Running head: MENTAL HEALTH IN HIGHER EDUCAITON 1

Mental Health in Higher Education

Melissa Bryant

Northern Illinois University

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Mental Health in Higher Education

The number of students entering higher education intuitions with mental health

disabilities increases each year (Clay, 2013, Kitzrow, 2003, LaFollette, 2009). In addition, the

number of students using university counseling centers has also risen exponentially (Kitzrow,

2003). Studies show that students who utilize the counseling centers are having more severe

mental health symptoms than they have in the past (Kitzrow, 2003, LaFollette, 2009). Mental

health affects a student’s academic performance, retention, and graduation rate (Kitzrow, 2003).

Incoming freshman reported having more stress than in recent years (Kitzrow, 2003). This paper

discusses mental health concerns in higher education institutions, different populations that are

more susceptible to mental health issues, the need for university counseling centers, and

implications and actions for university staff and faculty to support the efforts of a counseling

center and students in need.

Demographics

The age at which students are entering higher education is also typically the peak age for

onset of mental health and substance abuse disorders. In 75% of mental health cases, the person

has their first onset of symptoms before the age of 24 (Reavley, Jorm, 2010). The most common

disorders found amongst college students are anxiety, mood disorders, substance abuse, and

conduct disorder (Kitzrow, 2003). Although these disorders are heavily prevalent on campuses,

alcohol abuse causes the highest numbers of morbidity and mortality rates of college students

(Reavley, Jorm, 2010). Overall, 5% of US college students drop out of school due to psychiatric

disorders. Suggested factors that influence mental disorder symptoms are social and cultural

influences such as divorce, family problems, instability, poor parenting skills, frustration,

violence, drug and alcohol abuse, sex, and poor interpersonal attachments (Kitzrow, 2003).
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Reports indicate that 12-18% of all students in higher education have a diagnosable mental

illness (LaFollette, 2009). LaFollette (2009) reported that 14.9% of college students were, at that

time, currently diagnosed with depression, and 32% of those reported cases were diagnosed

within the past academic year. Counseling centers however, provide help to the students in need,

and are vital for student retention and success. In a 2000 survey at the University of Idaho, 77%

of students reported they were more likely to stay in school due to the services provided at the

counseling center, and without the services their academic performance would have been worse.

Of the surveyed people, 90% said that counseling helped them meet their individual goals and

helped reduce their overall stress. Students who went to counseling sessions had a 14% higher

retention rate (Kitzrow, 2003). Due to the increased rate of students with severe mental health

concerns, counseling centers are needed to support these students’ efforts and help them reach

their personal and academic goals.

Sex Differences. Mental health symptoms and disorders vary in different ways between

sexes. Although there are no differences in prevalence of severe mental health disorders

between the sexes, the patterns of on-set of disorders differs. Roles that play into mental health

disorders include; genetics, biological factors, and societal vulnerability (Gender and Mental

Health, 2002).

Women during adolescence, have higher rates of depression and eating disorders, and engage

more in suicide ideation and attempts than men (Gender and Mental Health, 2002). During

adulthood, women are more likely to be diagnosed with anxiety or depression. Due to these

diagnoses, women internalize emotions which leads to loneliness, and withdrawal. (Gender and

Mental Health, 2002, Eaton, 2011). Men, in comparison, show higher rates of conduct disorders

such as aggression and antisocial behaviors during childhood. During adolescence, men
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experience more problems with anger, participate in high risk behaviors, and have higher rates of

suicide (Gender and Mental Health, 2002). During adulthood, men are more likely to have

substance abuse disorders, and antisocial disorders. This results in men being more likely to

externalize emotions which leads to aggression, and impulsive behaviors (Gender and Mental

Health, 2002, Eaton 2011). In addition, although there are no differences in prevalence of

disorders between the sexes, men typically have earlier onsets of schizophrenia, while women

show more serious forms of bipolar disorder (Gender and Mental Health, 2002).

LGBTQ and Mental Health. Members who identify as part of the Lesbian, Gay, Bisexual,

Transgender, and Queer (LGBTQ) community are at a high risk for mental health disorders. Part

of the heightened risk is due to societal stigma against the LGBTQ community, discrimination,

and denial of human civil rights. Discrimination towards the LGBTQ community alone has been

directly linked to cause high rates of psychiatric discords, substance abuse, and suicide

(Communities and Mental Health, 2017).

