Mental Health Support on College Campuses: What Parents Need to Know

Most larger universities like Indiana University (close to where my office is located) have health programs called CAPS which stands for Counseling and Psychological Service. They are often staffed with licensed therapists/counselors and psychiatrists with a range of experience and expertise. Their primary goal is to act as a stabilizing resource for most mental/behavioral health or substance use issues. Many university CAPS typically offer individual, group and couples counseling along with occassional free workshops. Here’s the list from IU CAPS on what they typical help with:

  • Academic Concerns
  • Relationship Concerns
  • Stress Management
  • Power and Privilege
  • Time Management Help
  • Sleeping Issues
  • Adjusting to College Life
  • Anxiety
  • Depression
  • Substance Use
  • Body Image, Eating, and Exercise Concerns
  • Sexual Assault or Abuse

They have the same confidentiality requirements as counselors like me off campus but are limited in many ways. CAPS limits the number of unpaid sessions (IU CAPS allows for two) and mandates that a student must be working with one of their counselors if they want to meet with a psychiatrist for medication management/evaluation. Here’s a breakdown of IU CAPS fees:

COUNSELING  With IU Health Fee  W/O IU Health Fee
First two sessions (per semester) No charge $55 per session
Additional full sessions $30 per session $55 per session
Additional half sessions $20 per half session $35 per half session
Additional group counseling $15 per 60 min. session

$17 per 90 min. session

$29 per 60 min. session

$35 per 90 min. session

PSYCHIATRY
First visit $55 $105
Follow-up visit $30 per visit $55 per visit

IU CAPS does not accept insurance but does provide a super detailed invoice to be submitted to a student’s insurance company for reimbursement.
Over the last few years, I’ve noticed many CAPS programs around the country have had a huge increase in demand for their services while also having budget cuts or mediocre increases that leave them without the full team of professionals they need for each semester. At IU CAPS, every one counselor is responsible for 2,110 students (yikes!). This is not a new problem at IU and not isolated to IU.

So what can a parent or student do? If CAPS doesn’t seem like a good option, look for a therapist/counselor convenient to campus who specializes in college students. Therapists should be flexible to accommodate busy course loads and social events. In my practice, I have extended evening and weekend hours since many students a slammed with class 9-4pm most days. It’s also important that the therapist be willing to talk with parents and provide updates and suggestions. Parents can sometimes feel like their kids are a million miles away. A good therapist can often act as a bridge and lower the anxiety associated with having kids at school.

Finally, talk with CAPS (or encourage your son or daughter to) the first week of school. It’s easier to cancel an appointment than to stand in line after all the students are back on campus. The intake process should be thorough and your kid shoul feel like the therapist/counselor will really understand their issues and help.

How to Prepare Your College Student for the Semester

Holy moly, it’s almost August again and classes are just around the corner. Time to dust off the ‘how to’ guides for parents. Here are a few favorite tips from the last few years that parents have found helpful.

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  1. Organization. Organization is a concept, not a tool. Identify tools they can and will use. Make sure they are using the calendar app on their phone. Have them figure out the best use of online tools the school provides. Many students need the help of a counselor they see 1-2x per month to help oversee their organization habits and tools. Get this all figured out before the car is packed.
  2. GPA. Talk about what, if any, expectations you have for overall as well as per-course GPA. It’s a bit late to tell them at Thanksgiving dinner you wanted to see a 3.75 GPA for the semester. Best to discuss this in July and August. Make it realistic but also challenging. They are not going on vacation. They are coming to school to earn a degree and have some fun (after the work is done).
  3. Appointments. What ever appointments need to happen leading up to or during the school year, have your little college kid get them setup and on the calendar now. It’s not too early to get the dentist appointment scheduled. If they take any type of medication, do not assume they can just have a walk-in appointment for a refill. Get this scheduled now (especially if they need to find and work with a psychiatrist for antidepressants or antianxiety meds).
  4. Contact. How long is too long before you start to worry? Make it clear that if you text/call them, you expect a response (even a lame one) within XX hours. Stick to it. We all know they will get busy (or sleepy or drunk or distracted) but having you worry day after day is unnecessary if they simply check in regularly.
  5. Scheduling. Kind of along the same line as appointments above, one of the most powerful sessions I have with students leading up to classes cranking is sitting down with their schedule and putting EVERY assignment, test, meeting, etc. into their calendar. Most professors post their syllabus on the school’s intranet and every student has access. Every syllabus is required to have all dates/times of classes as well as assignments and tests.
    But wait, there’s more!
    After we plug in all the items from the syllabus, we reverse-engineer. For example, if Mary has a test September 18 for Calc, we schedule back one week for studying (start September 11). For each day, we carve out 1 hour for studying (eg. Mon, Sept 11 3:00pm-4:00pm Review Calc). This makes it so each study session is a known, expected quantity with a specific day and time.For more insider tips, tricks and ways to support your college kid, contact me

Indiana University Students: Anxiety, Depression and Drug Use (and how to fix them)

Since moving to Bloomington, home of Indiana University, a few things have become clear. One – everyone here wears red clothing, drives a red car or paints a room in their house red. They don’t mess around with school pride.

