Mental Illness and the transition to college

Parents Forum
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What we wish we did differently? Kept her closer to home, chosen a less academically stressful school. Maybe her therapist can discuss these options with her and she might be more open to them, than coming from parents. However I do agree that larger schools might have more resources and systems in place than a smaller school. The group sessions to prepare for college is an excellent idea too, if she is not open to gap year.

Our school provided good support, classroom and exam accommodations, allowed her to keep a pet as therapy animal. (we were open about all information) After initial few sessions with campus health counsellors they referred her to private therapists and drs close to campus. This proved crucial in having help at hand and someone for her to call who knows her. We got to know her roommates/friends and exchanged contacts. Although we had not told them any medical information, they noticed when something was wrong and alerted us.
In the end being on the right meds made all the difference, if that is already the case with your daughter, then she is on the right track.

This is a side question , what is hospitalization in cases of depression supposed to accomplish? Our experience with it was confusing. There was no change in medications or treatment while in hospital, seemed like just a big waiting game. She was released after two weeks of getting even more frustrated.I agree she was kept safe and that was invaluable, but is that the main reason? Depression meds take a long time to become effective, so even a change in meds would not show improvement within the week or two of hospitalization. Would appreciate some clarity.

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Overseasmom - thank you for your response. I am hearing the message about keeping her close to home loud and clear. In my ideal world, she would take a gap year and then do a year or two locally before heading off to a school farther away. I’m torn between the idea of a small school with a more personal touch and a larger school with more resources available. (My oldest is a freshman at a very small LAC and I am amazed at the sense of community and support they provide - things I think will be essential for my daughter to help her be successful.)

In my experience, the hospitalization for depression isn’t therapeutic, although sometimes medication changes occur. Mostly, it serves to provide 24 hour supervision at a moment of crisis. The environment of most adolescent inpatient mental health units is so chaotic that it doesn’t lend itself to any real therapy happening.

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Some schools have a limit of visits for psych services and then want the student to find outside provider. Some schools offer space on campus for outside providers. This helps as otherwise it’s hard to find someone, make appointments and get off campus. Also he does some sessions on skype with his therapist at home.

Regisitering with disabilites office helps if there are specific accomodations. Also helps in case anxiety/depression increase at midterms and finals and suddenly accomodations are needed!

Are meds currently stable? Changing meds can be a challenge at school, as you have to deal with unexpected side effects. DS was on a med that had him sleeping 18 hours a day. He needed to get off that.

DS also did not want to take a gap year, and wanted to continue at school. Unless there’s a specific plan for a gap year, I would be reluctant. Being at home and all friends are away at school, what wouid she be doing.

Last recommendation, Tuition Insurance if available.

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I have been on CC for a couple of years, and this is the first time I am posting, mainly because this community does such a good job in replying, that I have nothing to add. On this subject though, I do have a lot of experience. I could have posted the same question 2 years ago.
My post though is the positive one. My DD is 1050 miles away from home, finished her freshman year in an engineering program that is on the quarter system and now working on the co-op part of her program while living on campus( 26,000 student enrollment). It can be done.
Post #16 has a lot of the answers. First she must stable for what she, you, her therapist and her psychiatrist deem is an appropriate time. Contingency plans need to be made for when things go downhill (and they will).
We chose not to advise the school itself. She made use of the counselling office (there is a limit at her school, but she did not meet the max). We have the information as to services near her school if necessary, but she comes back home for her psychiatric follow ups (every 3 months- we schedule them around holidays and time off) and she calls her psychologist that she has from here and does a skype or phone session when necessary (usually around exam time and end of project time)
I did a lot of the therapy with her when she was in high school( a requirement of the DBT program we went through). This actually helped in establishing a bond of trust between us, so she was more likely to tell me when she felt she was going downhill. She then trusted me when I would suggest that it was time for some follow-up. That helped a lot.
I also visited her for a couple(2) of days A LOT. I started 2 weeks after she moved in, 2 weeks later, and the 3 weeks a few times and then once a month. When she is set to come home, I don’t visit, so it actually was not as much as it sounds. We are down to an every 4-6 weeks now. I go on the weekend and treat her to something she has not been able to do in the city
A big thing that seems to have worked for her is joining the club on campus that promotes mental health. At her campus it’s called something like “creative minds”. They have talks, go out on campus disseminating information to others, and from talking with other students, she realizes she is not alone with this problem. I think it helps her.
Sorry for the length. I know how scary this is. You can pm me if you have any specific questions. Good luck

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I have one child with serious medical problems and one child with a serious psychiatric diagnosis (originally “bipolar 1 with psychotic features”). I did not limit their choices in any way. I felt that was up to them. I drove the one with medical problems halfway across the country twice, to encourage freedom of choice (maybe overcompensating a bit) but she stayed an hour away. The one with a psych. illness went to a small LAC about 4 hours away, and I drove there when there was a crisis (only twice in a year). She had had a relatively recent hospitalization when she first went.

