Mental Health and the University


This year, the members of the State University System Board of Governors voted unanimously to request a $14-million state allocation to improve Mental Health Counseling Services and security at all state universities. The twelve state university presidents endorsed the request. Board of Governors’ members, for the most part very successful CEOs or managing directors, work hard to maximize taxpayer dollars devoted to higher education. University presidents loathe spending that does not enhance the academic enterprise. So the unanimity on this issue is both surprising and notable. Let me explain why I support the request.

I, too, would prefer investing in things that directly affect teaching and research: more faculty, laboratories, books, curricular enrichment... But universities teach people. A student paralyzed by anxiety, too self-conscious to speak aloud, too plagued by self-doubt to imagine succeeding, has difficulty learning anything, much less mathematics, literature, sociology, or chemistry. So do students devastated by depression or too restless to concentrate.

The Board discussion elicited the usual questions about whether universities could refuse to accept students with mental health difficulties. And it affirmed that this strategy is not only impractical (who is going to admit to something that would bar admission?), but is often illegal (think privacy of medical records) and runs counter to our universities’ missions. Our state and our country need college graduates, and just as most students will need to see a physician at some time in their college years, for the flu if nothing else, most will need counseling at some time in those years.

Today, two different things are happening.

First, more students are attending university. This is good, but the increase in the number of mental health professionals employed by the state universities has not kept up. In days when a much smaller proportion of the population attended university, those sending the students could better afford interventions and private help. Universities were also much more willing to tolerate high dropout rates. Over half the students with whom I entered graduate school in mathematics did not finish. They did not “fail” for lack of talent or interest, but because depression, or addiction, or a seemingly insuperable personal reverse made it impossible for them to study and to think. We can no longer afford to waste human capital like this. Increasingly many jobs require a university education, and appropriately so. Our students are entering a world where almost all will switch careers many times and work at jobs that we cannot yet imagine. They must learn to learn, and our society and they, personally, are hobbled if they do not graduate.

The second thing that has changed is that a larger proportion of current students need mental health counseling. There are over 300,000 students in the SUS system. Directors of counseling centers report that 26 percent are on psychiatric medication, more than double the proportion twenty years ago. Far more entering college students have been on psychiatric medication for over a decade. Well over half (57 percent) of all students report “overwhelming anxiety” at some point in the previous year, and over a third felt so depressed that that it was “difficult to function.” These proportions were up 10 percent from the year before last.

This second thing is more worrisome. Critics say that universities have morphed into ninny-versities. They allege that current students are spoiled and fragile, and blaming parents and universities for enabling them. Mental health professionals speculate that causes have more to do with information and technology overload, increased financial stress, and an ineffectual mental health care system. I think that the professionals are closer to the truth. The critics, perhaps, have never needed a mental health professional, but no one can live fully without experiencing periods of intense mental distress. And students today live in a world where every indiscretion, every awkwardness, every bad judgment is potentially the subject of a tweet or Facebook posting, and consequent public shaming.

Whatever the reasons, both trends (more students and a larger proportion with mental health difficulties) are real. The average number of students per counselor in the State University System has grown to 2081 to 1, which nearly 600 more that the minimum professional recommendation of 1500 to 1. To be sure, $14,000,000 is a lot of money, but at less than $40/student, it gets us caught up, and will be amply repaid by increased student success.

Dr. Donal O'Shea is president of New College of Florida.

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