Second thing I’ve noticed is the super-driven nature of IU students. They are high achievers and have big goals. Awesome. Big goals are great. Unfortunately, these same students are often not equipped for the challenges of living on their own and the intense academic load. Anxiety, depression and drug use are common here (as with most other big schools). Since there are so few counselors/psychotherapists in the area, I see a heavy load of students, especially when the pressure starts to creep in around mid-September. The partying picks up, parents are gone and classes start to dial-up intensity. It’s a toxic mix.

A great place to start is IU.

IU offers respite in the form of their counseling center (CAPS) but it’s a) triaging a problem, b) only short term and c) often doesn’t get to the underlying issues which are often years in the making. Don’t get me wrong, CAPS does a great job and the best they can considering how underfunded they are. The first two sessions for each semester are free. Each following session is $30. They generally have a waitlist so I recommend that students sign-up early.

CAPS also offers psychiatric care for those needing medical attention, like help or oversight with medication. The wait list is often even longer since there are fewer psychiatrists than counselors. Psychiatric visits are not covered under student health fees so insurance or out of pocket payment is expected.

For those struggling with more serious drug issues, IU offers OASIS/Journey. Students that sign-up for Journey get an assessment to determine the best level of care. Staff then decide between two evidence-based interventions in both group and individual settings, the Journey Program operates under 3 phases, designed to provide progressively more attention based on the student’s need.

Students referred from the Office of Student Ethics are charged $200. Alcohol and drug charges are applied separately. If a student was found responsible for both an alcohol and drug policy violation within the same incident, they get billed $400. For non-offense participants,they get charged a one-time fee of $25.00 after their first visit.

If IU doesn’t have the availability or discretion you and your family needs, reach out to me. If I can’t help, I’m happy to provide insight into other providers in the area who can.

The best thing for parents to do is start searching for professional support either through IU or the community in July and August. Getting appointments set and providers lined-up will be much easier when the semester has not started. Once the semester starts, a good counselor will work closely with parents and the school to ensure that everyone is aware of progress and prepared in case the students experiences more severe issues.

Hopefully, your son and daughter will not need any of this but if they do, act early and expect everyone to act as a team.

Spring Semester Planning for Kids Returning to College

You made it! The kids made it home, the in-laws were tolerable and there weren’t a ton of gifts that needed returning. Now that everyone is headed back to campus, it’s time to either let that old anxiety creep in or spend some time on the front end helping your son or daughter develop a plan to be successful for Spring Semester.

Money

If you have not learned by now, discuss how much you are giving to your kid and when you’ll give it to them. You don’t want to find yourself in a defensive position Sunday night while your son is blowing up your phone begging for their regular spending money to be put into their account early. I recommend putting money into the account 2x/month. Put it on them to create a budget which factors in their books, fun money and any other expenses. I also recommend a limit is set for any credit cards and deciding who and when it will be paid off.

Organization

Talk about starting the semester off with everything in it’s place – clothing, car, computer. Let’s make sure everything is reviewed, updated and ready to go. While we’re at it, let’s pull up the calendar and start looking into the future to see when things will need to be re-updated. Get the oil change scheduled, even if it’s two months out. Get the printer cartridge in your Amazon Wish List so that you can move it to the cart quickly when your printer gives you a frowny face.

Scheduling

Speaking of calendars, let’s go ahead and talk scheduling more in-depth. I recommend to every college student they use the following strategy: Get all your syllabi, Put all dates for tests, papers, office hours, etc on your calendar. For tests, count back from the test date one week and put schedule study times (no longer than 90 min). Do the same for papers. Break down writing the paper into reasonable and realistic chunks of time and put them on your calendar. Theme: Put everything on your calendar, everything. If your son or daughter are in greek life, there are a ton of events that can be put on the calendar. Same with internships or study abroad – break down all the details so that you can see things from 10,000 ft.

Travel/Visiting Home

Plan out whatever travel including home visits your kid will have mor might have. If travel plans are only possible and not 100%, put a question mark after it so at least everyone knows that period of time is possibly accounted for.

GPA 

If your kid’s GPA got beatin up a bit in the Fall, it’s probably a good idea to identify a reasonable expectation for the Spring. If your son or daughter limped home with C’s and D’s, ask what is a realistic GPA for which to aim. Talk about it but make it clear there needs to be something concrete. . Along with identifying a GPA to aim for, talk about specific strategies that will be used to support them. All colleges have student support and academic support options. For instance, here in Bloomington, Indiana University has a solid Academic Support Center with a ton of resources that work well for thousands of students struggling academically.

