Balancing Mental Health Concerns and Academic Concerns

College Search & Selection
1

Hi. I am a parent of a HS Jr who is intelligent and high-achieving (high SATs, high GPA in AP classes, etc) but has also suffered from depression (including hospitalization at one point) and chronic fatigue.

We’ve been searching for colleges–she is overwhelmed by the process, so I have been putting together a curated list of schools and hoping she would choose from those. Looking for mental health support on campus is part of what I consider when putting together the list.

My question is how to balance her need for a low-stress, supportive environment and her ability to complete advanced work. I don’t want her to lose out on opportunities from a peer group/classes at a higher level but don’t want her to be totally unchallenged either.

Given the choice, though, I’d rather have her be a little bored/unchallenged than worry about her not coming home at all if her stress becomes overwhelming enough that she considers suicide.

We are in the Washington DC suburbs, and would hopefully find a school within a couple of hours drive to provide even more of a safety net.

Any suggestions welcome on how to navigate this tricky balancing act.

2

I don’t have specific advice, but hugs!! I think you are handling things well. Our son was diagnosed with a serious mental illness as a college freshman, and in hindsight I wish we had brought him home and had him enroll in our small local university. He ended up in crisis at the beginning of his sophomore year and had to fly home on the next available plane, literally. The stress of college shouldn’t be underestimated - it can seem overwhelming to kids who struggle with a mental illness.

3

Mental health trumps academics always. I would not count on the campus counseling center anywhere to deal with a history of severe illness, so I would find a private counselor, hopefully on your insurance, and establish a relationship that is ongoing in any college town. You have good local options in DC like UVA etc.

4

I second the suggestion to find a private therapist and/or psychiatrist off-campus.

5

My concern was more about having a strong and visible mental health support system on campus so it is easy for her to find help if needed AND that it is easy for those around her (roommates, RAs, professors) to find out what to do to help her if needed. As well as a committment to general wellness/stress reduction activities for everyone on campus. Also a strong freshman program to help her become integrated into campus and develop relationships.

Of course, if the general atmosphere on campus is stress-filled, all those things won’t make up for it.

Finding off-campus support is a great idea to supplement, but I do want the on-campus support to be easy to access.

6

I’d suggest considering liberal arts colleges. Smaller size and student-to-faculty ratio make it more likely that students will be supported in various ways. Excellent LACs within a few hours’ drive of DC include Haverford, Bryn Mawr, and Washington & Lee. I’m not familiar with their mental health services, though. Best wishes to you and your family in this process.

7

This article from NAMI has some valuable suggestions and also includes a link that will give you a list of schools with NAMI
chapters on campus.

I echo @roycroftmom that mental health is the number one priority.

https://www.nami.org/Find-Support/Teens-Young-Adults/Managing-a-Mental-Health-Condition-in-College

8

On-campus mental health services are almost always completely overwhelmed. A two-week waiting period is more or less average. I’d definitely look for a school where she can access off-campus therapists.

I agree with @inboston’s suggestion about a smaller LAC, and hopefully one that fits her personality well. I think the social aspect of college is so, so important for undergrads to engage and thrive.

9

Your concerns are on target and your questions good. Yes, health trumps school. That is overwhelmingly the most important thing. Going to a “good” college and graduating in four years can feel really, really important. In the long run, though, managing a student’s’ medical needs are truly critical.

Many students deal with mental health issues today, and schools are necessarily ramping up mental health counseling capacity. I know my alma matter has about 30-40% more students than when I attended, and students visit the health center for counseling 10x to 20x times as often.

I don’t know much about schools with particularly strong mental health counseling. In general, I’d recommend smaller schools without reputations as being academically competitive or party schools. Alcohol is very prevalent at most schools, and unfortunately it is not helpful for students with mental health issues. But at some schools it is a much more central part of social life than others.

I’d also suggest a school that you could reach by car in a day, if you think a crisis is a real possibility, or just that being available might be helpful.

