Looking for Help

January 25, 2010

About 10.4 percent of students enrolled at four-year colleges and universities sought help at counseling centers in the 2008-9 academic year, up from 9 percent the year before -- a 16 percent increase.

The figures come from the National Survey of Counseling Center Directors, for which the 2009 data were just released. And statistics back up anecdotal reports that many counseling centers have been seeing increased traffic. While the statistics suggest a greater prevalence of many serious mental health issues, they do not show increases in suicide rates, or shifts in the demographic patterns of which students are killing themselves.

The data in the survey come from 302 campus counseling centers at four-year institutions, which together serve 2.6 million students. The figures cover both undergraduate and graduate students, but the vast majority of those served in the centers (and all students at strictly undergraduate institutions) are undergrads. The survey is co-sponsored by the University of Pittsburgh and the American College Counseling Association, and the numbers count only those who sought direct counseling, not the many others who attended workshops or who saw counselors appearing in classrooms, dormitory events and at other programs.

Robert P. Gallagher, who conducts the survey, said the figures represent "a significant jump" in the use of counseling centers. Gallagher currently teaches at Pitt, where he previously was director of the counseling center and vice chancellor for student affairs. In talking to center directors, Gallagher said, "they are all seeming stressed. Not only are they busier, but they are seeing problems that are more difficult and more demanding." A few weeks into the new semester these days, counselors are reporting that they must use waiting lists to schedule students who need sessions, he said.

In the new survey, center directors estimated that an average of 48.4 percent of their clients have "severe psychological problems," although most can be treated successfully while remaining students. More than 93 percent of center directors reported that they are seeing increases in the percentages of their student clients whose problems are severe. Examples of "severe" problems include anxiety disorders, depression, suicidal thoughts and impulse control. Examples of what the report calls "normal developmental concerns" that represent the issues facing other counseling center clients include relationship problems, identity issues, academic problems and so forth.

The report on the survey notes that while wealthier colleges and universities frequently have no limits on the number of counseling sessions an individual student may have, many other institutions (31 percent) have limits. Among all students, the average number of sessions per year per client is 6.2 -- and while the report says that this is typically sufficient for many students, it notes worries about care for severe issues, especially at campuses with session limits.

The survey also found a continuation of a trend in which greater percentages of counseling center clients are on psychiatric medication (as are many who are not clients). Among those who are in counseling at the centers, 25 percent were on psychiatric medication in 2009, up from 20 percent in 2003, 17 percent in 2000 and 9 percent in 1994.

Asked whether certain problems were on the rise among those seeking treatment on their campuses, here are the top items identified.

Issues Increasing at Many Centers

Issue Percentage of Campuses Seeing Increase
Psychiatric medication issues 75.9%
Crisis issues requiring immediate response 70.6%
Learning disabilities 57.7%
Self-injury issues 55.7%
Illicit drug use (other than alcohol) 46.5%
Alcohol abuse 45.0%
Eating disorders 26.5%
Sexual assault concerns (on campus) 24.7%
Problems related to earlier sexual abuse 23.0%

Gallagher said that he was struck by the increase in self-injury issues, which are quite serious even if they fall short of a suicide attempt. Common self-injuries being seen on campuses include self-cutting or pulling of one's hair as a means of reducing stress. While 55.7 percent of all directors reported seeing increases in such behavior, 75 percent of larger campuses reported increases in this behavior.

The survey found 103 suicides at the campuses in the survey -- statistically consistent with recent years' totals (which vary somewhat from year to year in the number of campuses included and their enrollments). Gallagher said he viewed it as a positive sign that, amid all the increases being reported in serious mental health issues facing students and their increased use of counseling centers, the suicide rate has not increased. Consistent as well with previous years' data, only a small minority of students (19) who killed themselves had sought help in counseling centers.

Also consistent with past years, those who killed themselves were overwhelmingly male (73 percent), undergraduates (72 percent) and white (77 percent), and they generally killed themselves off campus (81 percent).

Earlier this month, a study led by a San Diego State University researcher found that high school and college students are more stressed today than ever before -- even going back to the period of the Great Depression.

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