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Inside the minds of undertreated mentally ill college students.
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By Julia Trupp
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You won’t survive the night. We are here to help you end it all. We are the creatures from under your bed, but we’ve chosen a better place to live: your head.
His chest tense with the sensation of hot iron running through it. Christopher had no idea if he would make it through the night. He experienced suicidal depression, anxiety that altered his memory and focus and vivid hallucinations from taunting voices in his head named Mr. Face, something he began to experience when he was 15, and Mr. Wax, at the end of his freshman year of college.
“Sometimes they would just appear,” he said. “I wouldn’t look into mirrors for fear that they were legitimately real.”
It took Christopher, a University of Arkansas junior whose name has been changed for privacy, five years to finally decide to see someone about his mental health. It was not because he did not understand the dangers of not getting help, he said, but because of the fear of being rejected and the idea of finally coming to terms with his mental illness.
Depression and anxiety. These two words loom over the heads of college students as they transition into their new lives away from their childhood homes. Many people face depression and suicidal thoughts, but rather than work through the illness, they try to write their feelings off instead.
In 2015, young adults between 18 and 25 years old were 60 percent more likely to be diagnosed with depression than people 50 years old or older, according to a study by the National Alliance on Mental Illness. By that point, some teenagers will have already lived with some form of mental illness for four years one-half of all chronic mental illness begins by the age of 14, increasing to 75 percent by 24 years old, and that’s just in the United States, according to the National Institute of Mental Health.
“The demand for awareness is found in the medical side as well as counseling,” said Mary Alice Serafini, executive director for Pat Walker Health Center. “We just want to connect and make sure students know that we are here for them.”
Christopher said mental illness awareness needs to be prevalent on college campuses to better educate students on the necessity of healthy mental health.
“It would defuse the skepticism surrounding the subject of mental health,” he said. “I was ignoring the problem because I was afraid of how people would think of me. I don’t want to be viewed as unstable, weak or inferior because I have mental illnesses. I feel as though if people understood that, I could be open with something that has become a very big part of my life.”
Besides depression, anxiety disorders are among the most common forms of mental illness in the United States. They develop from various factors including brain chemistry, genetics and traumatic life events, according to Anxiety and Depression Association of America.
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Anxiety and depression are not typical traits in 10-year-old children. At a time when she could have been getting excited for Field Day at her elementary school or being in a hurry to grow up, Mallory, a University of Arkansas junior whose name has also been changed for privacy, started experiencing depression. But even with the sadness she was experiencing as an adolescent, she did not start going to counseling until nine years later in August 2015, simply because it didn’t seem there was a reason or explanation for her depression.
Once she started attending counseling sessions, she was diagnosed with post-traumatic stress disorder, or PTSD, for something she had repressed for 13 years.
“I didn’t understand what I was feeling, but I always had this lurking feeling about it,” Mallory said. “Did I see this event in a movie? A recurring nightmare? I didn’t know.”
About 18 percent of young adults in the United States experienced an anxiety disorder such as post-traumatic stress disorder in 2015, according to a study by the National Institute of Mental Health. Mallory became part of that statistic.
Mallory came across an article in June 2015 about the Duggar family and the child molestation allegations against Josh Duggar, the first-born son of the “19 Kids and Counting” Duggar family. Reports surfaced that 27-year-old Duggar had molested four of his younger sisters and a former babysitter––all minors––when he was a teenager. As his father Jim-Bob told Megyn Kelly on an exclusive Fox News report, “he said he was just curious about girls.”
And it just clicked.
When Mallory was 6 years old, she was sexually molested by a 14-year-old relative. The molestation continued for the next five years, but she said she suppressed it in order to protect herself.
“I had a moment to myself, a moment to process,” she said. “I had to go work at camp for four weeks after that.” So the memories were locked away once again in the back of her mind.
