Episode 47: Supporting Your Mental Health While in College

Episode 47: Supporting Your Mental Health While in College

• Episode 47 Transcript

  [INTRODUCTION]

  BT: You might hit up the athletics center to exercise your body, the academic assistance office to sharpen your study skills or a weeknight social event to build strong bonds with friends and classmates. But of all the resources for maintaining a healthy and balanced life on a college campus, where do you go to care for your mind?

  BHA: The answer is the counseling center, a place dedicated to helping students support their mental and emotional health. I'm Becca Haupt Aldridge from Bucknell University, and in this episode of the College Admissions Insider, we're learning how college students can leverage this important resource to care for their mental wellness.

  BT: I'm Brooke Thames, also from Bucknell, and today we'll discuss the types of services a counseling center might offer, the process of receiving counseling on campus, tips for developing self-help tools and more.

  BHA: Joining us today are two professionals from Bucknell’s own Counseling & Student Development Center. Staff Counselor Lee Bard and Staff Psychologist Kelly Shaw. Lee has worked with Bucknell for three years with an emphasis on LGBTQ plus issues, relationships and identity development. Kelly has worked at Bucknell for six years focusing on relationships, identity development, and mindful self-compassion. Welcome to the podcast.

  [INTERVIEW]

  LB: Thanks, for having us.

  BT: So, let's start off by talking about a counseling center’s role on a college campus. Kelly, can you tell us more about what your office does?

  KS: Sure. So, the function of the counseling center office at most universities and colleges has evolved a bit over the years. Initially, they started kind of mostly focusing on career counseling. But over the years as the mental health needs have developed for students, then the counseling center has adapted as well. And so increasingly, what we've seen is that counseling centers are the primary mental health services providers to students on campus. We don't provide clinical services to staff and faculty. We do, however, have a critical role in working with staff and faculty to provide training, consultation [and ] support to them about how they can best support students. So our focus as a counseling center is always grounded in how can we support the wellbeing, success — academically, personally, etc. — of students overall.

  Most counseling centers provide mental health counseling one-on-one, kind of what you think of traditional individual counseling. Group counseling for students; those could be support groups around a certain identity or a certain experience. It could be traditional therapy groups, what we “call interpersonal process” therapy groups. Then we also do a lot of outreach and education with different offices in specific student groups on campus.

  BHA: And are prospective students likely to find resources like the ones you described at most schools, or do mental health services differ depending on the college?

  KS: I would say that that is a question that's tough to answer, and so it's going to be important for families and students to look into the counseling center if that is a service that they expect to need. The Bucknell University Counseling Center, I would say, is on par with other centers that I worked at. I've worked at a number of different private and public universities. However, funding really significantly impacts a university's ability to provide consistent, longer-term counseling center services. So what we might find is that some universities are able to provide pretty consistent, unlimited, no session limits for students, while others maybe have a session limit of you get three in a course of an academic semester or a year. So, that's probably where you're going to see the biggest variation.

  BT: So, since services can vary so much from school to school, where should students and families start when trying to figure out what mental health resources a particular university offers?

  LB: Yeah, I mean, I would say our website or any institution’s website is probably the best place to just start collecting information. Our website is broken down by certain sections for students, faculty and staff, or parents. So that information is organized in a way that may be better suited for the needs of who might be looking at the website, but always the website is the best place to start.

  KS: Most university counseling centers are housed within the Division of Student Affairs or Student Life. So, if ever there isn't a insert-university-name-counseling-center search result that comes back, then I would say that the next best place for a prospective student or a family member to go to is Division of Student Affairs, Dean of Students Office, or even the traditional medical or physical health student services. Some counseling centers are housed within the health center, the general health center. Some are separate entities like we are here at Bucknell University — the Counseling and Student Development Center is different than the Bucknell Student Health Center. But we are both overseen by the Division of Student Affairs and Dean Badal.

  So, if ever, they couldn't find a quick and easy search result by searching for the university's website for counseling center — generally, that phrase “counseling center” — I would say then the Dean of Students Office or the Division of Student Affairs would be the next best place to start and ask them by calling or looking on their website to see what resources are available.

