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College is a time for young people to explore new ideas and dream about the future. However, over half of college students report feeling "overwhelmingly anxious" during their studies, according to the National College Health Assessment. The same study found that almost 30% of learners report feeling hopeless, and more than 20% report feeling so depressed that it's difficult to function.

Though college remains an enjoyable milestone for many people, recent statistics demonstrate that mental health has emerged as a predominant concern for colleges around the country. As the scale of this issue grows, schools must address students' psychiatric needs more proactively. The National Alliance on Mental Illness reports that 35% of college students experiencing a mental health crisis don't inform their schools, and up to 50% of learners with psychiatric disabilities do not request school accommodations.

In many cases, students struggle because their school lacks sufficient mental health resources like counseling and psychiatric services. As an example, the average U.S. postsecondary institution has only one counselor for every 1,600 students -- that's well below the ratio recommended by the International Association for Counseling Services. Implementing additional measures to improve student well-being can be cost-prohibitive for some colleges, and students may find it difficult to pay for off-campus mental health treatment when schools don't provide adequate resources.

College comes with many stressors -- like exams, socializing with peers, and finances -- which is why students shouldn't be left to prevent or cope with serious mental health challenges on their own. Fortunately, many schools are starting to pay attention to this issue, increasing their support services and disability accommodations to enable learners with psychiatric conditions to excel on the same level as their peers.

As our expert interviews show, there are also various tools and coping skills -- including proactive research, self-care techniques, and group therapy -- that students with psychiatric disabilities can use to facilitate their transition into college. Most importantly, these learners should recognize that knowledge and open communication are key to getting the help they need and overcoming the social stigma associated with psychiatric disabilities. We encourage you to read on and discover how students facing mental health challenges can succeed in college and beyond.

Interviews

Scroll through these interviews to learn more about how we can support students who struggle with their mental health during, and transitioning to, college. Each panelist also provides actionable advice on how to evaluate if a college will be a good fit for you.

Table of Contents 1 Janet Ferone, M.Ed. President, Ferone Educational Consulting

Table of Contents

1 Janet Ferone, M.Ed. President, Ferone Educational Consulting

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?

By Janet Ferone M.Ed. President, Ferone Educational Consulting
Learn more about Janet Ferone
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

About 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.

2 Dr. Arian Elfant, Clinical Psychologist

Someone with a mental health challenge should spend even more time thinking ahead about how the university experience might impact their overall state of mind. For some individuals this means staying away from a rainy, cold climate. For others, it means ensuring a small class size.

By Dr. Arian Elfant Clinical Psychologist
Learn more about Dr. Arian Elfant

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

Mental health challenges or a psychiatric disability absolutely does not need to impede a student’s ability to succeed in an academic setting. There are resources on and off college campuses that are there to support a student’s adjustment to college or to treat a prior condition. Picking a university setting where your individual needs will be met is entirely attainable. It may take some extra research and additional time to think through how you will best be supported, but it is worth the investment. There are many choices out there and there is a place that can meet your needs both academically and personally.

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?

Having a toolbox of resources that is filled before beginning college is essential. This toolbox should include options and ideas that can be utilized for self-care and to prevent crisis. The core people in your life back home are a big part of this toolbox. Scheduling consistent facetime appointments with loved ones to check-in ensures that the people that know you best continue to stay connected. If your mental health begins to decline, your loved ones will have a sense of what is going on with you before something becomes an emergency. Planning visits ahead of time and knowing exactly when you will see your loved ones is also important, especially during the first year of college.

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

During the application process, students with psychiatric disabilities should ideally communicate with a high school counselor, trusted teacher or academic mentor about how they might be best supported during the college years. Finding a school with student health resources that speak to your individual needs before deciding to apply or attend is essential. While at college, there are a number of ways to gain information and support. A residential life office, counseling center or student health center are some of the avenues where information on mental health resources can be attained.

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?

All students should consider whether the schools they are looking at meet their personal and academic preferences. Issues such as geographic location, university size and areas of academic emphasis are all important to consider. Someone with a mental health challenge should spend even more time thinking ahead about how the university experience might impact their overall state of mind. For some individuals this means staying away from a rainy, cold climate. For others, it means ensuring a small class size. And for someone else, it means making sure there are first class athletic facilities. Mental health is impacted by different factors depending on the person. Working with a college counselor and seeing how you feel during college visits will help you determine a setting that is right for you.

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

Gaining a sense of a school’s climate is not always easy during a college visit. If there are things that are important to you personally, don’t be afraid to ask your tour guide or find a student to talk to. It also helps to be a good observer and treat each visit like a research project. Walk around, take a seat in the cafeteria and attend a class. If you are active politically, find out if there are resources that speak to you. Find out how the school responds to crisis. And, in this age of social media, find ways to connect with current students that will allow you to ask questions that are important to you as you think about them.

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

This is a personal decision. Many students have written amazing essays about their experience of confronting an eating disorder, battling depression or managing symptoms of PTSD. However, this is vulnerable and private information. No one should feel pressured to open up if the act of doing so creates greater distress.

Once a student has been accepted, inquiring directly about the university’s resources for mental health is essential. Choosing a school is a big choice. Making sure that you feel comfortable with the support services available is essential.

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?

Beginning college is a big adjustment for almost everyone. More choices, greater flexibility and a major increase in independence takes time for many 18-year-olds to adjust to. Support with how to balance social, academic and familial pressures is necessary for a lot of undergrads. For this reason, there are many institutions out there that devote a tremendous amount of resources to ensure that there are student support services devoted specifically to the task of helping students adjust. Finding a college that advertises these services and is proactive about helping students before there is a crisis is entirely possible.

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?

Experiencing academic advisors and faculty who might not know about the mental health challenges their students are facing can be frustrating and painful. One helpful tactic is to make the problem more concrete. For example, “Professor, I know if I broke my leg you would understand and help support what accommodations I might need. A mental health problem, like a broken leg, requires that I receive support. Here is what I have found most helpful in the past. I am hoping we can work together so that I can get the most from your class.” If this kind of conversation is not possible, ask for help from your college’s student health services. There are advocates on every campus and they are there to make sure you gain the support and understanding you deserve.

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?

Colleges need to destigmatize mental health problems around their campuses by talking openly about how common and treatable mental health problems are. Skilled and dependable therapists who are trained to work with young adults is essential. Professors, residential advisors and administrators that are well-versed in mental health creates a culture where the entire student body can participate. It also makes it clear that taking care of one another is a core value. This kind of climate will encourage and make it much easier for students to come forward when they are struggling.

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

We have all struggled and/or know someone who has. Mental health problems are as serious as medical problems. And, like a medical condition, treatment is imperative. Opening the door to easier access to treatment means encouraging conversations with everyone.

Most people want to help someone in distress but do not necessarily know how. Honest and ongoing conversation with peers and school leaders who are interested in understanding and being helpful can be a powerful tool for change.

