by JENNIFER WANG ETHICS + POLICY
Towards a State
of Wellness
Results of the Stanford Student Mental Health
and Well-Being report
Problem sets, papers, midterms,
and finals—most would agree these
make up the standard drudgery of the
college experience. But meeting deadlines
and passing classes are not all the hurdles
a college student has to overcome.
Involvement in student groups, work-study
commitments, and varsity athletics, among
others, also factor into the delicate balance
of a college student’s life. Throw in a few
personal statements, and very quickly the
“ideal” college experience can spiral into a
frenzied battle against fatigue, stress, and
in the most extreme cases, depression and
suicide.
Sadly, the demanding lifestyle of today’s
college students often places mental health
low on students’ list of priorities, and the
Stanford campus is by no means immune
to this trend. In the fall of 2006, Stanford
officials formed a task force to seriously
re-evaluate the campus’s mental health
status in hopes of identifying and improving
weaknesses in providing for student well-
being.
The culmination of the task force’s two-year
study is the Stanford Student Mental Health
and Well-Being Report, released in October
2008. Drawing from surveys of almost 700
students and focus studies conducted
by representatives of various community
centers, academic departments, and
student affairs offices on campus, the Report
examines the aspects of student mentality
and university policy that contribute to
the overall mental health climate of the
campus and, based on those findings, sets
forth recommendations for bettering the
available support system on campus.
Mental Health at Its Worst
Such focused interest in the mental well-
being of Stanford students stems from a
much broader nationwide concern—that
of the overly competitive, overly stressed
adolescent. “It’s gotten a lot of attention
from students, administrators, the media,
and parents because I think there’s some
concern that the question of student well-
being is not in a good place right now,”
remarked Dr. Ira Friedman, Associate Vice
Provost for Student Affairs, Director of Vaden
Health Center and committee co-chair of the
Mental Health and Well-Being Task Force.
The unrelenting pressure to succeed has
caused today’s generation of young adults
to show an increase in mental and emotional
illness rates. Research by the Centers for
Disease Control and Prevention found an
eight percent increase in suicide rates for
adolescents in 2004, in spite of a decrease of
twenty-eight percent over the past fifteen
years. “The young adult age group has the
peak incidents of several mental health
conditions: bipolar disease, schizophrenia,
anxiety, depression,” noted Friedman.
College students in particular are prone to
developing mental health problems during
their transition to a new living environment.
“We’re talking about high stress levels and
distress, some students have mental health
conditions that either preexisted when they
were in high school or have emerged when
they were here,” Friedman explains. Indeed,
a random survey of Stanford students in
2007-2008 found that 23.4% experienced Credit: sxc.hu
depressed mood with 3.2% meeting the
diagnosis of major depressive disorder.
volume VIII 47
 ETHICS + POLICY
“[M]any students have been brought into this
belief that [academics] is why they exist” - Ira
Friedman
“I think we are seeing more students in
distress, not just us in the clinical setting,
but also staff in residences and faculty, so
that is a driver for our concern,” Friedman
concludes.
The Campus Climate:
Ducks Under Pressure
As part of their examination of the university
mental health environment, the task force
looked at the campus climate and student
culture with regard to emotional well-being.
As Friedman detailed, “What features of the
campus climate have to do with stress and
performance? How is it helping students?
How is it mitigating stress? How is it maybe
aggravating students’ stress and distress?”
The task force found that one of the
significant, but perhaps unsurprising,
contributors to student stress is the reputed
“Stanford Duck Syndrome.” In this analogy,
students are likened to ducks on a pond:
though they appear calm on the surface,
they are actually kicking furiously to stay
afloat. “The way I see it is the extra wear and
tear of needing to appear like everything
is effortless and under control when in
fact many students work very, very hard,”
Friedman adds.
Whether students experience the Duck
Syndrome as a sense of clandestine
competition among themselves or a
fear of showing weakness or failure, the
internalization of stress and emotional
discomfort should begin to burden a
student and affect his or her academic
performance—or so one may think.
Cr e
dit
According to the findings of the study,
: sx
c.h
u
academic success is actually not always
reflective of a student’s state of emotional
health. “Many students are able to achieve
and perform fine academically because
they’re so used to doing that, but internally,
www.stanfordscientific.org
48 stanford scientific
they’re not doing very well,” remarks
Friedman.