  BHA: That's super helpful. Kelly, given that many of our listeners are going through the college search process, having a keyword to take advantage of like “counseling center,” will probably really help some of our listeners know where to start.

  As students are clicking around on the website or exploring not only where a counseling center lives in an institution's organizational structure, what questions should they be asking, especially those who are going to plan to lean in to mental health support and services while on campus? Are there questions that come to mind that would help a student gauge what a school does or doesn't offer?

  LB: Yes, and I think typically, those kinds of offerings are laid out pretty explicitly on those web pages. And certainly, we would obviously welcome a call as well. So if there's any question about whether or not the services that you're looking for are available, just give us a call, and someone from our office will either be able to answer that for you then or return a call to you if they're not able to do so.

  Again, I think as an individual considering what they might need as they come to college, that can look very different depending on the student. So some folks that are listening to this may already be connected to a provider at home. They may be coming from out of state, and that care can no longer continue because that provider and our licenses are state specific. So that individual might have had a long history with another provider but be looking to transfer that care. When an individual is looking to do that, I recommend that the student or the parents get a release of information signed so that we have access to communicate openly with that provider about that individual's care, and then can kind of speed up the process and get them kind of better integrated into care here more quickly.

  As for folks who might not have had access to mental health care for the first time, but had been really been thinking about it, or thought maybe…for some folks, I think they're very keenly aware that, for the first time, they might have access. So, for them, I would invite them to review our website. We have compiled a list of our staff, and some areas of expertise, and some just background information on each of the providers in the Counseling & Student Development Center that might help an individual make a more informed decision about which provider they would like to work with. Students can certainly request a provider of their choice. However, requesting a certain provider might increase the student's wait time to access that care. That just depends on when in the year the student is contacting our office and, again, what individual schedules look like as the year goes on.

  BT: So let's switch gears a little bit and talk about the transition from high school to college, especially since Lee, you mentioned transition of care there. In a recent episode that we did on accessibility resources, we noted that students may not have the same exact resources in college that they had in high school. How might that translate to mental health and counseling services on a college campus?

  KS: That's a great question. I'm going to jump in there. So I think what's important to realize is that most college counseling centers provided and funded by the university, the student tuition dollars, etc., are not able to meet the exact same needs that a traditional outpatient provider or private practice practitioner are able to offer. As I mentioned something earlier, it's not uncommon for students to run into the experience of having a session limit, for example, a certain number of sessions that they can access with their provider here at the counseling center over the course of a given academic year or their academic career even.

  So that can be different from what students may have experienced at home. If they have previously been in counseling, they may be used to having their traditional Wednesdays at three o'clock guaranteed spot with their provider. That's provided a lot of comfort and consistency in the treatment that the student was able to provide. Most college counseling centers do not have enough staff to meet that consistent of a need. So I think it's going to be important for families to understand that while we are the mental health services provider, and we do want to support the mental health needs of our community, we're not likely going to be able to meet that to the same higher level that they might be used to with traditional outpatient providers.

  So if a student has a particular issue, they're going to want to think about what needs they have, do some research, be ready to accept the unfortunate reality that the counseling center at their university may not be able to meet that need in the way that they have been. And then to be willing to possibly collaborate with a counseling center on campus, or to continue to work with their off-campus provider or to connect with a provider off campus who provides similar services to what they were receiving before.

  LB: I may add that what might look different is the access to individual care and the frequency of that care. However, on the inverse of that, I think what actually happens on a college campus is that we are much more integrated with community resources in the way that I don't think providers externally are. So, when it comes to the needs of a student on a campus, we may be — if we are connected to a student, and we do have a release of information on file — oftentimes, we are communicating or connecting a student with those relationships that we have built here at Bucknell. With the Campus Activities & Programs office, we're connecting them with the Office of Accessibility Resources. We are connecting them with faculty and staff or assisting a student as they connect with their academic dean to get some support within the classroom.

  Whereas I imagine that that support might be more frequent off campus, however, it is much more integrated to the individual work that exists within the clinical room in the clinical space. So if a student has identified anxiety as their presenting concern, my role as the clinician off of a campus maybe to help that student or individual generate some coping strategies to manage that anxiety, whereas on this college campus, we might be able to integrate multiple different layers of care outside of the clinical setting that might not be as easy.

