College life with mental illness takes extra planning

Margaret Skoch of Cleveland felt a jumble of emotions as the day to leave for college neared. She was thrilled to be attending her dream school, Notre Dame University, her mother's alma mater. She was anxious about leaving home. And then there was her mental health. Skoch had been diagnosed with obsessive-compulsive disorder, depression and anxiety in high school. Although she was feeling confident and healthy, she worried her symptoms might return.

That worry turned into a full-blown panic attack her first night in her dorm. It was the beginning of a rough few months.

"I was really homesick. I called home every day crying," recalled Skoch, now a junior. "It was bizarre because I was so happy to be in this place that I loved and at the same time sometimes miserable."

Because of better mental health care and campus services, more young adults with a mental health diagnosis are attending college than ever. According to the 2013 National Survey of College Counseling Centers, 88% of college counseling directors reported a steady increase in students arriving on campus already on psychiatric medication. What parents need to know is that with strategies crafted in advance and monitored from afar, teens with a mental illness can thrive in college and beyond.

Like Skoch, many freshmen with a diagnosis arrive at college without any mental health care in place, said Nance Roy, clinical director of the Jed Foundation, a nonprofit that advocates for the emotional health and suicide prevention of college students. Skoch quickly sought out a therapist, but many students fail to ask for help until their illnesses compromise their academics and/or emotional well-being.

Roy urges parents to be proactive: Once a teen selects a college, contact the counseling office to find a psychologist and a psychiatrist on campus or nearby. Then schedule an introductory appointment for soon after the child's arrival. She also suggests having your teen sign a medical release before leaving for college. Otherwise, once he or she turns 18, you will not be able to access his or her health information unless there is a crisis.

The academics office also should be informed of a child's disability, according to Peter Lake, professor of law at Stetson University College of Law in Gulfport, Fla. College staff "are anxious to help, and peers are generally very receptive," he said.

Parents who have been advocates, cheerleaders and anchors in their children's lives must now, in the months leading to college, nurture the child's independence. Most college freshmen arrive on campus ill-prepared to care for themselves, according to Roy of the Jed Foundation.

"Some of the biggest challenges are basic life skills — doing laundry, going food shopping, managing money, paying the cell phone bill, learning to live with people different than you," she said. "College has less structure and more independence. There's time management, organizing your day and handling stressors on your own. If you're not on top of it and you have an illness, all those things become more challenging."

Improving a child's organizational and study skills should be a priority, said Rick Auger, a professor in the department of counseling and student personnel at Minnesota State University in Mankato, Minn.

"For almost all mental health issues, organization is so critical, especially ADHD, anxiety and autism spectrum disorder," he said. "Binders, folders, assignment planners — all those things are helpful getting students into the habit of being organized."

Parents shouldn't be afraid to let a child fail — modestly, according to Auger. It's time to be a coach rather than a problem solver, he explained.

Whether a teen attends a community college down the street or travels across the country, a parent is likely to have freshman jitters right along with the child. Staying in regular touch can help both, but the terms of communication should be worked out beforehand, suggested Lauren Freise of San Francisco, a sophomore at Boston College who has battled depression and anxiety.

Under the Americans with Disabilities Act, almost all colleges and universities must legally provide students with reasonable accommodations (such as being allowed more time to take a test, or to record lectures), as long as your child has a mental illness that meets the legal criteria. To receive academic adjustments, parents likely will be asked to provide written proof of a child's disability.

In higher learning, accommodations are based on individual needs, which could include arranging for early registration, reducing a course load or providing note-takers. Colleges are not required to make substantial modifications. For example, a student may be granted more time to take a test but is not entitled to changes to the content of the test. Accommodations can vary widely from college to college. Parents should research prospective schools until they find those that have the right mix of services for a teen, Lake advised.

How to learn more

"Transition Year":The Jed Foundation and the American Psychiatric Foundation teamed up to produce this guide to help students and parents prepare for college.

Active Minds: This nonprofit supports about 400 student-led, campus-based chapters that provide students with programming to educate others about mental health, connect students to resources and reduce stigma toward mental illness. activeminds.org

NAMI on Campus: There are about 90 NAMI on Campus clubs so far. These student-led organizations support fellow students, raise mental health awareness and promote mental health services.

Civil Rights of Students with Hidden Disabilities: The U.S. Department of Education explains the accommodations to which college students are legally entitled.

The American Association of People with Disabilities: The AAPD offers resources for students with disabilities who are planning their college search.