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The Mental Health of Students and Non-Students

December 2, 2008

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Ever since the killings at Virginia Tech last year, there has been widespread speculation about the relative incidence of mental health disorders among college students. A new study in The Archives of General Psychiatry finds that such disorders are common, and that far fewer students receive treatment than one might like. But the study -- believed to be the largest national comparison of the mental health of college students and comparably aged non-students -- finds that non-students are as likely to have mental health disorders and as unlikely to seek treatment as their peers in college.

The study is based on face-to-face interviews for the 2001-2 National Epidemiologic Survey on Alcohol and Related Conditions, which involved more than 5,000 individuals aged 19-25. Almost half of them, both in college and not, had some disorder, while only a minority in either group sought treatment.

The seven members of the research team that produced the study saw cause for both concern and optimism in their results. "The vast majority of disorders in this population can be effectively treated with evidence-based psychosocial and pharmacological approaches," the study says. "Early treatment could reduce the persistence of these disorders and their associated functional impairment, loss of productivity, and increased health care costs. As these young people represent our nation's future, urgent action is needed to increase detection and treatment of psychiatric disorders among college students and their non–college-attending peers."

The authors are all researchers at Columbia University, the National Institutes of Health, and the New York State Psychiatric Institute.

While the overall trends were similar for both groups of young people, there were some differences. The odds of alcohol use disorders were far greater for college students than for non-students. At the same time, college students were less likely than non-college students to have received treatment in the past year for conditions related to alcohol or drug use (5 percent vs. 9 percent of those with the condition).

College students are less likely than non-students to have nicotine dependence or bipolar disorder.

Here are some of the data, which cover a 12-month period.

Psychiatric Disorders, Personality Disorders and Substance Abuse in Students and Non-Students, 19-25

Condition % in College Students % in Non-Students
Any psychiatric diagnosis 45.8% 47.7%
Any substance abuse disorder 29.1% 31.5%
--Alcohol 20.4% 17.0%
--Drugs 5.1% 6.9%
--Nicotine dependence 14.6% 20.7%
Mood disorders 10.6% 11.9%
--Bipolar disorder 3.2% 4.6%
Anxiety disorders 11.9% 12.7%
--Social anxiety 3.2% 3.5%
--Specific phobias 8.1% 8.8%
Pathological gambling 0.4% 0.2%
Any personality disorder 17.7% 21.6%
--Obsessive-compulsive 8.2% 8.0%
--Paranoid 4.9% 8.7%
--Schizoid 3.3% 5.6%
--Anti-social 4.7% 8.5%
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Comments on The Mental Health of Students and Non-Students

  • The Norm
  • Posted by Ken on December 2, 2008 at 7:55am EST
  • Wow...based on the table, it appears that "Psychiatric Disorders, Personality Disorders and Substance Abuse in Students and Non-Students, 19-25" is basically the norm. Is this a modern trend, or have these numbers been consistent through the years?

    Have the definitions of disorders changed? In other words, is the mental health industry getting more and more "categorical" by putting people into one bin or another, blurring the line between 'healthy' and 'disorder'?

  • And where do you go from here
  • Posted by ccb on December 2, 2008 at 8:15am EST
  • Great. Yet another study published about the rampant existence of mental health problems among young adults. And yet there are no viable solutions to helping these people. Why? Because of the ridiculous law that makes an 18 year old a full adult and allows him or her to "benefit" from the even more ridiculous privacy laws.

    So what do we know from all of these studies. We know the age group most susceptible to mental illness is the college student age group. You know that the sooner a mental health problem is detected, diagnosed and treated, the more productive that person becomes, but the longer you wait to seek treatment the harder it becomes to treat. We know that family is key in helping a young person get through what might end up being a lifetime condition---AND YET, these misguided laws require just the opposite. Somehow a person who is 17 one day and 18 the next is expected to recognize and seek of their own accord the help and support they desperately need to get through a difficult period. All by themselves. Please. A little reality would go a long way here.

    College administrators embrace FERPA because it gives them the perfect legal excuse to do nothing. When a tragedy occurs they can raise their hands and cry "It's not my fault, the law made me do it." It being NOTHING. And legally they are right, but morally they are criminals. Instead they should be using these studies to change the laws. To raise the age of "adulthood" and to allow persons of authority to contact and share information with family members.

    How does it benefit society when you have a young person, newly fledged, who develops a mental health problem, and the privacy laws require that their health care professionals as well as their college administrators, counselors, professors, security guards, maintenance people, cleaning crew, administrative assistants, keep their mouths shut, not inform any one in the family of the condition that their child is suffering from, and keep that person, who is a child of a mother and father, isolated from getting the help and support they need from the people who love and understand them the most. Help and support that could prevent a tragedy or shorten the suffering of a human being by getting him or her the medical attention they need.

    FERPA is an insane law that needs to be seriously revisited. And the idea that an 18 year old is on the one hand allowed to buy a gun and vote but is not allowed to buy a drink or rent a car is ridiculous. The age of adulthood should be raised to 21.