  KS: Yeah, I would say that that speaks to the specialty of a college mental health provider. All of us who have worked in college mental health for years, really see this as a specialty that allows us to understand the unique developmental needs and challenges commonly faced by students, especially students have a traditional college age like we typically see here at Bucknell. But then to also understand that those identity development issues that are pretty common, might intersect with serious mental health. And then for us to also be aware of the other offices on campus that can be a supportive resource.

  BHA: I think, Kelly, what you're describing, and Lee, is kind of a hallmark of your small liberal arts college experience, too. Not to say that a large, public institution can’t achieve that, but there's a way that I've seen that it happens here where those integrations happen and supporting a student happens from multiple offices that seems pretty indicative of the type of education at a place like Bucknell.

  And Lee, you talked about this a little bit already, but if somebody is seeing a practitioner throughout high school or for however long, and then they're getting ready to transition to college, you mentioned a release form that signed. How smooth is that transition, and do student's records truly follow them from clinician to clinician? What does a student need to know to be prepared for that?

  LB: Yeah, so they certainly follow you if you initiate the process for them to follow you. So that is something that we leave to the student to kind of coordinate. If that office or practitioner has a release of information in their office, we would invite the student or we would encourage the student to complete that documentation. And we have a fax number that can be sent over to us, we would review that, and then if the student or that clinician were to make contact, we certainly could connect with that provider. On the flip side of things, if that student wants to wait until they are connected to our office, we can have them sign a release of information digitally that is kept in their electronic record here. And then we would initiate contact with their former provider to try to set up a time to do a consultation.

  Sometimes that can be a little complex because providers may not be billing for that consultation time. So it might be a really valuable thing to consider if you are connected to a provider off campus, or a conversation to have is, “What were the consultation as I was going to advance with another provider look like? What are your expectations around that? How much notice would you need?” There could be some coordination of that with your former provider because, in the community, that kind of consultation does look different from a private practitioner. But we can certainly facilitate that process. So you can sign a release of information with your former provider, or we can provide a digital release here.

  BT: Yeah, those are all really great things to keep in mind. So far, we talked a lot about the one-on-one sessions and that option that students have to meet with a mental health professional. Kelly, can we break that process down a little bit more and can you outline for us the process of actually getting in to see a counselor?

  KS: Sure. The quickest, easiest way is to call our office. I can't speak to how it works at every other university counseling center. But for us, our office is staffed 8:30 a.m. to 4:30 p.m. during the academic year — 8 to 4 p.m. during the summertime — and we have somebody available during that time to schedule appointments. So when you call, you just say, “Hey, I'd like to schedule an appointment.” And they'll ask you, if maybe if you've been here before, if you've worked with a provider specifically here at the counseling center. They may have a couple of questions that will just help them to decide who and when to route you.

  Most often, what we have done as a center historically is that we then have several what we call “placeholders” that are scattered throughout the day — every day of the week, Monday through Friday — for of all of our clinicians. So, we each have several of these what we call “initial intake spots.” That allows there to be a wide variety of availability during the business day for students to get in and to get in with a specific counselor if they had a preference, or to just get in with the first available counselor.

  So when they call our main office number, say they want to schedule [their] first time coming to the counseling center, “I'd like to schedule to meet with a provider.” Then the office assistants will ask them a few questions about their name and contact information and start to go through, “Okay, this is our next available time: Monday at one o'clock. Does that work for you? No? Okay, so then the next time is Monday at three o'clock. Would that work for you? No. Okay, so then we have Tuesday at 9 a.m. Will that work for you? Yes, okay, great.” So, they will then put that student's name and information into our center’s software services to hold that spot for the student. That will also generate an automatic link to the student to say, “Hey, 24 hours prior to your appointment, we need you to complete this online paperwork.” So the student will be asked to do that paperwork the day before their appointment to ensure that the provider that they're going to be meeting with has as much information to help kickstart that counseling relationship.

  It's usually as simple as that.

  BHA: So as we mentioned at the start of the episode, individual counseling isn't the only resource that's available for students at Bucknell but also across lots of college campuses. So can you talk more about what other services a counseling center might provide or what opportunities students might find to seek support from a counseling center?

