- Special Reports
When the demands of college life became overwhelming for Frostburg State University student Jennifer Cruz in fall 2012, she paid a visit to her Maryland campus health center complaining of chest pains. Though she met with a doctor who was able to check her heart, Cruz’s condition was unable to be confirmed. Cruz and the doctor discussed options that could help reduce her stress.
The following spring, Cruz decided to visit the school’s wellness center. Through the wellness program, she learned how to balance her residence hall supervisor job, 18-credit course load, independent study and mounting personal responsibilities, which consisted of her involvement with several campus organizations, including the Student Communications Studies Association (SCSA), Anti-Bullying Club, Latin American Student Organization (LASO) and PACDEI (President’s Advisory Council in Diversity, Equality and Inclusion).
“It made me think about my wellness in a different aspect—not just physical or eating,” says Cruz, 21, a psychology major from Columbia, Md. “I now have more of a balance between me and stress and my relationships with other people.”
Cruz’s stress soon diminished, the chest pains subsided, and her grades improved, landing her back on the dean’s list. She admits to sometimes feeling stressed, but says she now has the tools to manage it better.
Stress and related conditions are growing increasingly common among college students, according to the spring 2012 American College Health Association-National College Health Assessment. More than 44 percent of student respondents reported feeling hopeless within the last 12 months, 85 percent felt overwhelmed, and 29.5 percent felt so depressed it was hard to function. In the last 12 months, 12.1 percent had been diagnosed or treated for anxiety and 10.6 percent for depression.
In an effort to be proactive and address the upsurge in students’ stress-induced ailments, colleges and universities are expanding their health care services to include wellness and health promotion, mental health and substance abuse. They are providing a full scope of counseling services such as stress reduction, mental health screening and suicide and sexual assault prevention, as well as educating students about nutrition, sleep deprivation and exercise.
College health services are now taking a holistic approach to health services that can inspire good physical, mental and academic outcomes for students. The shift toward providing a more comprehensive approach to health services began in the mid-1990s as more students began seeking counseling services for severe psychological problems. The increased awareness and treatment of mental health intensified over the next decade as evidenced by surveys of student health and behavior.
According to the 2012 National Survey of Counseling Center Directors, 87 percent of directors reported an increase of students arriving on campus already taking psychiatric medication. Fourteen percent of center clients were referred for psychiatric evaluation, and 24.4 percent were on psychiatric medication, up from 20 percent in 2003, 17 percent in 2000, and 9 percent in 1994.
Such findings further underpin the need for health services that extend beyond traditional medical care to include mental health and prevention services to address these issues.
Depression and anxiety remain the most common mental disorders treated at college counseling centers, but other serious problems persist. Chronic conditions such as diabetes, eating disorders, physical impairments, substance abuse and self-injury continue to plague collegians at high rates.
Such menacing conditions are shown to directly affect students’ academic performance. Studies have shown that students dealing with stress, lack of sleep and unhealthy behaviors such as smoking had lower GPAs than their peers.
“As our … students’ health needs have become more complex, so have the level of services provided at student health services,” says Patricia Ketcham, president of the American College Health Association. She notes that regulations do not mandate institutions of higher education to provide health services on campus, but most colleges and universities offer them in varying sizes and scope. Most colleges require their students to pay a health fee to offset some health center services, while others are provided free to students. Institutions such as Duke University and Auburn University also provide student health insurance plans, as do health insurers such as United Healthcare.
The fee-based funding models on many campuses allow physicians and staff to spend more time assessing their patient’s needs without the pressure of meeting insurance company demands, explains Ketcham, also associate director of health promotion at Oregon State University. Staff can also engage students in conversations about lifestyle choices and behaviors that can impact their wellness for life.
“Health services provide personalized, student-centered health care by clinicians and health promotion specialists who work in an interdisciplinary mode with students,” says Ketcham, noting that many campus practitioners (e.g., health care providers, mental health professionals, health promotion staff) work in close collaboration with one another to provide students with the best care possible. “The level of service type of comprehensive service is not commonly found outside of our campus communities.”
Frostburg State University offers no-cost wellness coaching and a health center that combines clinic services and wellness counseling. Its Brady Health Center is staffed by nurse practitioners, registered professional nurses and a collaborating physician.
Oregon State University’s Student Health Services provides a full range of clinical services from acupuncture to lab, X-ray and health promotion programs, including smoking cessation, alcohol and substance abuse prevention, nutrition and sexual health. The Health and Wellness Alignment—an interdepartmental partnership of Counseling and Psychological Services (CAPS), Recreational Sports and Student Health Services—allows students to access the many wellness services that the three departments provide, such as the Dixon Recreation Center, the Mind Spa at CAPS; health coaching, nutritional consultation or seeing a clinician at Student Health.
Recently, Union College in Schenectady, N.Y., opened the Wicker Wellness Center, a two-story, 6,600-square-foot facility. The first floor of the new building is occupied by the Health Center, which is staffed by nurse practitioners, registered professional nurses and a collaborating physician. Among the services available are treatment for illness and injury, physical exams for terms abroad and volunteering, gynecological and sexual health care, immunizations, blood draws and vision tests. Added services include an on-site dietician and a therapy dog, Jenna.
The Eppler-Wolff Center for Psychological Services is located on the second floor and provides confidential individual counseling, couples counseling and roommate conflict mediation. The space includes a private entry. Between 45 and 51 percent of Union’s students use the Counseling Center at least once by the time they graduate.
Good medicine produces good outcomes for students, as studies have shown a link between good health and academic performance and retention. College students tend to be healthier than non-students, and they are half as likely to commit suicide. They also tend to be more successful academically when they are healthier, mentally and physically.
“Millennials are very smart consumers and they are acutely aware of the benefits of having a healthy lifestyle,” says April Baer, director of Student Wellness at Frostburg State University. “I’m always impressed how easy it is to get our Millennials to embrace health and wellness.”