Friday, June 15, 2012

Emotional Health in the Transition to College Life

College mental health professionals want the beginning of your college experience to be healthy and rewarding.  Incoming students with concerns about emotional health, including a history of psychological or psychiatric conditions, need to take care to preserve the progress they have made in treating those conditions.  Following some rather simple guidelines before and right after you arrive on campus can help ensure that your early days on campus are productive and enjoyable.  What follows are generic considerations only.

Health Insurance

Check your health insurance policies and make sure they are up-to-date.  If you are in the position of making decisions concerning health insurance, choose plans that provide for mental health services on a par with medical coverage.  Ideally, your plan will provide adequate coverage for therapy or counseling services, psychiatric services, and medication.  Also, before you arrive, check your plan to see what providers in your new home are covered by your plan.  If you find that there are few or none on that list, contact your insurance representative and ask for local providers to be included.  If you are unsure about which providers could be included, contact your campus mental health service.

Health Records

If possible, bring copies of your important health records with you to campus.  This may include copies of medical, psychiatric and therapy records.  In most cases, summaries of these records will suffice.  You have the right to ask any health or mental health care provider you have seen to send your records.  You can and should ask your home providers to send these records to your new campus area providers, but if possible keeping copies for yourself is a good idea.  It is very important that your local providers have this information, as it improves the continuity of the care you have received.  This is especially true of any records relating to psychological testing, even if it occurred several years earlier.  Without such records it may feel like you are starting all over again, resulting in unnecessary delays in your treatment and progress.

Referral to Local Providers

Your current providers can and should offer to assist you with a local referral.  Your campus mental health service can also assist you with such referrals.  In general we believe that students who are taking any form of psychotropic medicines, such as anti-depressants and anti-anxiety medications, should also be in therapy or counseling due to research that suggests superior results when the two are combined.  Students with a history of any serious disorder, such as chronic addictions, Bipolar Disorder, Schizophrenia, and Personality Disorders, should arrange for long-term care well ahead of their arrival on campus.  Due to the long-term nature of such conditions, treatment by private mental health professionals off campus is sometimes indicated.  Finding and securing the appropriate providers will avoid the “ping-pong” effect that some students experience if they delay treatment or seek it in a random manner.

Use and Misuse of Medication

If you have been on medication prior to your arrival on campus, it is highly important that you remain on it during the transition to college.  Make sure that your prescriptions are current and that you have an adequate supply, at least enough to last two months.  Many students have the idea that college is a “new start” and that the stresses they experience will somehow disappear when they arrive.  Many underestimate the normal stresses and strains of college life, and by the time this is apparent to them it may be very late in the first semester.  When a student discontinues medication it sometimes takes weeks or even months to recover previous gains.  For example, it is not uncommon for a student who relapses in October to not be fully functional until December or January, too late to make up for any losses that may have occurred in the fall semester.

Avoid any misuse of your and others’ medication.  Take it as prescribed to you and don’t make changes in dosages without consulting your physician or psychiatrist.  Avoid taking medication prescribed for others, or giving your own medication to others.  This can lead to problematic or even disastrous consequences including side-effects, serious medical complications, and death.  It may also be against the law.

A Word about Attention-Deficit Conditions

If you have been diagnosed with an attention-deficit disorder before your arrival on campus, follow the same guidelines as noted above.  Remember to give your local providers all past and current information about your condition.  If you have never been diagnosed with such a disorder but notice problems with attention or concentration after beginning college courses and suspect an attention-deficit disorder, please keep a few things in mind:
  • Almost all college students experience challenges to focus and concentration.
  • Other conditions or disorders can mimic an attention-deficit disorder, including anxiety disorders, acute stress disorders, some mood disorders, substance abuse disorders, and even ordinary family or relationship conflict.
  • Diagnosing an adult with an attention-deficit disorder is more complicated than diagnosing a child or early adolescent.  Ideally, a battery of psychological tests is used to confirm the diagnosis.  Simply relying on self-report or symptom checklists can result in a misdiagnosis.
  • The criteria for an attention-deficit condition include impairment in two areas of functioning prior to age seven.  If you have a history of adequate or better academic performance it may be unlikely that you have an attention-deficit disorder. 
For Parents and Family Members

In addition to observing the practices listed above, families can play an important role in monitoring loved ones on campus.  Regularly ask your student whether they are receiving treatment or taking medications.  For serious conditions, get confirmation from the providers’ offices.  Watch for early signs of adequate adjustment to college and academic performance.  If you see indications of relapsing or slippage, follow-up promptly.  This can sometimes involve making a trip to campus to check on your student.  Consult with your student’s providers, while taking care to respect their right to privacy and some degree of control over their affairs.  If their providers give you suggestions or advice about how to manage a specific issue, follow it carefully.

Conclusion

Again, these are all simple principles in the management of emotional health care of students.  Professional experience is that the time devoted to following such guidelines is small compared to that spent on rectifying problems later on.  If you have other questions not addressed here, please contact your campus mental health service for assistance.