{image credit :: Matt Katzenberger}
It’s easy to romanticize the college experience. When someone mentions my alma mater, my heart flutters a bit as I recall the excitement of a new syllabus (I am not being ironic, just so you know — I really am a nerd), meeting friends for lunch in the student union, warm spring days spent sitting on my porch curled up with a good… book.
But college isn’t a time of frivolity and freedom for everyone. And even those among us who had a great college experience face our challenges. A deeper look back quickly brings to mind all the things that made this transitionary time challenging: I was alone in a relatively huge place without anyone or thing that was familiar. I didn’t know who I was or exactly what I wanted to become. I was anxious about running out of money and scared I wasn’t wearing the right thing.
Of course, I wasn’t alone. I was surrounded by thousands of other students in the same exact boat, trying to navigate these choppy, unchartered waters. But most people weren’t talking about their fears of fitting in or getting lost in the shuffle. They were too busy drowning their anxieties in the alcohol that was suddenly copiously available or perfecting their AIM away message to sound just busy but available (read: cool) enough.
And, as a recent Huffington Post piece explored, there may be another reason that college kids aren’t talking about their feelings: they don’t want to get kicked out. The story looks at the way that universities are handling college mental health, staring by highlighting the experience of Rachel Williams who faced an eating disorder while at Yale.
The piece struck me because this is an issue that I face on a very regular basis as a psychologist. I’m constantly face to face with students who have been asked to leave their universities, chosen to take a leave, or soon facing the decision (their own or the school’s). I’m also often asked by universities to help provide a recommendation for whether a particular student should be on a medical leave.
What’s been fascinating to me sitting on this side of the couch is that there is so much variability in the way that universities handle issues of mental health. I’ve worked with students who have been in a strong place of recovery for a significant period of time, but their university won’t let them return until a specified period of time has passed. This is often a semester, but has been as long as a year. Other students I’ve treated have been essentially ignored at their schools, despite our best efforts to enlist the help of the university to grant a leave or provide services.
It begs the question of whether there is a best practice for universities in addressing students with eating disorders. While nothing formal exists for the field of eating disorders, it’s heartening to know that 55 universities very recently signed up to take part in The Jed & Clinton Health Matters Campus Program, a program evaluating mental health services on campuses. The universities will take part in self-assessments and commit to improving their practices.
I can only hope that one of the outcomes of such an initiative is to develop effective ways of managing individuals with eating disorders on college campuses. With prevalence rates of eating disorder symptoms nearing 20%, it’s not an issue that can be ignored.
Further, it’s not an issue that can be addressed with a one-size-fits-all approach. Taking the stance that students with eating disorders cannot continue with academic pursuits can be short-sighted. We have to consider the particular student and the potential impact of having them step away from their university. For some students, college can be incredibly helpful in the process of recovery, providing a source of focus and meaningful activity outside of the disorder and the chance to socialize and interact with people not trapped in the grips of their own disorder. Some students find that leaving school sends them into a spiral of depression and anxiety, feeling like all they have left in their lives is their eating disorder.
Of course, this is not the case for all students. Many very much need to step away from the school environment in order to give themselves a chance to really reflect and focus on their recovery process. College campuses aren’t exactly known for promoting great eating and health habits, and the stress of academics can sometimes make it impossible to participate fully in one’s own treatment. For students with severe eating disorders, taking time off to address their health — just as they would do with another health condition — can be life-saving.
The point is that protocols are nice in theory, but cannot forget to take into account the individual needs of individual students. While campus suicides and other deaths are heart-wrenching for a school, colleges also cannot react to student mental health concerns from a place of fear. This only leads to further stigmatization, which students with mental illness already face on a daily basis.
If you struggled with mental health issues during college, how did you university handle things? What kinds of practices do you think would be most effective in getting students the services they need?