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

Developing a support system both on and off campus is essential. Keeping up with your professional team at home (psychologist, psychiatrist, etc.) and having them communicate with your professional support system at college will help ensure continuity of care. Professional support of any kind is there to making sure your emotional tank stays full. This means maintaining basic self-care needs (sleep, nutrition and exercise) while also balancing social and academic demands. Finding this balance requires a great deal of diligence. The more measures in place to consistently monitor these factors (individual therapy, group therapy, family check-in) the less likely there will be a crisis. Group therapy is an amazing resource for college students. It allows for peer interaction, confidential dialogue and normalizes mental health struggles. There are therapy groups on most college campuses. Seek one out and benefit from the knowledge that you are not alone. If being on campus for mental health treatment feels uncomfortable, ask for private practice referrals.

About Dr. Arian Elfant

Clinical Psychologist

Dr. Elfant opened her practice in New Orleans in 2003. She earned her Ph.D. in Clinical Psychology from Nova Southeastern University in 2001 and completed her predoctoral and postdoctoral training at Vanderbilt University’s Psychological and Counseling Center. Dr. Elfant continued to work at Vanderbilt as a clinician, supervisor, and as the Director of Assessment Services until August 2003.

Her practice focuses on providing individual therapy to adults and adolescents and she devotes a portion of her practice to working with couples. Additionally, Dr. Elfant conducts child assessments for the purposes of admission into private school.

Dr. Elfant loves any opportunity to consult, teach, or conduct outreach. She presently serves on the faculty of the Department of Psychiatry and Behavioral Sciences at the Tulane University School of Medicine and has previously served on the faculty at LSU Health Sciences Center and Loyola University’s City College.

3 Dr. Mark Scholl, Associate Professor, Counseling, Wake Forest University

I would encourage students to consider the overall climate of the university. Though it is important to consider the specific goals of a given student (such as attending a highly competitive university), some universities focus more on providing a supportive climate for students and are generally more student-centered.

By Dr. Mark Scholl Associate Professor, Counseling, Wake Forest University
Learn more about Dr. Mark Scholl

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

First, it is important to acknowledge that mental health challenges and psychiatric disabilities represent a broad array of disorders and disabilities. Mental health challenges typically make succeeding in college more of a challenge, depending on the nature of the mental health concern. For example, an anxiety disorder may make it difficult for one student to speak in public, whereas another student may experience anxiety primarily in social situations. Psychiatric disabilities significantly interfere with individuals’ functioning in one or more life activities potentially including living, working, and/or communicating. For convenience, I will refer to both as mental health concerns.

I encourage students with mental health concerns to consider attending college, and to explore their options before deciding they cannot attend. The Americans with Disabilities Act (ADA) requires postsecondary institutions to treat individuals with disabilities, including psychiatric ones, in a manner that does not discriminate and affords equal access to postsecondary programs and services. However, the ADA does not guarantee that students will be provided with accommodations related to their psychiatric disabilities. The disability services administrator makes the determination on a case-by-case basis, and receiving an accommodation in high school is no guarantee one will receive the same accommodation in college. Also, the decision whether to provide a specific accommodation for a mental health concern may vary from college to college. For this reason, it is a good idea to contact disability service administrators in advance of enrolling to find out whether accommodations are likely.

Nevertheless, college campuses are communities with highly skilled professionals who provide counseling and support services to students with mental health concerns. Colleges also provide the opportunity for students to learn and benefit from interaction with a diverse variety of students including other students with mental health concerns. Pascarella and Terenzini are researchers who have written extensively about the robust literature indicating that colleges promote the holistic development of students. For all of these reasons, I strongly encourage students with mental health concerns to attend college while also recognizing that the ultimate decision belongs to the individual.

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?

Students can begin planning well before they leave for college. Students might adopt the criteria represented by the acronym SMART in developing a plan for staying in contact with friends and family. That is, formulate goals that are Specific, Meaningful, Achievable, Relevant, and Time-Specific when building such a support system. Technology makes it achievable for students to communicate with friends and family using Skype, Facetime or a social media site. For some students, texting or talking by telephone might be more meaningful or relevant to their needs for support. It is important for the student to identify a specific timetable for connecting with significant others and to make this a priority. Sometimes students who live a long way from family may be able to visit members of their extended family who live in closer proximity when they are unable to meet with their family of origin. Another possibility is to select a mid-point between the college town and the hometown that is a relatively more convenient destination for all parties. With regard to being time specific, consult the college’s academic calendar well in advance in order to maximize opportunities for spending time together.

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

Students should begin by forming a relationship with their school counselor as early as possible. The importance of establishing a good relationship with this mental health professional cannot be overstated. A competent and supportive school counselor can help them not only navigate the application process, but also manage the transition from reliance on a secondary school counselor to reliance on a mental health counselor in a postsecondary setting. Students who have a positive experience with a counselor are more comfortable seeking help from a counselor in college. During college, some of the most important resources are the office of student disabilities, the student counseling center, and the student’s academic adviser. More and more, academic advisers are adopting a more holistic approach to academic advising that includes an interest in promoting the student’s successful adaptation to the college environment. Academic advisers receive training that prepares them for providing active listening, empathy, and referrals to appropriate student support personnel.

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?

I would encourage students to consider the overall climate of the university. Though it is important to consider the specific goals of a given student (such as attending a highly competitive university), some universities focus more on providing a supportive climate for students and are generally more student-centered. In addition, I think that it is important to consider the quality of an institution’s personnel support services including the offices of disability services, and counseling services. With regard to counseling services, it is important to know what type of professionals comprise the staff (counselors, social workers, psychologists, psychiatrists, etc.). How well does the makeup of the staff match the student’s specific mental health concerns? I recommend finding out whether the university provides free counseling sessions and if so how many sessions are provided per semester and per academic year. How does the counseling center help ensure that students who need more sessions are given appropriate referrals and related resources? Finally, what is the scope of available outreach and ancillary programming provided by the counseling center? Some examples include the provision of support groups, and the opportunity to communicate with counselors via email.

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

I recommend asking questions regarding the location of offices related to student support services. Universities are moving towards a holistic wellness philosophy. In addition to counseling centers, there are centers with personnel and programs designed to support students during their first year of college. There are also wellness centers that are designed to promote optimal student functioning which might include preventive and holistic health programs. For example, wellness centers and related programs might teach students about nutrition and healthy eating habits. I also recommend asking where academic support offices such as the locations of the campus writing center and tutoring services.

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?

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

The answer to this question may differ for each individual student. For example, a student who graduated at the top of her high school class with test taking anxiety might share this information in an application essay. While the ADA protects individuals from discrimination on the basis of their psychiatric disability, I recommend not sharing this information during the application process unless the applicant has a compelling reason for doing so, because it is impossible to predict how this information might affect perceptions of the student. The student is not obligated to share this information during the application process. Once accepted, the student should not waste any time in contacting the Office of Disability Services, becoming registered, and learning about the range of services and programs, including potential eligibility for accommodations.

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?