But somehow the lock and chain around the painful visions were broken, and what was once suppressed had now escaped. One day at the summer camp she worked at as a counselor, Mallory was suddenly overcome by debilitating panic from her surfaced realization, making her physically ill. She could not keep this to herself any longer. She finally told her parents about the abuse on July 18. Two days later she called her older sister, and a week after that she told her 14-year-old brother. This was the toughest part for her, she said.
As a child molestation victim, Mallory often wakes up with anxiety attacks or nightmares, and sometimes has vivid flashbacks, but she said she has a feeling everything will get better as she goes through her process of telling her story and going to counseling.
“It’s not equivalent to someone stealing my Barbie doll, and I was mad at them,” Mallory said. “It’s more like having a broken arm, and understanding it’s broken, but shooting it up with morphine so you can’t feel it. I did a lot of that. But now I’m coming off the morphine, and ultimately the feeling of hope is coming back.”
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At the University of Arkansas, the Pat Walker Health Center and its Counseling and Psychological Services program, or CAPS for short, has helped to open the discussion and lower the stigma of mental illnesses with its services for on and off-campus students. With the continued increase of the student body population, sitting at 27,194 enrolled students as of September 2016, an expansion to the health center is underway, which will create more space for services. Once the expansion and renovations are complete, health center officials plan to hire more counselors to make a healthy ratio of counselors to student population.
The International Accreditation of Counseling Services recommends a staff of 18-27 counselors for a university the size of the University of Arkansas. CAPS has 13 full-time clinical staff members––counselors, therapists and social workers––which is substantially less than what is recommended. The IACS advises schools the size of the University of Arkansas have a ratio of one counselor to every 1,000 to 1,500 students. The university’s actual ratio is one counselor to 2,076 students, which is not necessarily considered healthy, but it is still a goal of Serafini and CAPS Director Josette Cline to get there.
“There is great support and recognition of mental health in Pat Walker Health Center and our divisions across campus for CAPS,” Cline said. “There is support to move towards the ratio, but it’s a space issue.”
By 2009, the CAPS department of Pat Walker Health Center started taking over offices across campus, and in 2010, Serafini decided it was time to ask for an expansion. Slowly but surely the plans started to come together because in 2015, Interim Chancellor Dan Ferritor and the Board of Trustees approved the building plans to expand Pat Walker Health Center and double the size of CAPS, north by about 17,000 square feet, leaving them just 16 feet away from the Northwest Quad residence hall.
“Right now with only 13 of us, we can’t possibly provide long-term services, but we can target our responses at an appropriate level … We want to be as accessible as we can, which is more along the lines of our mission,” Cline said. “(There’s the) assessment, short-term intervention and then a referral to which service would be the best, whether that is a CIR (counselor-in-residence) or a psychiatrist.”
These short-term services give more access to the high demand of counseling services from the increasing student population, and it is really a public health model that is in good condition, Serafini said. Because the health fee is connected with students, when there are more fees, there are more services. Accessibility to the students has been the top priority for Pat Walker officials, even if they haven’t always been allowed to keep up with the demand.
“We’ve expanded a number of touchpoints of immediate access,” Cline said. “This expansion is putting money where our mouth is.”
There might be a little digging and preparation taking place at the health center in December, but the official groundbreaking of the building expansion and renovation will be in January 2017, with CAPS slated for a fall 2018 finish. Even while the construction is happening, services will still be available for students, but the surroundings might not be as peaceful with the nonstop grinding of nearby jackhammers. Whatever the case may be, Serafini said she believes they will always be accessible and always engaged in the educational process with trainings, group therapy and wellness sessions.
With this expansion, not only will CAPS have more room––completely spread out on the second floor, making the women’s clinic move downstairs near primary care––but new classrooms and training programs will be added, which means more counselors will be hired to fill the refreshed space. And on top of those additions, more outreach initiatives will be put into effect so “students can see counselors as normal humans,” Serafini said, by going into classes or helping train Resident Assistants in University Housing.
Along with its clinicians and psychiatrists, CAPS also employs counseling interns and counselors-in-residence, or CIRs. A CIR is a doctoral student with advanced training in counseling. Their offices are located in residence halls, making the counselors more accessible during the day for students living on campus.
