This looks like a decent initial run-down of issues and ideas, but I’d love to hear from parents who’ve been through this - what worked, what didn’t, advice for those starting out.
You can expect a kid whose symptoms are not controlled to get worse under stress. I’m kind of an extremist, but I want a kid to be asymptomatic before going far away to a residential college. That may take years – it did for me. I think that’s OK. College will still be there. And whatever you’re doing at home that’s working (medication, therapy, both) must continue at college.
Of course, asymptomatic people can have a recurrence. But the odds are a lot better if you can get the problem under control at home.
It takes a lot to get both the mental illnesses appropriately treated and have a young adult develop the tools to manage such an illness. Some illnesses compromise both quality of life and safety.
Agree with Hanna that health is the priority and college process should work around that. Families who are aware of a problem pre-college have an advantage, as treatment can be grounded with familial support from the start and relevant variables stirred into the college search. As the late teens or early twenties are common ages of onset, some students find themselves ill for the first time in a new environment; tough for all.
My advice would be to use what you know and in no way expect that college will provide a “geographic cure.” Confer with your student’s treatment team and keep it realistic. Build in lots of support pro-actively; they can always be reduced later. There are many ways to make college work and it is good to minimize false starts and overwhelmed students.
Hanna, many illnesses, whether medical or psychiatric (often a false distinction in my opinion) are chronic and an “asymptomatic” situation may not be possible. This is the reason for college disabiilties offices and accommodations. Students with a wide variety of challenges can still be successful given the right accommodations and support.
That said, any family dealing with either medical or psychiatric disorders should expect the road to be bumpy, be open to medical leaves, changes in plans, changes in course load or intensity of program, and will need to earn resilience, keep relationships trusting, and develop faith in the long term even when the short term is discouraging.
Well, that’s true, but it’s also true that far-away colleges and dorm life are not for everyone. IMHO, families may be too eager for the child to go away because it’s a cultural expectation in the community. They may also confuse admission to a prestigious university with a sign that the student is medically as well as academically ready. If the child has a chronic condition requiring ongoing monitoring, parents should view this challenge skeptically.
I’ve experienced firsthand, and we’ve seen many threads on CC, noting the huge detriment to roommates and floormates when a peer is decompensating in shared space. Dorm life is a communal exercise. Families need to take into account the possible impact on others as well as the potential pros and cons for their child.
And families need to recognize that the roommate is a 17 or 18 year old with zero mental health training or awareness. The RA is a 20 year old who has gone through a few training sessions and roleplay’s on “how to deal with conflict” or “how to negotiate boundaries when living in tight quarters”. Neither the RA nor the roommate can be expected to be alert to early warning signs, understand the side effects of medication (unless they are spelled out in detail) etc.
I see so many families feeling betrayed that the roommate didn’t get the kid back into therapy when the kid decided to stop (As if…) I see families who think the roommate has a legal obligation to call them if they notice something is amiss. And these same families- who sometimes had enormous difficulty keeping the kid compliant with meds and treatment think an RA is going to police it and do a bed check, monitor the diet?
Dose of reality. SOME roommates become besties and take care of each other, and wouldn’t hesitate to call a kids parents if something started to feel off. SOME roommates loathe each other, and figure out how to co-exist without interacting. SOME RA’s will be acutely sensitive to a kid whose patterns seem off suddenly, but some RA’s are going through their own existential crises and are just there to handle lock-outs and to call maintenance when a towel bar falls off the wall.
This thread is more than a little disturbing so far…
Students with chronic conditions have a legal right to attend college wherever they want (and get in) with whatever accommodations enable them to function at their best. There are families whose kids are fully treated and who are fully educated on the condition, who nevertheless expect the chronic condition to continue, whether in flares or on a more continuous basis.
Noone should expect a roommate or RA to handle problems that come up. Students with chronic conditions should register with disabilities services, medical health services, or mental health services, and have a dean or other administrator in the mix. the attitude here seems to be that students with chronic conditions should just stay home so a roommate doesn’t have to deal with them.
Are you saying that a student with type 1 diabetes, who may have low blood sugars and has a number of medical devices in the room, should not attend a residential college? How about a student with asthma, or epilepsy? Now consider a student with bipolar disorder or major depressive disorder.
And single rooms are a frequent accommodation anyway.
Wow, @compmom i see where you’re coming from but its a bit apple/orangey. Let’s take a kid with type I diabetes…if that kid had trouble staying on top of that condition in high school, I could make an argument that he/she should attend a local college with perhaps a slower transition (a freshman at NYU died last week after she forgot to monitor her blood sugar). But, for the most part, many physical ailments stay at consistent levels whether a kid is at a local college or away at college. Mental health issues are different, in my mind. Many of these issues worsen or even begin in college and it’s really dependent on each family…some kids can handle it, others can’t…yes, a kid can “legally” go where-ever he wants to college…but harder to say whether it’s the best move.
"Students with chronic conditions have a legal right to attend college wherever they want (and get in) with whatever accommodations enable them to function at their best. "
Of course they do. The OP’s question is how families determine the best ways to exercise that right.
The dorm life issue is an ethical question, not a legal one. No one has to care, or teach their children to care, about whether they may terrify their floormates. That’s a choice. But I believe it’s something families should take into consideration, because a major lesson I’d like students to gain from dorm life is how to get along with other people. That means everyone thinks about their neighbors’ needs.
