Please note that these responses include advice from former students with mental health issues who are now successfully navigating college.

What advice would you give students who don’t believe they can attend college with mental health challenges or a psychiatric disability?

Years ago, it might have been almost impossible for a student with mental health issues to successfully complete college, due to stigma and lack of services. But today with more celebrities going public with their struggles, as well as statistics showing 20% of U.S. population has a mental health diagnosis (jumps to 35% of college students according to 2018 Boston University School of Public Health study), attending college and earning a degree is a surmountable challenge for all students. There are legal protections, mandated services, and a growing awareness on campuses that this is a serious issue that needs more attention. Students should be reaching out to high school guidance counselors (and vice versa) to discuss what accommodations are needed for them in high school, as well as college, and should have an IEP if qualified under “emotional disturbance” or a 504 plan. Knowing their learning style and preferences, as well as working with a supportive counselor or teacher will help them identify what type of college is a good fit and begin the preparations to attend early in the process.

What are some ways you suggest students start to build a long-distance support system if they are planning to attend college away from friends or family?

After identifying which colleges would be a good match for the student, they should make a connection with the office of disability services and the health center to identify how they will get needed supports. They may also need to find an outside provider if they are prescribed medication. This should be done as soon as possible, as there is a shortage of psychiatrists/prescribers in most areas. If a student has outside counseling, they should make plans with their current therapist to transition. Many therapists will now do Facetime/Skype sessions for continuity of care. A former student reported to me that she was able to successfully advocate for her needs, as she attended a high school program I directed for students with depression/anxiety/suicidality, and the self-advocacy skills we taught her gave her an advantage over peers without such experience. Since family and friends at home know the student well, they should also plan on how to regularly communicate for support.

Can you recommend any resources for other students in a similar disability situation to help them with challenges during the application process? During college?

There are many resources, online, at a student's high school, and at college. Many students with mental health issues shy away from seeking help and tend to go it alone, which leads to feeling overwhelmed and shutting down. Having a trusted high school staff person working with them is essential as they can initiate contact regularly to check on student progress. As mentioned above, they can help with SAT/ACT accommodations and assisting with contacts with colleges and helping find the best match for the student. There is a great deal of information for students with learning disabilities, such as The K & W Guide to Colleges for the Learning Disabled: A Resource Book for Students, Parents, and Professionals. This guide can be helpful to see which colleges are serious about helping students with disabilities. Many high schools offer specific college help for students with disabilities through nonprofit initiatives such as Project Reach at UMass Boston, with counselors trained to assist special education students.

What do you feel are the most important attributes or characteristics a student with psychiatric disabilities or mental health challenges should consider when selecting a university experience and why?

Since all colleges and universities are mandated by law to provide services to students with disabilities, it is important for the student to research which schools actually do it well. In addition to researching colleges online including BestColleges.com and through the guidance office, the best way is to visit and speak with both staff, and if possible, students. Other considerations are size of the institution, as many students do better in a smaller, more personalized setting. The level of competitiveness should also be a factor, as students often do better without the added stress of a cut-throat campus. Additionally, if a student is also part of an ethnic, racial, religious, or sexual minority, it is important to find out if there are students on campus that they can identify with and help them feel welcome on that campus. Financial considerations are also important, as a lack of funds for activities and transportation home can add to student stress. Students can learn a lot on the college website and should look for language that suggests the college is welcoming to all (words such as diversity, inclusion, etc.).

If a student does tour a campus, what are some questions they should consider asking the university?

Before even asking any questions, students should soak in the atmosphere and do a “gut check” of how they feel on the campus. Do they feel comfortable and welcomed, can they envision themselves on the campus? As a former student said, " Does this campus/college/university support people like me? Are they open to understanding me and accepting me into their community?” While college visits can be difficult for low-income students, they should see if there is financial assistance for visits, particularly if they may be of an underrepresented minority.

