“Going to college is exciting, but students need to know that this experience, though positive, may also be stressful,” said REACH faculty member Elena Man, MD. Dr. Man recommends resources (see below) and strategies that pediatric primary care clinicians can use to prepare patients for this significant transition to a new environment for learning, living, and friendships.
First, talk with patients about ways to stay healthy. Address the need for sleep, nutrition, exercise, stress management, and social connections.
Next, review the 5 Ws to help you clarify the steps patients need to take to obtain support and be prepared for college.
This point is critical for patients who need extra support. Encourage patients and families to explore who will provide any needed mental health and academic support at school. If students will not be home often enough for you to follow them, they will need a local prescriber at college. If they learn that campus health and counseling services can’t offer enough support, families should look for in-network providers that are near campus.
Advise parents to encourage their young adult children to take responsibility for their needs. Suggest that students organize a list of campus phone numbers, including, if possible, a relative or family friend in that state. Parents and students can become familiar with the topics listed below.
Once children turn 18, their privacy is protected to an extent that often surprises parents. If parents and students agree, students can sign an authorization form to give parents access to their college information, including grades and campus health records, and a separate authorization for their medical information.
College is a time when identities may emerge more openly. Explain to parents the importance of accepting their young adult regardless of how they identify. The biggest predictor of long-term well-being in the LGBTQIA community is family support, which reduces otherwise increased rates of depression, anxiety disorders, and suicide.
Use patient education resources to counsel students about:
Now! Students should identify and contact campus and local resources.
Families should identify clinicians and pharmacies that are covered by their insurance and figure out how students will travel to an off-campus provider.
College can be overwhelming! Even patients who are well-regulated at home may have to adjust their approach to mental health in response to the demands of college life. Meanwhile, students who have not experienced anxiety or depression symptoms are still at risk; 75% of mental illness begins by age 24.
In a fall 2018 survey, three out of five college students said that they had experienced overwhelming anxiety in the last 12 months; two out of five students said they were too depressed to function. Although many students experienced new or worsening symptoms of a mental health condition, only 10-15% sought professional help.
Finally, Dr. Man offered this suggestion: “Emphasize that college is exciting and fun, but that it is not unusual for students to experience difficult feelings or to find at some point that they need more support to get back on track. If you normalize that experience for upcoming freshmen, perhaps they will take steps to get help if they need it.”
Dr. Man offered education resources you can suggest to help patients and families plan for college transition.
For all patients:
For patients with an existing mental health condition:
For patients with disabilities (including mental health diagnoses):
“The opportunity to learn information to help me manage psychiatric conditions in my patients in this time where demand clearly outweighs supply of services, is going to be excellent for me as a PCP in my community.”