Your student has been accepted to college – congratulations! An extra cheer if they will be the first in your family to go.
With the excitement, there may be some worry. That’s normal, especially if your student has a hard time with issues like life transitions, independence, social situations, or learning. You may also be wondering about how they will take care of their mental health; continuing counseling, medication, and self-care are all important considerations.
It’s possible to put your worry to good use, taking it as the push you need to be proactive in getting resources in place at home and at their new school. College websites are full of good information if you know what to search for, and I’m here to offer some insider tips from fifteen years of counseling and teaching on college campuses.
1) Take an honest look at how your student is doing, and how they’ve done. Going to college is a great time for students to leave behind old ways of being, make new friends, and have a chance to reinvent themselves. Great growth is definitely on the horizon!
Keep in mind how your student has done in other times of transition – for example, from middle to high school, moves, or changes in friend groups. It’s important to keep in mind that even positive change and excitement create psychological, social, and biological stress. How your student has handled change before can preview what the college transition will be like; it’s not unusual to see a return of some symptoms in the first weeks of starting fall classes.
Also take stock of how their current daily functioning is and where any existing mental health symptoms and disabilities are at (or how they might be shifting). Talk to your student about their sense of how they’re doing or how they think they will do. And keep in mind whether they tend to overestimate their coping skills or downplay struggles.
2) Make an inventory of what mental health care, academic supports, and other resources have been critical to your student’s success. A key question I ask all clients is “What’s worked in the past?” With a big transition on the horizon, keeping the resources your student can rely on is a good idea. More below on finding campus resources, but…
If they are commuting to campus or will be in the same state, considering whether their current counselor can continue to see them (at least to start off the year). With the rise of telehealth during the pandemic, this is now more of a possibility than ever. But also be aware that counselors are generally only licensed to practice in one state; if your student is moving out of state their therapist likely won’t be able to continue working with them while they’re on campus.
And please (please please please) make arrangements for them to continue any medications. Prescribers were in short supply even before the pandemic, and now the shortage is even more critical. It is possible that the services on campus will not include a prescriber. Start planning whether your student can stay with their current prescriber if they will live at home, be able to do telehealth visits, or time visits with coming home for breaks.
3) Find out what support offices are on your student’s new campus. Services which support students’ learning and growth, including mental health needs, are typically available at all colleges. Search online for the on-campus counseling center and disability services office to start to get a feel. I also highly recommend attending the accepted students’ day (even if it’s virtual) to find out more.
Every school is a little different, so you may need to hunt a little. You may find counseling housed with the health center or separate, or in a broader wellness division. Prescribing services, if they exist, might be with counseling or might be in the health center. Disability services may also be called accessibility services or a few other names. If you can’t find one of these, look for the office of student life or student affairs, which typically oversee these departments. They can point you in the right direction.
4) Reach out to the counseling office to find out what services are available. What services are available (and for how long) will vary from college to college. Websites may talk generally about services, but not have specifics. It is also possible information may be from before the pandemic, or talk about what is available right now, but not necessarily what will happen come fall. I recommend calling the center and ask if you could do a brief consultation with a counselor about your student’s needs. Say you hope to find out if your student will be best served by their office, and off-campus provider, or a combination.
Most commonly, counseling offices will say they offer “short-term” or “time-limited” treatment, which may be anywhere from a handful of visits to regular appointments for a semester or two. Ask for specifics or clarification of this sort of wording. Ask about how quickly into the semester a waitlist typically starts.
Additionally, there may or may not be treatment available to address more specialty concerns such as eating disorders, substance abuse, or psych evaluations. Some clinics may have medication prescribers, but many do not or prescribers may not write for controlled substances (e.g., stimulants like Adderall, or benzodiazepines such as Xanax). It pays to be up front with your student’s needs, as it will give you the most realistic picture as to how to put together the right treatment team.
5) Ask about fees, and whether services are included as part of student fees on the tuition bill, through insurance, or something else. College counseling and health centers are typically funded by student fees, which you will see as a line separate from tuition on your student’s bill. These fees fund a wide variety of programs and services on campuses. meaning the counseling center is only one of many which rely on these dollars.
So while that means services will likely be at no additional cost per visit, it also means that services are smaller in scope than a community mental health center or private practice which takes insurance. Alternatively, some colleges are starting to move to other funding models, such as taking insurance, doing fee-for-service, or collaborating with an off campus community clinic or telehealth company. Find out what to expect financially.
