- College student mental health issues continue to mount, with depression and anxiety among the most common psychiatric disabilities.
- Under the Americans with Disabilities Act, colleges and universities must provide students with mental health illnesses necessary academic accommodations.
- Students must complete a disclosure process to access these accommodations, including providing documentation.
- To maintain their mental health in college, students should seek support from counselors and campus chapters of organizations like the National Alliance on Mental Illness.
According to recent statistics from the National Alliance on Mental Illness, one in five U.S. adults experience mental illness annually. Mental illness is a broad term defined by the Mayo Clinic as any disorder that affects one's mood, thinking, or behavior. When mental illness influences family life, work, education, and other aspects of daily life, the condition is known as a psychiatric disability.
Psychiatric disabilities are persistent conditions that may have a significant, lifelong impact. Those diagnosed with psychiatric disabilities may mitigate the effects of their condition with medication and/or ongoing psychotherapy. Even with treatment, many psychiatric disabilities persist in some form.
College students with psychiatric disabilities face unique educational challenges. Mental health counselors and disability coordinators are available on most campuses. To help students find the assistance they need, we examine instructional strategies, course accommodations, and other campus services designed to serve this population. This guide attempts to provide a comprehensive resource for postsecondary students who have a mental illness.
What is a psychiatric disability?
A psychiatric disability, as defined by the Americans with Disabilities Act (ADA), refers to a "mental impairment that substantially limits one or more of the major life activities of an individual." The terms mental illness and psychiatric disability are sometimes used interchangeably to describe a variety of emotional and mental conditions.
What are the most common mental illnesses among college students?
A 2013 survey conducted by the Association for University and College Counseling Center Directors revealed that over 41% of college students struggle with anxiety. Depression followed close behind, affecting more than 36% of respondents.
What percentage of college students struggle with mental health?
According to the nonprofit organization Active Minds, 39% of college students experience significant mental health issues. Furthermore, about two-third of students with anxiety or depression do not seek treatment due to lack of healthcare and/or campus resources, as well as the stigma that individuals with mental illness commonly face.
What qualifies as a disability in college?
Under the ADA, a disability is any condition that "substantially limits" the proper functioning of the human body, including talking, hearing, moving, seeing, and sleeping. ADA guidelines also cover major life activities, including learning, thinking, working, performing manual tasks, and self-care.
Do colleges have to accommodate disabilities?
Federal disability law dictates that public and private higher education institutions must provide equal access to education for students with disabilities; if these institutions do not comply, they risk losing government funding. However, colleges are not required to offer accommodations that would fundamentally change the nature of an activity, service, or program.
Mental Health in College Students
First, let's explore some of the most common psychiatric disabilities college students experience. Keep in mind that this list is by no means exhaustive; there are more than 200 classified types of mental illness, and each of these can evolve into a psychiatric disability.
- Anxiety disorders
It is normal to become anxious in stressful or unpleasant situations, like speaking in public or getting stuck in traffic. However, when intense distress and fear prevents you from doing everyday activities, an anxiety disorder may be the cause. The National Institute of Mental Health (NIMH) reports that nearly 20% of American adults have an anxiety disorder, with symptoms typically manifesting by the time an individual turns 21 years old.
The five major types of anxiety disorders include general anxiety disorder, panic disorder, post-traumatic stress disorder, obsessive-compulsive disorder, and social phobia/social anxiety disorder. While symptoms largely depend on the specific anxiety disorder, you should look out for general signs, such as persistent feelings of dread, restlessness, and irritability.
College students must navigate many significant changes in their lives, which can be both exciting and scary. An anxiety disorder causes you to hone in on your fear, making you live in constant worry of academic and social failure. You might also experience trouble concentrating or even have visible panic attacks.
Depression takes many forms, but it often leaves you feeling helpless and despondent for two weeks or more. As a result, it can be difficult to eat, sleep, work, and study. According to research published by the University of Michigan, students with depression are twice as likely to drop out of college as their peers. This common — yet serious — mental illness may also result in other symptoms, and it can even lead to suicide.
A number of factors can cause depression, including genetics, trauma, certain medical conditions, and drug/alcohol misuse. Additionally, symptoms differ significantly between people. You may experience changes in appetite, loss of energy/general fatigue, feelings of anger or frustration for no distinct reason, and/or trouble concentrating.
Depression can lead to thoughts of death and dying. If you or someone you know are having suicidal ideations, please contact the National Suicide Prevention Lifeline. Fortunately, with early detection and diagnosis — as well as an effective treatment plan — most depressed individuals can find comfort and relief.
- Substance abuse disorders
Partying, drinking, and recreational drug use have become commonplace on college campuses. According to 2018 data from the National Institute on Alcohol Abuse and Alcoholism, about 55% of full-time college students drank within the past month and about 37% engaged in binge drinking. Unfortunately, what starts as a social tradition can lead to full-fledged addiction, which is defined as the repeated use of and dependency on a substance.
