College mental health: How to provide care for students in need

College mental health services can be valuable training venues for senior psychiatric residents and child and adolescent fellows.⁹ College students can provide exposure to a broad array of problems—such as anxiety disorders, obsessive-compulsive disorder, dysthymic disorder, adjustment disorders, and panic disorder—that psychiatric trainees may not confront in a hospital clinic. Students are particularly responsive to short-term talk therapies with or without medication management, and working with this population can be a strong antidote to the “therapeutic nihilism”—the unfortunate sense that talk therapies are of limited effectiveness and that only pharmacotherapy can help psychiatric problems—often experienced by psychiatric trainees who spend much of their time working with patients with serious, chronic illnesses. Psychiatric residents can be particularly helpful in managing student patients who require combined medication and talk therapy.

College-based psychiatrists are well suited for educating residents about developmental issues of “emerging adulthood,” including:

• exploration of and anxieties about relationships and sexuality
• balancing connectedness to family with increasing sense of autonomy and independence
• establishing personal life goals and values and career choices and goals.¹⁰

College counseling services also are an excellent setting for residents to learn principles of community mental health and medico-legal concepts related to confidentiality, duty to warn, and disability law.¹¹

Treatment outside college

Because college students have high rates of substance abuse¹² and other psychiatric disorders, it is important for psychiatrists who treat these patients in private practice or community-based clinics to develop a basic awareness of and competency in relevant developmental and clinical issues. Psychiatrists who work in emergency services in areas with high concentrations of college students need to be particularly attuned to issues related to college mental health, substance abuse, and life on campus.⁸

Related Resources

• The Jed Foundation. www.jedfoundation.org.
• National Research Consortium of Counseling Centers in Higher Education. www.cmhc.utexas.edu/researchconsortium.html.

Disclosure

Dr. Schwartz reports no financial relationship with any companies whose products are mentioned in this article or with manufacturers of competing products.