ANN ARBOR, Mich. —
The day before his junior year at the University of Michigan, George Orley loaded his car and kissed his mom goodbye before starting the 45-minute drive to school.
Days later, police told his parents that George — popular, funny and blessed with loving family and boundless charm — had taken his own life just outside Ann Arbor and the university.
George, 20, had lived with depression for 18 months and was diagnosed with bipolar disorder shortly before he died. Plus, he’d been managing diabetes and recuperating from hip surgery that set him back a semester. He’d also stopped taking medication because he didn’t like how it made him feel.
Nearly four years later, George’s mom, Diane Orley, says her son couldn’t see past the sheer weight of his emotions at the time.
He was far from alone in his struggles.
Record numbers of college students feel weighed down by mental health challenges according to a host of studies. It's almost as if a “Help Wanted” sign hangs on the Ivory Tower as U.S. colleges scramble to meet needs of students like Orley.
Experts describe a burgeoning crisis. The number of students seeking help for mental health has exploded in the past five years and the search for mental health experts with new ideas and strategies has become no less important than competing to hire prestigious faculty.
Ben Locke, executive director of The Center for Collegiate Mental Health at Pennsylvania State University, says demand for mental health services is growing five to six times faster than enrollment. Since enrollment largely funds services, colleges are hard-pressed to meet need.
Anxiety is the chief complaint, often alongside other mental illness. The Center says 70 percent of students seeking services at campus mental health centers have anxiety, and for one-fourth that’s the sole concern, based on 160,014 students at 160 colleges last year.
A 2017 American College Health Association Survey of 63,000 college students found 2 in 5 described being so depressed they “struggled to function,” while 3 in 5 felt “overwhelming anxiety” during the previous year. Another study suggests 1 in 5 college students “are so stressed they consider suicide.”
“College counseling centers across the nation are pretty much at capacity,” says Nance Roy, who teaches at Yale School of Medicine and is chief clinical officer for The JED Foundation, which has 200-plus universities in its college suicide-prevention program. She calls the challenge “double-edged,” noting more students are seeking help because stigma has declined. “But it’s hard to keep up.”
Dozens of experts confirm anxiety’s increase — and college students may have a unique vulnerability because mental illness often appears amid the transition from childhood to adulthood. Of those struggling, some brought anxiety to college and others began to flounder there.
Experts call it the perfect storm: Young people are stepping into new, more independent roles, often miles from home, trying to define themselves, navigate relationships and make career and other decisions with potential lifelong impact. Meanwhile colleges, never designed as mental health centers, are inundated with mental health demands.
Sheer volume isn’t the only challenge. As students seek help for anxiety, depression, bipolar disorder, PTSD and other mental illnesses, their symptoms appear to be growing more severe, says Daniel Eisenberg, professor of health management and policy at the University of Michigan and director of the Healthy Minds Network, which researches teen and young adult mental health. His data suggests nearly half of students with serious need aren’t treated. Monthslong waiting lists and inadequate resources thwart efforts.
Students may not accurately assess their needs, either. Healthy Minds surveys routinely show students underestimate symptom severity, classifying as normal indicators a clinician would diagnose as mental illness.
While research in Journal of the American Academy of Child & Adolescent Psychiatry says 20-36 percent of college students exhibit “serious psychological distress,” just a third of those receive treatment.
At stake is whether struggling college students break through to healthy adulthood or break down. The ripples are far-reaching.
“Considering that students are a key population for determining the economic success of a country, colleges must take a greater urgency in addressing this issue,” says Randy P. Auerbach of Columbia University, lead author of a study published by The American Psychological Association finding other nations grapple with mental illness on campus, too.
Two facts jump out at Locke. He believes Americans are “oversold on the idea that any form of emotional distress requires professional help.” Conversely, though, “We are seeing debilitating levels of anxiety that are more and more common — where, by the time they get to college, students are so worried about different aspects of their lives it can be a real problem. Students struggling with very severe symptoms who don’t get treatment are likely to have consequences.”
As they grieved their terrible loss, Diane Orley and her son Sam, a high school senior when George died, searched for a way to help other college students address mental illness and prioritize mental health. They found a UM peer-to-peer network in its infancy.
Then-studentbody president Bobby Dishell says a handful of students had recently taken their lives, but people were reluctant to discuss personal mental health. Still, he noticed when they talked individually about mental illness, they were engaged and open.That was eye-opening to Dishell, who struggled himself with anxiety and depression. It reminded him of Harvard-Westlake School in Los Angeles, where he’d grown up. It had a popular “peer-led and facilitated” program.
That inspired the network he, a few other students and administrators were trying to launch. They wanted to offer students small groups of strangers who could become friends, who would listen, console and buoy each other.
They called it Wolverine Support Network, after the Michigan mascot.
Sam Orley became a founding member of the network, which launched its first small groups in winter 2015. Meanwhile, Diane Orley and a friend, Linda Aikens, raised $100,000 so the program would have money to spend for activities.