Megan Little, a CIR in Maple Hill East, always knew she wanted to help people because, as she put it, “everyone has stuff.”
“It’s okay to not be okay,” Little said. “We as a society want to be perfect and have it all together. If we all looked a little deeper, we’d see our imperfections are part of what make us up.”
But for sophomore Andrew Frank, hovering imperfections have played a role in his battle with self-worth, and that battle has lingered for as long as he can remember.
“It’s always a game of comparison (with friends),” he said. “They are always doing things better than me, and there is a snowball effect from there. My depression is based on my role in this world, and to have an even bigger role. Even as a toddler I was aware of this, like if I got in trouble about something, I’d hide under my bed and cry, ‘I don’t deserve to sleep in my own bed.’”
He realized that his snowballing sadness as a child was depression in middle school, he said. He heard about it through school and talked to friends and teachers when it hit him that a lot of the symptoms associated with depression and anxiety sounded a lot like his.
A survey released by the National Alliance on Mental Illness in 2012 showed that 65 percent of college students with mental health problems believe a walk-in health center is critical to their college success, yet only 55 percent used their campus’ mental health services. For students who want counseling, 36 percent of students said a barrier between them and help was the stigma of mental illnesses.
For Andrew, it wasn’t the stigma that stopped him from seeking professional help. He didn’t think it was a big enough issue for that. He read journals and continued talking with his friends and mentors, which he still does, but last summer things changed.
Andrew was home from college for his last two weeks of summer vacation before moving back to Fayetteville in July, and he was ready to get back to campus. He was banking on school being his sanctuary, he said. But after experiencing “a bit of a meltdown,” school was not the next stop on his path.
Andrew and his family live off a small, private lake called Prairie Lee Lake in Lee’s Summit, Kansas. The family pontoon boat is anchored right in their backyard, waiting for its next family boat trip along the inviting Ozark waters.
On that hot June afternoon, coasting along the lake out back was not a highlighted part on the Frank family’s schedule hanging in their kitchen. Instead, the private lake that was once warm and inviting turned dark. Andrew opened the back door to his house and walked down to the shore, believing these last steps were the ones worth remembering.
This was it. No longer would he need to think about what he meant to the world because it was all right in front of him, the waters now turning cold with the looming presence that would soon overcome them.
The boat rocked with the wind as Andrew brought the anchor, securing the boat to the Franks’ backyard, up to the surface. But he was not taking the boat out for a last spin. Andrew had something else on his mind. He looped the anchor rope around his neck and tightly tied a few knots in it. Right as he was about to throw the anchor back into the cold water to end his young life in the small, private lake behind his house, near the family pontoon boat where years of memories floated around him, his parents and 21-year-old brother Thomas came running outside to save him from this fate.
He argued with his family that it was just a meltdown and he would be fine in due time, but they put him in a two-week long hospital program immediately, despite his opposition.
Andrew came back to campus to start his sophomore year after finishing the program, and he is “happier than ever studying my German.” But with finding his sanctuary in school as he planned, he also keeps a list of campus resources, which he has quaintly deemed “The List,” in his room, just in case.
“A lot of people on campus need to know they aren’t in a serious place alone,” he said. “Even though I don’t use the resources, having them there is a relief. It’s like having a safety net under the tightrope.”
And if students are not sure about counseling services or don’t feel they need them like Andrew, Justin Cook, a CIR in Pomfret Hall, said he believes it is important to develop a rapport with students in order to build trust.
“I think everyone could use someone to talk to,” Cook said. “Whenever you have the opportunity to provide those services to reach a hand out to, they’ll reach back.”
Students like Christopher, Mallory and Andrew have that hand to reach out to, and with services on campus like CAPS there is new hope and awareness for mental illnesses.
“It’s perfectly acceptable to seek help for mental health,” Christopher said. “It’s as scary as the monsters inside your head, but it’ll be worth it in the end. It feels like I’m waking up after a very long time, and I’m able to silence the entities that follow me.”
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