Two of the most common significant roadblocks encountered by students are interrelated. First, students who encounter difficulties may keep things to themselves rather than talking with their adviser, professor, or a peer. Second, students get into trouble when they place too much emphasis on academics to the exclusion of getting involved in the life of the campus. It is important for students to recognize that social involvement on campus enhances academic performance and is a protective factor relative to feelings of isolation, loneliness, and depression.

A helpful strategy is for students to seek opportunities for meaningful social interactions with other students. Most colleges have a campus activity board or an extracurricular fair where students can learn about extracurricular organizations and opportunities to get involved. In addition, recreation or wellness centers commonly have programs related to holistic health. One example is sessions where students practice mindfulness meditation. These sessions are opportunities to connect with peers as well as participate in a holistic health practice on a regular basis. Finally, social involvement fosters the development of good relationships in which students feel comfortable communicating problems they are experiencing. These trusting relationships counter the tendency for students to keep their concerns bottled up inside.

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?

As mentioned previously, part of the academic advisor's role is to listen to problems related to adapting to college. Academic advisers are prepared to listen and empathize regarding issues outside of the academic realm. If something is affecting or may eventually affect a student’s academic performance, then they should let professors know sooner rather than later. Faculty will appreciate a student letting them know in a timely manner, will view the student as responsible, and likely will attempt to help or refer the students to someone at the counseling center who can be of help. Communicate early when problems are usually more manageable and easier to resolve. Students should not feel like they need to solve their problem alone or “power through” a problem without support from an adviser, faculty member or counselor.

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?

A college can provide opportunities for students to meet with representatives of the counseling center, disability services, and academic advising prior to the start of the fall semester. One approach is provide an event during the summer where students and their parents can receive general information as well as the opportunities to speak one-to-one with counselors and advisers.

Another helpful approach is to provide outreach programming. For example, counselors from the university center might provide information sessions in the residence halls where students can learn about the purposes and services provided by the counseling center. This type of programming can help students gain familiarity with services provided by the university center. In addition, students can learn how to support a friend or roommate who they believe might benefit from counseling.

College counselors can meet with faculty and staff who have daily contact with students. For example, college counselors might attend faculty department meetings and let faculty know what to do if they have a student of concern. Sometimes faculty and staff on a college campus are concerned but unsure how they can help. Students who are seeking advice can talk to a faculty member, academic adviser or professional counselor. Faculty and advisers who are concerned about a student should encourage the student to go to the counseling center, and may even accompany a student to the counseling center if the student is distressed or in a state of crisis.

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

To a certain extent, the campus climate, including whether mental disorders are stigmatized, is an aspect of the environment that students cannot control. Understanding that mental health concerns are prevalent among college students can help the student to recognize that they are not alone. Results of the 2016 American College Health Association survey showed that 23.2% of students reported that anxiety adversely affected their academic performance during the previous 12 months, and 15.4% reported their academic performance was hindered by Depression, and 20.7% were adversely affected in the same way by sleep difficulties. Resilience theory and Alexander Astin’s involvement theory indicate that it is important for students to cultivate a sense of belonging on a college campus. It is important to find a co-curricular club, activity, group or campus employment in order to facilitate one’s sense of belonging. Sense of belonging, or social integration, enhances a student’s academic success as well as persistence to degree completion.

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

I like to think of it more in terms of resources than tools. The most important resource appears to be a good relationship with a trusted other. Students appear to thrive if they are able to establish a relationship with at least one faculty or staff member they can trust. I have also seen a number of first year students benefit from having an emotional support animal living with them in the residence hall.

Any final thoughts for us?

As I mentioned previously, there is a tremendous amount of diversity among students with mental health concerns. It is important not to overgeneralize because each person is unique. I want to emphasize how important it is for students to seek a sense of belonging in their new college environment. A caring staff member or a friendship with a single peer can be enough to ensure that a student stays enrolled at that college and persists to graduation. Finally, I want to add that I enjoy working with college students with mental health concerns a great deal, and the primary reason is that I admire their courage.

About Dr. Mark Scholl

Associate Professor, Counseling, Wake Forest University

Dr. Mark Scholl is an associate professor in the Department of Counseling at Wake Forest University and an expert in culturally responsive approaches to counseling and supervision, existential counseling and psychotherapy, constructivist approaches to counseling, and has experience with career counseling among the ex-offender population and individuals with disabilities. Additionally, he has done research on the counseling preferences of Native American college students and reasons that this population under-utilizes counseling services. He is passionate about increasing diverse students' participation in and engagement with mental health services.

4 Rhonda Lesley, Director, Missouri State University Counseling Center

Speak up and ask about not only the type of care provided, but evidence of the quality and satisfaction of mental health and counseling services. Many schools publish student satisfaction and outcome data, and comparing this info, school by school, can help you in making a better informed decision.

By Rhonda Lesley Director, Missouri State University Counseling Center
Learn more about Rhonda Lesley

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

College can be very stressful without additional challenges like mental health concerns, so it’s no wonder you are questioning whether attending college is right for you. The good news is these days there are good supports in place for students with mental health concerns, such as the campus disability resource center, counseling center and student health center. Student support organizations, specifically those geared toward promoting successful mental health coping during your college years, can be great resources as well.

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?

Participate in as many opportunities on campus as possible to get to know others, and volunteer for at least one organization that fits with your personal passion. If you start to struggle with typical concerns, such as homesickness, anxiety or depression, seek the help of the campus counseling center sooner rather than later.

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

I am not very familiar with strategies to address the application process, but I would encourage them to work with the university admissions office and/or the disability resource center on campus.

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?

Obviously, the more opportunities for ongoing professional and peer support in these instances, the better. Seek out schools that offer on-campus psychiatric and counseling care -- and if these services are free or discounted, so much the better. Preview student organization/activities offices to determine whether the college offers extra-curricular involvement for students interested in mental health support and prevention. When looking at credentials of providers, seek schools where providers are licensed.

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

Speak up and ask about not only the type of care provided, but evidence of the quality and satisfaction of mental health and counseling services. Many schools publish student satisfaction and outcome data, and comparing this info, school by school, can help you in making a better informed decision.

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?

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

I think this is an individual decision. ADA has specific rules in place that prevent public entities from discriminating against individuals due to disability. Speaking up about a mental health concern or disability can certainly help lay the groundwork for success from the first day. Doing so will most likely connect students with the appropriate support resources that are in place at the university to increase the success and satisfaction of students with special needs.

Again, I am not very familiar with strategies to address the disability during the application process, but I would encourage students to work with the university admissions office and/or the disability resource center on campus.

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?

The adjustment from being dependent on parents and family members to meet many of their needs to becoming essentially self-sufficient is one of the most common roadblocks students encounter to their success. Parents are no longer present to help them get up and get going in the morning. There is no one doing their laundry or helping remind them to do their homework or attend important meetings. Even taking care of themselves and getting proper nutrition and sleep in the campus environment can be huge obstacles for students.

My advice to students is to create a schedule and stick to it. Allot time for study and leisure, but most of all be certain to schedule 7-8 hours per night for sleep. Not getting enough sleep impacts memory, mood and can even affect our immune system in negative ways. If a student has tried the above and is still struggling, it is time to enlist the help of a friend, mentor or counselor.