Drastic changes to physical appearance, including weight gain/loss, represent common symptoms of addiction. You may also feel anxious, fearful, and paranoid for no apparent reason. Substance abuse disorders often lead to (or in some cases are caused by) another psychiatric disability in what health professionals refer to as dual diagnosis or co-occurring disorders.
- Eating disorders
Eating disorders are extreme attitudes, behaviors, and emotions concerning weight and food. Three main types of eating disorders exist.
Anorexia nervosa manifests as an unhealthy fixation with thinness that causes disturbed eating behaviors leading to emaciation. Bulimia nervosa causes individuals to go through cycles of binging and purging, which can lead to tooth damage, acid reflux, and even heart failure. Lastly, people with binge eating disorder regularly lose control, eating vast quantities of food in a short amount of time without feeling the need to purge or exercise excessively.
- Bipolar disorder
Individuals with bipolar disorder experience significant shifts in their energy, mood, and the ability to think clearly. They go through periods of exceptionally high and low moods, known as mania and depression. NIMH statistics show that 2.8% of the U.S. population is diagnosed with this mental illness, which affects women and men equally.
While the average age of onset for bipolar disorder is 25 years, some people see signs as early as their teens. Because manic periods are characterized by impulsive decision-making (usually without regard to consequences), suicide stands as an ever-present danger. The depression stage of a bipolar episode may cause feelings of personal failure and helplessness that make the smallest, most mundane tasks seem overwhelming.
Schizophrenia strips away an individual's ability to manage their emotions, think clearly, and connect with other people. Due to the complex nature of this mental illness, researchers find it hard to pinpoint its prevalence, although NIMH estimates that 0.25-0.64% of American adults have schizophrenia or a related psychotic disorder. The average age of onset among men ranges from late teens to early 20s, while women generally see signs for schizophrenia in their late 20s to early 30s.
Genetics, brain chemistry, substance abuse, and environmental factors can all cause schizophrenia. Symptoms include hallucinations, delusions, and cognitive impairment. Schizophrenic people may also exhibit negative symptoms that cause them to become emotionally flat and unable to follow through with activities or sustain relationships.
- Autism spectrum disorders
People with autism spectrum disorders (ASD) display repetitive/restricted patterns of behaviors, activities, and interests, which often affects how they communicate and socialize with others. According to NIMH, boys are four times more likely than girls to develop ASD symptoms, which usually appear during the first three years of life.
As the term "spectrum" indicates, symptoms, behaviors, and severity differ by individual. ASD can cause a delay in language development, difficulty recognizing facial expressions or subtle gestures, and a lack of social understanding. The College Autism Network notes that the variety and complexity of ASD symptoms pose substantial challenges for higher education institutions as they attempt to provide adequate accommodations to students in this population.
Transitioning to College and Unique Challenges
For students with diagnosed mental health issues and psychiatric disabilities, a primary challenge when transitioning to college life is to ensure they have the resources they need to maintain their treatment plans. This usually entails working with their high school counselor and/or therapist to ensure that they have access to medication as well as social and clinical support.
Additionally, many students develop mental health issues while attending college. First-generation learners from low-income and underserved communities are particularly vulnerable. In this case, students should seek immediate guidance from campus administrators. Colleges also need to do their part to treat mental illness as a public health issue that requires systematic approaches. Campuses should promote well-being and work to reduce unnecessary stress, substance abuse, and suicide.
How Schools Accommodate Students With Disabilities
Most colleges and universities provide various forms of community support and academic accommodations to help students with their mental health. Consult a school administrator to discover what resources are available to you.
Types of Accommodations
- Priority class registration
- The option to reduce your course load
- Substituting one class for another
- Access to notetakers and recording devices
- Individual study skill training
- Support for specially trained mentors and tutors
- Extended assignment deadlines and more time on tests
- A private room when taking tests
- Transportation services
- Special on-campus accommodations
- The ability to switch rooms and/or roommates
- Leave of absence that does not hinder you financially or academically (e.g., the ADA considers retroactive withdrawal due to mental health challenges a reasonable accommodation)
- National Alliance on Mental Illness
Many colleges maintain NAMI on Campus clubs. These student-run organizations dedicate their mission to raising mental health awareness and advocating for better policies and services.
- Active Minds
With over 400 campus chapters across the U.S., Active Minds delivers training programs that teach mental illness prevention techniques to faculty, administrators, and students. The organization's website contains crisis information and referral resources.
- Individual initiatives
Most colleges and universities prioritize mental health and self-care, particularly as part of new student orientation events. Do not hesitate to seek guidance from your peers, professors, and counselors.