Questions should be based on their needs and preferences, but asking about the level of services at the disabilities and wellness centers and getting specific examples will help gauge if they are just giving lip service or actually focus on assisting students. Other questions could relate to the attitude of professors working with students with disabilities and what is offered via the student wellness center for counseling. For example: Is there group and/or individual? How long to get an appointment, are the sessions weekly? What about self-care and stress relief programs? Is there a nearby emergency room and how can I get there if needed? Find out how your health insurance covers you and if uninsured, see what health insurance options the school provides and what services can you access without insurance, if any.

Should students be up-front with universities about their disabilities during the application process? Or is this something students should bring up after they have been accepted and plan to attend that university?

This is really a matter of preference and how comfortable students are sharing this information beforehand. With the lingering stigma of mental illness, often students choose not to, but obviously, if they are checking out the disability services and wellness offerings, they are giving a clue that they have a disability. It is totally up to the student to decide how much information to share. For example, they need not give a specific diagnosis (bipolar, depression, etc.) but can say that they have a disability that impacts their learning in the following ways and these are the supports they need.

If so, what are some strategies you have seen students successfully use to address their disability with universities during the application process?

One way has been for the students to write about their personal struggle in the college essay, with an emphasis on their strengths and how they overcame their challenges to succeed. If they have been leaders in a high school mental health or other affinities/advocacy group, they could also highlight that. They should present their situation that shows that the disability doesn’t define them and they are confident in knowing themselves and the supports that help them succeed. As I have advised many students, if the school does not seem receptive during the application process, it might be best to consider another college.

What are the most significant roadblocks you have found students encounter once they attend college? What are some strategies/support resources to get through these situations?

Not all professors are on board and may see students with depression as “just being dramatic.” One former student noted that often the discipline determines the acceptance, e.g. psychology professors are more understanding than business professors. Students may be used to the IEP process where services are brought to them and find it difficult to be the one who has to advocate for themselves. The process of securing accommodations can be overwhelming due to the online paperwork and in-person exchanges. A student who needs extra time for testing often runs into issues with scheduling when midterms and finals are scheduled back to back. NAMI statistics show that adjustment to college is difficult for most freshman. Bad habits such as poor sleep and hygiene, drugs, drinking and unhealthy relationships can exacerbate mental health struggles, especially if students take prescribed medications while drinking or using non-prescribed drugs/marijuana. Having at least one trusted adult for support, as well as positive friends for peer support is essential, as well as joining interest/affinity groups. As a former student advised, “don’t join activities unless you really want to and it matches your interests, not just because your roommate is going.” If living in a dorm, students should build a relationship with the resident advisors, as often they are the first line of defense in a crisis. Keeping their dorm or apartment space as comfortable and uncluttered as possible, with personal touches from home, helps with stress reduction.

Do you have advice for students on ways to interact with academic advisers and faculty who may not have the specific knowledge dealing with people who have mental health challenges or psychiatric disabilities?

Students can often be the best educators as they have lived through years of challenges, but may feel overwhelmed having to explain their situation to many people. Having training in self-advocacy is useful, along with a supportive person (peer or faculty) that can assist in the conversation. Disability services should have a written plan that student can share with faculty. While the plan may list accommodations, the student can be very specific in how they best can use them. For example, extra time may help only if the proctor can give reminders of time left, taking a break may only be helpful if the student has a particular calming tool to use during the break. Professors may be more accustomed to addressing learning disabilities, and students can piggyback on that knowledge. Students may want to share a particular article or essay that they feel illuminates their situation, as it may be easier than a face-to-face talk. A former student noted that when she had an issue with a difficult professor, she would have disability services intervene. Often student campus groups focusing on mental health such as Active Minds, To Write Love on Her Arms, and general psychology clubs can increase awareness and acceptance for students with depression, anxiety, and suicidality and can advocate for faculty education.

What are ways a college can successfully support students with mental health challenges or psychiatric disabilities? Where can students seek help/advice if an issue does arise?

