Mental Health Challenges for College Students

For high school seniors graduating this spring, making the transition this fall from living at home to living on a college campus may be an exciting but also daunting experience, especially if they’ve been navigating mental health issues. At home, students may have a strong support system and mental health care providers they trust. But campus may be an unfamiliar setting where it takes time to build a new support network of friends and providers. With rising rates of depression and anxiety in college students during the COVID-19 pandemic, packing for college needs to include creating a care plan and finding new resources.

“Many college campuses have affiliated clinics and hospitals with mental health services,” says Aude Henin, PhD, psychologist in the Department of Psychiatry at Mass General. “But it is important to research how to access those services in advance, before a student is in need of them.”

Why do college students struggle with mental health?

Many college students experience mental health challenges. This moment in their lives is full of new independence, responsibilities, and pressures. They’re making new friends, managing academic stress and coping with financial worries. Students are navigating many unique changes and challenges amidst a pandemic. They may not have experienced these stresses or managed them on their own to the same degree as when they were living at home with their parents.

“It is important to have a conversation with your existing mental health provider about coordinating care when you’re in a new place with different resources, especially when moving out of state will likely necessitate a change in provider due to licensing laws,” says Eugene Beresin, MD, Executive Director, The Clay Center for Young Healthy Minds; Senior Educator in Child and Adolescent Psychiatry in the Department of Psychiatry at Massachusetts General Hospital. “Advanced planning can help ease the stress of this transition for students and their parents.”

Tips for planning the transition to college

Tip 1: Create a mental health plan now.

“Plan for the worst-case scenario, not the best,” says Dr. Henin. “It’s better to have scaffolding in place if they need it rather than scrambling if things start to fall apart.”

Do research on what mental health programs exist within the college or university’s health system and how to access them. Can you register in advance to become a patient so you’re already in the system? Is there a waiting list you can get on now? Is there an emergency phone number you can add to your contact list on your cell phone?

Beyond clinical care, another important part of a mental health plan is self-care. In this video from The Clay Center, college students share what practices have helped them navigate stressful times. There are also a broad array of resources — many new and innovative, often founded by students or recent grads — that offer mental health support for students. They do not, of course, replace professional help, and are meant only to supplement counseling services and treatment.

The Clay Center for Young Healthy Minds at Mass General is a free, practical, online educational resource dedicated to promoting and supporting the mental, emotional, and behavioral well-being of children, teens, and young adults.

Clay Center college-related resources

Tip 2: Coordinate care with your existing psychiatrist or therapist.

It is important to coordinate care with your existing behavioral health providers and start this conversation as soon as you know you’re moving.

“Continuity of care can be challenging if a student is going to school out of state because licensing laws don’t allow for providers to practice across state lines including telehealth care,” says Dr. Beresin. “This law isn’t in the best interest of the patient, but it’s what we have to deal with, so I try to make referrals to providers in the state where my patient is moving.”

This means that you may need to have providers at home and providers at school—ensuring communication between these providers will greatly improve your care and well-being.

Tip 3: Research educational accommodations for mental health conditions.

Post-secondary institutions in the US that receive federal funding (most do) have to offer reasonable educational and/or housing accommodations for identified disabilities to allow all students access to the curriculum. Many mental health conditions such as anxiety disorders, mood disorders, learning disabilities, autism spectrum disorders, and ADHD may qualify. If you had an IEP or 504 in secondary school, that can make it easier to obtain them in college. Getting these accommodations involves collaboration with the college student disability/accessibility services center and may require specific documentation and procedures. 

Dr. Henin recommends starting the process early to make sure that things are in place before the start of school.

Tip 4: Talk openly about plans for privacy and sharing information.

“This can be a thorny issue and one that parents and the college student need to have conversations about,” says Dr. Henin. “Involving parents, guardians or other trusted adults can be important to increase support. I often remind students that there is a difference between being independent and doing things alone.”

Dr. Henin notes that students will have the most autonomy and voice when they plan ahead around potential difficulties and let others know how they can be most helpful and most supportive.

Most colleges will not share academic or mental health information about a student with parents unless the student signs permission giving parents access to this information. This can be important to set up in some instances and students can designate what information can be shared and for how long.

Tip 5: There are many paths to success. Focus on what is best for you.

For some students, a more gradual transition to college will be a better fit. For others, taking a structured gap year to work on specific skills and/or gain life experience may be a good first step. Pay attention to your own style, needs, and goals rather than getting stuck in doing things the “right” way or timeline like everyone else.

Dr. Henin reminds students that if you find yourself struggling at college; even if you have to transfer, drop out or take a medical leave, please don’t lose hope or think that you can’t do it. Many, many students have had to pivot or change course. 

“In my experience, although these can be difficult choices in the moment, students can figure things out (with support) and can be successful in reaching their goals.”