If you are in the DC area, I’d think about looking at Dickinson College, St. Mary’s (in MD), Muhlenberg College, Susquehanna University. What about a women’s college? I think they might make it a little easier to find a supportive environment. Smith and Mount Holyoke are excellent schools and members of the Five College Consortium (with Amherst, Hampshire, and U Mass Amherst). Students can take some classes and take advantage of other opportunities at the member schools. Maybe also Wellesley, which has a stunning campus and is also a great school. These schools are farther away, but you can get there in a day.

https://www.fivecolleges.edu

Also, if you and your daughter feel like farther is okay, maybe look at Sewanee. Also great academics, but I’m really thinking that just being in nature is great for people in general, including people with mental health concerns, and it is on top of a mountain, with nature all around. It’s beautiful and has outstanding academics.

http://www.sewanee.edu/student-life/university-wellness-center/

http://admission.sewanee.edu

Truly, these schools will give a student the same quality academics as anywhere. I just suggest them as possibilities, and maybe you can explore mental health services at any that feel like they might be good fits, to both of you. Good luck, enjoy the college selection process, feel like it’s about fit and a positive environment, and it all will be a much more pleasant endeavor!

10

Not all LACs are laid back and not all larger schools are impersonal behemoths. In fact it can be the opposite. And don’t assume that a small cloistered environment may not be probalamtic. Especially if you don’t fit in or feel like you’re under a microscope. I would personally suggest a mid size school and not one so socially intimidating as Washington and lee. Mid size for the personal attention but big enough to give you room to breathe. And a safe and protected campus.

Examples in your area. William and Mary. University of Richmond. VT.

11

If she had cancer you probably would not rely much on the campus health clinic as your first stop for your daughter. This is no different. Long waits, turnover in staff, and short term, limited support are the norm-the counseling office isn’t designed for anything other than brief and occasional visits at any college. That is their function, not comprehensive emotional support. Think carefully before relying on campus services for this (or for cancer, too, for that matter).

12

You might also remember that friends, roommates, resident advisors and professors may not notice or choose to intervene to assist your child. It would be nice if they did, but you can not count on it.

13

What are her areas of interest, academically?

This is so tough, because our messed-up culture equates high achievement with high productivity and competitiveness. Students like your daughter highlight this, but so many who can withstand the stresses of a high-stress environment would still be so much better off if they could have a healthier and more balanced lifestyle without sacrificing intellectual rigor.

How do you and she feel about keeping her academic load lighter even if it means taking longer to graduate? Some schools are very “all or nothing” but others are more flexible in this regard.

14

We are looking at many of the colleges suggested above, which makes me feel like we are on the right track… But even with her high stats, she is a maybe for William and Mary or Haverford, which concerns me about stress level when she is there.

She would prefer a small-to-medium sized school (bigger than her HS of 2000 kids but not more than 7000 students). She has expressed an interest in science, (biology related) but is less sure about that than she was earlier.
I’ve been thinking about schools that would be considered a “safety” academically as a way to ramp down the stress level overall (and increase affordability on our end if she gets merit aid) but it is hard to shut out the “you need to go to the “highest” college you can” voices that surround all of us.

Lightening the academic load is an idea to keep in mind–thanks for that.
I’m hoping some AP credits might at least give a little wiggle room toward that end, another way to lighten the pressure.

15

Another factor to consider: privacy laws

If you rely heavily on campus based support, and she runs into trouble, both HIPPA and FERPA may end up being obstacles. Even if there is great support on campus, be sure you are familiar with the local hospitals and outpatient programs. Consider filing Healthcare Proxy or other appropriate paperwork with them ahead of time, so they know they are authorized to talk with you, and don’t have to rely on her telling them in the middle of a crisis. Also, don’t expect to rely on roommates, classmates, or professors to push her to get help, because all to often it doesn’t happen - and it’s not a fair burden to place on her roommate, who will have her own stressors to worry about.

My advice would be to call the disability service offices (you will want their help arranging any accommodations if she needs them), and counseling services, and it would be appropriate to visit their offices as well. You will want to find out how frequently they can use counseling services under the student health plan, and what options are available that would be covered by your own health plan. Sometimes the on campus counselors work there part time, and also have private practices, so she could continue with the same counselor under your insurance.

16

A relatively self-contained small Honors College within a larger “safety school” might strike the right balance, too.

I’ve heard good things about the Cook Honors College, just to give one example. https://www.iup.edu/honors/

You just have to evaluate very case-by-case, because some so-called Honors Colleges are much more porous than others.

