Sky-High College Costs and Student Mental Health Care

Track star and Ivy-League freshman student Madison Holleran, age 19, had been a “happy go lucky,” though achievement-oriented, kid all her life, according to her father.  She had no history of mental illness.  At home for Christmas break last year, she broke down and told her parents that she had been having suicidal thoughts and was depressed.  Her mother said that “I was shocked.  She’s never been depressed before,” according to the Daily Mail.  “I knew she needed a therapist, but I couldn’t get her an appointment because it was the weekend.

Madison seemed to respond somewhat to the TLC she received at home.  Her parents begged her to transfer to an easier school and not go back to UPenn, but she insisted.  Back in the dorms, she declined again.  Her father texted her to plead that she see a regular therapist and consider anti-depressant medication, and Madison agreed.  But the pretty, bright young woman simply ran out of time.  Later that same day, she walked to the top of a parking structure off-campus and jumped to her death, leaving behind a suicide note in which she mentioned the pain of being “locked in.”

There does appear to be something of a mental health crisis on American campuses.  University counseling centers are reporting being overwhelmed with the sheer flow of student patients, who often have to wait weeks for sessions even when in desperation.

“We know that colleges have actually increased their staffing and increased their budgets in many, many cases,” said Dr. Victor Schwartz, the medical director for the JED Foundation and the former medical director of counseling services at New York University.  “It hasn’t kept up with the demand. As much as they seem to increase, students are coming in. There does seem to be a very, very large need.”

But the body count suggests that the American university system is not ramping up its capacity with anything resembling enough effort. 

Financial anxiety and hopelessness may be playing a role.  After the Great Recession began in 2008, a steady uptick in youthful suicides started that still hasn’t abated.  In 2008 the rate was 9.9 per 100,000 young people (defined as those aged 15-24); in 2013 the rate was 10.9.  (The rate is still around half that of the highest class of those killing themselves, middle-aged men, which has been steadily increasing for the last 15 years.)  But any steady trend upward is disturbing nonetheless, and it is particularly heartbreaking to see in the young.

The cost of college is skyrocketing with no end in sight, forcing most students to go into massive debt to finance their four-year education.  “The average amount of student loan debt again crept up for the Class of 2013, and is approaching $30,000,” according to US News and World Report in 2014.  Could the specter of debt have contributed to Madison Holleran’s depression?  We don’t know.  Her family did say that she viewed her 3.5 GPA at UPenn as unacceptable to her sense of self.

In 2011, the American College Health Association-National College Health Assessment ACHA-NCHA – a nationwide survey of college students at 2- and 4-year institutions – found that about 30 percent of college students reported feeling "so depressed that it was difficult to function" at some time in the past year.  While most depressed people are not suicidal, most suicidal people are depressed, and it is obviously in the depressed group of college students that most of the suicide prevention work needs to take place.

The College Board found that the average cost of tuition and fees for the 2014-2015 school year was $31,231 at private colleges, $9,139 for state residents at public colleges, and $22,958 for out-of-state residents attending public universities.  With these astronomical and rising sums being levied upon our children and their parents, you would think it would not be too much to ask for Higher Ed, Inc. to do the following:

  1. Heavily increase the number of counselors to screen and treat depressed college students so the backlog in patients can be dispelled.
  2. Spend money raising consciousness on campus about the warning signs of depression and suicide.
  3. Consider mandatory twice-annual mental health inventory screening for all students, with the results kept confidential for the students’ benefit and possible voluntary referral to campus counseling.

If the stigma of mental illness is not going to end, let us at least resolve to badger those responsible for the care of our children while they are in college to provide the same level of mental health care now afforded to students’ physical health care.

Christopher S. Carson, a lawyer, was formerly a Kohler fellow at the Wisconsin Policy Research Institute.

Track star and Ivy-League freshman student Madison Holleran, age 19, had been a “happy go lucky,” though achievement-oriented, kid all her life, according to her father.  She had no history of mental illness.  At home for Christmas break last year, she broke down and told her parents that she had been having suicidal thoughts and was depressed.  Her mother said that “I was shocked.  She’s never been depressed before,” according to the Daily Mail.  “I knew she needed a therapist, but I couldn’t get her an appointment because it was the weekend.

Madison seemed to respond somewhat to the TLC she received at home.  Her parents begged her to transfer to an easier school and not go back to UPenn, but she insisted.  Back in the dorms, she declined again.  Her father texted her to plead that she see a regular therapist and consider anti-depressant medication, and Madison agreed.  But the pretty, bright young woman simply ran out of time.  Later that same day, she walked to the top of a parking structure off-campus and jumped to her death, leaving behind a suicide note in which she mentioned the pain of being “locked in.”

There does appear to be something of a mental health crisis on American campuses.  University counseling centers are reporting being overwhelmed with the sheer flow of student patients, who often have to wait weeks for sessions even when in desperation.

“We know that colleges have actually increased their staffing and increased their budgets in many, many cases,” said Dr. Victor Schwartz, the medical director for the JED Foundation and the former medical director of counseling services at New York University.  “It hasn’t kept up with the demand. As much as they seem to increase, students are coming in. There does seem to be a very, very large need.”

But the body count suggests that the American university system is not ramping up its capacity with anything resembling enough effort. 

Financial anxiety and hopelessness may be playing a role.  After the Great Recession began in 2008, a steady uptick in youthful suicides started that still hasn’t abated.  In 2008 the rate was 9.9 per 100,000 young people (defined as those aged 15-24); in 2013 the rate was 10.9.  (The rate is still around half that of the highest class of those killing themselves, middle-aged men, which has been steadily increasing for the last 15 years.)  But any steady trend upward is disturbing nonetheless, and it is particularly heartbreaking to see in the young.

The cost of college is skyrocketing with no end in sight, forcing most students to go into massive debt to finance their four-year education.  “The average amount of student loan debt again crept up for the Class of 2013, and is approaching $30,000,” according to US News and World Report in 2014.  Could the specter of debt have contributed to Madison Holleran’s depression?  We don’t know.  Her family did say that she viewed her 3.5 GPA at UPenn as unacceptable to her sense of self.

In 2011, the American College Health Association-National College Health Assessment ACHA-NCHA – a nationwide survey of college students at 2- and 4-year institutions – found that about 30 percent of college students reported feeling "so depressed that it was difficult to function" at some time in the past year.  While most depressed people are not suicidal, most suicidal people are depressed, and it is obviously in the depressed group of college students that most of the suicide prevention work needs to take place.

The College Board found that the average cost of tuition and fees for the 2014-2015 school year was $31,231 at private colleges, $9,139 for state residents at public colleges, and $22,958 for out-of-state residents attending public universities.  With these astronomical and rising sums being levied upon our children and their parents, you would think it would not be too much to ask for Higher Ed, Inc. to do the following:

  1. Heavily increase the number of counselors to screen and treat depressed college students so the backlog in patients can be dispelled.
  2. Spend money raising consciousness on campus about the warning signs of depression and suicide.
  3. Consider mandatory twice-annual mental health inventory screening for all students, with the results kept confidential for the students’ benefit and possible voluntary referral to campus counseling.

If the stigma of mental illness is not going to end, let us at least resolve to badger those responsible for the care of our children while they are in college to provide the same level of mental health care now afforded to students’ physical health care.

Christopher S. Carson, a lawyer, was formerly a Kohler fellow at the Wisconsin Policy Research Institute.