  • When Will We REALLY Help This Population?
  • Posted by Patti , Counselor/Instructor on December 2, 2008 at 10:45am EST
  • I cannot say it any better than ccb "AND WHERE DO WE GO FROM HERE". FERPA is a smoke screen used in the education setting to avoid confrontation or real problem solving and the magic number 18 is what the professionals in your community use to cover their behinds when they don't or aren't doing anything productive. Maybe not all but... I have seen it BOTH ways and it is so frustrating and sad to see a student spiral downhill because of the hidden facts that should be used to assist that individual in working a plan of recovery and staying healthy- in school- happy- the list goes on. FERPA really needs a change and I have not heard where or if this is being talked about even after such tragic and negative events. Sickening.

  • Posted by Anne on December 2, 2008 at 12:00pm EST
  • Interesting that nicotine addiction is classified as a psychiatric disorder (which technically it is)and is included in this study, but eating disorders are not. I'm not sure the numbers in this study are very meaningful, but the overall message is extremely important: we need to find better ways to identify and treat mental/behavioral disorders in young people -- in college or not.

  • Rampant Normality on Campuses!
  • Posted by Rod Bell , Adjunct Professor at College of DuPage on December 2, 2008 at 12:00pm EST
  • Wouldn't it be great if this study could be automatically linked to the next "research" news story that comes out about some alleged worrisome trend, if not outright epidemic, of drinking, anxiety, depression, or some other malady that supposedly requires urgent action (and increased budgets?) by campus mental health folks? As we might expect, if we would but ask ourselves the question, there is no college trend; students are the same as everybody else.

  • Posted by Michael , psychologist on December 2, 2008 at 2:35pm EST
  • First of all, blaming FERPA for limits on what therapists can communicate to whom misses the point. State laws governing psychotherapist-patient privilege (confidentiality) would still be in effect if FERPA were repealed tomorrow. Confidentiality is the cornerstone of psychotherapy for the simple reason that if confidentiality were to be significantly limited, people wouldn't come to therapy. This is especially true when dealing with students who are financially dependent on parents and who engage in behaviors of which their parents would disapprove. Therapists can and do communicate with parents and other college staff in emergency situations and we have been developing protocols and response teams specifically to try to prevent tragedies such as Virginia Tech. The contention that college administrators hide behind confidentiality in order to "do nothing" and avoid liability is ridiculous. If that were the case, plaintiff's attorneys would be drooling at the prospect of big settlements. Surprising as it might sound to the cynics, most of us who work in higher education are dedicated professionals doing our best to help our students learn and develop. From the point of view of a psychologist who has worked in college counseling centers at three different universities for a total of thirty years, our motivation is to do more and be seen as necessary, not to do less and hide behind the law.

  • How can our students learn?
  • Posted by Stanislaus Dundon , Professor Emeritus at California State University, Sacramento on December 2, 2008 at 2:35pm EST
  • I continue to teach college students and I quickly develop attachments to my students. It breaks my heart to think how many of them are trying to learn what I teach (especially the logic and critical thinking components of every course I teach) while dealing with whatever is causing this astonishing rate of mental stress and instability among them. I remember when I was newly in love and dealing with a 4000 mile separation and trying to teach logic. I would write a formula on the board and be unable to read it! I would have to ask the students to help. Fortunately all went well, I got married and settled down. This is normal stress and it is bad enough for studies and for completing a Ph.D.
    Why is it that the researchers and commentators specify drugs, anti-depressants, etc. when the conditions affecting these students, especially the women, ARE depressing. The drugs will only be masking reality. What I refer to is the massively increasing frequency of humanly destructive behaviors in the most important part of young lives, the finding, falling in love, and uniting of young couples? It is not as if there is no good research pointing out that something genuinely and disastrously new is happening out there. Dr. Miriam Grossman, a college psychiatrist (Her book "Unprotected"), Kathleen A.Bogle, a sociologist ("Hooking Up")and Allison Kasic, all depict the epidemic proportions of heart-breaking, emotion-rattling behaviors all conspiring to turn this happiest of events, the encounter with true love, into a tragedy, dismissable only by trying to convince the self-inflicting victims and the genuine victims that their hearts' desires don't matter. They do matter! And both parties are injured in making erotic love into a drunken, meaningless encounter. Only a change in behavior is going to bring back mental peace, physical health and emotional stability. And a change is surely possible. People used to date, court and get married during their college years. What is going on now is damagingly, dangerously abnormal and makes the classroom a mockery for fully 20% of the students if not more. These behaviors are a major cause of the resort to alcohol. Beer doesn't taste that good!I'm from Milwaukee and drank beer from age 16 without ever getting drunk. When it comes to beer, drunk in not an accident.It's either aimed at doing stupid things or to soften the pain of ones already done. Why don't we see more open admission of the dangers our kids face in college and stop talking as if this havoc is a mystery?
    Some of my colleagues used to regard me as hopelessly "incorrect" in my counseling approach. Once the "relationship" basis of the student's failing performance is clear, I would (and will) say: "Do you expect to study while going through these things? Either cool the relationship or get married and stay married." It's hard to do, but it is not rocket science.

  • comments
  • Posted by Larry on December 2, 2008 at 2:40pm EST
  • Patti,

    Just wondering – are you proposing treating students that are over 18 different than non-students? You seem to be saying that just because someone is a student, people should have access to their medical records.