How self-directed is your d? If she is internally driven and likes to do her own thing, then the flexibility of a more “alternative” school like Hampshire might give her the flexibility she needs to pace herself. (But some kids - mine for example! - are more stressed by having to self-structure rather than by having structure provided for them, so YMMV.)
New College of FL is another in this genre, with a bit more structure than Hampshire I believe, but narrative evaluations instead of grades and a very progressive and lower-stress vibe.

One downside is that a significant drug culture often goes along with the “alternative” type schools, so you’d have to judge whether this could create a risky situation for your d or whether she has a good head on her shoulders in that regard.

On the high-structure but not high-pressure end of things, there’s St. John’s in Annapolis, where she could spend four years being a Renaissance Person and soaking up a Great Books based curriculum with a supportive cohort of like-minded peers. (There is math and science covered, not just humanities - they just use primary sources for all subjects.) If she enjoys reading, writing, discussing, and being evaluated qualitatively rather than being focused on grades, it might be something to consider. While no college is stress-free, this approach definitely brings out the love-of-learning aspect over the need to perform, which seems like a big step in the right direction to me… but it’s definitely not for everyone.

Then there’s the “better mental health through nature” approach. College of the Atlantic is super-tiny but has a really interesting and possibly emotional-health-promoting curriculum: https://www.coa.edu/academics/human-ecology-degree/ Or, http://www.greenmtn.edu/academics/undergraduate/honors-program/ There’s also Eckerd College in Tampa, which has the Gulf Coast version of a nature-centric campus, is very strong in life sciences, and is supposed to be the most pet-friendly campus in America (Are you considering the Emotional Support Animal route?) Has an Honors Program too.

I don’t know if anything from the stream of consciousness above will help, but fwiw :slight_smile:

17

Thanks, all. Maybe I need to clarify–I would not count on campus services or roommates, but it seems that some schools make a concerted effort to anticipate problems and work on prevention, including very prominently featuring info on what to do if you have concerns about a student, while others have the same info/supports but only if someone is really looking for them. We would, of course, prefer the former over the latter–not because they will solve all her problems, but because they are providing more opportunities for support and assistance–improving the odds, nothing more.
The biggest quandary is the one of choosing the “level” of school. Finding that sweet spot between “too easy” and “too hard”. Lots of kids face the same issue, but the consequences seem greater in her case.

18

Ha! We just talked to the Hampshire rep at a college fair this week. It was definitely a little too out there for her (even for me and I am way more of a hippie than she is!)

College of the Atlantic is awesome, except for the part about being in Maine for the winter (which lasts until from about October to April, IME ) Although we have considered a few rural-ish schools that definitely have access to nature as a big plus, so that track is worth exploring, just in a slightly warmer location.

I don’t think she is interested in going to Florida–she is not a fan of the south in general for political reasons.

And St John’s would definitely not be her scene at all.
Honors colleges are definitely on our radar, just need to find one that has all the pieces we need.

I appreciate all the suggestions–thanks!

19

I think it’s a mistake to rely on on-campus mental health services. Their MO is assess and refer. They do a quick evaluation and then to refer to other services, like stress-reduction classes, outside therapists, psychiatric evaluation, or social resources like LBGQT organizations. And, as someone else upthread said, the counseling centers often have long waits for appointments. The counselors are not equipped to deal with serious mental illness, and they’re not available 24/7.

My recommendation is to find a college in close proximity to a strong, academically affiliated hospital with psychiatric services. Of course, any place in or near Boston, NY, Philly, or DC would qualify. A lot of smaller cities have good medicine too. Albany, NY has good medicine, so maybe Skidmore, in Saratoga, could be a possibility. UMASS Memorial is in Worcester, which is home to Clark University, a small, supportive college. Pittsburgh has excellent medicine, so maybe take a look at University of Pittsburgh.

So bottom line, don’t rely on university services. Get her set up with a private psychotherapist so that she has a go-to person who responds to emergencies. Make sure she knows where the nearest hospital is. And, as someone else above suggested, have her name you as her agent on a healthcare proxy. Once she is 18, you have no access to information, even in an emergency and even if she’s on your insurance. Have her sign one for your home state and another for the state where she goes to college. Scan it and keep it on your phone.

20

Completely agree. Also - and I don’t mean to sound too cynical here - if there is any whisper of liability, the school (any school) will tend to protect itself.