorders. It is at this time of the semester, when first exam grades have been posted and class withdrawal deadlines are approaching that students with issues like bipolar mood disorder, eating disorders, severe OCD, or more rarely, psychoses or delusional disorders are especially overwhelmed. A significant number of people with these disorders are not diagnosed until early adulthood, so if they are in college when the first episode occurs, they usually find themselves alone, without psychiatric care.
It has become routine on college campus for a review of mental health services to be part of new student orientation. Many colleges offer a number of free counseling sessions to every student. However, when students are faced with an actual mental health crises, their thinking process tends to be derailed and they don’t always know what do to. The most frustrating aspect of mental health care is that oftentimes, even people with severe mental illness may fail to recognize they are at risk and need help.
College students can play an important role when it comes to mental health by being attentive to their peers. Students should trust their instincts and take action when they sense a fellow student is under mental duress.
All students should know the warning signs for suicide. An easy mnemonic has been developed by the American Association of Suicidology: IS PATH WARM (Ideation, Substance Abuse, Purposelessness, Anxiety, Trapped, Hopelessness, Withdrawal, Anger, Recklessness, Mood Swings). Students should know where to turn for immediate help if they suspect a fellow student is suicidal.
Students do not need to sense a problem is as serious as suicide to take action. If a fellow student seems down, or has stopped eating, is losing or gaining weight rapidly, or getting intoxicated frequently, that person may need help. Help can take many forms. A student could ask a peer directly, “are you ok?” If that feels awkward, a student could bring up the topic in a general way, ie, by talking about something they heard in class, or on the news, ie, “I heard that severe stress in college can trigger (an eating disorder, a drinking problem, severe OCD, hearing voices). What do you think?”
Or, a student could say to a peer, “you have seemed really worried lately. Would you like to talk about it?”
A student should not take it upon themselves to be the sole source of support for a student in need. Before approaching the student in need, a college student should speak to a professor, resident assistant, a mental health provider, just in case the situation is more serious. This can easily be done in a way that protects the other student’s privacy and dignity.
On the other hand, talking with other students about the student having problems without ever offering support to the person who is depressed or behaving erratically is not only unkind, but potentially dangerous. There is still a great deal of stigma regarding mental health issues, and contributing to this should NOT be part of the college experience. Nowadays there are effective treatments for even the most serious of mental health challenges. Taking positive action in the face of mental duress can be rewarding for college students. Preventing mental health tragedies is something which will enhance the college experience for everyone involved.