    Mr. Bell, Good point. I would even go one step further: of course people have angst in college. Nobody is going to argue that college doesn’t involve new experiences and competition. These are what always causes some degree of angst.
    CCB, There is an even better legal excuse to do nothing. Once you start doing something in this area, you are assuming a duty not to malpractice. Essentially, a little caring is a lot worse than no caring.

  • In response to "Where do we go from here"
  • Posted by Kelly on December 2, 2008 at 2:40pm EST
  • I feel like it's important to recognize that FERPA isn't the legistlation that protects a students medical records. The protection of their medical records really has nothing to do with Educational laws. Their records and medical related behaviors are protected by HIPAA.

    Also, if a student is a direct threat the themselves or others, there are no laws that say their privacy needs to be protected over their safety. Privacy laws exist to protect people and communities. Getting rid of all privacy laws would never do any good; it would only contrast the goal of higher education - holistic development of contributing citizens.

    Finally, before you consider raising the age of adulthood to 21, take a look at our military. You would likely cut out a vast majority of the men and women currently serving or have served at an age younger than 21. We expect men and women to graduate high school and either go to college, get a job, or join the military. Notice that two of those are considered adult activities and the first is not. Maybe we should think about really making all of our expectations equal that men and women are adults at 18?

  • Not surprised!
  • Posted by Sue on December 2, 2008 at 5:45pm EST
  • After watching my daughter struggle with depression at during her undergraduate years with virtually no help from the university health center at her school, I am hardly shocked by these results. Many times I was amazed that more kids didn't crack under the pressures, especially when they sought help only to be re-directed and left on their own to pursue another avenue of help.

  • FERPA is not HIPAA
  • Posted by ccb on December 3, 2008 at 9:10am EST
  • To Michael, psychologist:

    FERPA does not simply protect the records of students and to think that is how college administrators interpret it is completely naive. As for having protocols and response teams in place to prevent tragedies, that is also something that looks great on paper but just doesn't happen. The response teams are in place AFTER the tragedy--the family of student is not involved until after suicide has been attempted or has been successful, until after someone has shot up a campus or goes off the deep end in some other way.

    FERPA is to be blamed for encouraging college administrators to not only do nothing regarding the behavior of students but to actually interfere in the relationship between the student and their family because it encourages such an extreme state of privacy. I'm not speaking of the dr./patient privilege. I'm speaking of untrained, unqualified people who are administrators who take it upon themselves to determine whether or not a student is suffering from "something". Let me explain my cynicism.

    As a parent I contacted the college where my son attended because I was concerned about a dramatic change in his behavior. After going through a maze of administrators and personally involving the head counselor, I was told my son was fine--even though to every member of his family he obviously wasn't. After one session with the psychologist I contacted, he lied to them, told them he was abused and she IMMEDIATELY--without any doubt--advised him to put both me and his father on a PNG list. The Dean of Student Affairs was in swift and complete agreement. My husband and I were sent a form letter from the Head of Security informing us of our new status as Persona Non Grata and that to step foot on campus was to invite arrest by the local police! It was determined by the Dean of Students that the parents were the problem and we were legally and summarily dismissed. There was no protocol in place, there was no form of due process, there was no attempt at inviting us down to discuss our concerns and bring some sense and sanity to a very disturbing situation. The entire administration used FERPA as their great flag and shield. They--the dean of student affairs, the head counselor, and head counsel and the President--caused irrevocable harm to my son and entire family.

    Maybe your personal experience and wisdom of 30 years as a psychologist would have brought us to a different end had you been involved, but we were dealing with fanatic, irresponsible people who used FERPA to sweep us under the rug. I now warn every parent of a college student to never, ever under any circumstances contact or involve any college dr., psychologist, teacher, advisor or administrator regarding any concern they may have for their child's behavior. The first and foremost loyalty of all college personnel is not to the student but to their employer--the college or university. If my son hadn't been considered an adult at age 18 and if FERPA hadn't been interpreted to shut out his parents completely, perhaps there would be a more humane end to this story. My son has since disappeared and we have spent thousands trying to locate him. I am not the only parent with such a story. I have read many other examples on some of the blogs on College Parents of America. FERPA needs to be addressed along with the legal age of adulthood.

  • Sick Culture - Not a Norm of Sick People
  • Posted by Juliet Davis , Associate Professor at University of Tampa on December 5, 2008 at 1:55pm EST
  • It's time to realize that it's our culture that's sick. For example, when sexual abuse is such an epidemic that it's the norm, isn't it time to start realizing that our culture is a medium of violence? And when mental disorders among young adults is the norm, isn't it time to start looking at culture rather than prescribing another antidepressant? The backlash against "being a victim" has become an endorsement of power structures that actually do victimize--and individuals who have no way of "taking responsibility" against capitalism gone wild. Similarly, it's a sick culture that got us into our current economic mess, even as we believed we were the richest country in the world. We better start being the most self-reflexive country in the world--otherwise, we'll just have a bunch of mentally ill people in an economic black hole. Okay, that was my rant for the day. . . .