Universities struggle to help students deal with depression

Ann Coulouris knew she was in trouble. For weeks, she had been sleeping in and missing classes. She had had depression before. Then her mood plunged in March after attending a national depression conference on campus.

She left crying and panicky. “I wasn’t sure I wanted to be here anymore,” said Coulouris, 22, a fifth-year senior at the University of Michigan in Ann Arbor.

A relative immediately arrived to help. But when they called the University of Michigan’s emergency psychiatric center, they were told there was no psychiatrist working at the time and “we’re not a treatment facility,” Coulouris said.

Instead, she stayed overnight with a good friend, then went home to Saginaw, Mich., to talk to her mother and to her psychiatrist. They all agreed it would be best for Coulouris to sit out the rest of the semester.

After relaxing several weeks at home and changing her medicines, she started to feel her usual self again and planned to return to the university soon.

This time, she is finding the university very helpful. A new policy — part of a University of Michigan initiative to increase awareness and improve mental health resources on campus — gives advisors clear guidelines to help students withdraw from school temporarily and resume classes without stigma and obstacles.

The problems getting emergency help that Coulouris initially encountered underscore the tough issues universities face as they mount efforts to expand mental health resources.

Those campaigns address the reality that college years coincide with the onset of many mental disorders, including depression, bipolar disorder and schizophrenia.

One in 10 college students has been diagnosed with some type of mental illness, according to the American College Health Association.

This year, an estimated 1,100 college students will commit suicide. Suicide is the third leading cause of death among young people ages 10 to 24, according to the National Institute of Mental Health.

Students ages 20 and older, international students and young people with access to firearms are at highest risk of committing suicide, studies have found.

And while suicide rates among college-age students are lower than among other age groups, like the elderly, the number of students seeking help from campus counseling centers has been rising in the past decade, including at the University of Michigan.

Federal and campus health leaders are working to find ways to help, and to end discrimination against the mentally ill.

Significantly, for the first time, students are leading some of the efforts. Harvard, the University of Pennsylvania and the University of Michigan are among the schools with the first student mental health organizations.

Last year, Ross Szabo, 25, a 2002 American University graduate, talked to 85,000 students through his work as director of youth outreach for the National Mental Health Awareness Campaign ( www.nostigma.org), a privately funded group trying to improve recognition of mental health issues and eradicate the stigma commonly associated with mental illness.

He talks openly and eloquently about his own story of coping with bipolar disorder since he was 16.

In high school, Szabo drank excessively when he hung out with his friends. His thoughts raced constantly from subject to subject, like a channel-surfing TV viewer, he says. He tried to commit suicide his senior year. He got better with medicine and counseling only to relapse two months into his freshman year in college. After taking time out from school, then returning to a small local college, he returned to American University, where he obtained a master’s degree.

“What’s really scary is young people aren’t talking about it,” Szabo says. “The way they deal with it in college is probably the way they’ll deal with it the rest of their lives.”

The new student groups give young people real stories to associate with, and to help them see successful young people who have overcome mental illness.

“I refused to accept the shame and stigma,” explained Natasha Coulouris, Ann’s sister-in-law, and cofounder of Mentality Inc., one of the nation’s first student mental health groups. She started the group in 1996 at the University of Michigan. It uses theatrical performances to help students talk about mental illness ( www.mentality.org.)

She and several student leaders spoke in March at the University of Michigan’s second national conference on depression on college campuses. The same week, the University of Michigan released an update on a program, begun last year, to improve awareness and eliminate gaps in mental health care on campus.

As a result of the program, the school recently expanded hours and added therapists at its psychology and counseling center.

Its emergency psychiatric center sees patients, though officials acknowledge there are times when people who call, rather than come in, and who aren’t clear about the urgency of a situation may not be helped, as Coulouris found.

“We’re trying to maintain a bird’s-eye view of the system, to find ways to simplify it and to make it easier for students to access care,” says Stephanie Pinder-Amaker, associate dean of students at the University of Michigan.

The University of Michigan also hopes to launch training to help faculty recognize students with mental health problems.

A big push is to help students understand how common depression and bipolar disorder are. “Our message is, this is an illness; it’s treatable; now go get some help,” says Dr. John Greden, director of the University of Michigan’s Depression Center and chief of its psychiatry department.

“We really encourage people to seek treatment, but the quality and accessibility of services are extremely difficult,” said Natasha Coulouris.

Ann Coulouris would like to see student volunteers who could spend time with people in crisis, or a place where they could seek help without a lot of bureaucracy.

Ann’s mother, Vicky Coulouris, tells parents to look for warning signs. Many are subtle.

She describes her daughter as unusually nurturing and caring, the kind of young woman who puts herself last, after her family and friends. “She always stuck up for other people in school,” she says. “I always was real proud of it. But in hindsight, it may be too much sometimes.”