6) Understand the spectrum of counselors and other professionals who might be available to work with your student. All counseling centers will be staffed by licensed providers, but it is common that services will also be provided by trainees working towards their masters or doctoral degrees working under supervision. Your student has the right to request to only work with a licensed provider, but this may lead to a significantly longer wait.
More services are also being offered by case managers or wellness coaches with varying degrees and types of training. These can be incredibly helpful services, but are different than therapy. Ask about whether the counseling center employs a “stepped care model,” which may mean that a student who is not in crisis first is offered (or even required to try) coaching, online programs, groups, or other resources before connecting to individual counseling.
7) Consider whether you and your student will feel comfortable with the providers at the center. Finding the right match with a counselor can be tricky. Especially if you have private insurance, you may be used to being able to choose counselors who are a fit based upon skills, style, and identities. Counseling centers may be able to accommodate some preferences, but again this may lead to a longer wait. Depending on the size of the staff, there may also be limitations to choice.
You may also want to consider how the values of the center and their staff come through. Is your student part of the LGBTQ+ community, a student of color, or of a particular religious faith? Look at how values are communicated in the web materials and listen to what you hear in a consultation. Many centers are committed to providing care which addresses the needs of students of all identities and backgrounds, but the level of training and how up-to-date that training is can vary. Ask questions, and trust your gut when it comes to whether you feel comfortable with this team working with your student.
8) Learn about what accommodations are available for learning, physical, and mental health issues. If your student had an Individual Education Plan or other supports in place in K-12, make sure you get copies of every evaluation and the various services plan they had. These can be infinitely helpful in starting the process at college. Reach out to ask about how to get engaged with services and what documentation will be needed.
Know that many things are different about accommodations in college, and what your student might get will be a bit (or a lot) different than the standard in the K-12 system. These accommodations commonly involve additional time on tests, one-time extensions on assignments during periods of acute illness, taking tests in a distraction-free space, or adaptive technology to help with reading or note-taking. On the other hand, it usually does not include alternative assignments, repeated extensions, ongoing permission to skip classes or assignments, or not taking certain courses required for a major.
9) Prepare your student for independence. One of the best things you can do for your student is model advocating for themselves through this process. Have them with you while you make calls, so they can see how to talk to office staff, counselors, and others. Remember that even basic greetings and how to phrase questions might be foreign to your 17 or 18 year old.
Additionally, have them start to practice making their own appointments while you’re there. Once your student is over 18, it may be that they alone will be able to book an appointment for themselves due to privacy laws related to medical care and educational records. This way you can coach them the first few times and help them manage anxiety.
Maybe the most important thing I tell families and students is that a rough start doesn’t mean the end. In the first weeks at a new school, things could get a little bumpy. Your student may want to come home. They may tell you that everyone else is happy and has friends and they’re miserable and alone.
You know your student best, so while it may be that they need to leave or they are in serious trouble, it may be that they have the inner resources and experience from past therapy to make it through. Normalize that the transition is hard and express compassion for how they’re feeling. Ask if they feel they can hang in there while upping their self-soothing and using coping skills. Pay them a visit if you can. Most students turn the corner at about the four to six week mark.
Working in college mental health, we also see a handful of students who will experience severe symptoms and need strong supports (including hospitalization). Encourage your student to share how they’re feeling with you. If calls or texts are coming throughout the day (and night), and you’re feeling more crisis counselor than parent or family member, it’s probably time to consider a higher level intervention.
If they have not arranged counseling, reach out to the counseling center or start a search with them through sites like Therapy Den for local providers. If they seem to need more, or are expressing any suicidality or self-harm thoughts, three-way call their on campus counseling center, existing counselor or prescriber, primary care doctor, or local psychiatric crisis center. If you are immediately worried for their safety, search the college’s website for the number to the campus police or public safety office to get a wellness check immediately.
But even if there is the need for hospitalization, all is not lost. Campuses understand that students struggle, and most times there is great compassion for a student who needs to step away for a week or two to get their mental health stabilized. If your student is out for “medical care” (which is all you need to say), reach out to the counseling center to find out if they or another office can help notify faculty of the absence and assist in the return to campus.
And maybe most importantly, take care of yourself. You have your own big transition ahead with the launch of a student into adulthood and their future!