Graduation/End of Semester

Part of that schedule should also have details that show your finals and last day of classes. Put details about studying for finals, having family in town, etc. If your son or daughter is graduating, figure out details early in the semester since 1) things get crazy busy/expensive during graduation and 2) hotel rooms get sold-out.

On Campus Help

Besides hooking up with academic support, it’s not a bad idea to find a counselor/life coach that can act as liaison between home and school. This professional should provide regular updates to parents, meet and be available as often as needed. They should be well-versed in young adult issues like anxiety, depression and ADHD. Universities often have counseling centers on campus that provide individual counseling for about six sessions and then they refer to a community professional. They might have ideas about professionals near your kid’s school that can offer support.

Final bit of advice – trust your kids and trust the process. With a bit of planning, your kid’s semester will have highs and lows but ultimately, they’ll finish the semester better than they started it.

Insider’s Guide: Top 5 Things for Your College Student Transitioning to Fall Semester

Most of the students with whom I work have depression, anxiety and mild substance abuse. One of the easiest, cheapest and most effective tools for combating these struggles in college is detailed planning. Below, I’ve outlined the Top 5 things I tell every student to implement as they are showing up for Fall semester.

  1. Syllabi Dates. Encourage your college student to plug-in all dates into their calendar from the syllabi they receive over the coming days. Once all the test dates are put in, reverse engineer two weeks prior to the test dates and put study dates into the calendar for no longer than 90 minute chunks. If it’s not scheduled, it will get pushed off till the last minute.
  2. Professor Office Hours. Everyone will want to meet with professors the Thursday and Friday before Thanksgiving. Have your above-average college student pull their professor’s office hours from the syllabus (yes, all professors put office hours on there) and plug into the calendar.
  3. Download Your University’s Academic Calendar. In June, I downloaded the Indiana University’s academic calendar for Fall 2016. It is a small file from Indiana University’s Academic page for any student or parent to view or download. Once downloaded, your college student can upload it into their calendar. Now, they’ll know Add/Drop dates, Fall Break, Winter Break, Finals, etc.
  4. Don’t Talk Every Day. Plan to talk 2x/week – (eg. Wednesdays and Saturdays). It’s time to intentionally create more autonomy, build trust, and not feel like you need to hover over them.
  5. Set up Counseling Early. Counselors and mental health providers get slammed since there are so few of us in most college towns. There are even fewer psychiatrists for medication management. Start looking for a counselor/therapist now before the semester gets in full swing. Psychiatrists are often scheduled out 2-3 months.

Good luck and please reach out for more suggestions and strategies to mitigate the challenges your college student is facing with depress, anxiety or substance abuse. Don’t go it alone.

5 Signs of Suicide Risk in College Students

FACT: 15% of graduate and 18% of undergrads have seriously considered attempting suicide

FACT: 15% of graduate and 18% of undergrads have seriously considered attempting suicide

There is nothing more exciting than dropping of your college freshman in late August as the cool nights of Autumn return. But not all students carry with them the same energy and positive outlook for the Fall. Some are carrying some heavy baggage from High School or even younger while others don’t start to develop any major issues until they first get to college (and their first taste of freedom from parents). What parents don’t know is that you likely know your college friends (or at least a side of them) better than their own parents do, and you may be able to tell that something is wrong way before anyone else. This quick list is as much for parents as it is for you students out there. 

The following signs might indicate a student is considering suicide:

  1. A good student who’s behavior suddenly changes – they start ignoring assignments and missing classes which are likely signs of depression or drug and alcohol abuse, which can affect their health and happiness and put them at risk of suicide. And yes, good students and good kids use drugs. Seriously. 
  2. Anyone who doesn’t have friends or who suddenly rejects their friends may be at risk. A friend who suddenly rejects you, claiming, “You just don’t get it,” may be having emotional problems.
  3. College students may be physically or emotionally abused by a member of their family or their girlfriend or boyfriend – or suffering from abuse that occurred long ago but triggered by the new college environment. Abusive relationships can make a college student feel like crap about themselves. Signs that a person may be in an abusive relationship include unexplained bruises or other injuries that he or she refuses to discuss. 
  4. This is a common one – Significant changes in a someone’s weight, eating or sleeping patterns, and/or social interaction style may indicate that something is wrong. Eating disorders are super common at college. Lot’s of perceived competition, anxiety and stress that translates into really unhealthy views of one’s self. 
  5. Coming Out? College students may suffer from depression or have thoughts of suicide if they have a difficult time adjusting to their sexual orientation or gender identity. Gay, lesbian, bisexual, and transgendered students have higher suicide attempt rates than their heterosexual peers.

We understand regret and their could certainly be a real consequence of getting help for someone who seems to be really hurting. They might get pissed at you for not minding your own business. But think of it this way – is the regret of possibly losing a friend better or worse than the potential of knowing you could have saved your friend’s life but did nothing? Tough choice but that’s part of the burden of mental illness.