University of Arizona staff psychologist Dr. Phil Gibeau recalls a time when there were only a handful of college students seeking help at the campus’ Counseling and Psych Services (CAPS).
But over the past five years, Gibeau says the number of students seeking clinical help has “increased tremendously,” estimating it to be double or even triple of what it was not too long ago.
Gibeau’s clinic isn’t alone; university counseling centers throughout the country are scrambling to deal with a record number of students seeking treatment for depression and anxiety disorders. The rising demand for on-campus psychological services, in addition to signs that point to increasing anti-anxiety prescription drug use, appears to paint a bleak picture of deteriorating mental health among young people.
However, a significant number of campus psychotherapists interpret the trend as a good thing, a positive stemming from societal destigmitization of mental health problems and treatment. They view today’s college students as the generation more likely than ever to seek professional help when encountering a mental or emotional health crisis.
A growing trend
A recent report by the Center for Collegiate Mental Health found that total annual appointments provided by college counseling centers increased 38.4 percent from 2009 to 2014, dramatically outpacing enrollment growth.
Also trending upward is the number of young people taking medication in order to treat anxiety. A study from Medco Health Solutions, Inc. found that anti-anxiety drug use among Americans ages 10-19 increased 49 percent from 2001 to 2010.
Both reports are backed up anecdotally by the experiences of campus counseling centers across the nation, including those at the University of Arizona, the University of Washington, BYU and Utah State.
“We have two different counseling centers, but (they’re) both backed up,” said Chris Keller, a predoctoral intern at the University of Washington Counseling Center. “It’s always very busy; there’s people who always want to come in. We just can’t see students for maybe as long as we would like all the time so that we can make sure there’s room for other students who come in.”
Utah State CAPS psychologist Charles Bentley similarly indicated a struggle to schedule time with each client. The waiting period for students hoping to schedule an appointment with a counselor has recently expanded to a six weeks.
The dilemma also extends over the 125-mile distance from Logan to Provo, where in-house BYU CAPS data shows a 45 percent increase in annual unique clients from 2009 to 2015 alone.
“We see more students coming, and it’s the same experience that all of the counseling centers have across the country,” said Barbara Morrell, BYU clinical professor of counseling psychology.
Morrell has seen a steady increase in student clients ever since she started working at the university in 1996.
Although it may seem alarming, the spike in the number of students seeking treatment for mental health issues doesn’t necessarily equate to deteriorating mental health. The trend may simply reflect a destigmatization of issues involving depression and anxiety within society.
“I see it as positive,” Bentley said. “I definitely imagine that when mental illnesses really stigmatize, a lot of people really just sit in silence and suffer … it’s sad to think that anyone would sit in the dark and suffer when there are treatment options available to help.”
The negative stigma may be losing ground most among today’s college students.
“At least on the college campuses, mental health services are less stigmatized than in the past,” Bentley said, “Students appear to be more comfortable than others with utilizing counseling services.”
Outreach initiatives have been part of the strategy utilized by counseling centers to spread student awareness of services offered.
“We do a lot of work actually just on campus with outreaches and getting our name out there and kind of just offering ourselves as a resource,” Keller said. “That helps students feel more comfortable with coming to the counseling center because they know who we are, they know what we’re about, they know our values of meeting with students where they’re at.”
Aiding counseling centers have been grants commissioned by the Garrett Lee Memorial Act, which provides funding for suicide-prevention efforts. Nearly $480 million have been provided to recipients from 2005-2015, $63 million of which went specifically to colleges.
With old stigmas attached to mental disorders appearing to wane, more students are becoming aware of the different treatment options available to them, including prescription medication.
Although campus psychotherapists generally aren’t able to write prescriptions, they are able to refer students to medical doctors and psychiatrists who can both evaluate students and prescribe medication.
Morrell strives to educate students that both counseling and medication can be equally effective, emphasizing that medication can be especially helpful for those whose symptoms regularly inhibit the ability to function.
“The great thing about medication is that it can take the ‘edge’ off and make it easier to cope,” Morrell said. “It can’t solve the underlying perfectionism or negative view of self that fuels the anxiety and/or depression. But sometimes when people have been in a state of depression for a while and they take the medication, it gives them the mental energy to work harder in therapy or to gain new perspectives.”
Twenty-two-year-old student Andraya Funke was diagnosed with depression following her first semester of college.
“(The doctor) gave me medication and he also told me that medication can be great … but the things that are going to be best are social contact and being outdoors and exercise. And so then I started going hiking with friends, getting all three of them into one, and it really helped me a lot, just being outdoors and exercising and being with people.”
Unrealistic expectations, lower distress-tolerance
Not all factors behind the counseling trend are believed to be positive. Unrealistic life expectations and lower distress-tolerance among young people are believed to be hindering their capacity to deal with change, hardship and failure.
“We expect ourselves to feel good all the time, which is unrealistic, and then we want a pill to cure it if we don’t feel good,” Morrell said. “So I would say that one of the things that gets in the way of good mental health is people not understanding that life is challenging and that we have all kinds of emotions, including negative emotions, depression and grief, and that we would benefit from working to learn skills to manage anxiety and depression and not relying on medication.
“On the other hand,” Morell said, “many (students) are reluctant to take medication even when it could really benefit them, fearing being dependent on it or believing they need to solve their anxiety or depression on their own.”
Gibeau has also observed that more incoming students are struggling to make the adjustment from home to college life. School assignments become heftier and more difficult than they were in high school, ingrained daily habits often need adjustment and living arrangements with roommates at times require problem-solving skills and sacrifice.
“They’re having problems leaving their house, leaving their parents, leaving their dogs, leaving their boyfriend,” Gibeau said. “They show up at a new environment and they don’t know how to deal with it.”
What it means for the future
Regardless of the factors driving the trend, the dramatic increase in students seeking help at counseling centers remains an issue that must be addressed.
“I see it as a challenge,” Bentley said. “As the demand for services increase, the resources needed increase.”
For public universities, greater funding for the resources necessary to stem the tide would first need to be provided by the state. Universities then must consider how to allocate the funds. Proposed increases in state funding must navigate through the complex legislative process before becoming a reality.
“It’s complicated and it seems like there’s just not enough funding in this system as probably everybody wishes there was,” Bentley said.
Whether the increase in demand for psychological services leads to more funding, counseling centers nationwide will continue helping students cope with mental health crises.
“Different generations and cultures foster different emotional challenges, but I don’t know if that means there’s more of it out there than not,” Keller said. “I’m thankful though, whether there’s more or less (anxiety and depression) out there in the world, that people are feeling more comfortable coming to counseling centers.”