On a huge campus like the University of Michigan, with 30,000 undergrads and 16,000 graduate students, it could be easy to feel lost, even with campus clubs and other efforts to foster a sense of belonging. For students struggling with loneliness, mental illness, fledgling independence or rigors of a tough academic schedule, the network is designed to be an anchor forged of fellow students — a place to listen and be heard, to learn about resources and build community.
It’s not a mental illness program, says Sam Orley, executive director last year, before graduating. It’s a “holistic mental health and well-being effort” that’s spreading to other universities.
College is hard
Kelly Davis thinks parents and others minimize college students’ struggles. “There’s a lot of condescension — dismissal of how hard that period of life is,” says Davis, who directs peer advocacy, supports and services for Mental Health America.
It’s not just the challenging life stage. College life — the world, for that matter — has changed greatly in just a generation, she says, adding doubters should consider events just since the year 2000.
If you wonder what worries college students, ask them. That’s what the Deseret News did last spring. For nearly two hours, students in one of social work professor David Derezotes’ classes at the University of Utah talked about their anxiety and fears: Fear of being seen, imperfections and all. Fear of being invisible. Feeling uncertain and helpless with issues as diverse as environmental degradation and political discord. Fear of missing out. Fear of failure. Job competition. Substance abuse. Fear of being judged or excluded. Too many demands for time, for money, for “success” in its assorted definitions. Constant change. The cost of everything, from tuition to housing. Personal safety, including sexual assaults and school shootings. Peer pressure. Parental expectations. Inability to handle adversity. Social media comparisons. With the professor as scribe, the list blanketed the whiteboard spanning a wall in the spacious classroom.
At the end, a student looked at the list and sighed aloud. “The bar is just so high for everything,” she said, while another noted shyly that she’s grateful no one sees the chaos in her mind. Several students nodded sympathetically.
Anxiety and depression, paired or alone, are part of being human, says Kate Sweeny, psychology professor at University of California Riverside. Anxiety’s often helpful, a motivator and warning system to ward off danger. It’s trouble, though, if it can’t be made productive or overexaggerates a situation — common for highly anxious young adults.
Many college students have pondered “Am I good enough?” since they were children, especially if they’ve been propelled or pushed themselves toward particular universities. Parents often “helicopter” or “snowplow,” protecting children from failure. Without a chance to fail at small things, experts say children don’t build resilience for when stakes are higher, like during college. They say students also need to learn to live with some discomfort.
One can thrive despite a very rocky road, says Maggie Musso, 25, a member of Mental Health America’s peer leadership network. She was diagnosed with generalized anxiety disorder and obsessive-compulsive disorder at 13, near the end of her freshman year in high school. When she started having panic attacks several times daily at Notre Dame as an undergrad, she asked for a semester’s leave, but was forced to take a full year off, per standardized policy at the time. When she returned to school, she got involved in mental health issues and helped convince administrators to decide cases individually. She’s now a third-year medical student at Loyola, studying psychiatry, and still active in campus mental health.
Colleges try to ace this
Students arrive at college with varying degrees of eagerness to transition to adulthood. The realities of academics, finances and relationships may leave them lonely or overwhelmed. Even without mental illness, college students may have challenging lives. Some are chronically hungry, broke, sometimes even homeless.
Michael L. Sulkowski, psychologist and associate professor at University of Arizona, notes the “pace of life is getting faster,” and technology means what happens anywhere is an internet click away. “We’re all inundated with things that stress us out and cause anxiety.” Add to that facets of youth — less life experience and maturing but not fully developed brains — and souped-up stress among students is no surprise, he says. “Colleges aren’t necessarily built to provide mental health services as part of their mission statement. … I think they’re doing the best they can with the fact they’re under-resourced and deal with a huge systemic problem daily.”
Colleges aren’t necessarily built to provide mental health services as part of their mission statement. – Michael L. Sulkowski, psychologist and associate professor at University of Arizona
More young people than ever are in college, including students whose mental health struggles might have kept them out in the past, says Roy. But rising enrollment doesn’t explain the precipitous climb in mental health needs, says Lauren Weitzman, staff psychologist and director of the University of Utah Counseling Center. A year ago, 27 students were hospitalized for mental illness. “It used to be two or three a year,” she says.
Parents and incoming students need to know the campus' capabilities to deal with mental health issues, says Locke, who calls it "uneven." A community college might have one counselor for 20,000 students, which he calls “a disaster.” Small private liberal arts colleges might be able to provide robust services to lots of students.
Colleges coast to coast are beefing up counseling staff, promoting mindfulness practices and training faculty campuswide to watch for significant stress in their classrooms. The need is so great that some schools, like the U., earmark a few dollars from each student’s fees to bolster treatment services, while others, including UM and University of Illinois, have physically placed some of their mental health providers throughout campus on the theory that locating a therapist in a department makes services more accessible to those students.