In a 2011 study done on 246 LGBTQ youths, one out of three participants met criteria for a

mental health disorder. The study administered diagnostic tests for the results. Overall, 7% of

the subjects were diagnosed with conduct disorder, 15% with major depression, and 9% with

posttraumatic stress disorder. Of the 246 interviewees, 31% had attempted suicide in their

lifetime (Mustanski, Garofalo, Emerson, 2011). Nationally, 38-65% of transgender individuals

experience suicide ideation (Communities and Mental Health, 2017). LGBTQ youth have a

higher prevalence of mental health disorders than the overall national sample. LGBTQ

individuals are 2.5 times more likely to experience depression, anxiety, and substance misuse

(Communities and Mental Health, 2017, Mustanski, Garofalo, Emerson, 2011).

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International Students and Mental Health. International students are another identified

population that are at a high risk for experiencing mental health concerns. When international

students enter the United States higher education system, they can experience cultural

adjustments such as homesickness, culture shock, loss of identity, frustration, linguistic demands,

academic failure, and financial stress (Kung, 2017, Kwon, 2009, Mori, 2000, Working with

International Students, 2017). These feelings can be due to the demands to assimilate to

American culture, and pressures of acculturation. In some international cultures, seeking mental

health help and counseling is considered taboo, and thus students who need the help do not

utilize the resources available to them (Kung, 2017, Kwon, 2009, Mori, 2000).

International students must take an English placement entry exam to enter American

higher education institutions. Tests such as the Test of English as a Foreign Language (TOEFL)

are common amongst all colleges across the United States. International students must pass a

minimum requirement to be admitted to an institution. The TOEFL score, however, does not

measure oral or comprehensive English skills. Although a student may receive the minimum

required score on the TOEFL, their English skills may not be suitable enough for them to feel

comfortable in American culture (Mori, 2002). Hesitation with English proficiency can lead to

international students feeling secluded, frustrated, and misunderstood.

Historic Context

University counseling resource centers first started in the late 1930’s-early 1940’s (Clay,

2013, LaFollette, 2009). Early counseling centers were created to support and guide students on

life changes such as leaving home, academic success, and obtaining employment (LaFollette,

2009). These resource centers were typically staffed by faculty who advised the students (Clay,
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2013). Counseling services became more popular post World War II, as veteran students started

returning back to school, in causation of the GI Bill (Clay, 2013, LaFollette, 2009).

The Servicemen’s Readjustment act of 1944, or the GI Bill of Rights, had reservations from

the government when it was first passed through Congress. Many government officials thought

that colleges and universities were not a place for veterans, as college was typically a place

reserved only for privileged rich men. The GI Bill was agreed upon because a system was

needed to be put in place to assimilate veterans into civilian life. By 1947, 49% of college

admissions were veterans. The GI Bill helped many veterans seek a track in education rather

than overflow the job market at the time (Education and Training, 2013).

Veteran support at the counseling center was originally focused on vocational services but

quickly changed to personal and social concerns as more soldiers attended college (LaFollette,

2009). As the demographics and diversity of campuses started to change, so did the needs of the

counseling centers. In 1958, the National Defense Education Act (NDEA) pushed students

towards careers that would support the Space Race against the Soviet Union. The NDEA funded

guidance and counseling at institutions across the nation, funded fellowships in counseling

preparation, and expanded counseling services across many different campuses (LaFollette,

2009). Counseling services and the need to support students psychologically was becoming

more popular. After the Civil Rights Movement, there was an increase in diverse populations on

campuses with more women and people of color attending college. Counseling centers needed

to shift their goals to meet the new demographics of incoming students (LaFollette, 2009).

Today, there are direct correlations between the use of a counselor and positive retention

rates (Clay, 2013). College counseling centers’ universal mission statement is “Assist students

to define and accomplish personal, academic, and career goals by providing developmental,
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preventive, and remedial counseling” (Kitzrow, 2003). From this statement, it is shown that

counseling has moved from an educational and career guidance based model to treating mental

illnesses and implementing crisis plans (LaFollette, 2009). Higher numbers of students are

entering college with mental disabilities (Kitzrow, 2003). One reason for this, is that there have

been medical advances that make it possible for this population of people to succeed

academically who might not have been able to in the past. As well, the number of students

seeking help has increased due to the change of stigma for mental health counseling (Kitzrow,

2003). Counseling centers have changed with the influx of diverse students, and will continue

growing and changing with students’ needs.

