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UNC students ‘aren’t alone’ in pandemic-related mental health crisis, expert explains

·8-min read

Recent events at the University of North Carolina (UNC) have prompted concerns about the lingering effects of a year of remote learning on students' mental health.

Last week, UNC canceled classes and declared a "Wellness Day" amid the suicides of two students over the previous weekend.

And UNC "isn't alone and the students aren't alone," Sara Abelson, a co-investigator and lead for diversity equity and inclusion projects at the Healthy Minds Network, told Yahoo Finance. "We know that mental health has been a growing issue of concern for institutions of higher education and that was definitely growing as well before the pandemic. And there's growing evidence to indicate that the pandemic has added stressors and it's further taxing mental health."

According to Healthy Minds' data, suicidal ideation among college students has risen from 6% in 2007 to 14% in 2020. Overall, suicide is the second-leading cause of death among college students.

A student studies in an open-air seating area on the campus of the University of North Carolina at Chapel Hill on August 18, 2020 in Chapel Hill, North Carolina. (Photo by Melissa Sue Gerrits/Getty Images)
A student studies in an open-air seating area on the campus of the University of North Carolina at Chapel Hill on August 18, 2020 in Chapel Hill, North Carolina. (Photo by Melissa Sue Gerrits/Getty Images)

UNC's leadership, for instance, made it clear in their message to students that they were going to address the issue.

"We are in the middle of a mental health crisis, both on our campus and across our nation, and we are aware that college-aged students carry an increased risk of suicide," Chancellor Kevin M. Guskiewicz said in a statement to students on Oct. 10. "This crisis has directly impacted members of our community — especially with the passing of two students on campus in the past month."

Dr. James Rachal, chairman of the department of psychiatry & psychiatrist at Charlotte-based Atrium Health Behavioral Health Services, said that the university's response was appropriate and stressed the unique set of problems college students face.

“I think that UNC’s response is commendable," Rachal told Yahoo Finance. "Observing a wellness day is a good way to bring the faculty and students together and help raise awareness that behavioral health is critically important and affects all of us. A day devoted to wellness demonstrates UNC’s commitment to putting students' mental health first.”

Masked to protect against COVID-19, a Georgetown University student joins others taking advantage of the warm sunshine to study outdoors March 9, 2021. REUTERS/Kevin Lamarque
Masked to protect against COVID-19, a Georgetown University student joins others taking advantage of the warm sunshine to study outdoors March 9, 2021. REUTERS/Kevin Lamarque

Rachal noted that the transition into adulthood for college students can be one that is highly stressful.

"Most college-age people are living away from home for the first time and navigating new challenges, such as increased responsibility and decreased structure and support," Rachal explained. "Increased rates of anxiety and depression are seen in this age group, and anxiety disorders and major depression account for the most mental health diagnoses."

And the 18-to-23 age range is "often when we see mental illness like bipolar and schizophrenia emerge," he added, not to mention it is "also a common time to experiment with alcohol and other substances that can exacerbate behavioral health disorders. Navigating these challenges while going through global pandemic amplifies the impact on a person’s well-being."

'Drastically underfunded public health system'

All things considered, college students may likely need more support from their institutions. 

Unfortunately, America and its "institutions of higher education are not adequately resourced to respond to young adult mental health," Abelson noted. "As we've seen with the pandemic, we have a drastically underfunded public health system. We need to not only be investing in enhancing treatment and clinical resources for those struggling but enhancing in mental health promotion and prevention."

Many students who use schools' mental health services — such as campus counseling — greatly benefit.

In a Healthy Minds survey of more than 155,000 students from nearly 200 campuses, researchers noted a jump in college students using behavioral health services between 2007 and 2017 from 19% to 34%. During that time, student lifetime diagnoses also increased from 22% to 36%, and the prevalence of depression and thoughts of suicide increased as well.

Mental health service utilization had increased over the years. (Chart: Psychiatry Online)
Mental health service utilization had increased over the years. (Chart: Psychiatry Online)

"We've seen the pandemic has added all sorts of stressors, [such as] social isolation and disconnecting individuals from being able to connect to their loved ones and their communities," Abelson said. "We know that social support is a really important protective factor for mental health."

Socioeconomic stressors, such as students losing their jobs or their families facing financial hardships, on top of grief and loss in the family due to COVID-19, can all affect students' mental health, she added. 

The data so far hasn't revealed the full extent of the isolating effects of the pandemic. Preliminary data from the Centers for Disease Control and Prevention (CDC) noted that in 2019, 47,511 people died by suicide. In 2020, that number dropped to 44,834

The numbers don't tell the full story, according to Rachal. 