Tips for College Success
Build support networks
College is a great time to create new support systems by making friends and engaging with campus clubs. It is also important to maintain connections with family and friends back home.
Maintain healthy habits
A challenging academic schedule can make keeping a steady sleep schedule difficult, but try to get 7-9 hours of rest each night. It is also useful to plan ahead so you can maintain a healthy diet and exercise routine.
As part of the orientation process, most schools show students how to access tutoring services, mental health support, and study groups. Your workload will vary as the semester progresses, so experiment with time management techniques to find the strategies that work best for you.
The hectic nature of college life can make it hard to notice changes to your physical and mental health. By keeping short records of daily symptoms and details of your general feelings, you can better recognize worsening conditions and seek support.
Common Assistive Apps
Nicknamed SAM, this highly rated app monitors anxious thoughts and behaviors in order to create sustainable long-term management plans.
This app helps people with eating disorders by allowing them to create healthy meal plans, monitor their urges to binge, and create long-term management systems.
Suitable for people with ADHD and other conditions that affect focus, this app tracks a user's daily activities and offers strategies for balancing work, school, and leisure.
This app tracks daily emotions using graphs, calendars, and other interactive displays to help students prone to depression, anxiety, and other mood-related disorders.
This app features animated displays to discuss proper responses and procedures for panic attacks and other sudden bouts of anxiety.
Meet Psychologist Dr. Crystal Lee
Dr. Crystal Lee is a licensed psychologist in Los Angeles, California. She is passionate about launching adolescents and emerging adults into adulthood and specializes in treating adolescents and emerging adults with neurodevelopmental disorders, particularly autism spectrum disorder and attention deficit/hyperactivity disorder. Dr. Lee owns a private practice called LA Concierge Psychologist, where she provides "house calls" for her patients on the Westside andf teletherapy to families all over California.
- What are the three most important attributes or characteristics a student with psychiatric disabilities should consider when selecting a university experience and why?
Besides all of the typical attributes that college applicants look at, it's really important for students with disabilities to know what kind of support the college has. Though the ADA covers all college campuses, there are definitely some schools that have more robust academic accommodations.
Additionally, look at the mental health supports that the college offers. Most college campuses have a college counseling center, but the services and supports offered vary widely. Some colleges provide primarily group therapy, while others may limit how many sessions you can access per year. If the college has limited mental health supports, then it's important to look at the community at large and see if there are available psychologists, therapists, or psychiatrists that can serve your particular needs.
Lastly, look at the campus culture. Some campuses embrace student differences and proudly destigmatize mental health struggles. Some colleges will even have student-run groups (like Active Minds) where you'll be more likely to find allies. Do students generally seem supportive or is the environment more competitive? Students with disabilities would likely do better on a campus that's more supportive.
- How important is a university's community and resources for students with psychiatric disabilities when deciding on a college?
Extremely! As I mentioned above, you definitely want to do some research and determine what resources the college supports. If possible, visit the campus' disabilities office and meet some of the staff. Get a feel for how friendly and supportive they seem. You'll probably want to steer clear of a campus that has a very disorganized disabilities office or one that feels unsupportive.
- What is the process like when working with university staff, professors, and disabilities/mental health services?
Unlike high school where your parents and high school staff rallied around to support you, getting your accommodations and getting the support you need falls solely on your shoulders. You have to do the legwork in terms of getting set up with accommodations at the disabilities office, making sure you're communicating with the disabilities office and your professors, etc.
In college, you are the engine that moves along everything you need to be successful. It's highly unlikely that someone else will remind you to schedule your extended time testing at the disabilities office or to renew your accommodations each semester.
- How do you suggest a student addresses stigmas that may be associated with psychiatric disabilities on a college campus?
I think the majority of college counseling centers are trying to contribute in the fight against mental health stigmas. Many campuses also have an Active Minds club, which has the mission of fighting mental health stigma. Most major cities have a chapter of NAMI, which also helps with fighting the stigma. Getting involved in these groups or their campaigns can help destigmatize mental health struggles.
- What are some strategies to approach professors or campus resource centers, if a student is feeling unsure?
It can be really difficult to take that first step in asking for help. Sometimes it helps to go along with a trusted friend for moral support. If a student is uncomfortable doing that, then it usually helps to go in with a few prepared questions or tasks that need to be accomplished. Usually this helps the student feel a little more prepared and confident; also, if they get flustered, the student can always reference the prepared points they made.
Another strategy is to ask some peers who they've worked with that have been helpful. Sometimes just knowing that the person is already someone known to be friendly helps take the pressure off of meeting that person and asking them for help.
- What advice would you give to a student with a psychiatric disability who is considering college?
I would suggest that a student work with their support system to prepare for college in the spring and summer leading up to leaving for college. This is the perfect time to create a solid transition plan, learn any needed skills to be successful, and set up some supports so they're in place when fall semester starts.