Another common struggle is relationships. Friendships, romantic relationships and even communicating effectively with teachers can all present special challenges to students. Students seem to cope best when they have a wider base of friendships and when they manage their stress well. If you find yourself struggling to find satisfactory relationships, or if you are worrying a lot or stressed out about your friends or lack thereof, it is a good time to seek out professional help at the counseling center. Discussing patterns in relationships with an objective professional and setting goals for success can make a big difference in whether or not a student develops and maintains healthy, rewarding friendships and other types of relationships.

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?

Academic advisors and faculty are becoming more and more knowledgeable about assisting students with mental health concerns, and most will be able to help. If you have approached your adviser or teacher and you still are not getting the help or understanding you need, the Dean of Students office can usually provide assistance in helping to communicate your needs or concerns to campus staff.

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?

By becoming knowledgeable about student mental health needs and responding appropriately to that need.

This may be in the form of universities and colleges providing educational programming to faculty and staff about assisting students with mental health concerns or disabilities or committing to offering the kinds of services students with mental health concerns need in order to be more successful in their academic pursuits, such as diagnostic testing, counseling and accommodations. They can also become advocates for destigmatizing mental health on campus and by promoting prevention and education.

Students who do not feel they are supported in their special needs and challenges should contact their university’s Dean of Students office to discuss their concern. If they have contacted the Dean of Students office and they still feel their needs are not being addressed, universities and colleges provide student ombudsmen and equity officers to assist in these matters.

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

There are so many opportunities to positively impact mental health awareness and destigmatization on your campus. Join a campus effort, such as a NAMI Students (www.nami.org) organization or the campus chapter of Active Minds (www.activeminds.org). Some campuses have peer support education programs that assist in destigmatization of mental health and psychiatric disabilities.

No student chapters like this on your campus? Then start your own! Another idea is to work with your campus Student Activities office to develop a program for the campus and wider community on understanding mental illness. Bring in speakers who have successfully managed their mental health concerns, watch a related film, hold a panel discussion, or hold a mental health awareness fair on your campus.

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

I think I’ve mostly addressed this one already in previous questions. Students use their own creative and resilient spirits to succeed when faced with mental concerns or disability. They use available resources, such as the Counseling Center, Student Health Center, Disability Resource Center, Learning Diagnostic Center, Dean of Students office, and other available support groups and related student organizations.

Any final thoughts for us?

Sometimes students with mental health concerns experience crises that require the immediate assistance of a professional. Students can in most cases access emergency mental health assistance through their campus counseling center during business hours. After-hours mental health emergency assistance is often provided through a crisis hotline or through residence life assistance. Consult your college or university website for mental health emergency assistance. Nationwide, 24-7 assistance is also available by contacting 911, going to the nearest hospital emergency room or contacting one of the following support agencies:

  • National Suicide Prevention Hotline: 800-273-TALK (8255)
  • Crisis Text Line Text 741741 for a quick reply by a crisis counselor
  • Substance Use Support Line: 800-662-HELP (4357)
  • Veterans Crisis Line: 800-273-8255 and press 1 or Text 838255
  • TrevorLifeline: 866-488-7386 (LGBTQ+ Youth support line)

About Rhonda Lesley

Director, Missouri State University Counseling Center

Rhonda Lesley is the director of the Missouri State University Counseling Center in Springfield, Missouri, serving a campus community of more than 24,000 students. Rhonda has been a Licensed Professional Counselor for more than 20 years, focusing primarily in higher education and private practice. She specializes in cognitive behavioral therapy, solution-focused brief therapy and using biofeedback, mindfulness/meditation and resiliency in the treatment of anxiety, depression and other mental health concerns. Rhonda is a Certified Gottman Therapist, treating couples in research-based therapy, and a Registered Yoga Teacher with the Yoga Alliance.

5 Katie DiMuzio, Partnerships Manager at Zencare.co

Struggling with a mental health issue or disability doesn’t mean you can’t survive and thrive in college! Given the proper tools and resources to succeed, you might be surprised at how resilient and capable you are, even in a new and at times stressful environment like college.

By Katie DiMuzio Partnerships Manager at Zencare.co
Learn more about Katie DiMuzio

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

Know that with the right support, you can thrive! Mental health challenges and psychiatric disabilities are common among college students, and many colleges offer on-campus support and can guide you to off-campus resources. It can be helpful to conduct some research in advance about your school’s psychiatric and counseling services, as well as to learn how to access the care you may need while you’re there so they’re more easily accessible when you need them.

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?

Think about who your supports are in person. When you’re struggling, do you reach out to your parents, friends, siblings, or anyone else in particular? Discuss ways to stay in regular contact when you’re at school, especially if things get difficult. Some options include:

  • Regular phone calls or FaceTime check-ins
  • Text or email updates as a way to keep your supports in the loop on days you don’t feel like talking
  • Planned vacations and trips to see family and friends

Make sure your supports have your local contact information. If possible, share the name and number of a college friend or roommate they can reach if you need extra help from someone in person.

Finally, be honest with yourself about what distance feels comfortable to you. If you are concerned that, say, you may really struggle being across the country from your family, then have an open conversation about this and consider how to make the move work in a way that makes you feel supported.

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

It can be helpful to call, research, and ideally visit the potential college disability services offices to ask questions about the supports and services they provide for students with psychiatric disabilities. If the college can introduce you to others students who share similar disabilities, connecting with them can also provide you with up-to-date resources and tips that only a peer can provide. This may include recommended providers, student groups, and peer support services.

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?

It’s important to consider what resources the university offers and the location of the school itself. Many schools provide counseling/therapy and some provide medication management, but these are often short-term solutions.

If you anticipate that you’ll need continuous care for a semester or more, consider whether those resources are available off-campus near the college, and how to access them. Access considerations include:

  • Distance of the services from campus
  • Public transportation options, including services like Uber and Lyft
  • Costs for services, both using and not using insurance

It can also be helpful to check the mental health withdrawal and re-entry process in advance, in case you ever face that need throughout your time at school.

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

Ask the tour coordinator about the health services on campus and how students access them. Student guides can be a great resource for finding out about the mental health “climate” on campus, including attitudes toward mental health and whether university officials, advisers, and professors are supportive of student mental health needs.

For example, you may ask:

  • Do students feel comfortable coming forward with mental health issues, and do they feel heard and understood by the university?
  • What local student advocacy groups are available on campus?
  • What are typical wait times for mental health appointments?
  • Are there medication prescribers on campus?

If the tour coordinator doesn’t have this information, you can ask these questions at the health center directly, too.

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?