We did a full neuropsych. evaluation on the second daughter which did turn up some processing issues and also resulted in an additional diagnosis of ADHD inattentive.

I wrote the letter listing accommodations myself and asked the psychiatrist to sign. In my experience, neither medical nor psych. professionals know what to list. Thanks to Google we listed single room, excused absences (yes, these were granted), reduced courseload if needed (with financial aid for the extra time on campus), extended time on assignments, postponed tests or exams, and for my first daughter, testing in a separate room (she has some medical devices that require attention during an exam).

Every college is different. Often the office for disabilities serves more of a “guard dog of the curriculum” function, because colleges really do want to preserve their programs and standards. Accommodations cannot pose undue financial or administrative burdens and cannot substantially change the academic program. These murky areas are being dealt with in court at times and so policies evolve with the law.

The office for disabilities mainly gives each student a letter which the student then gives to the professor, and the student is supposed to advocate for him or herself.

In our experience, it is usually a dean of some sort who actually makes accommodations happen, coordinates documentation of a visit to the doctor or clinic (sometimes required for an accommodation like postponement of exam or extension on paper), and many times, in our experience, that dean will tell the professor, in no uncertain terms, to accommodate the student. Often they are empathetic, but let’s face it, the school also doesn’t want legal or media trouble.

Support services can include psychiatry and counseling, extra advising or tutoring, help with time management and so on.

I asked my daughter to make an appointment with the campus psychiatrist when she got there (rural LAC). She did not like the MD and that was the only appointment. She relied on a wonderful advisor mostly. And on my drives up there (one time I took her to a motel to have a soothing weekend away).

Tuition refund insurance is a must. We used it three times for two of our three children.

Make sure all physical causes for anxiety or depression are covered, of course.

Finally, I think it helps to have a long range view. Going to college in the “normal” way is important for your daughter, and she should probably be able to choose where she wants to go unless she is actively psychotic or suicidal, in which case this discussion is irrelevant. If it doesn’t work out, it really won’t be a disaster. My daughter had a great year at the LAC, but didn’t take her meds for the beginning of sophomore year (I didn’t know- guess what I would have done differently) and left after two weeks.

A couple of bumpy years but things are great right now and she is doing college a little differently, part-time, while she engages in an art form she loves, works two jobs, and lives with friends. She is very happy and productive. The right meds are so important. (It may take a few years for compliance in some cases though!) At any rate, these diagnoses are not doom.

Another young woman we know with anxiety and depression is determined to do college the “normal” way but does a reduced course load. She lives in a dorm and focuses on school most of the time.

Different strokes.

The main thing is that these things can work out over time, even if not in the way you now expect. Safety is paramount. As long as our kids are safe, there is a lot of room to zig and zag in life :slight_smile:

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Thanks Bminfla and Compmom - it is really reassuring to hear your stories. We’ve had a few years to come to terms with the fact that success is not a straight line for anyone, but especially not for someone with mental illness. The advice on tuition insurance is especially helpful - I wasn’t even aware that it existed. I will be looking in to it.

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Folks on this thread may want to see the Chronicle of Higher Education’s new 26-page report, “Today’s Anguished Students and How to Help Them.” A parent’s “College Wish for My Son,” especially. The Chronicle is usually behind a paywall, but you can download this pdf for free if you fill out their simple form. (See the sidebar on this page):

http://chronicle.com/article/Students-Who-Feel-Emotionally/233684

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I remember reading a similar article in 1969. Seriously. There was no Internet then so can’t cite it!

A distinction needs to be made between emotional struggle versus clinical conditions that are brain-based and not primarily situational in nature.

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I printed this and will read later. At the risk of making a thread drift, I will say that I am always so shocked when I find out how many college freshmen have never been away from home before or done things independently. I think it’s a recipe for disaster if the child has never been away for more than a day or two.

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Lots to ponder. A small school could be more nurturing. But don’t underestimate the warm fuzzy paretn value of being able take the kid to Sunday brunch to asses the stress level etc. (

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Make sure any tuition insurance does not exclude MI conditions.

