Adding counselors won’t solve mental health crisis (opinion)

Emotional stress is now the number one reason students are considering dropping out of college, according to the recently released State of Higher Education 2022 Report by Gallup and the Lumina Foundation. The mental health crisis facing campuses has become so dire that U.S. Surgeon General Dr. Vivek H. Murthy recently urged higher education leaders to hire more counselors, expand peer support programs and collect data on utilization of mental health resources on campus.

Increasing mental health resources will undoubtedly be needed to address the crisis. But it won’t be enough. We also need a fundamental change in the way we approach student wellbeing.

We need to move from traditional approaches that implicitly convey expectations of fragility and pathology to those that promote resilience and strength. We need to improve the coordination of student experiences and services that have traditionally operated in relative isolation from one another. And we need to provide ample opportunities for students to build specific coping skills.

Clues to the origins of the student mental health crisis can be found in a larger mental health paradox. Specifically, the rate of diagnosed mental health problems continues to rise, especially among adolescents and young adults, despite the fact that treatment has never been more widely available, including new short-term psychotherapies, an ever-growing array of psychiatric medications, and countless groups for support. In every other field of medicine, as treatments become better and more widely available, the incidence rate decreases; however, we see the opposite in mental health.

Although experts debate the exact reasons for the increase in mental disorders, there is consensus that part of the explanation lies in the broadening of the criteria experts use to define mental illness. Problems that were once considered ordinary life challenges are now considered mental disorders.

This “criterion creep” contributes to the pathologizing of normal life challenges, including those faced by young adults. Operating from this framework, mental health professionals often communicate in ways that unwittingly and tacitly convey expectations of pathology and instability. For example, consider the case of trauma. In the immediate aftermath of a traumatic event, people tend to be highly susceptible to the effects of language that promotes either resilience or morbidity. There is increasing evidence that messages emphasizing the negative effects of trauma, even when well-intentioned, can contribute to increased symptoms and poorer outcomes. In contrast, communications that reinforce productive coping strategies and establish resilience expectations may lead to better outcomes.

Of course, there is a very fine line between promoting resilience on the one hand while not minimizing suffering on the other. Victim shaming, toxic positivity or stigmatization should be carefully avoided. But given the growing evidence that people tend to react strongly to professionals’ expectations, especially in times of stress, we need to carefully consider the tone we set with our students and the way we frame their experiences.

Messages of strength, resilience, and the expectation of positive outcomes must extend beyond college counseling to all aspects of the student experience, including the classroom. At the University of New England, we encourage our students to engage in difficult conversations and topics that are framed as opportunities not only for learning but also for growth. These respectful dialogues are essential for students to foster the skills to deal with challenges and discomfort and build resilience.

There is another innovation needed to promote student strength and resilience: we need to connect student experiences in a well-coordinated network, ensuring that each node in the network provides sufficient opportunities to help students build specific skills. We must encourage both faculty and professional staff to work as members of a dynamic, interdisciplinary team rather than as isolated units. Simply put, we must work together to synchronize efforts to support and empower students’ intellectual and psychological growth.

For example, a student exhibiting a significant change in behavior may be approached by a faculty member or athletic trainer who has been trained by counseling staff in a mental health “first aid” program. The program develops the language and tools to identify students in need of support and to refer them to appropriate resources, which may include mental health counseling, but also referrals to outdoor recreation staff, academic support specialists, or feeding if needed. Counseling itself can address catastrophic thoughts through mindfulness training, improve problem-solving and communication skills, and reduce self-isolation through activity planning. A health and wellness teacher can review sleep patterns and screen use with the student. Residential counselors encourage students to avoid isolation and follow the treatment plan. These interventions are coordinated with the student’s consent, while the team protects the student’s privacy by avoiding sharing unnecessary details.

This networked, skills-based approach contrasts with more traditional models where student services are fragmented, isolated and uncoordinated.

Like most colleges and universities, the University of New England has increased the counseling resources available to students. We’ve supplemented traditional counseling with unscheduled mini-drop-out sessions as well as 24-hour remote counseling services. Incoming students undergo a Wellness Wave self-assessment that helps them identify issues that may need additional attention, while instilling a sense of agency in maintaining their own well-being. We partner with programs like Campus Unlonely and Essie to offer art therapy and other activities to improve student well-being.

But successfully addressing the mental health crisis in higher education will require more than adding counseling resources. We need to rethink the fundamental way we think about student welfare. We must be intentional and consistent in conveying messages of hope, strength, and resilience, not those that suggest pathology and fragility. And we must do so in the context of multifaceted, coordinated networks of supports and opportunities to develop students’ coping skills.

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