Because resources are always in too-short supply, campus therapy and mental health services are often short-term. Many schools now task case managers with what psychologist Luke Henke, coordinator of peer initiatives for UM’s Counseling & Psychological Services, calls a “warm hand-off” to community professionals when students needs more than the university can provide. But insurance limitations, cost and student reluctance or inability to accept and manage outside help may form formidable barriers to care, he adds. And in some communities, waiting lists and therapist shortages are a fact of life.
What happens if students don’t get needed help? “Someone with public speaking phobia could potentially be pretty successful but still have great distress in specific situations — and they’ll probably avoid it,” Henke says. “Someone experiencing generalized anxiety disorder and most days pretty high levels of distress will probably see negative impact in relationships, in work, at school. At the very least, it just plain hurts.”
Small groups, big impacts
It’s the second week of fall quarter at Michigan, and Henke and a half-dozen Wolverine Support Network leaders sit in a circle under shade trees on this storied campus as hundreds of students bustle through the quadrangle yards away. Diane Orley’s there, too, and they’re discussing what they hope this year will bring. They expect 600 members, maybe more.
They hope students see value in building community, seeing different perspectives, learning skills, and being OK with who they are, no apologies, no pretense. Students spend too much time curating their identities, an activity experts know amps up anxiety.
WSN’s 69 facilitators and seven directors have risen through the ranks, as did new executive director Jordan Lazarus, 21, a senior from California studying cellular and molecular biology.
Henke and other mental health experts have trained these young adults to get the conversation in small group meetings rolling and to nudge it along if talk lags. They’ve learned listening strategies and know campus resources, so they can help students in crisis find help.
Watching them, a stranger gets a sense of what the weekly hourlong gatherings might be like: Just six to 10 people talking, a chance to speak and really be heard. The intent is genuine conversations with people outside their usual social — or unsociable — lives. Groups are formed based only on handy time and place, so they include people with different ideas, politics and backgrounds. The goal’s to become a small community where you can think through problems, stretch and also celebrate good news.
It’s not just for mental health: People who are lonely form connections. Those who are anxious can be directed to stress reduction and mental health resources. People who want to kick back have a different social outlet.
“Aside from my co-leader, I prefer not to have any prior relationship with my members,” says Jackson Gray, 20, an organizational studies major from Illinois. “I want to be comfortable sharing and not be worried that any prior relationships or opinions will come into play. Open and authentic.”
Says psychologist Henke, who meets weekly with group leaders to plan, “You don’t have to be any version of yourself that anyone thinks you should be or expects. You can just be yourself.”
Josh Felsher, 22, a senior studying economics and history from Missouri, joined the network to boost his mental and physical well-being. “I felt overwhelmed academically and socially. I felt like I was being pulled in several different directions and I could not truly discuss these feelings or issues with my friends and family.” He hoped he’d meet people with different thoughts and attitudes than his; the network didn’t disappoint.
Anyone can join a network group walk Sundays or hang out at the no-alcohol Kickback Fridays twice a month — anything from bowling or laser tag to karaoke or bingo and burritos. Some activities are packed, other times, the crowd is small. Gabriela Hirschler, 21, a communications and psychology major from California, remembers when just one member showed up. “But I think his life might have been saved,” she says earnestly. She’s benefited from the network. “Sometimes the simple act of being able to vocalize my stresses has helped me manage the anxious feelings that have stemmed from being on a college campus.”
The structure itself is special, says Noah Gassman, 20,a junior from New York majoring in psychology and political science. The deliberately loose, casual tone makes it “truly organic and great for fostering genuine conversation.”
Hudson Ling, 22 is a senior business major from California who likes the multiple perspectives networks offer. His father died when he was young and a peer network “diverted me from a bad path.” He joined the Wolverine group because “this is when I’m happiest, healthiest and when other people are, too.”
Psychologist Eric Endlich founded Top College Consultants to help students gain admission to the right college for them. He’s not surprised a peer-driven network helps students. Psychotherapy studies suggest “therapist-client relationship may be even more important than the actual therapy techniques involved. While peer support programs aren’t true psychotherapy, they do have the critical component of a caring relationship,” he says. He thinks anxious people often feel isolated and “different;” peer relationships can greatly reduce those feelings.
The support group is not intended to be therapy. Lazarus says the job is “facilitating vulnerability” — helping each other feel free to share in a physically, mentally safe space.
The network is growing in size and reach, spreading into other universities as The Support Network. The University of Cincinnati has Bearcat Support Network; Michigan State’s home to Spartan Support Network. The board offers guidance, but WSN director of program development Stefan Santrach, 21, a senior and business major from nearby Novi, Michigan, is quick to quash any notion of monetary gain. “We want them to have money for their goals, not ours.”
Sam Orley now works in the San Francisco area and serves on the board of the newly incorporated nonprofit The Support Network. He thinks his brother George might still be here, if only the network had been around when he was struggling. His mom’s not sure of that, but she is absolutely certain the group helps college students every day by linking them to peers.