  LB: Yeah, so I think the providers at the CSDC and most folks at Bucknell are really interested in creating a campus of care. What I mean by that is creating a well-informed community where many folks on the campus feel like they are playing some role or a vital role in maintaining the wellbeing of students. So when I think about what that looks like, even in our office, some of us in the last several years piloted and ran different group counseling opportunities that sometimes might require a small commitment or could just be a drop-in group for students to connect out adjustment to college or about something related to an identity that they might hold.

  Oftentimes, that looks like someone like myself or Kelly connecting with an individual and another office within the Division of Student Affairs or with a faculty member to kind of co-create this space that provides some type of wellness component that is beneficial well beyond individual counseling. Sometimes, that has looked like accessing some of the resources like Cognito that are suicide prevention or kind of encourages students to discuss suicide in a way. There are certainly some online modules that students can access on their own terms that include topics like suicide prevention and having difficult conversations around suicide.

  We also recently launched Togetherall in partnership with Bucknell student government, which creates almost like a social media platform where students can post or share images that might allow them to reflect on how they're feeling. So again, there are a multitude of different spaces that can be created that look very different than individual counseling. Sometimes those spaces might be created within athletics, so it might be offering yoga, or reiki or some type of spin class, that might have a mental health component.

  KS: I would also just add that I think it's incredibly important for students and those who love, and care, and want to support these students to see the students as really holistic, well-rounded human beings. That means not seeing them exclusively as academic scholars. This is a place where students can come and not only learn, and become scholars, and proficient in a specific academic subject but also to grow and develop as human beings and to understand their identities.

  So the more students can get creative in thinking about, “Well, what's important to me? Do I like being outside? Oh, there's a kayak club or a hiking club.” All of that contributes to supporting their mental health and wellbeing. I really want to get across this idea that it's not just about mental illness, [it’s about] mental health and wellbeing. We all have a state of mental health just like we have a state of physical health. And when I “work out” my physical health by walking, or biking, or other things, I get stronger physically. And similarly, when we think about our mental health and well-being, we can absolutely “work out” our mental health and well-being, and that's by building relationships, putting ourselves out there, taking risks, being scared and doing something anyway. All of those things, by building community, by stretching ourselves — just enough — but not too much, helps us support our mental health and wellbeing.

  BT: Yeah, I loved everything you had to say there, Kelly, about holistic health. I think it was in our episode on religion where one of our guests kind of conjured this image of a student as a brain on a stick, which he was saying is not what college is about. It's really about educating and nurturing the whole person, which is really a community endeavor at the end of the day.

  Speaking of community and people rallying around a student to take care of them, I want to talk about parents and families for a little bit here. They've been the primary people looking out for their student’s well-being. But once a student is at college, that relationship shifts a bit and students take on more responsibility for themselves. So what role can and should parents and guardians play in their student's mental health journey while at college?

  KS: It's such a great question. It's such a tricky question. No easy answer. A few thoughts, though, that I want to share: Families who have had teenagers have started to experience their teenagers pulling away a bit — pushing back, questioning, maybe rebelling a bit. All of that has been necessary for the student to be able to feel confident enough to fly from the nest and go off to college. So that has been a key training ground. All of the arguments, and questions, and just frustrations that you may have had with your teen have been preparing them for this moment.

  So if we can see this college phase, as an extension of that. This is an opportunity now for the students to figure out who they are and to deepen the roots that they've been building under your guidance, and your care, and your support for all of these years. So I think for guardians and families to really think about seeing themselves more as sideline base coaches, occasionally being asked to consult, but they are not there with the board to tell the player exactly what the next move is.

  You can send a message that's just checking in and saying, “Hey, I'm thinking of you. I know you've got a test tomorrow and some of the things. I hope you're doing well. Look forward to hearing from you next time.” Letting them know that you are attuned to what's going on their life without expecting them to keep you apprised all the time is going to be a key piece of them developing the independence and the intrinsic motivation to actually do things for themselves.