The most significant roadblocks I observe students facing in college include:

  • Challenges in adapting new routines: Students may feel overwhelmed by all the changes to their routine, and the adjustments they need to make.
  • Adjusting to being away from home: Students attending college away from home can struggle to adjust to both a new geography and being far from family and friends.
  • Academic stressors: Many students feel inundated by the number of assignments they have, or the hours they are dedicating to studying.
  • Balancing various responsibilities: It’s common for students to have trouble finding a good balance between completing your schoolwork, getting involved in extracurricular activities, clubs, and internships, and establishing and maintaining friendships.
  • Roommate and professor stressors: Finally, many students struggle with relationships with roommate and/or professors.

If you’re feeling overwhelmed, talk about it! Here are some resources to get through these situations:

  • Share your feelings first with whomever you feel most safe with, such as your parents, a friend or fellow student, a pastor, etc.
  • Call your health center or counseling service to get an appointment with a counselor to talk things through and find out about resources available to you.
  • Remember to focus on your own self-care: Eating healthy, getting enough sleep, exercising, avoiding drugs and excessive alcohol intake, and connecting with loved ones. Routine self-care will help keep you grounded, helping you navigate said roadblocks.

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

It often helps to be as clear and communicative as possible on what your concerns are, especially regarding how your mental health challenges could impact your academic performance. If you think you’ll need accommodations over the course of the school year, it’s a good idea to specify those as much as possible up front.

Talk with an adviser to develop strategies for potential obstacles such as getting to classes regularly and on time, completing assignments, sitting for midterms and finals, and any other required tasks like group projects.

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?

First, colleges can make sure they have the staff and resources to support their students. Hire and train mental health providers who understand and can respond to the needs of college students. Have enough staff and support so that appointment wait times are kept to a minimum. Be transparent with students and parents about what services the school does and does not offer, as well as how to access any off-campus resources. If a referral coordinator is available, keeping off-campus provider availability and insurance information up-to-date can be a huge benefit to students and parents.

Having a robust presentation on mental health and university resources at freshman orientation, and periodically throughout the school year, is a great way to get the word out to students. It also demonstrates that the school takes mental health concerns seriously. Wellness events like stressbuster workshops, guided mindfulness meditations, talks on specific mental health topics, or coordinating to have therapy dogs available during midterms and finals are great ways to show students you take their needs seriously. For professors, they can support student mental health by allowing for accommodations with advance approval (alternative testing, giving presentations, etc.).

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

Join a student support or advocacy group like Active Minds. Bring up your concerns to health center staff. Never discourage a friend or peer from sharing their mental health concerns or from seeking care.

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

Students who are proactive about seeking help when they’re having a hard time may find the following tools to be useful:

  • Zencare.co: Therapy search website to find off-campus therapists.
  • On-campus counseling services: Therapy, medication management, and therapy support groups offered by the university.
  • Headspace and Calm: Meditation apps to find quiet amidst the busyness of college.
  • ADHD executive functioning coach: Support to balance the effects of ADHD on academics.
  • Student clubs: Active Minds, Project LETS, Lean On Me
  • Free peer texting support: Lean On Me, Seven Cups of Tea, Samaritans
  • Online therapy tools: Talkspace, Betterhelp, Maven Clinic, Doctor on Demand
  • Uber and Lyft: Ridesharing companies have allowed students to more easily access off-campus therapists.

Any final thoughts for us?

Struggling with a mental health issue or disability doesn’t mean you can’t survive and thrive in college! Given the proper tools and resources to succeed, you might be surprised at how resilient and capable you are, even in a new and at times stressful environment like college. Focus on self-care and be proactive about your mental health needs so you can give your all to your school experience!

About Katie DiMuzio

Partnerships Manager at Zencare.co

Katie is the partnerships manager at Zencare.co, a website for easily finding quality-vetted therapists. At Zencare.co, Katie works with university counseling services to help students access excellent off-campus mental health care services. A licensed therapist, Katie was previously a clinician at the Pentagon and the Veterans Health Administration, and most recently worked as a psychiatric case manager and referral coordinator at George Washington University.

6 Anisha Makhija, Support Community Lead at Supportiv

Mental health challenges are really common among students -- 1 in 4 young adults have a diagnosable mental illness. For those who don’t believe they can attend college because of such challenges, I would suggest seeking out the systems and resources in place at prospective colleges that can enable you to manage your mental health and still give you the opportunities to do your best.

By Anisha Makhija Support Community Lead at Supportiv
Learn more about Anisha Makhija

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

Mental health challenges are really common among students -- 1 in 4 young adults have a diagnosable mental illness. For those who don’t believe they can attend college because of such challenges, I would suggest seeking out the systems and resources in place at prospective colleges that can enable you to manage your mental health and still give you the opportunities to do your best. It can be scary and overwhelming to start looking into colleges, but researching where you can go for help beforehand can help ease the intimidation factor of going to college with a mental health challenge or psychiatric disability.

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?

Keeping in touch with your support system is really important. If you’re someone who prefers structure, try something like a series of weekly calendar invitations to video chat with your friends and family. If you prefer something more chill, you can promise to never leave a text message unanswered for longer than a week or ask your friends and family to text you if they haven’t heard from you in a while. Something my friends and I do is have code words we send to each other that indicate our crisis mode and how badly we need to talk. You need to find what communication system works best for you, and it's okay to figure it out through trial and error!

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

Something pretty cool about our generation is the variety of resources available to us through technology. I’m the Support Community Lead for an app called Supportiv, where users are anonymously connected to others who are struggling with similar issues and can talk things through with live moderators facilitating the conversations. Also, if you’re comfortable reaching out to your high school counselors, they may be aware of colleges with specific resources that can cater to your needs. Applying to college can be really overwhelming, so having a support system in place and giving yourself mental health breaks from the stress is so important. During your first few weeks of college, I recommend that you visit your school’s center for students with disabilities as well as your school’s mental health services center to learn more about resources available to you as both preventative measures and help in times of crisis.

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?

Mental health challenges and psychiatric disabilities are very individual, and everyone needs to choose the university campus that's right for them. Some things to consider are whether you would be more productive on a big campus or a small campus, available ways to de-stress (clubs, sports, etc.), and the type of environment where you feel most comfortable (do you prefer the city, or is accessibility to nature more important to you?). You can also rely on your intuition and your gut feelings about the best university for you. While this deliberation process may be a privilege not available to everyone, focus on finding the best fit among the universities available to you. One idea is to make a list of pros and cons for each school and then try to find possible solutions for those cons. The process of choosing a university is not an exact science and is often limited by what you can reasonably do, but there are ways to prepare for a better university experience.

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

Some questions you may want to consider include what resources are specifically available to you (such as who handles disability and mental health needs for students) and the processes required to attain this support. Another element you may want to ask about is support available from other students -- for example, is there someone you could connect with that has been through this process before? Are there student clubs or other individuals who could advocate on your behalf and inform you of available resources and services and their views on them? Finally, explore how a school would serve your individual needs by asking questions about financial feasibility, accessibility on campus, and any other aspects of the college experience that may be affected by your unique challenges.

Should students be upfront 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?

College is all about discovering yourself, and everyone has a different path. If you want to be upfront during the application process and learn about the support available to you, that's awesome. However, it’s also okay if you want to figure that stuff out later once you’re accepted or attending a university. The most important thing is to have access to help if you need it.

