Mental Health Warning Signs to Look Out For This Semester
After many months of uncertainty, students have finally returned to college and university campuses across the country. But that doesn’t mean the uncertainty has gone away, and there are many reasons why the normal stresses of university life continue to be compounded by factors directly or indirectly related to the pandemic. Social distancing and so much time spent away from the natural bustle of college campuses has led to an increase in social anxiety for many young people. Some of them have had difficult events occur in their lives, such as the loss of jobs or loved ones. And with widely varying and frequently changing rules regarding masks and vaccinations across universities and states, many students feel additional stress about their health and safety and that of their loved ones, as well as confusion about the guidelines.
While many students self-advocate for their well-being and seek out campus counseling services when needed, there are various reasons why some of them do not, even if they are struggling. For this reason, it will be helpful for university faculty and staff to look out for possible warning signs indicating that a student may be in need of help.
A Problem Predating the Pandemic
It’s helpful to first recognize that even though the pandemic has created and exacerbated numerous problems, it has not created an entirely new mental health crisis. For years now, in college campuses across the U.S., there had already been a significant increase in the mental health challenges that students were facing. In 2019, a full year before the pandemic, the American Psychological Association reported new research showing a dramatic increase in the rates of depression among young people aged 18 to 25, surging 63 percent from 2009 to 2017 (from 8.1 percent to 13.2 percent). The same report also showed that rates of suicidal thoughts or suicide-related outcomes increased 47 percent among the same age group during roughly the same time period (from 7 percent to 10.3 percent). A study by San Diego State University showed that rates of moderate-to-severe anxiety among college students nearly doubled from 2013 to 2018.
Those of us who work in campus counseling centers have been witnessing these challenges firsthand. Between 2009 and 2015, counseling center utilization across the nation rose by an average of 30 to 40 percent while enrollment only increased by 5 percent during the same period. In 2019, nearly 90 percent of counseling centers reported an increase in students seeking mental health services over the previous year, according to a report from the Association for University and College Counseling Center Directors.
Again, what this data shows is that an increased need for campus counseling services had been occurring well before the pandemic, but the pandemic added to students’ stress levels and negatively affected their lives in various ways. Keeping the broader context in mind can help faculty and staff to appreciate the scale of what today’s students are experiencing.
Noticing the Possible Danger Signs
Students need to be reminded that it is OK to not be OK.
Given this overall increase in students’ mental health challenges, faculty and staff can play an important role in maintaining the health and well-being of the student body. Because some students need help but do not seek it for various reasons, faculty and staff (as well as students’ friends and family members) can be on the lookout for a range of danger signs that can indicate a student is struggling. Though the signs may vary, the underlying commonality is that they are all changes in behavior that could be considered unusual or unexpected. Some examples of behavioral changes to keep an eye out for include the following:
- Acute anxiety or panic
- A noticeable decline in academic performance
- Frequent absence from class
- Social isolation and withdrawal
- Dependency on advisor/professor/staff member
- Low energy, lack of motivation
- Changes in appetite, weight, personal hygiene
- Increase in risky and/or unhealthy behaviors
Something to keep in mind is that even changes in behavior that might be interpreted as “positive” may point to a problem if the change seems too abrupt, unnatural or extreme. A sudden surge in exuberant mood, confidence or energy, and especially if it fluctuates, could potentially indicate the presence of bipolar disorder or a substance use disorder, for example. A student who has been struggling with depression and suddenly and abruptly appears happy and carefree could indicate that they are experiencing relief due to making a decision to end their life.
To gain skills in spotting warning signs, faculty and staff can pursue training in Mental Health First Aid. They should also learn about campus emergency plans for connecting a suicidal student with the appropriate support and be aware of their duties to report Title IX issues.
The First Line of Defense
Generally speaking, faculty and staff are the ones who see students most often other than their friends and classmates. You are thus positioned to be among the first to notice any of the aforementioned warning signals. If you do notice something, you should definitely bring it up with the student—but in private and in a quiet, relaxed setting, if possible (an empty classroom or private office can work well for this purpose). This minimizes any embarrassment and the likelihood that the student may become defensive or evasive. Honestly express what you’ve noticed in as caring, sensitive and non-judgmental a way as possible and listen attentively to what they are willing to share.
While a staff or faculty member’s role isn’t to counsel the student per se, it may take some back-and-forth conversing before a student is able to share that they are struggling. In the process, take care not to make any promises regarding confidentiality. It’s not uncommon for students to admit that something is indeed going on but that they would like what they share to be kept confidential. A good response to such a request is something like, “I’ll try my best, but there are some situations that I would be required to report.”
If the student says they are fine, which is fairly common even if they do have something going on, you want to respect their answer. However, you can leave them with the knowledge that there is a campus counseling center and ask if they have the phone number in the event that they do want to talk to somebody at any point in the future. Many colleges also have an early alert system, so if your intuition tells you that something is wrong despite the student’s assertions of being fine, then it may be worth filling out an early alert form so that others who are linked to the student in some way—such as academic advisors, mentors or life coaches—can also keep an eye out.
Finally, it is always helpful to try to destigmatize and normalize the need for help, both in private conversations as well as in everyday contexts in the classroom and on campus. Students need to be reminded that it is OK to not be OK. Not all students experiencing distress want or need counseling services, but it is always helpful to be reminded that seeking emotional support is a healthy and positive thing to do.
For persisting concerns, faculty and staff can contact the campus counseling center for consultation on how to help the student and how to help connect them with support.
Prevention Is Better Than Reaction
One of the reasons why it’s important to look for mental health warning signs is that it’s far more effective, and ultimately easier on everyone involved, to take preventative action than to respond reactively when a student’s mental health challenge has become serious. We know from the research that interventions work at alleviating students’ mental health challenges and at increasing their social, educational and economic well-being. This, in turn, helps their academic performance and helps them to stay enrolled. Conversely, it reduces the known negative impacts of mental health struggles on students’ well-being and academic performance.
Professors and staff members have certainly had to face their own set of challenges throughout the pandemic. To ask them to pay attention and notice if their students are exhibiting mental health danger signs is therefore not an insignificant thing to ask. But when the benefits of doing so are stacked up against the potential risks of not doing so, it becomes clear that it is in the best interests of everyone who is part of a college or university to help look after the well-being of the students who have been entrusted to us.