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@ovrseasmom I think modern stays in phosp are designed mainly to ensure safety of self and others and not really for therapeutic treatment. This has been driven by the managed care system and deinstitutionalization movement/regs, it seems to me. The long treatments prior to the, say 1980s, where a med wash and adjusted med therapies could be tried are long gone. This also leaves no space or time for non-drug inpatient therapies to be used. Imho.

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I certainly agree with the joint planning with the students, parents and current therapist. There are some things I think need to be in place before the student arrives on campus. First, if the student will use a community therapist, please find that person before the beginning of college and start a relationship, if possible. I never understood why parents wanted to wait until the student arrive before finding a community therapist. Is there a belief that high school graduation produces something that postpones or prevents a mental health crisis or is a mental health problem going to politely wait until later in the fall until it becomes apparent.

College is not trivial. Mental illness is not trivial.

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Agreed on the importance of tuition insurance, learnt the hard way. Check out www.collegerefund.com

@dyiu13 @llamBehini thank you for your thoughts on the hospitalization question. It does confirm what was our impression. Although in the few months prior Drs referred to it as a last resort fix all. Or maybe that was our hopeful misunderstanding, thinking it was the last resort option like surgery that would provide a miraculous cure. They said there would be intensive therapy and again talked of it as an intense treatment that was needed. But there was no change in treatment and no one on one therapy, only group. And when everyone in the group is at a different level of functioning it really doesn’t accomplish anything at all, and is in fact quite scary. Overall an experience that lead to more frustration and scared of what the options are if a crisis happens.
Anyone else can share their thoughts?

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This doesn’t necessarily apply to OP’s kid, but parents of kids with mental health issues need to consider how their kid’s roommate will be affected. (I know a few kids greatly stressed by their roommate’s issues–including addiction, OCD, depression. Imagine finding your roommate dead by suicide. . .) Honestly ask yourself what kind of burden (if any) is my kid going to put on the roommate/staff? If it seems too risky, don’t put your kid (and others’ kids) in that position.

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Tuition insurance can cover MI but only if there is hospitalization.

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My son has been hospitalized three times. The first two times weren’t so helpful, but the one in February was. He was there for four full weeks. The doctor on his hall was wonderful - spent a lot of time getting to know him. It was due to the efforts of the doctor and the social worker that my son was placed in an excellent group home. Otherwise, he would have been on a waiting list for a year or two! So it depends on the particular treatment team a patient ends up with. Some are good, and some aren’t. During my son’s second hospital stay in 2013, I was so upset at the lack of care that I called his regular psychiatrist in tears. That doctor called up the head of the hospital and let him have it! All of a sudden, I saw action! So mama bears can get results sometimes.

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It’s really hard to know how a child will fare once she gets to school. My daughter was very stable when she started college, but the week before finals in the spring semester, had a major relapse of her anxiety, depression and cutting. She didn’t sleep for 48 hours straight (that alone can make a person crazy), so she had to come home until her meds were adjusted and she became stable. She did finish the year. Her sophomore year went a lot better, but we had much more realistic expectations once we realized that this may be something she has to deal with the rest of her life.

Hormones, stress, and life circumstances can all affect mental health, and may require adjustments to medications that had worked just fine for months. Now, after a break-up and the death of a professor she admired, our daughter, who is studying in France this year, is in trouble again and we’re going over there to see what we can do and whether she will be able to finish out the year there.

We didn’t send her blindly hoping for the best. Before we allowed her to go over, we required her to sort out the details, including getting a year’s worth of medication, finding a therapist overseas and dealing with our insurance company. We did this not to make things harder, but to make sure she could handle herself and that she could find the resources she needed. At the very least, you should require something similar of your daughter before you let her go to college in another state. There are no guarantees that all will go well, but at least you and she can be assured that she knows how to take care of herself.

If at any point, you think she really isn’t ready to go to college right away, don’t hesitate to play the mom card. There is no shame in a gap year and she shouldn’t go if she’s not at her best.

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Thanks to everyone who has shared their family’s story. It is really helpful to hear what has worked, what hasn’t and just that other people are dealing with the same issues. Parenting a kid with mental health concerns can be lonely, and I often feel like I am wandering through the wilderness without a map.

Massmomm, I am sorry to hear that your daughter is struggling. I hope that she is in a good enough state of mind that she can access the resources available to her.

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Dewar’s covers withdrawal without hospitalization.