The best way for colleges to support students is to provide an inclusive and welcoming environment with structures in place to support ALL students. The less students with disabilities have to ask for special services, the better it will be for all students. For example, colleges can record all lectures, offer alternative ways of showing knowledge, and provide stress relief for all students. Stress relief services might include stations in the library with coloring areas, comfy chairs, and Legos; yoga or meditation classes and spaces; emotional support animals, etc. Schools can also help support all of their students and decrease stigma by offering services such as academic coaching to help keep them on track (while not overdoing it as students with anxiety are prone to do), as well as study skills/organizational supports and structured study groups. Schools can use ULifeline, which focuses on simple mindfulness techniques to help manage common stresses and emotional challenges that are broadcast on over 700 college campuses and available for any school or organization to use free of charge via Half of Us.

How do you suggest a student addresses stigma that may be associated with mental health or psychiatric disabilities on a college campus?

It is inspiring to see celebrities such as Selena Gomez be open about her struggles with depression and addiction, or Lady Gaga addressing her mental health struggles with her movie A Star is Born, which deals with suicide. Student groups can promote events that use celebrity videos to destigmatize mental health and provide trainings to faculty. Twitter is also trying to decrease stigma with hashtags such as #FightInTheOpen, #StopTheStigma, #MentalHealthAwareness, #MentalHealthMatters. Finding supportive peers, both with mental illness or allies, can help diffuse situations if stigmatizing arises.

What are tools you see students with these challenges using to succeed once they get to college?

In our digital world, apps are often the tool of choice for college students. There are calendar apps that help with scheduling, meditation apps for calming, quizlet to help with studying, and a crisis text line for texting support -- there are apps for everyone. Some popular ones are: Calm, Talkspace, Big White Wall, Breathe, Sam, Intellicare Hub,and Lantern. Along with apps, social contact is also extremely important to prevent isolation, and joining interest/affinity groups, yoga/meditation groups, self-care, advocacy groups and social activities is helpful. Activities in nature are very promising as they provide activity, socialization, as well as soothing effects of being in green spaces.

As previously mentioned, having regular contact with supportive family and friends, and uses resources of the wellness center and disability services center, as well as supportive faculty are keys to success.

Resources

Janet Ferone

M.Ed. President, Ferone Educational Consulting

For more than 30 years, Janet Ferone, M.Ed., has successfully founded and ran school programs for adolescents with special needs, primarily behavioral, social-emotional and mental health issues, in both inclusion and substantially separate models. As founding director of a Boston public high school program for students with depression/anxiety/suicidality, her program was recognized by the Gates Foundation and received a Goldin Foundation Award for Excellence in Education. A major part of her work was guiding students through the college admission process, including getting them certified for accommodations on SATs and help them advocate for themselves to get accommodations in college. She has also assisted students with dual enrollment into several colleges in the Boston area, including over-age, under-credited students with mental health challenges and some on the autism spectrum. She supported them throughout their college attendance.

Ms. Ferone has also been trained at two special needs colleges, Landmark College and the PAL Program at Curry College and currently serves as adjunct faculty at Curry College, where she also supervises student teachers earning special education degrees. Additionally, she consults at Boston University and Pine Manor College, and is in frequent contact with former students who have moved on to college and continues to assist them as they adjust to new demands. As a result, she has both the high school and college perspective, including both community and four-year institutions. Attending former students' college graduations is a highlight!

Now as president of Ferone Educational Consulting, Ms. Ferone provides training, program design and evaluation, and technical support to transform district, charter, and independent schools into places where all students, especially those with special needs, can thrive and succeed. She will be presenting at ASCD (Association for Supervision and Curriculum Development) in Nashville and CEC (Council for Exceptional Children) in Massachusetts on supporting students with mental health challenges. In addition to special education and ELL supports, Ms. Ferone consults on school climate and discipline, social justice and equity programming, and gender/sexuality issues. Ms. Ferone has a passion for excellence and equity in education. She is a former president of the National Organization for Women, Boston Chapter, a feminist and gay rights activist, and serves on boards addressing social inequities. You can find out more at www.feroneconsult.com.