Talking with parents is something I rarely did when I began my job as a college psychiatrist twenty-five years ago. However, in response to students coming to my office with more complex problems and severe symptoms, I have tried to get parents involved with the hope of strengthening the student’s support system.
Before I call their parents, I have the student sign a release of information form. Then, I usually put their parents on speaker phone with the student in the room. I say something like:
“I recommend your daughter take antidepressants, but she thought you would be against this. I wanted to include you in the discussion as I think it’s important that she start medication, since her depression is making it hard for her to complete her school work. Let’s discuss your concerns and review the risks and benefits of medication.”
“Your son has been feeling overwhelmed by school and has stopped going to class. Sometimes he has thoughts of hurting himself. We are trying to decide if he should go home or enter the hospital. We wanted your feedback about what you think is best.”
Nowadays, I find myself having more conversations like these with the parents of my patients. While the college years have always been a time when mental health problems can emerge, the problems have escalated in the last seven years according to data from the American College Health Association (ACHA) survey. In the ACHA 2011 National College Health Assessment survey, 21% of college students were diagnosed with at least one mental health disorder, including 12% with anxiety and 11% with depression. By comparison the 2018 survey found 30% of college students were diagnosed with at least one mental health disorder in the last year, including 22% with anxiety and 18% with depression. This shows a significant increase and the need for more support for students, especially during times of increased stress.
So, what specific actions can parents take in the face of rising mental health problems? Can they teach their children coping skills to deal with extreme academic pressure? How do they recognize the difference between a sad mood and depression? Would they know what to say or do if their child expressed suicidal thoughts?
I answer these and other questions in my book, The Campus Cure: A Parent’s Guide to Mental Health and Wellness for College Students. The twelve chapters cover conditions like depression, anxiety, substance abuse and eating disorders; pressures like loneliness, perfectionism, cultural challenges and financial stress; and crises including suicidality, sexual assault and psychosis.
Each chapter tells the story of how a parent helped navigate their child’s journey of recovery. This book is my way of offering hope to parents who often feel overwhelmed and alone when their child struggles. It mentions NAMI and other groups that provide support and guidance to families.
Here are a few tips from the book for parents to prevent, respond to and treat common campus challenges. Remember the five Ts: Tell, Test, Teach, Talk, Take Action.
1. Tell Your Child They Can Come To You With Any Problem.
Your child may avoid sharing problems with you because they think they should be independent or they worry about burdening you. Explain that you can handle any problem they present to you. They can come to you day or night.
2. Test Their Academic Health By Checking Their End Of Semester Grades.
At the start of college, request your child sign a FERPA waiver form allowing you to view grades. I have seen students not tell parents that they are doing poorly or failing, thinking they should be able to solve academic problems on their own. When their grades continue to slide, they could develop symptoms of depression and anxiety. If you’re aware of their academic struggles early on, you can link your child to campus resources like advisors, tutors, professors, success coaches and therapists.
3. Teach Them How To Recognize Depression And Anxiety.
While many parents talk with their children about preventing drug abuse and sexual assault, they rarely educate them about depression and anxiety. You can teach your child the warning signs and that these are common and treatable conditions. With this knowledge, they may seek help more quickly.
4. Talk With Them More Often Or Visit If They Are In Distress.
Some students will inform their parents that they are in distress and ask for help, while other students won’t tell parents until the situation is more serious. Keep in touch by Skype or Facetime or another app, so you can both see their face and hear their voice. Make sure you visit your child in the fall of freshman year either at parents’ weekend or another time, since the first semester of college is a time of high stress. Ask about friends and how they like their classes. If they tell you they are in distress or if you suspect it, encourage them to speak with a counselor. You can also call more often or visit if you are concerned. A visit can provide them enough support to work through a problem and continue to keep up with schoolwork.
5. Take Action If Your Student Is Experiencing High-Risk Mental Health Concerns.
If your child is experiencing severe symptoms of mental illness such as suicidal thoughts or psychosis, it’s essential to ensure they’re actively engaged in treatment. Request they sign a release of information form allowing you to speak with their mental health provider. If you feel your child’s safety is at immediate risk, contact campus police, administration and mental health services.
I am grateful to the parents of the patients I have worked with over the years who have heroically stepped up when their child needed help. My wish is that the stories told in The Campus Curewill offer other parents the hope and skills to help their child’s recovery.
Marcia Morris, M.D. is the author of The Campus Cure: A Parent’s Guide to Mental Health and Wellness for College Students. She is an Associate Professor of Psychiatry and Associate Program Director for Student Health Psychiatry at the University of Florida. Her college parenting blog appears in Psychology Today.