My freshman floor was all single rooms, but that didn’t help us very much when a troubled student was repeatedly in hysterics in the hallway and the RAs were helpless. It wasn’t her fault. But she shouldn’t have been in that dorm.
I’m not suggesting that a student stay home. But I know several families who assumed that the roommate would be acting in loco parentis… and I think that’s unfair to both their own child and to the roommate. A physician (whether a psychiatrist or not) in health services has the training and the resources to deal with a student who has ongoing mental health issues. An 18 year old stranger does not.
Reality check time.
Thanks, all. I don’t think this is anyone’s first choice, but as @compmom points out, there may not be an asymptomatic period. And in putting together the support team and structures, it’s certainly a mistake to assume that roommates or RAs will be a part of that.
In my experience, chronic health conditions do not stay at consistent levels at all (including type 1 diabetes, which is tough to manage in some cases regardless of conscientious self-care). Lupus flares, asthma flares, seizures break through meds. In the same way, a kid on Lithium may have some breakthrough,agitation. People with chronic conditions cannot hide in their homes until they are better: the conditions never do truly get better.
This discussion is portraying mental illness as if it is either treated and “asymptomatic” or some kind of nightmare for others. This is a false dichotomy,
Hanna, I am sorry you had a hard experience. But it has left you with some prejudices.
The issue of parental expectations is separate from the rights ot students. It is too bad if some parents rely on roommates. To met, that is unimaginable.
If a student is having too much trouble to function well at school, academically or in the dorm or any other way, generally schools will intervene. There is usually a procedure and various requirements for returning.
There are all kinds of ways to do college or not do college, over a few or many years, at home or close to home or far away, with a family, with a full-time job, living in a half-way house, whatever. Families and students dealing with chronic conditions will make their own choices which may change over time. But it is absurd to suggest that anyone with a chronic disorder- which by definition does not have long periods of remission- should not attend if they want to.
“People with chronic conditions cannot hide in their homes until they are better”
Who’s setting up a false dichotomy now?
"Students with chronic conditions have a legal right to attend college wherever they want (and get in) with whatever accommodations enable them to function at their best. "
Not “whatever accommodations” … schools do not have a legal obligation to do whatever the student wants them to do. They need to make reasonable accommodations, but that does not mean that students can or will get any and every accommodation they want. It’s not that I am unsympathetic, believe me - but at the same time, I think it’s important to realize that schools will do what they can, but that is not always what a person might want done. It’s important to talk to the school first to be honest about a condition and make sure that the accommodations they can make will be acceptable to the student.
The phrase is taken out of context: it belongs with the rest of the sentence. The standard for accommodations at colleges is lower than at the elementary, middle or high school level and to some extent is still being defined. Accommodations cannot change the curriculum and cannot pose an undue financial or administrative burden for the college. Since the definition of the standard is both complex and evolving, I chose to simply write “whatever accommodations enable them to function at their best,” which is a functional description based on the “level playing field” idea rather than legal language.
@Hanna, is this realistic? I mean, did you NOT EVEN apply to college until you were non-symptomatic? Or did you go, then take a leave of absence from Harvard (after starting) until you were non-symtomatic? It seems to me that gaining admission after a mental health post-high-school-graduation gap is problematic.
I would also note that problems that flare up in the college environment are difficult to treat unless the student is in the college environment. So a support strategy should be in place, but the student probably needs to wade in, or the problem will remain occult and the student will remain at a stale-mate.
Student disability offices vary. Sometimes they will not take an appointment, or if they do they will not discuss a specific case, until the student is registered and enrolled. It makes it really difficult to strategize.
The best strategy is to attend school in a location where you are familiar with, or can put in place, a support structure ahead of time (therapists, psychiatrists, coaches, whatever), with all the contingencies you can think of. Then wade in at the level the student can handle. Maybe that means going, taking a break and processing what happened that term, then going back. Multiple times.
College is a learning experience, and for many it is as much emotional/somatic learning as it is intellectual. There are few alternative crucibles for this necessary growth and development.
“I mean, did you NOT EVEN apply to college until you were non-symptomatic?”
That’s right. I took two gap years.
“It seems to me that gaining admission after a mental health post-high-school-graduation gap is problematic.”
What makes you think so? I work with students in this position every year. They do just as well as their numbers would predict, if not better. Much more importantly, they do better after enrolling in college.
The very high level of competition and the need to explain any gap years would seem to me to make admissions more problematic. It is refreshing to hear that is not the case!
How does one confront a problem that presents mainly in a school environment, though? How do you solve a non-problem in anticipation for going to school?
Written words are hard to gauge: I am being sincere in my questions. Thank you for your posts!
“How do you solve a non-problem in anticipation for going to school?”
Of course, you can’t predict a problem. Mental health issues that arise during college have to be dealt with in real time. I interpreted the OP’s question about “those starting out” to be directed at families where a problem arose during high school.
Some people are never (reliably) asymptomatic, as wrote before, and that applies to many medical as well as psychiatric disorders.
I agree with Hanna that the gap year post high school (for mental health or any other reason) is rarely a negative and often a positive.
Hanna, we are talking apples and oranges here. If I had a child with a new condition that had not yet been clarified or treated of course it would be wise to wait. But with well-established continuing/chronic issues that have been fully diagnosed and planned for, it is misguided to wait for a person to be fully “asymptomatic” since that might not ever happen. I feel that your use of that term assumes that people can be cured or treated so effectively that there are no symptoms, and that is not the case for many who should nevertheless go to college and who often thrive despite their challenges.