UW students parallel the findings of a Kansas State University report, released Feb. 3, that stated more students are being diagnosed with more severe mental illnesses across the country, according to UW Counseling and Consultation Center director Dr. Bob McGrath. Depression is the No. 1-treated mental illness among UW students — of the 4,000 students treated at the UW Counseling Center each year, 35 percent are treated for depression, McGrath said.
UW’s mental-health standing
Dr. Eric Heiligenstein, a clinical director at UW’s Counseling Center, said in the early 1980s, UW opened three off-site counseling locations as satellite offices of University Health Services to better meet increasing needs of students. Located in Sellery Hall, Elizabeth Waters and Family Housing in Eagle Heights, these offices are open 20 hours each week and serve as conveniences for students living in the areas.
Heiligenstein also said psychologists at each location develop a close relationship with housefellows in the dorms and that housefellows often consult with the psychologists if they see a change in behavior of a student. The psychologist can offer suggestions for the housefellow to approach students and help them deal with issues or refer them to the psychologist.
Psychotherapy, one-on-one counseling between a psychologist and a patient, at UHS is free for UW students, Heiligenstein said. He said UW’s segregated-fee system covers all costs associated with a medical assessment and counseling sessions, which otherwise are expensive.
“Not only do students have easy access to counseling here, but because segregated fees pay for it, it’s also a darn good deal,” Heiligenstein said. “UW is light years ahead of other universities to offer these services.”
If symptoms are more serious, however, McGrath said a combination of psychotherapy and anti-depression medications may be the answer. Approximately 30 percent of UW students treated for depression use a combination of psychotherapy and medication to treat their symptoms, he said.
Segregated fees do not, however, cover the cost of psychiatrist-prescribed medications, Heiligenstein said. Health insurance providers often cover the costs of these prescribed medications, including Prozac, an antidepressants, he said.
For students who are uninsured or underinsured, more options are becoming accessible so they can obtain such prescription drugs. Generic options are becoming more readily available, and most drug companies offer patient-assistant programs that subsidize prescription costs for underinsured people, Heiligenstein said.
McGrath said preoccupation with thoughts of suicide is a sign of severe depression. This also fits the trend identified by Kansas State University’s report — that the severity of mental illnesses is also increasing among college students.
Although McGrath and Heiligenstein both say the suicide rate at UW is much lower than the national average, they agree it is a problem that needs to be addressed everywhere.
“Suicide, although not a big problem at UW, is something we take very seriously. One individual who commits suicide is one too many,” Heiligenstein said.
According to McGrath, anxiety disorders are the second-most-treated mental illnesses among UW students. He said 20 percent of UW students who are treated for mental illness each year are treated for anxiety disorders. This area of mental illness includes obsessive-compulsive disorder, general anxiety disorder and specific anxieties, such as test-taking.
Heiligenstein said stress also contributes to mental illness. UW’s Counseling Center experiences its busiest season shortly after midterms, Heiligenstein said, attributing this to high stress levels as students receive their first benchmarking grade of the semester. Bad grades often harbor symptoms of anxiety and depression among students, Heiligenstein said.
Other mental illness among UW students include relational disorders, such as problems with break-ups, which make up 12 percent of UW students treated for mental illness, 7 percent for eating disorders and 3 percent for substance abuse, including alcohol, McGrath said. The remaining percentage includes impulse disorders, sexual-identity concerns, trauma (most commonly past and recent sexual assault), sleep disorders, career uncertainty and academic concerns.
Nationwide trends in mental health
Kansas State University’s report drew on empirical data as well as interviews from campus counseling-center directors. More than 80 percent of the nation’s 274 campus counseling-center directors agreed the number of students with mental illnesses has significantly risen during the last five years.
The report also announced a doubling of college students treated for depression between 1989 and 2001. These numbers are reinforced with raw numbers from the National Institute of Mental Health. In 2000, the organization reported that 10 percent of college students were diagnosed with depression sometime in their life. Moreover, the group reported that 9.5 percent of all American adults, 18 or older, have a depressive disorder.
Treating depression
During an appointment with a counselor at UHS or a satellite office in the dorms, a patient undergoes a medical assessment, administrated by the therapist. The assessment measures the patient’s symptoms and how these symptoms are affecting his or her life. The test also measures the severity of the symptoms and the possibility of danger the person may be in as a result, said Heiligenstein.
After an assessment, the therapist and the patient discuss options for treatment. For mild symptoms, Heiligenstein said psychotherapy is a common solution, although some students are more effectively treated with a combination of psychotherapy and medication.
Increasing mental illness among college students
McGrath said it’s difficult to determine why there has been a recent increase of college students being treated for mental illness. He said one theory is that the number of people with mental illnesses has remained constant through time but more are being treated in recent years because of increased awareness of the illnesses and increased access to treatment.
Another explanation for the increase in mental illness is a change in society, McGrath said. McGrath said eating disorders are new to the mental-illness scene, popping up in the last 15 years. He partially attributes eating disorders to society’s recent fascination with extreme thinness, as seen in models and television actors.
“Eating disorders are now a part of culture. In the 1980s, they were not a problem,” McGrath said.
Heiligenstein agreed that eating disorders are on the rise at UW and nationwide. He said there are various levels of eating disorders, and although some are less serious than others, earlier symptoms often evolve to full-fledged disorders that can be life-threatening. He said many eating disorders start as “sub-threshold disorders,” that involve restricting food consumption or infrequent purging after eating.
McGrath said self-mutilation — cutting oneself — is also a new trend among teenagers and college students but is becoming a significant mental illness.
Although it’s not clear why the number of college students with depression is so high, Heiligenstein said alcohol could play a role. He said students often look to alcohol to make them feel better or to reduce stress, an approach he says is counterproductive.
“Alcohol is not the best way to treat depression,” Heiligenstein said. “Because it’s a depressant, alcohol may precipitate depression and make you feel worse.”
Instead of improving a bad mood, Heiligenstein said alcohol has been linked to deep depression and thoughts of suicide.
Compound illnesses a problem among college students
McGrath said another concerning trend in college students with mental illness is that often students struggle with multiple issues. He said students already dealing with depression during high school face new stressors when entering college, such as independence, relationship issues and academic stress, that often worsen their existing illness.
McGrath said it is becoming more common for students to struggle with more than one mental illness during college. McGrath said he sees students enter college with depression, experience struggles and eventually get treated for various mental illnesses, such as anxiety disorders or substance abuse. Many categories of mental illness also overlap. For instance, eating disorders often have an anxiety or depressive component, McGrath said.
“A big problem lies in students coming to campus with preexisting psychological problems that are exacerbated by additional college stress,” McGrath said.
Madison West High School counselor Jim Mankopf said high schools are trying to do their part to help students make a smooth transition to college. He said West High School offers classes in health education and stress management, both designed to help students deal with stress in their lives. These classes urge students to use exercise and relaxation techniques to relieve stress, and they also aim to educate students about mental illness.
Mankopf said he’s not surprised that the No. 1 mental-health issue among college students is depression, because it’s also the No. 1 mental illness among students at West High School.
Heiligenstein said students should make an appointment at University Health Services if they are experiencing depression symptoms. He said difficulty sleeping, a lack of interest in things that used to be exciting, helplessness, hopelessness and a continual sad mood are all signs that could indicate a depressive disorder.