"This is not unusual during a pandemic," he explained. "We actually saw suicide numbers drop during the Spanish flu as well. Also, keep in mind, suicide is a lagging indicator so we may see numbers rise later."

At his practice in North Carolina, Rachal said he's seen an increase locally in people using mental health services recently but added that it was hard to pinpoint the reason for the increase. 

"Reasons vary from stress of the pandemic to build up in need for behavioral health disorders not treated in the pandemic to increased availability of telehealth services that make entering treatment more private, convenient, and less expensive," he said.

Chance Bonar, a PhD candidate at Harvard, tilts his screen while teaching an online class from his dorm on April 16, 2020 in Cambridge, MA. (Photo by Blake Nissen for The Boston Globe via Getty Images)
Chance Bonar, a PhD candidate at Harvard, tilts his screen while teaching an online class from his dorm on April 16, 2020 in Cambridge, MA. (Photo by Blake Nissen for The Boston Globe via Getty Images)

Many schools braced for the emotional toll of remote learning, Abelson added, but the broader trend was something that campuses have yet to catch up on.

"One thing we're seeing in our data is that schools did begin to figure it out more," she explained, referring to the very first semester when classes were pulled off campus and moved online. "We know that many institutions worked very, very hard to give access to teletherapy, and for many schools, they were doing that for the first time, so there were suddenly new ways that students could connect to those services."

There remain barriers to accessing help: For instance, telehealth providers were limited in reaching students when students joined from a different state than the school was in.

More broadly, with mental health issues and concerns increasing over the last decade, "both colleges and universities honestly in our nation as a whole are under-resourced for addressing mental health," Abelson said. 

Graduation outcomes tied to mental health: study

Investing in mental health resources can also pay dividends in other outcomes that colleges focus on, such as graduation rates. 

In a 2009 article in the B.E. Journal of Economic Analysis & Policy, researchers found that depression is a significant predictor of lower GPA and also indicated a higher probability of dropping out, especially among students who have an anxiety disorder. While a quarter of students with GPAs below 3.0 who had symptoms of a mental health problem dropped out, only 9% of students without mental problems with the same GPA did so.

The study said that there could be "potentially large economic returns" if colleges invested in the prevention and treatment of mental health problems. 

"It is in the best interest of schools to address and support student mental health because mental health is tied to academic success, to retention, and to many lifelong outcomes that colleges and universities care about for their students," Abelson said.

Boston, MA - August 26: An graduating army veteran, center, is recognized for her service during the 53rd Commencements of the University of Massachusetts Boston at TD Garden in Boston, MA on August 26, 2021. UMass Boston held two ceremonies to celebrate the Class of 2021 and also the Class of 2020, which didn't have a traditional in-person graduation due to the COVID-19 pandemic. (Photo by Craig F. Walker/The Boston Globe via Getty Images)
UMass Boston held two ceremonies to celebrate the Class of 2021 and also the Class of 2020, which didn't have a traditional in-person graduation due to the COVID-19 pandemic. (Photo by Craig F. Walker/The Boston Globe via Getty Images)

The Department of Education (ED) and the Department of Justice also weighed in on this issue recently, sending a letter to educators laying out the civil rights obligations of schools and colleges to students with mental health disabilities.

“The COVID-19 pandemic’s effects on student mental health are widespread and deeply concerning,” ED Acting Assistant Secretary for Civil Rights Suzanne B. Goldberg said in a press release. “OCR is committed to providing resources to support students with mental health disabilities, including those who may be at risk for self-harm.”

But while the pandemic has intensified the need for mental health resources, there was a silver lining, according to Rachal.

"COVID has really changed how we think about mental health," he said. "Because most everyone struggled with anxiety or depression during COVID, people became more open to discussing these phenomena. It is now a topic that is more openly discussed in the media, socially, and at home. More people are willing to seek treatment due to less stigma around behavioral health disorders."

He also noted that with telemedicine, his company, Atrium, was able to offer virtual therapy. Atrium Health’s adult outpatient therapy no-show rate dropped from 14% in 2019 to 9% in 2020.

Rachal recommended professors and educators get training for mental health first aid. "Just like knowing CPR, knowing what to look for, what to ask, and how to link for help if someone is suicidal can save a life," he said.

— 

Aarthi is a reporter for Yahoo Finance. She can be reached at aarthi@yahoofinance.com. Follow her on Twitter @aarthiswami.

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