A Mental Health Checklist for College Students

As fall approaches, new students will arrive on college campuses toting all kinds of things: luggage and school supplies, mini fridges and sports equipment. But in the midst of the preparation for move-in day, many have not considered what tools they will need to support themselves emotionally.

In other words, what can they do to protect their mental health?

In a 2017 survey of more than 700 parents and guardians, over 40 percent said they did not discuss the potential for either anxiety or depression when helping their teenagers prepare for college or postsecondary school. In addition, most of the caregivers said mental health services on campus were not a priority when choosing a school.

But a large number of teenagers are struggling. According to the Centers for Disease Control and Prevention, more than 1 in 3 high school students experienced persistent feelings of sadness or hopelessness in 2019, representing a 40 percent increase since 2009.

Once they arrive on campus, these problems don’t go away. A survey conducted in March by Inside Higher Ed and College Pulse found that undergraduate students were more than twice as likely to rate their overall mental health as “poor” (22 percent) versus “excellent” (9 percent).

And a new study using eight years of data from more than 350,000 students at nearly 400 campuses found that the mental health of college students across the United States has been on the decline. More than 60 percent of students surveyed during the 2020-2021 academic year met criteria for one or more mental health problems, a nearly 50 percent increase from 2013.

Experts suggest that parents and teenagers take proactive steps now to help plan for and preserve mental well-being during the big transition to college.

Connect early with the counseling center

Consider contacting the college’s counseling center before you arrive on campus. This is particularly important for those who already have an emotional disorder or other mental health concern.

At SUNY Broome Community College in Binghamton, N.Y., the counseling center begins seeing registered students as early as Aug. 1, one month before classes begin.

“A lot of times the students who come to us early, they have a lot that they need to unpack,” said Melissa Martin, a licensed social worker and the chairwoman of counseling services at the school.

The Jed Foundation, a suicide prevention organization that aims to protect the emotional health of teenagers and young adults, suggests asking the following of the school’s counseling center:

• What services are provided?

• Are there a maximum number of sessions allowed per year?

• Is there a counselor on call 24 hours a day? If not, what after-hours emergency services are available?

• What accommodations are available through disability services for students with emotional disorders?

• What is the school’s policy on taking leaves of absence?

• Are there other types of support available, like text lines or resident advisers?

Check to see if the counseling center provides off-campus referrals, and assemble a short list of potential providers to have in your back pocket ahead of arriving at school. This is a good practice for any student, as it may be necessary to seek outside support if the school’s counseling center develops a waiting list. It also helps to familiarize yourself with your insurance plan to see what type of coverage it provides. If you won’t be using your parents’ plan, compare the campus health insurance to other available options like those provided by the Affordable Care Act.

“I think it’s never too early to say, ‘Hey, I need help,’” Ms. Martin said. “You might not see anyone else reaching out for help, but they might not be talking about it.”

Studies have found that students of color are less likely than white students to use mental health services offered on campus, in part because of the stigma associated with mental health care but also because of a lack of diversity among counseling staff.

Those seeking a provider of color may have to take on the extra burden of trying to find a therapist off campus, said Ebony O. McGee, a professor of diversity and STEM education at Vanderbilt University’s Peabody College.

“That student might actually not do it, which opens the possibility of turning to unhealthy things,” she said.

Embrace other types of support

There are many resources available to students besides the counseling center. Tutoring, academic and peer advising, education coaching, student activities and career services can all help support a student’s emotional well-being.

Connecting with other students is especially important, the experts said.

“College students report that loneliness and isolation and feeling like they don’t fit in — those kinds of emotions are very common and challenging in first year of college,” said John MacPhee, chief executive of The Jed Foundation.

Spend some time looking at the school’s extracurricular activities and clubs, and thinking about how to engage with others while on campus. And consider having a roommate even if you have the option of living alone, Mr. MacPhee added — it can broaden your social network and help buffer stressors.

Don’t count out high school friends or anyone back home — a sibling, parent or religious leader, for example — who has been especially helpful.

“I often recommend making a list of your three to five biggest supporting people in your life,” Ms. Martin said. “And when you’re not feeling the best at school, you know you can reach out to one of them.”

One way that students of color can protect their mental health is by taking an African American history or ethnic studies class and exploring some of the structural problems that contribute to stress, anxiety and depression, said Dr. McGee, who has studied the emotional struggles experienced by high-achieving Black students.

“When many Black and brown students have mental health situations, it is often because of racialized or gendered racialized experiences,” she said. “It is about that environment that breeds alienation.”

Dr. McGee recommended seeking out spaces of comfort and understanding. “Go to places and spaces where you are affirmed and celebrated, and not simply tolerated,” she said. It could be an extracurricular activity or a religious organization — anywhere you might find other marginalized students of color.

Practice basic wellness habits

In the summer before college, teenagers should take stock of how they’re eating, sleeping and socializing, the experts said, especially given that they may have formed some unhealthy habits during the pandemic. If a student’s basic needs are neglected, it becomes more difficult to cultivate a healthier mental state.

Learning how to support yourself and taking steps to become more independent can also make the college transition less jarring. Before arriving on campus, practice managing a budget; advocating for yourself with a teacher, doctor or coach; or spending time outside of your childhood home — perhaps with a relative, or at summer camp.

Senior year can be “a rollicking ride” especially during the age of Covid, said Dave Anderson, a clinical psychologist at the Child Mind Institute, a nonprofit that provides therapy and other services to children and families with mental health and learning disorders. “It’s just ups and downs, and disappointment and hopes, and trying to figure out where they’re supposed to be.”

He advised one teenage client (who had slept an average of five hours a night during his senior year) to begin getting eight hours of sleep each night this summer, and to be aware of how much time he was spending on screens. His client also began eating a healthier diet that included more vegetables, and started working out first thing in the morning because he knows his college classes will start later in the day.

Drinking is “another thing that we’ll discuss very openly with teenagers during the summer before college,” Dr. Anderson said. Many high school students are already drinking alcohol socially with friends, he added, and in college they may feel pressure to binge drink or “pre-game.” But teenagers can prepare mentally for this and other types of circumstances — including drug use and sexual situations — by setting boundaries now.

“How can we make sure that this summer you’re setting intentional goals related to your limits and what you feel like is safe for you?” he asks college-bound teens. That conversation can sometimes make parents nervous, Dr. Anderson added.

“But if we can speak honestly to kids about that, they will be more likely to set those limits when they get to college because they’ve practiced.”