Jordyn Kelso remembers holing up in her room and not wanting to participate in the activities she loved as soon as she arrived on campus at Simpson College in Indianola.
The 21-year-old psychology major and management minor from Kalona, Iowa, had been a well-rounded athlete and student in high school but those passions didn’t follow her to central Iowa.
“(I felt) a lot of anxiety, stress and really (felt) alone,” Kelso, a junior battling depression while in college, said. “I felt that the friends I had made here were in a completely different place than I was. They were excited about college.”
National statistics show that Kelso’s case is not unusual.
Mental illness is the most common invisible illness students deal with when trying to get a college education.
Nancy Reasland has seen it in her 20 years as Cornell College’s student health services director in Mount Vernon. Students with mental illness struggle when academic pressures get high, adding to their stress levels.
Sometimes the stress can be related to being on a block plan, under which students take one course for three-and-a-half weeks, take four days off and then start a new class. Students feel they have to intensely cram one course into a short amount of time and manage this type of routine.
For others, dealing with the move to college from home and learning how to cope with it can also lead to depression and anxiety, Reasland said for an IowaWatch/Simpson College journalism report on hidden illnesses Iowa college students face.
“That switch from high school to college is big in a lot of ways,” she said. “Sometimes in high school, the parents are very involved in helping the student with time management, helping the student with medication schedules, just kind of running interference.”
Tammy Marti, director of health and wellness at Loras College in Dubuque, said proactive students address mental illness problems in her office.
“It’s a good thing that students are coming,” Marti said. “But the other thing I have noticed too is that students are coming to college with a lot more issues than they would’ve been able to 10 years ago.”
She added, “The trend that we have noticed here on campus is that our numbers in the last year have doubled in mental illness.”
DEALING WITH THE PROBLEM
While federal law does not require colleges to track invisible illnesses, health services professionals are learning more about what students needing help experience and need. Marti attempts to track the numbers of students who visit her health center and their visiting reasons.
Coe College in Cedar Rapids has a partnership with St. Luke’s Family Counseling Center that gives students access to medical help in addition to their on-campus student health center. Dean of Students Tom Hicks said the partnership includes counseling and therapy services.
“They have eight or nine counselors available for students throughout the week,” Hicks said.
Hicks said monthly reports show how many students visit counseling and therapy services primarily for depression and anxiety.
Stephanie Newsom, director of counseling at Wartburg College in Waverly, said 25 percent of that college’s student body seeks help from counseling services for various illnesses. “The top two reasons students utilize counseling is to help manage symptoms of depression and anxiety,” Newsom said.
At the University of Iowa, a survey conducted in spring 2014 for The National College Health Assessment showed depression and anxiety were the most commonly diagnosed or treated conditions in the mental health category.
Lisa James, University of Iowa’s associate director for clinical outreach, said students and parents often ask her if the university offers enough psychiatric help to deal with the growing numbers.
“With trying to get through an academic year, there are highs and lows based on what students are going through,” James said. “I think we do a lot better job than we used to for all of us being aware of all the resources out there.”
WHAT IT’S LIKE TO STRUGGLE
Kelso said she always was a straight A student in high school, a perfectionist who didn’t want to miss school. “And then when I came to college, it started snowballing I guess,” she said.
She remembers how difficult it was to wake up each morning and not knowing what her purpose was in college. As a freshman, she also found it difficult to reach out to her professors because she lacked a close enough relationship to share her concerns.
“You feel like they’re not going to be understanding about it, which might totally not be the case,” she said.
Now she advocates for students to reach out as soon as they feel a shift in their lives that causes them to shut down mentally. “As soon as you are starting to feel those things, you should definitely find someone to talk to, even if it’s not on campus,” she said.
Kelso admits that opening up is hard.
“This is the hardest about talking to someone about depression and invisible illnesses is that, if you have never struggled with it, you never know what it’s like,” she said.
She said she worried about writing emails explaining her depression and what she describes as a dark, black cloud hanging over her head fully controlling her ability to push through.
“You always feel kind of awkward or like you have something to hide,” she said. “I feel like the whole thing is really stigmatized.”