Interestingly, this paradox may be a
consequence of the campus climate at
Stanford. “There is such an overwhelming
emphasis on academic accomplishment that
it displaces other forms of personal pursuit,”
Friedman explains, “and many students
have been brought into this belief that
[academics] is why they exist.”
In addition to a greater need for balance in
their lives, the Report notes that students
tend to experience anxiety when their
expectations of the university are not
met. Unrealistic expectations of advising,
academic support, and faculty-student
interaction often lead to disappointment,
which, in the opinion of one student survey
respondent, is “a horrible source of stress.”
University Policies: Change
from the Top
Despite some students’ sentiments that
university resources are not up to par, the
Report found that the mental health support
system on campus is very strong in many
ways. Residential education, from the variety
of student staff to the programming in
student dorms, helps to foster an important
sense of community and belonging that
can mitigate the effects of high stress.
Several facilities and resources dedicated to
promoting mental health and well-being,
from the Bridge Peer Counseling Center to
the Counseling and Psychological Services
(CAPS) referral system, provide students
with necessary services.
Nevertheless, there is room for growth. One
of the areas for improvement identified by
the Report is academic advising, mentoring,
and support for both undergraduates and
graduate students. Expanding the scope
of an academic advisor’s role to that of

“There is such an overwhelming emphasis on
academic accomplishment that it displaces
other forms of personal pursuit,” - Ira Friedman
a mentor and further encouraging the
utilization of academic support resources
are among some of the recommendations
proposed for this area of concern.
For graduate students, it may be useful to
provide a second advisor separate from the
primary academic advisor to whom students
can turn for non-academic guidance. This
way, as Friedman explains, “students can
know that they can go to someone for help
or to share information about themselves
that they would otherwise want to protect
because they fear it would be seen as a
negative by someone who is evaluating
their progress.” This practice has already
been adopted by the Stanford School of
Medicine and, if adopted by all academic
departments, would be a major step forward
in addressing student mental health and
well-being.
Another identified area for improvement is
strengthening the already robust safety net
of resources for students. A major criticism
of CAPS was that it was, for a long time,
understaffed and therefore unable to meet
the increase in student demand for services.
However, the shortage of counseling staff
has already been resolved by an increase
in available positions. Furthermore, the
recent establishment and accreditation of a
pre-doctoral psychologist training program
at Vaden Health Center will contribute to
the growing pool of mental health care
providers on campus.
Student Mental Health as a
Student Initiative
But what good are the improvements in
university policy and practices if students
do not begin to recognize the importance of
their own mental well-being? Dr. Friedman
gives several of his own suggestions.
First is a change in collective campus culture
regarding mental health. “The student
ETHICS + POLICY
culture will survive here and it will be shaped
largely by students,” Friedman asserts. In
reference to the Primal Scream, a Stanford
tradition in which students across campus
scream at the stroke of midnight the week
before final exams, Friedman remarks, “None
of us invented that, but it’s an indication
of what students are experiencing.” More
efforts to encourage open expression
of emotional hardship could potentially
alleviate the stress associated with the Duck
Syndrome.
Another healthy change would be a shift
in mindset from academic all-stars to
emotionally and spiritually whole human
beings. “I’d particularly like to see more
emphasis on the balance issue,” Friedman
notes. Students should be encouraged
to talk with each other more about non-
academic interests and leisurely pursuits.
“Those are de-stressing things, and only
students can create the communities that
are supportive of each other.”
Though the Student Mental Health and Well-
Being Report focuses largely on changes
at the administrative level, students should
not take its findings for granted. “I really do
believe a large piece of this is in the hands
of the students,” Friedman states, “and
what’s exciting about this document is that
it gives us a platform from which we can
say, ‘This is what we think—what do you
think?’” Through proactive collaboration
and a willingness to confront the issues
surrounding mental health, it will be
possible for students to achieve a state of
wellness at Stanford—not simply to help
each other but to help themselves.
To Learn More
For more information, visit the Stanford
Student Mental Health and Well-Being
group’s website at http://www.stanford.edu/
group/mhwb/index.shtml. Credit: sxc.hu
volume VIII 49