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

When students write about their disability not as a weakness that will hinder them but instead as a way they have gained strength through learning to overcome the associated challenges, that can be a successful strategy. Being honest and speaking your truth is vital to a successful application.

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?

It’s easy to get swept up in college because there are so many choices, people to meet, and things to do. It can be hard to figure out the right path for you, and you can easily get overwhelmed and end up in crisis mode. The best advice I have is to be prepared by knowing what’s available to you -- both in preventing crises and knowing where to go if they happen. Additionally, I would encourage students to look into not only what their school provides, but also outside resources in their community or that are available through technology.

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

You only need to share what you are comfortable with sharing; you're not obligated to tell your entire story if you don't want to. It's so easy for people to dismiss “invisible” illnesses, but the truth is that these illnesses cause actual challenges, and you might have to explain that. You can try seeking advice from other students who have gone through this before and exploring your school’s centers for disabilities and mental health challenges to find the best ways to approach advisers and professors.

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?

Colleges being transparent and public about the services and resources they offer from the moment students step on campus is so important. I also think listening to students about what the college is and isn't doing well can help make these resources even better. There should be different ways for students to seek help; not everyone is comfortable going to a health center, so more informal methods should also be available. Also, the mental health needs of different communities can vary. People can experience different cultural and racial pressures and challenges, and there should be resources that are geared specifically towards these issues. Colleges also need to take into account financial pressures, commuting issues, time constraints, and all the other needs students have when structuring resources. Students should know both where they can go for support even before school starts and what the school is doing to improve these resources.

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

Stigma can be so difficult and disheartening to combat. I would encourage students to be as open as is comfortable for them. It’s important for students to stick to their truths that their mental health or psychiatric disabilities do cause challenges, and they have the right to support for these challenges. I would also encourage students to turn to their support systems when they need help and to explore what perpetuates these stigmas and how everyone can work together to end them for future students.

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

The strength of students with these challenges is incredible. The tools they use to succeed are their resolve and motivation to seek help when they need and taking time to focus on self-care. There will definitely be hard days, and I hope that these students will become equipped with the knowledge of what to do to get out of those slumps -- whether it’s making a plan with their roommate, texting their parents, going for a run, listening to music, or whatever it takes to overcome their challenges.

Any final thoughts for us?

There is an app for nearly everything nowadays because of how powerful technology is for our generation. I work for Supportiv, an app where you can have anonymous and confidential conversations with peers who are dealing with a situation similar to yours. This support is available 24/7, with conversations facilitated by trained moderators who can kick out trolls and refer resources, and it's free for any students out there going through difficulties with the code at http://www.supportiv.com/teens.

About Anisha Makhija

Support Community Lead at Supportiv

Anisha Makhija is the Support Community Lead at Supportiv, an online network that offers anonymous peer support on any topic 24/7. She recently graduated from the University of California, Berkeley, where she double majored in psychology and biology. During her time at Berkeley, Anisha served as both the undergraduate representative on the Chancellor’s Advisory Committee on Mental Health and director of the Mental Health Commission for students. Mental health advocacy is her passion, and she continues to volunteer with organizations like Crisis Text Line while preparing to apply to medical school in pursuit of a career in psychiatry.

7 Ameila Dillon, Director, Open Sky Community Services

If a student doesn’t ask for help, then no one knows that he/she needs the help. At the college level, professors expect students to be independent and to ask for help if they need it. Professors will typically list their phone number, email address and office hours, so that students know how to reach them for extra support.

By Ameila Dillon Director, Open Sky Community Services
Learn more about Ameila Dillon

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

I would say that anyone can attend college, regardless of mental health challenges or psychiatric disability. All they need to do is set themselves up for success by accessing the supports that are available at all colleges.

If a student is feeling really hesitant about going to college, they could also consider starting off at a community college, perhaps starting with two classes. This would allow the student to get a feel for the experience of college and gradually work into going to school full-time once this feels comfortable to the student.

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?

It’s very helpful for students to become familiar with the services and resources available to them in the college, so that they can utilize them when needed. It’s also very helpful for students to develop a connection with the college community. They can do this by joining clubs and/or intramural sports teams. In doing so, they can develop friendships/supports with people who have similar interests.

Students should become familiar with the office hours of the disability services office and/or counseling services so that they can access these supports if and when they need them.

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

When going to college, it’s very important to become familiar with supports and resources that are available at colleges. Every college has a disability services office/adviser. I would recommend setting up a meeting with the disability services adviser ASAP. The disability services adviser will ask for documentation of the person’s disability, as well as a description of how the student’s disability could impact them in the school setting. This documentation is usually provided by a psychiatrist or therapist. During the meeting, the disability services adviser will determine which accommodations the student would benefit from and are available to him/her.

Other crucial resources are tutoring services. Every school offers tutoring service hours. It’s so important to get off to a good start in classes, since it’s very difficult to catch up once a person falls behind. Tutors can lend very helpful services, since they are familiar with what the teachers are looking for in classes.

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?

That’s really a very personal choice, since every student has their own preferences about environment (small school vs. big school, rural location vs. city location, etc.) However, I would say that smaller schools or campuses can provide a more personal touch. School advisers and disability services advisers are more familiar with the professors and can provide some guidance about which professors are more understanding, compassionate and accommodating to students.

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

Students should ask about student-to-teacher ratio, since smaller classes tend to feel less overwhelming for many students and help them to feel like teachers are more approachable. Students should also ask about disability services office hours, so that they are aware of how “present” the disability office services are on campus.

It’s also important for students to develop a social network while at school. A great way to do this is for students to get involved in extracurricular activities or clubs. During a tour, students could ask their tour guide about some of the fun activities, clubs and extracurricular groups that are available.

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?

A student’s application should showcase their strengths. If a student can demonstrate a well-rounded application without disclosing, then it’s not necessary to disclose one’s disability. Upon acceptance to the school and decision to attend the school, students should schedule a meeting with disability services so that they can collaboratively determine which accommodations the student could receive.

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

Thanks to the Americans with Disabilities Act of 1990, employers and schools cannot discriminate based on a person’s disability. Therefore schools are prohibited from asking whether a person has a disability during the application process.

An example when a student might disclose their disability could be when writing an essay for college application. A student could use their disability as an example to describe how he/she has overcome an obstacle or significant life event, thus demonstrating many of the student’s strengths, such as resilience, perseverance, and determination.

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?

I have seen students encounter several roadblocks when first going to college. One major issue is that students might not review their syllabi right away in order to plan out how to be proactive with completing assigned reading and homework, as well as planning ahead for papers, quizzes, and exams.

Another challenge is that some students have not utilized their supports, such as school advisers, disability services adviser, tutoring services, counseling services and their professors. If a student doesn’t ask for help, then no one knows that he/she needs the help. At the college level, professors expect students to be independent and to ask for help if they need it. Professors will typically list their phone number, email address and office hours, so that students know how to reach them for extra support.