Even with the fear of being stigmatized, she said getting a conversation started about the struggle is needed to get help.
ALL HANDS ON DECK
Charles Strey, dean of students at Central College in Pella, encourages students and their families to set up meetings with their school’s counselors, professors, health directors and other faculty to talk about students’ mental illnesses. Strey said this could help determine which services will help students in college.
“We offer assistance for the student and the faculty member to discuss accommodations that might be necessary and they work out individual plans,” Strey said.
He and other college officials said addressing mental illness only can happen if colleges are transparent about their policies and services. Strey said Central strives to provide students who need assistance with the appropriate accommodations through a specific outreach program.
For example, the college has a program called Early Alert, under which the class dean is told if a student is not showing up to class. The dean then talks to the student to help identify specific needs to improve both class attendance and college experience.
Central students have several options that exist at several other colleges, such as a Student Support Services office and the college’s counseling center. Both help with classroom accommodations and mental illness concerns such as depression.
Ensuring success requires teamwork, from the health services department to the disability coordinator. Reasland said while invisible illnesses differ from a case-to-case basis, almost every situation has multiple people who work to coordinate plans to fit the respective student.
“It doesn’t fall necessarily on one person to figure it out,” she said. “It’s a team approach, I would say. There are almost always several people working on an issue.”
James said the University of Iowa has boosted efforts to ensure students and parents know about available resources for any illness. Student Health works closely with the university’s Counseling Services and Student Disability Services, she said.
“I think we do a lot better job than we used to for all of us being aware of the resources out there,” she said. That led to the establishment in the past few years of an Office of Student Retention. “They look a lot more at students who are struggling with one thing or another and try to get them resources early,” James said.
But students bear some responsibility if colleges are to understand how to better serve students, counselors at Iowa colleges said in interviews for the IowaWatch/Simpson College journalism report.
At the University of Iowa, Student Health participates in summer orientation for incoming students. Its professionals give parents a presentation and hold an information fair where parents can speak personally to the health services staff.
“We have quite a few (situations) every year where parents will come up and say, ‘I have a question for you about my son or daughter,’” James said.
School officials at several colleges said colleges can make necessary accommodations as soon as students fully disclose what they need for hidden disabilities. Sometimes, however, a student might have to take a leave of absence or withdraw for a term.
“Although we need to retain as many students as possible, we don’t put the institution before the student,” Coe’s Tom Hicks said. “If a student feels they need to take a leave (of absence), or if we feel they need to take a leave in order to get coping skills or learning how to manage whatever issues they have, we want the best for them. We will encourage that.”
PROBLEMS COLLEGES FACE
While colleges may be transparent about resources available on campus, sometimes those accommodations might not be enough. Health services directors interviewed for this report said that’s when getting appropriate help or accommodations might get difficult.
Unlike a larger university, Cornell, along with many smaller colleges across Iowa, doesn’t provide services to travel off campus to clinics or other medical centers.
“If they can’t drive, don’t drive or don’t have a car, then that’s an issue,” Reasland said. “We do not provide transportation.”
However, Reasland said being at a smaller college can mean getting immediate help for mental illness from friends or faculty and staff. “On a small campus, there are so many pros and cons, but one of the pros is that students, faculty and staff really develop great relationships,” she said.
Hicks said a lot of colleges provide relatively helpful short-term support but that long-term care might not be as easy.
“I think a lot of colleges struggle with: how do we work with students who need some longer term support? How do we identify that, how do we afford that, how do we have conversations with family if that’s the case, too?” Hicks said.
Part of that struggle might come from a general underservicing of mental health issues that college officials who were interviewed said exists. Those officials dealing with students said they are pushing to get that conversation going.
“It seems like the whole mental health issue is underserved in this country,” Loras’ Tammy Marti said. “We’re, maybe, able to identify the students more and are able to offer more resources if we can.”
But for now, that sometimes might not cut it, which is why school officials and health services directors urge students and parents to speak up about any assistance they may need.
This IowaWatch story was published by the Des Moines Register under IowaWatch’s mission of sharing stories with media partners. To learn how IowaWatch’s nonprofit journalism is funded and how you can support it, go to this link.