While Pikes Peak region high schools have stepped up mental health programs in the wake of a record number of teen suicides in 2015 and 2016, approximately one in four students in the area enters college with mental health issues.
“We have way too many students struggling with mental health issues,” said Stephanie Hanenberg, executive director of Health and Wellness at the University of Colorado at Colorado Springs Recreation and Wellness Center.
UCCS, with nearly 12,600 students, mirrors national trends, said Z. Benek Altayli, director of mental health services at the Wellness Center. The school is seeing an 8 percent yearly increase in the number of students seeking assistance, compared to an annual enrollment growth of about 2 percent, she said.
Anxiety continues to be the most common mental health challenge for college students, prevalent among a quarter to nearly half of students nationwide, according to self-reported student surveys, as well as the 2017 annual survey of the Association for University and College Counseling Center Directors.
Stress affects about one-third of college students, and one-fifth to one-third of students report they are depressed.
About one in four students has had suicidal thoughts in the past 12 months, according to multiple surveys, including the National College Health Assessment, an annual student poll. Suicide is the leading cause of death in the 10- to 24-year-old age group in Colorado.
Not only are more college students experiencing problems, but the severity also has increased consistently in the past decade, Altayli said.
“We’re seeing more students coming with diagnoses, prior hospitalizations and on medications,” she said.
Addressing students’ mental health is a top concern of UCCS Chancellor Venkat Reddy, who says even with additional counselors and programs, it’s been hard to keep up with the demand.
The school’s psychiatric nurse practitioner who writes prescriptions is “completely booked,” Altayli said.
Psychiatric appointments increased by nearly 25 percent last fiscal year to nearly 1,000.
One in four college students nationwide is taking psychotropic medication, according to the counseling centers directors survey, a statistic that has remained unchanged for the past three years.
Altayli’s department has grown from herself and a part-time worker in 2008 to nine counselors, clinical social workers and psychologists, with a 10th employee in the works.
But, “We’re still behind,” she said. “By finals, we’ll have a four-week wait time, except for emergencies and crises.”
Last semester, the wait list grew to 42 students, she said.
To handle the growing need, colleges and universities across the nation are turning to preventive measures to elevate the importance of good mental health to a level equal with good physical health. The goal is to stop blips from advancing to meltdowns.
“We can’t hire ourselves out of this problem,” said Heather Horton, director of Colorado College’s Wellness Resource Center. “Colleges are increasing capacity to meet the demand, and that’s great. But the reality is not every mental health challenge requires counseling,” which involves a screening, psychotherapy and a care plan.
More than 30 percent of CC’s 2,000 students seek the services of a campus counselor, she said, which is higher than the 12 percent to 15 percent average on college campuses nationally.
Nearly one in four Colorado College students said they experienced symptoms of depression in the past year and about one in five had anxiety, Horton said, based on results of a Healthy Mind Survey the school distributed this year.
“We’re a highly selective, very academic-oriented population of folks,” Horton said, which can create a pressure-cooker type of environment that can be hard for students to handle on their own.
Why is this happening?
The reasons behind the trend are not all bad, according to experts. While the stigma of mental illness hasn’t disappeared, it’s far better than it was, said Lori Jarvis-Steinwert, executive director of the Colorado Springs office of the National Alliance on Mental Illness.
“We didn’t really talk about it when I went to college; we may have partied through it,” she said. “There’s more sophistication and general awareness of the symptoms with this generation.”
Improvements in the professional fields have led to better identification and diagnoses of mental health conditions and more effective medications, Altayli said.
“Students just used to drop out before, but now they’re able to complete secondary school and move on to college,” she said.
But as competent as mental health care providers and drugs have become, “We’re still talking about 18- and 19-year-olds,” Altayli said.
And the stress of redefining one’s life can seem overwhelming, said 21-year-old DaShon “Ace” Dean, a senior biology major and co-president of a student club called Active Minds: Mental Health Society at UCCS.
“Everything about your entire life changes in college: your location, familiarity, diet, sleep, exercise, schedule, friends,” he said. “Students in high school don’t understand how impactful that change is. They’ve had support systems and have never been met with these expectations to know how to deal with these situations. So they think they should just be able to get through it.”
Add the pressure to succeed, do well in classes, make new friends and figure out what you want to do with your life and it can be like trying to balance a tall, heavy stack of books on your head.
“Having people to talk to without fear or judgment has been beneficial for me,” said 19-year-old Nathan Hughes, a UCCS sophomore. The Active Minds club “is not a substitute for counseling but a supplement,” he said.
Signs of mental illness typically emerge in young adulthood for those whom genetics or early-life traumas were not the catalysts, Jarvis-Steinwert said.
At college, teens often share a room with a stranger, have more alone time and are unused to being in charge of their lives.
“They don’t have those external factors that helped manage their symptoms before,” Jarvis-Steinwert said.
All-nighters, a pizza and popcorn diet, binge drinking and isolation — which historically have defined the college experience — set the scene for anxiety, depression, substance abuse and stress-related illnesses, experts say.
“Sleep deprivation is a huge factor in the onset of mental illness and symptoms kicking in,” Jarvis-Steinwert said.
Research shows that stresses of the 21st century are more significant for this generation than for previous generations, and contemporary parenting styles mean teens don’t necessarily learn resiliency or healthy coping skills before they get to college.
“When we grew up, we just had to figure things out,” UCCS’ Hanenberg said. “Now, they have the internet to tell them something, or their parents take care of everything. Every little bump becomes overwhelming because they don’t have the basic skills to manage their day-to-day lives.”
Social media can be trigger
Social media can be a mental health monster.