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

Students should ask themselves the following questions: What skills are needed for going to school? What functional limitations might interfere with going to school? What accommodations are needed to overcome these limitations? What behaviors or symptoms might the teacher observe? What steps can the school/teacher take if these behaviors or symptoms are observed?

The answers to these questions will help students to determine what to share with their professors. It is not necessary for students to share details about their disabilities and diagnoses. The only information that is relevant is those details that will help the student to succeed in the classroom and to receive the supports needed from their professor.

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?

Students should fully utilize the supports offered through the school counseling center. They should also connect with disability services immediately. Following the meeting with disability services, the disability services adviser will send an email to the student that outlines those accommodations the student can receive from the school. Students should then email a copy of the accommodations letter to their professors.

Accommodations could be supports and services such as: extra time to take tests, a separate room to take tests, copies of notes from a classmate, use of calculators during exams, and smart pens that capture everything you hear and write.

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

Unfortunately, many people do not understand mental health and psychiatric disabilities. I would recommend that students choose carefully to whom they share information about their disabilities, so that they can avoid being the target of stigmas. However, if a student struggles with a diagnosis such as anxiety, it can be very helpful for students to identify peers with those they feel comfortable around and who might be good supports to them when they are experiencing high levels of anxiety.

Many people have disabilities that they choose to not disclose at work or at school, so there is no obligation for students to share their mental health or psychiatric disability. They should consider self-disclosure if they know it will benefit them and provide additional support.

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

I would recommend that students utilize a planner so that they can organize themselves and plan out enough time to do assigned reading and homework. This can be very useful for students to plan in time to do multiple drafts of assigned papers and to plan enough time to prepare and study for exams and presentations.

Any final thoughts for us?

When a person has a mental health or psychiatric disability, that is just one part of the person. It does not define the person, nor should it be a barrier to any goal that a person has. Going to college allows a person to achieve their career goals and opens so many doors, so that they can have a fulfilling life.

About Ameila Dillon

Director, Open Sky Community Services

Ameila Dillon is the director of employment and education services, which involves her oversight of the Supported Employment and Education (SEE) program for Open Sky Community Services. The SEE Program provides assistance to individuals served by our adult mental health programs, to help them identify and pursue their goals related to employment, education, and careers.

Supported employment is an evidence-based practice with the goal of assisting individuals served to find and maintain competitive employment, based on their strengths and interests. It is a promising, evidence-based practice that helps individuals pursue their educational/career goals. From 2013 - 2015, the agency collaborated with researchers at Boston University to gather further evidence in support of the supported education model through a pilot study.

Ameila has overseen the SEE program for the past 5 years, and she is a compassionate advocate about the short-term and long-term benefits of both supported employment and supported education.

Ameila has a bachelor’s degree in psychology and music from the University of Pittsburgh.

In May 2014, Ameila earned a National Certificate in Supported Competitive Employment for Individuals with Mental Illness, issued by Association of Community Rehabilitation Educators.

8 Lauren Rigney, Licensed Mental Health Counselor

If you do not want to disclose a disability, you do not have to. You can go your entire college career without anyone on campus needing to know your struggles. However, still know where services are in case you need them. You can always get help after your acceptance or anytime during your college career.

By Lauren Rigney Licensed Mental Health Counselor
Learn more about Lauren Rigney

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

In short, you absolutely can. Colleges have specific departments that are there to help make your college career a success. They are typically called the Office of Accessibility or the Office of Disability. There are also mental health counseling services at most colleges that can help you short-term and link you with mental health professionals in the community for long-term help.

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?

Make plans from day one at college to stay in contact with your family and friends. This could be daily or weekly check-ins over text/email, phone, or video chat. You can set up a plan for if you feel you need extra support in a given moment.

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

During the application process, if your high school offers services in the guidance office, use those services. If you have a teacher who you really like, ask for their help. The biggest part of having resources is to use them. You may be surprised how many people will be invested in helping you.

During college, you first have to identify the resources available to you. During open houses, orientation, or talking with an admissions officer, ask about mental health resources and academic resources on campus. During campus visits, go check out these departments. You can introduce yourself to the counseling department, the accessibility office, and the housing office (if you plan to live on campus) during your visit and get literature from them about how they can help you.

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?

Schools that are aware of their mental health resources and can easily direct you to them for information are schools that value students with mental health challenges or a psychiatric disability. If a school is unsure where to direct you when you ask that question, you may likely have a hard time utilizing those services once you are attending school there.

Schools that ask about any diagnosed disability you have and give you options for accommodations in classes also value students with mental health challenges or a psychiatric disability. You will be asked to fill out paperwork and provide documentation regarding your disability to receive these accommodations (such as extra time on exams or note takers), but please know that this is standard procedure and is necessary to get you the help you may need.

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

Where is your disability/accessibility office? Where is your counseling office? If there is a student leading the tour, it often helps to ask if they know people who work with these departments and see if you can talk with anyone in-person during your visit. If you talk to people in these offices, ask them if you can visit the first week of classes to check in. If you qualify for accommodations, ask what paperwork they will need to get started and if you can set that up prior to the first week of classes.

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?

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

If it is in your comfort zone to talk openly about your disability, you can definitely bring it up during the application process if asked or you can volunteer it. The benefit to this is that you can set up services for yourself as soon as possible and be organized for the first week of school.

If you do not want to disclose a disability, you do not have to. You can go your entire college career without anyone on campus needing to know your struggles. However, still know where services are in case you need them. You can always get help after your acceptance or anytime during your college career.

I have had students come to the counseling department during their campus visit and introduce themselves. We have worked with that student to meet their Residential Advisors early, if they are living in the dorms. We have made sure all their paperwork is complete with the Office of Accessibility prior to the start of classes. We also have an initial meeting set-up with them to check-in during their first few weeks on campus.

I have also had students talk to the admissions officers directly asking about resources and services on campus to help them. Admissions officers should be aware of all the mental health resources on campus and can connect you with them.

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?

Roadblocks can occur with faculty who are uneducated about accommodations and Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act (ADA). If you have registered with the Office of Disabilities/Accessibilities and are given accommodations, all faculty must adhere to those accommodations. If you find a professor giving you a difficult time, ask the people in the disabilities office to help you. It is their job to help you navigate this situation and they can speak to faculty on your behalf if you’d like them to. You can also use your support system to give you emotional support during this time. Roadblocks like this can be stressful and trigger negative emotions. Use your tools and the people around you to help you through it.

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?

Similar to the answer above, it is not fully your job to educate faculty. If you feel comfortable talking about it and letting them know your needs, go for it. If you do not feel comfortable, ask someone in the counseling or disabilities/accessibility office to help you talk to that faculty member.

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?

Students can receive support from:

  • On-campus mental health counselors
  • Office of Disabilities/Accessibilities
  • Office of Housing/Residential and your Resident Advisor (if living on campus)
  • Academic tutors/Writing centers

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

Join a club. Students who get involved on campus and work with other students can have a platform to educate and address stigmas.