Relevance

Counseling services began as a self-reflecting accommodation, but now uses the medical

model for treatment and intervention (LaFollette, 2009). Because counseling centers are a

service that are in high demand, these centers are often understaffed, and students are either put

on a wait list, or referred out to other community providers (Clay, 2013). Students are faced with

more pressure than ever before. Incoming students face stressful factors including but not

limited too; financial ability, working while in school, social pressure, and academic success

(LaFollette, 2009). As mentioned before, anxiety and substance abuse are common amongst

college age students. Although the need for counseling centers and services has grown in

number, there are still students who do not utilize these services. Instead, students with severe

mental health disorders typically delay seeking help or do not seek help at all. In these cases,

students usually turn to alcohol as a form of self-medication. Reasons as to why students might

not seek professional help could be due to mental health literacy, attitudes and perceived stigma,

family, educational institutions, and lack of community support (Reavley, Jorm, 2010).
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Resource centers are needed for the growth in students with mental health disabilities, but there

are measures that should be taken to reach out to the students who do not use counseling services

but would benefit from these resources.

Accommodations & Resources on Campus

Due to the rise in mental health issues on college campuses, universities must have

resources and accommodations available to students in need. The national Institute of Mental

Health believes that one in five people will experience some type of psychiatric disability in their

lifetime (Maximizing Productivity, 2017). An accommodation is an adjustment to a setting that

make is possible for persons with disabilities to perform at their best level. Possible

accommodations include; flexible workspace, adjustments in scheduling, or leave and breaks

according to the individual’s needs (Maximizing Productivity, 2017).

In 1990, the Americans with Disabilities Act (ADA) became a law. The purpose of this

law was to make people with disabilities have the same access and opportunities as people

without disabilities. The ADA is also defined as “a civil rights law that prohibits discrimination

against individuals with disabilities in all areas of public life, including jobs, schools,

transportation, and all public and private places that are open to the general public” (National

Network, 2017). Under the ADA law, schools and universities must provide accommodations to

students in need.

Students at Northern Illinois University must work with the disability resource center to

discuss any barriers they may face due to their disability. Students meet with an advisor called

an “access consultant” for a schedule 60-90 minute meeting to discuss any accommodations that

they would need. Students are encouraged to meet with an access consultant at least six weeks

before the accommodation shall be needed. Once an accommodation plan is agreed upon by the
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student and the access consultant, the access consultant will then provide professors, or

whomever needs to be contacted about the accommodation request (Accommodations, 2017).

Strategies and Implications

Supporting students’ mental health must be the priority of every staff member on campus.

Different strategies suggested for university student affairs professionals, is to train faculty and

staff how to recognize signs of mental health distress (Clay, 2013). By training university staff

how to recognize who needs help, students will have more resources to turn to, and staff will

know where to refer students in need (Kitzrow, 2003). Making mental health a campus-wide

issue rather than just a counseling center issue will allow students to be more aware of

treatments. This in turn will reduce stigma for seeking help at counseling centers (Kitzrow,

2003, Reavley, Jorm, 2010). In addition, it is suggested that the counseling center collaborate

with different multicultural centers as another way to promote their services and speak to a

wider, diverse range of people (LaFollette, 2009). Universities as a whole should have a crisis

plan and be able to effectively assist students who need the help (LaFollette, 2009).

Counseling centers are often understaffed, and therefore students are put on a waitlist.

Counselors in centers at universities are typically working 10 hours a week just on administration

work (LaFollette, 2009). To help with these efforts universities should hire more counselors and

administrative assistants. The counselors could then spend more time on counseling rather than

focus their time and administration tasks (LaFollette, 2009). Counseling centers could also

create workshops around campus for students to find their strengths and apply this into how to

use an individual coping mechanisms (LaFollette, 2009).

Conclusion
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Student affairs professionals and campus faculty must recognize that different

populations of people are more susceptible to mental health concerns. Across campus, all staff

should have a plan of action and be knowledge about how to identify warning signs of mental

health, and where to advise students to seek help. As more students enter the higher education

system with more severe mental health concerns (Clay, 2013, Kitzrow, 2003, LaFollette, 2009),

universities must be ready to combat any adversities and be available to make accommodations

to all. Promoting healthy lifestyles, and breaking stigma of mental health concerns will increase

retention and graduation rates and make students more successful, overall.
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References

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https://niu.edu/disability/accommodations/index.shtml

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