The messages from Instagram, Twitter, Facebook and other sites can be detrimental, Dean said: “I’m not liked if I don’t get ‘likes’ on Facebook. Everybody else seems so happy. My life sucks.”
Social media can be isolating as well, since users tend to interface more frequently with a device than in-person, said 22-year-old Anthony Goos, co-president of the Active Minds club at UCCS.
“It’s a huge factor with depression,” he said, adding that the condition is something he has struggled with.
While social media posts may seem casual and spontaneous, said Horton of Colorado College, one selfie photo might have taken 30 minutes and 12 attempts to achieve.
“People post joyful, wonderful, fun things, not ‘I’m home bored and unsure what to do,’” Horton said. “So when you’re bored at home and looking at curated presentations, it can make any person feel, ‘Why is my life so lonely and miserable when everybody else seems to be happy?’”
Making new friends has been one challenge for Pikes Peak Community College freshman Ramona Salgado, who graduated from Rampart High School.
“Classes are the least of my worries — I’ve always done fine in classes,” she said. “It’s everything else.”
With rough years in high school that included the ending of a committed relationship, eating disorders, a foray into drugs and a diagnosis of severe depression and anxiety, Salgado feels like she’s gotten a “clean slate” and is starting fresh.
“You really get to explore yourself in college,” the 18-year-old said. “I feel like a lot of kids are steering away from the expectations their parents want them to meet and figuring out who they are as a person.”
Being open and honest about mental illness is “still pretty stigmatized,” Salgado said. “A lot of people don’t want to talk about it.”
It may seem silly, and kind of like a “Saturday Night Live” skit, to get up in the morning and repeat “I am smart,” “I am capable,” “I am happy,” “I am attractive,” “I am loved” or other encouraging affirmations.
But the technique works, say Dean and other members of the Active Minds club at UCCS, which provides students with nonjudgmental peer-to-peer conversations, coping strategies like the positive affirmations, group activities and workshops.
“I used to be very pessimistic; you have to reverse your brain to think optimistically,” Dean said.
“Your brain believes whatever you tell it,” he said, “so I put positive messages on my binder that I see and say every day.”
The practice has helped 19-year-old Scout Rhodes, vice president of Active Minds.
She routinely places sticky notes with upbeat messages on her closet.
“I’m a perfectionist and not that realistic, which can turn out really bad,” she said. “So I remind myself I don’t have to get all of these things done today. And I’m taking breaks, and it’s OK.”
What colleges are doing
During budget reviews this year, UCCS departments such as veterans affairs, security, international students and a crisis response team said the majority of their resources are going toward students with mental health issues, Hanenberg said.
“It affects the classroom,” she said. “A huge amount of referrals that come through here are from other departments on campus.”
Because counselors and budgets are being stretched, colleges are trying all kinds of proactive approaches.
UCCS’ Wellness Center, which opened in 2016 and is connected to the school’s recreation center, is among the first in the nation to integrate all areas of health: physicians and nurse practitioners, dietitians, wellness programs, fitness facilities and coaches, and the spectrum of mental health.
UCCS also created a “wellness wing” in a freshman dorm this semester, which Hanenberg said is about “how do we give students skills from the moment they walk into the door.”
Healthy cooking, free yoga classes and fitness buddies are among the programs for 30 freshmen participating in the pilot program.
Campuswide support groups address grief and loss, eating disorders, modified substance intake, dealing with sexual violence, learning interpersonal skills and self-regulation through behavioral therapy.
As president of the National College Health Assessment, a program of the American College Health Association, Hanenberg volunteered UCCS for a pilot program involving a new student survey that will be administered to students in the spring semester. Results will drive an action plan consisting of evidence-based strategies to address what students are dealing with.
Not only do good mental health practices help students perform better academically, experts say, it also helps student retention, which at UCCS is 68 percent. On a patient satisfaction survey, 88 percent of students who used UCCS Wellness Center services stayed in school and graduated, and 94 percent linked the services directly to them doing so.
‘Hub for prevention’
Colorado College’s Wellness Resource Center opened five years ago in the campus student center. Students can grab a Hershey’s kiss or an apple, work on a community puzzle, read about quitting smoking or sexual health, talk about their concerns or just relax.
Student interest and recognition of addressing the needs of the whole person led to its creation, Horton said.
“We’re a hub for prevention, training and health programs,” she said.
The center seeks to “remove the barriers” to students accessing resources with peer support programs and educational events on preventing suicide and sexual assault, for example.
“With our society demonizing it and emphasizing rugged individualism, people think there’s something wrong if they’re struggling and vulnerable,” Horton said. “Not, ‘Oh, you’re human.’”
The center works on building students’ self-awareness, teaching them how to manage stress, develop coping strategies and build social networks.
“Helping people feel connected while they’re building new social networks is a challenge on all college campuses,” Horton said.
AFA has own spin
The Air Force Academy has taken its own spin on helping college students through mental health issues.
The academy’s Peak Performance Center offers services including therapy and substance abuse help.
The center’s staff is “comprised of licensed social workers, psychologists, behavioral health technicians and certified alcohol and drug abuse counselors, skilled in the unique developmental, personal and military challenges cadets face at the academy,” the school says on its website.
The academy also has assets other colleges don’t, including the ability to order cadets into care, including an in-patient mental health ward nearby at Fort Carson.
What parents can do
NAMI’s Jarvis-Steinwert recommends parents talk to their kids about what college might be like, and ask them to look for mental and physical signs that something might be wrong.
Parents also should arrange with the school’s health center to obtain access to their child’s health status, she said, because medical privacy acts can make it difficult to obtain information without permission.
Above all, tell your college students you’d like to know what’s going on and be there for them, she said.
The Gazette’s Tom Roeder contributed to this story.
Contact the writer: 719-476-1656