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

Show up to your appointments and follow through on your goal setting. If you have meetings with a tutor, go. If you have a session with a counselor, attend. If your disabilities staff asks you to come to a testing center for your exam, go. In college, you have to work to set up your relationships with these people. Once you have them, use them.

About Lauren Rigney

Licensed Mental Health Counselor

Lauren Rigney is a Licensed Mental Health Counselor with a private practice in NYC. She was previously an Associate Director of Counseling and Wellness at NYIT in Manhattan where she worked with the Office of Accessibility, trained faculty and staff in student mental health needs, and worked directly with students as a therapist and advocate. She continues to work with college-aged students and other adults in her private practice. Lauren is trained and specializes in anxiety work, LGBTQ+ populations, and mindfulness techniques. She is a former college basketball player and coach who has a unique and effective approach to working with clients. Lauren can be found on the web at www.laurenrigney.com.

Thought Leadership Gallery - Barriers to Education - Mental Health

A 2016 report from the National Alliance on Mental Illness (NAMI) encourages all of us to begin conversations about mental health. Citing that most mental health challenges start before the age of 24, and that 1 in 5 young people face mental health issues, NAMI makes the connection with college students. Mental health conditions can have a serious impact on college success. Conversely, the stress of academic work and the life changes that occur when making the transition to college can impact mental health.

“We have all struggled and/or know someone who has. Mental health problems are as serious as medical problems. And, like a medical condition, treatment is imperative. Opening the door to easier access to treatment means encouraging conversations with everyone.”

- Dr. Arian Elfant, Clinical Psychologist, Private Practice

Mental health issues can affect how a student perceives his or her future opportunities. Where college is concerned, this can include aspirations of higher education and navigating the application process, as well as achieving success once enrolled. Fortunately, many colleges and universities are developing a greater awareness of students’ mental health needs and the importance of providing mental health programs to support and improve their educational journeys.

Mental Health and College Decision Making

Students who are already diagnosed with mental health conditions or psychological disabilities can, and should, work with their high school counselors to begin to explore what types of resources may be available at the college level.

Taking the time necessary to conduct the college research and comparisons that allow for good decision-making is critical. These students and their parents can talk with counselors and teachers, as well as connect with community organizations, to ask for help. What support do you need to succeed? Finding a mentor in this process is helpful, but don’t wait until the last minute. Get the conversation started now.

Making direct contact with school representatives, at a distance or in person, to ask the following questions will begin to help you determine how well a school might meet your needs:

  • How can I access specific services and programs, e.g. group counseling, referrals?
  • What are the costs for services and programs, if any?
  • Are disability services aligned with academic support services or integrated into classes?

“If a school is unsure where to direct you when you ask ... you may likely have a hard time utilizing those services once you are attending school there.”

- Lauren Rigney, LMHC, Private Practice

As with other types of disabilities, it’s a student’s personal choice whether or not to disclose a mental health issue in his or her college application. There’s not right or wrong choice here. However, to receive related support services once enrolled, as directed by the Americans with Disabilities Act, students should expect to not only disclose their conditions, but also provide documentation. More information can be found by contacting any institution’s disability services office or resource center.

Mental Health and Academic Success

Becoming a college student can come with a steep learning curve, even for those without a disability. These challenges, such as balancing school and work, adjusting to college-level academic expectations, and becoming familiar with a new environment, are even more risky for those with a mental health related condition.

“During college, some of the most important resources are the office of student disabilities, the student counseling center, and the student’s academic adviser.”

- Dr. Mark Scholl, Associate Professor, Wake Forest University

After enrolling, students should connect with the available resources if they haven’t already. Now is the time to make appointments, participate in workshops, and ask questions. It’s also a good idea to connect with other students who may be facing similar challenges to learn more about how they are using these resources and successfully implementing strategies in their day-to-day lives and studies.

Developing good habits during the first year of college is a particularly helpful. What does this mean? Our panelists shared a host of helpful ideas, such as:

  • Maintain connections with friends and family through scheduled check-ins.
  • Connect with a counselor, advisor, professor, or peers who are willing to listen.
  • Get involved through academic and non-academic activities, like clubs, volunteering, and sports to foster a sense of belonging.
  • Practice self-care, such as getting enough sleep, eating a healthy diet, taking breaks, and exercising.

Prepare for roadblocks by learning more about the activities, events, and resources offered at a range of campus-based offices from counseling and disability services to student health centers, wellness facilities, and residential life support.

No matter where you may be in your college exploration journey, taking a crisis prevention approach, instead of one that is focused on reaction, is encouraged. Know that you are not alone and that resources are in place to support you as you move toward your goals and help you succeed.

Further Reading


Starting the Conversation

The National Alliance on Mental Illness’ College Guide includes a collection of video and resources aimed at helping students and parents openly discuss mental health and identify campus resources.

Depression and College Students: Answers to College Students’ Frequently Asked Questions About Depression

This resource from the National Institute of Mental Health provides a helpful definition of depression, as well as descriptions of the different symptoms, types, and treatment options.

Managing a Mental Health Condition in College

Another resource from the National Alliance on Mental Health, this site is written for students with advice on picking the right school, preparing for college, disclosing a mental health condition, and more.

Warning Signs of Mental Illness

The American Psychiatric Association provides a collection of resources for parents and families, including this article about developing symptoms.

Best Colleges Guides


The Top Mental Health Challenges Facing Students

Explore the common symptoms of and resources to support students with depression, anxiety, suicidal thoughts, eating disorders, and addiction.

A Student’s Guide to Managing Stress

What is stress? This resources provides some definitions and signs of physical, emotional, behavioral, and cognitive stress as commonly found among college students.

College Guide for Students with Psychiatric Disabilities

The transition to college can be particularly challenging for students with disabilities, such as ADHD, addiction, and autism. Learn about accommodations and assistive technology, as well as wellness strategies.

Understanding Suicide Prevention

Explore the many misconceptions about suicide in America, common warning signs, and how to get help for yourself or someone you know who may be at risk.

Understanding Eating Disorders

Learn more about the different types of eating disorders that affect more than 14 million people in the U.S., as well as their causes and treatments.

Organizations That Can Help


Crisis Text Line

Free, confidential support is available in the U.S. 24 hours a day, seven days a week. Trained crisis counselors respond to help texters get through an immediate crisis, moving people “from a hot moment to a cool calm” and a plan to move forward safely. To access: text HOME to 741741.

American Foundation for Suicide Prevention

Whether you are having thoughts of suicide or want to support someone who might be at risk, this organization provides a place to start with web-based resources, local chapters, and links to additional relevant organizations.

National Suicide Prevention Hotline

Supported by partnerships with crisis centers all over the country, this toll free service is involved in a wide range of suicide prevention and mental health initiatives, including 24/7 access to mental health professionals. To access: call 1-800-273-8255.

MentalHealth.gov

Provided by the U.S. Department of Health and Human Services, this collection of articles focuses on starting conversations about mental health issues. Browse the resources on topics ranging from eating disorders to post-traumatic stress.