Chemical Reactions: The reality behind mental illness in college

We imagine college as an enchanting place where hundreds of new friends are waiting for you. The reality of moving away from home and coming to school is a bit bleaker.

It’s much easier to talk about the great house parties than the crippling stress and pressure that comes along with being in college. When the reality sinks in, it's not only a wake up call, but also can seriously take a toll on someone’s mental health.

And because of the stigma against mental health, it's not easy for a student to call home and admit that they're struggling.

Many mental illnesses begin to appear between the ages of 16 and 24. That, combined with the stress of transitioning to college, can attribute to developing anxiety, depression and other mental illnesses.

According to Dr. Rhea Merck, a psychology professor at USC, adapting to college sets a challenge for many students.

She knows there are a large number of students experiencing a variety of mental health issues on campuses everywhere, but it’s nearly impossible to know exactly how many because so many of these struggling students resist coming forward.

In fact, only 37.7 percent of college students receive psychological or mental health services according to the American College Health Association.

Nearly everything about a student’s life changes when they go to college — social networks, schedules, activities, even the water that they drink. Drastic changes are stressful,and not everyone is equipped to handle that. In the midst of all this change, anyone with an underlying predisposition for a mental illness is likely to begin experiencing problems.

“It’s like adding sunshine and water to a seed,” Merck says.

But coming to college is only part of the equation.

The leading mental health issues among college students in 2015 were social anxiety and academic distress, followed by generalized anxiety, then depression, according to the Center for Collegiate Mental Health annual report. The Association for University and College Counseling Center Directors tells us other common concerns of students receiving mental health services stemmed from relationship problems, suicidal ideation, alcohol abuse, sexual assault, self-injury and ADHD. There's a wide range of concerns students are reporting, but few come forward to talk about the problems they’re facing according to Merck.

It's been proven that counseling services can improve academic performance, so the question remains: Why don’t students more frequently take advantage of the mental health services universities offer? At the end of the day, it all comes down to stigma.

Merck says many students are afraid to admit they’re struggling or feel like they’re failing if they ask for help. Some fear someone will tell them what they’re experiencing isn’t valid. Mental health isn’t something people like talking about because with it often comes shame. While the general views on mental illness have been gradually improving through awareness over decades, there’s still plenty of destigmatizing to be done.

Aside from centuries of these false perceptions being spread about the reality of mental illness, much of this stigma comes from the separation of mental and general health, not only in the public eye, but also through much of the health care system.

The first step to beating the stigma is integration of these health services, says Dr. Mark Kilgus, USC health center psychiatrist and former department chair of psychiatry at Virginia Tech.

“The reality is there is a biological basis for so much mental illness that it’s kind of a false dichotomy now,” he said.

Kilgus believes the two are too integrated to separate them, considering nearly all mental illnesses can have serious physical symptoms.Despite some common views, mental health is  just as physical as a broken leg, and treatment should be prioritized as much. Just because there’s no cast doesn’t mean there isn’t a healing process.

“Before the age of biological psychiatry, it was supposedly just a spiritual issue or a psychological issue, not a biological issue. People thought it was all in your head,” he said. “Well, it literally is all in your head because there’s a three pound organ in there that is responsible for a lot of these symptoms.”

Mental health is thought of as a taboo by many, so people are more likely to ignore their symptoms and wait until they’ve reached a severe state to reach out for help. In Merck’s point of view, the more people spread awareness about mental illness, the more hopeful the picture becomes.

“I think that if students get the idea that a lot of these big problems can be headed off early, prevention works, and it works well,” Merck said. “By then, they haven’t flunked out of their classes, lost weeks of attendance. What happens when it goes untreated is that everything starts to fall apart underneath you, and the hole gets bigger and bigger.”

According to a survey on mental health by the National Alliance on Mental Illness, 73 percent of the respondents said they experienced a mental health crisis in college, yet 35 percent of those students said their college did not know about their crisis. Due to the isolation of one student in a pool of thousands of others, many self diagnose.

USC’s counseling center's goal is to reach out to students before they reach a critical point. Tobin Lovell, assistant director for community- based services at the counseling center, is one of many working toward making the counseling center more accessible on campus.

“Our goal is to not wait for students to come into the counseling center but to make counseling center services more available in a preventative fashion to students outside,” he said.

The biggest challenge, Lovell said, is overcoming the stigma that surrounds mental health problems and getting treatment. Beating this stigma starts with more visibility of counseling on campus and letting students know that reaching out for help is not only important but admirable.

“It is strong to reach out for help. It is strong to seek counseling center services, and it is effective,” he said. “The way to bust the stigma is to say, 'Wait a minute, health is health.' If you look at health holistically, there is no difference between mental and physical illness.”

In this case, USC is actually ahead of the game. Counseling and psychiatric services are done within the university health care system and kept in-house, rather than contracted out to third-party counselors, like many other universities. By hiring their own psychologists and psychiatrists, the university is able to more successfully integrate mental and physical health services.

As for the future of the counseling center, they’re taking the integration plan a step further. The university is planning to continue expanding their services across campus by joining the counseling and general health services in the new building being constructed between the existing health center and the library, which is set to open in July 2017.

Counselors like Kilgus hope that physically connecting the health center and the counseling center into two buildings will decrease the stigma and integrate health in a more holistic fashion.

“It’s not medical and mental,” Kilgus said. “It’s all medical.”