It's tempting to just try and wing it once you land on campus because the preparation can sometimes feel stressful or be time-consuming, but I would strongly advise against that. Transition planning will set you up for success so you can focus on enjoying the college experience!
- What advice would you give students who don't believe they can attend college with a psychiatric disability?
More and more students with mental health struggles are going to college; the highest number in history, actually. This is because colleges are getting better at supporting these students, and families are getting savvier about transition planning to set up their students for success. This is not to say it's a walk in the park; college is tough for students with and without disabilities, but it would be a shame if a student interested in college is deterred from applying just because of their disability.
- What are tools you see students with these challenges using to succeed once they get to college?
Depending on the specific strengths and areas of growth, students may need support from any of the following people: a psychologist, a psychiatrist, an educational therapist, a subject-specific tutor, an executive functioning coach, a life skills coach, a college advisor, and/or a disabilities office counselor.
I would encourage the student to have at least one trusted person on the college campus they can go to when they are struggling; this could be a college advisor, therapist at the college counseling center, resident assistant at the dorms, or disabilities office counselor.
There are some fantastic apps that students use to help them with everything from stress reduction to tracking their mood to scheduling. I would encourage students to start trying out different apps prior to fall semester (senior year of high school is a great time to test things out) so they land on campus with an arsenal of supportive tools.
- What are some of the ways family and friends can support students with psychiatric disabilities during this time of transition?
I cannot stress enough the importance of working on a transition plan the spring and summer before starting college. This is when family, friends, and supportive professionals can come together and figure out what specific supports the student needs to be successful in college. With some preparation, the inevitable curveballs and stressors of college will feel more manageable.
For example, if an area of growth for a student is that they struggle with making friends, the student can participate in a social skills program prior to college; if they have a friend going to the same college, the friend can act like a social coach to help the student meet new people and navigate tricky social situations. The student could continue to see a psychologist to reinforce the needed social skills and help the student cope with the social stressors of college.
- What are the ways a college should support students with psychiatric disabilities? Where can students go for help if an issue does arise?
Colleges that provide academic and mental health supports are doing what they can to support students with mental health struggles. Many colleges are doing more to train their professors on how to work best with students with disabilities, which is fantastic.
The disabilities office or the college counseling center are the best places for a student to go if an issue arises (depending on if it's more of an academic issue or social-emotional struggle). If the student has a trusted academic advisor, that person would also be a good person to reach out to.
Scholarships for Students With Disabilities
There are a variety of scholarships available to students with psychiatric disabilities. Be sure to do your own research to see if there are scholarships geared specifically towards the college you attend or your field of study.
- AAHD Frederick J. Krause Scholarship on Health and Disability
This one-time award of up to $1,000 is available to college students who are currently enrolled in an accredited degree program. Applicants must provide a note from their physician or therapist to prove they have a disability. Two letters of recommendation, college transcripts, and a few personal statements are also required.View Scholarship
- Google Lime Scholarship
This one-time, $10,000 award is reserved for students with disabilities who are currently pursuing a degree in computer science. Candidates must submit three essays describing their passion for computer science and their career goals.View Scholarship
- National Center for Learning Disabilities Scholarships
Students with ADHD, ASD, and other learning disabilities may qualify for four different awards offered through NCLD. Award amounts range from one-time, $2,500 scholarships to recurring awards of up to $10,000 over the course of a four-year program.View Scholarship
- Organization for Autism Research Scholarship
The $3,000 award is presented to applicants who have been diagnosed with ASD. Candidates must be enrolled as full-time students at an accredited school.View Scholarship
- Baer Reintegration Scholarship Program
This program awards $1,000 scholarships to students with schizophrenia, schizoaffective disorder, or bipolar disorder who are pursuing various levels of education. Candidates must be currently receiving medical treatment and be actively involved in rehabilitative or reintegration efforts.View Scholarship
The leading federal agency in the field of mental health research, NIMH is one of 27 branches of the National Institutes of Health. NIMH's website contains news, published reports, academic journals, data tables, and other academic resources.
Founded in 1979, NAMI is the nation's largest grassroots organization that supports people with mental illness. NAMI maintains a toll-free hotline to provide advice and medical referrals. Representatives from the organization also work closely with lawmakers nationwide to ensure fair and equal protection for people with mental health issues.
This nonprofit organization has worked to promote mental health treatment and fight social stigma related to mentally ill individuals for nearly 20 years. TAC also collaborates with researchers to publish developments in medication and treatment for mental illnesses.
This website, maintained by the U.S. Department of Health and Human Services, has a list of toll-free hotlines accessible to people living with mental illness.
An organization of mental health consumers/survivors, NCMHR leads the development and transformation of the mental health field by implementing and suggesting healthcare, mental health, and social policies.