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Understanding teen stress, anxiety, and depression has been a major focus at the Institute of Mental Health blog this year. Today’s article, by American higher education expert Bree Hernandez, takes a closer look at how university students -- particularly those studying at the graduate level -- are impacted. Bree has made a career out of discussing the benefits of graduate education, and she is quite knowledgeable about student issues both in and outside of the classroom.

Mental Health Problems Continue to Plague Higher Education
Psychologists have increasingly noted that mental health issues among college students have been on the rise for more than a decade. While the entire college-level population is generally perceived to be at higher risk for depression, anxiety and other conditions than other adolescent or adult communities, recent data shows that occurrences are especially high among graduate students.

In 2010, the American Psychological Association (APA) reported that mental illness among college students had risen dramatically within the previous 10 years. Based on a survey of more than 3,200 American university students, 96 percent of students who visited their campus clinic for psychological treatment were diagnosed with at least one mental disorder. While cases of average depression remained the same (“relatively mild”), rates of severe depression rose seven percentage points between 1998 and 2009. Furthermore, doctors noted a steady rise in the number of students using medication to combat their mental issues. In 1998, 11 percent of students took medication for depression, anxiety, mood disorders and ADHD, among other conditions; in 2009, that number reached 24 percent. There is reason to believe it is still on the rise.

Margarita Tartakovsky, Associate Editor of PsychCentral, recently noted that graduate students are at the greatest risk of suicide. Based on a study conducted at Berkeley University, nearly half of all graduate student respondents suffered from an emotional or stress-related disorder that affected them on a daily basis. The demanding nature of graduate-level coursework – which is typically taught within a less structured environment than undergraduate studies – plays a crucial role in the mental health of grad students, Tartakovsky found. When coupled with the stress of accruing massive student debt in order to receive a master’s degree, the deck often seems stacked against the student. While 52 percent of stressed out graduate students considered receiving help from mental health assistance services, only 27 percent actually followed through.

To mitigate the negative consequences of mental health issues, many of today’s campuses provide accommodations to affected students. According to a report by the University of Washington, these accommodations may be made in regard to classroom policy (preferential seating, early availability of textbooks and syllabi), course examinations (extended time, assistive computer software) or assignments (relaxed deadlines, substitution). However, some of these accommodations may actually be doing students a disservice by customizing the academic experience to fit their specific needs. According to a report by the Jed Foundation, institutes of higher education should not “fundamentally alter” courses in order to accommodate students with mental health issues, nor should the schools incur an “undue burden” (logistical or financial) to make accommodations.

There is also a question of fairness, argues a recent report from a professor at the College of New Rochelle. “Accommodations allow students equal opportunity to participate in all aspects of college life,” the report states, “but should not provide unfair advantage over other students or fundamentally alter the nature of courses.”

Many experts today are touting low-impact strategies that students can employ as an alternative to campus-wide accommodations for individuals with mental health issues. Studies have shown that many first-year students enter university studies with pre-existing mental health conditions which have not yet been addressed, and seeking professional help prior to arriving on campus could mitigate some of the problems related to these conditions. And because many of these mental disorders are stress-related, health experts urge students to regularly exercise, get eight hours of sleep every night and refrain from frequent drinking or recreational drug abuse. And according to Psychology Today contributor Julie Hersh, all students can play a role in fighting mental health issues on campus by forming committees and support groups for affected individuals.

Students who suffer from mental health issues should not exclusively rely on counselor treatment or campus-wide accommodations in order to succeed in college. By practicing low-impact strategies like those listed above, affected men and women stand the greatest chance of completing their courses and earning a degree in spite of a debilitating mental disorder.

Well what a week. There has been progress with the MHRN Industry Group of service users and carers. This group has met twice now and are preparing to meet again in a few weeks.  The MHRN are pushing for more recruitment to these types of studies and although it is very complicated, we were privileged to have a good few people attend our first couple of meetings and give positive comments on being involved. The next meeting is the subsequent step where we discuss as a group the way forward and look at where we can get involved in the different studies. Personally I find it quite a difficult subject to understand but I am sure I will get there. (Perseverance is the key.) How can we as a small cog in such a massive, global enterprise make our way into what seems a very closed shop when often, so I have been informed that the large organisations that develop these studies have never ever involved the public and users of the medication that they produce. More positive things have happened within the MHRN - we seem to be ironing out difficulties which moving into the new building have bought about.

Another positive for me this week has been on a personal basis really and a big boost to my self-esteem. I have been asked by various members of IMH staff about patient involvement and have been glad to help. Thank you to those who have asked and if I can be of any help to others please let me know. My experience within the Trust has been over a good few years and I have met a quite a lot of individuals from doing this. My mum always asks me if there is anyone I don’t know. It’s not unusual for me to go out without seeing anyone from work or the classical music scene.  Keep fingers crossed for me, I am seeing a new singing teacher today based at the Uni.

Patient and Public Involvement for the MHRN took a great boost on Friday 27^th July as I went to the Rosewood involvement centre up in Ollerton to talk to their Friday Group about the MHRN and can I say, I came home feeling like I was walking on air.  The Friday group is a well attended group of service users and carers who get together for support and encouragement to each other and to hear about different things going on in the Trust and outside. The Rosewood centre is the sister Involvement centre to the one at Duncan Macmillan house and is a very thriving place to go. They even have their own belly dancing troop. There was so much enthusiasm from the entire group to listen, ask questions and equally wanting to become involved it was just astounding. Can I post a great big thank you to them all. I have so many contacts to make and friendships to develop, it was extraordinary.  The MHRN as an organisation is obliged to involve service users and my job is to co-ordinate the involvement and recruitment to different research studies. The boost from attending the Rosewood centre was that we could form a group in the North Nottinghamshire area and help researchers who can sometimes be Nottingham centric develop studies in the north of the county. I am sure the group would be very useful. The wealth of experience is an added bonus to anyone in the field of research.

I was one of the first service users to be employed by the Trust way back in 1999 (I think it was then). And have seen a tremendous development in this area. I cannot thank all my friends and colleagues enough for their hard work in developing Involvement. It started off with one young man called Liam O’Neil who sadly is no longer with us but his name is kept alive with one of the Trusts OSCARS bearing his name, and has developed into quite a large staff team.  Liam was a service user who I met when I was a volunteer at the Nottingham Advocacy group; he was quite a cautious man but was very vocal and knowledgeable around involvement of service users in any aspect of their care and the organisation of the Trust. Liam worked on his own to begin with to set up the involvement department in the Trust until a manager was appointed then things seem to go all out to what we have today, two Involvement centres.

Posted by:
Debbie Butler
Patient and Public Involvement Coordinator
NHIR Mental Health Research Network
Mental Health Research Network
East Midlands Hub