  For example, we don't, at the counseling center allow, parents or even friends to call and say, “Hey, my friend wants to go to counseling, but she's really anxious and nervous about calling, so can I just make an appointment?” We actually don't do that. And there's a lot of psychological reasoning for that. I know it can be really frustrating. A lot of families say, “Well, if I could just make this I'm just sure my child will come.” But we as psychologists and mental health providers know that the more a student is choosing to do this of their own volition and stepping outside of what may be their comfort zone to make that appointment, the more committed they're going to be, the more engaged in the process they are going to be. And the more beneficial, the experience of counseling is going to be.

  LB: I often use this metaphor of planting the seeds of care and support, and being direct with questions about what that support might look like, as Kelly was saying. So that that can be fostered through additional interactions that might actually lead to the outcome that Kelly and I as the clinicians hope to see, or the outcomes that the parents also hope to see, that have the best interest or have actually the best outcomes for the students.

  KS: I often think of that phrase, give someone a fish, feed him for a day. Teach them how to fish, feed him for a lifetime.

  BHA: I feel like we just concluded the metaphors and analogies portion of our podcast today. We covered planting seeds, teaching someone to fish, leaving the nest and acting as a base coach for your student. Kelly and Lee both provided some beautiful examples of how to set expectations and how to set boundaries as your student’s entering college.

  But anytime parents, guardians, loved ones enter the conversation, so does the conversation about privacy concerns or even FERPA which we've discussed on previous episodes. So what does that look like when it comes to counseling? And are there things that our listeners should be aware of?

  KS: Yeah, mental health providers, we’re subject to pretty much the strictest privacy and confidentiality laws, and that's why we are wanting students to really take ownership for this process and experience themselves. If a student gives us permission to collaborate, let's say, they do experience a family member as just a key part of their treatment team, absolutely. I want to bring that person in, whether it's a home provider, a parent, a close friend. But I'm also always on the lookout for how those people might be used by the student to not grow and develop skills themselves.

  So I'm going to want to make sure that I'm talking with the student. “Okay, so you'd like to have a conversation with your parents. What are you hoping will come from that conversation? Are there things that you would want them to know that you haven't said that maybe you want to talk about that day? Were there things that you were hoping I would let them know?” I'm going to have that conversation in advance with a student to make sure that I understand their goal for bringing in outside folks to their treatment team.

  Because my obligation is ultimately to protect the privacy of my client, and many students are used to just being like, “Oh, yeah, my parents know everything. No big deal.” And sometimes, it can be perceived that we are trying to shut out the parents or others who care about the student, and that is not at all the case. We just want to make sure that the student is making an informed decision about what information is being shared, and what the goal is. Long term, we always have our eyes on how is this ultimately meeting the student's treatment goals, and that includes even just thinking about and weighing the pros and the cons of bringing in a parent or somebody else to a session.

  So, I know that can seem a bit obstructive at times or can be experienced by family members as if we're trying to keep them shut out. But it's really because we're thinking long term about what is in the mental health best interest of the student, and how bringing somebody in or not bringing them in may impede their progress, may contribute to their progress, may do both.

  BT: So, as Becca said, this episode has been full of really awesome, beautiful, vivid metaphors for this time in a student's life and the tools that they are learning as they enter this period of change and new experiences. It's also a time when students are discovering more about themselves, right? Their beliefs, their values, and what they want their futures to look like. So at a time, that's so developmentally crucial, how can students on their own, by themselves, also work to develop tools to care for their mental and emotional wellness? And why are those tools important for not only their time in college, but the rest of their lives?

  LB: Yeah, I might jump in here and say that, certainly, that the development of those skills seems to diminish the effort or the progress that an individual has made to even make it to a college campus, right? So I often remind students when they engage with our office for the first time that they have already cultivated a plethora of skills that have allowed them to cope with stress, anxiety, depression.

  What are the challenges they might be facing as they enter campus? What might need to happen and to think about, “How can I strengthen those coping mechanisms? What might be making these coping mechanisms not as effective as they were in the past? And what other challenges are kind of raising the temperature (for lack of a better word) that might require me to explore additional avenues of coping?”

  Again, we're not starting from square one. We’re maybe starting further down the road and thinking about, what can I add to my toolbox to be more successful in this space? Even if it is an unfamiliar environment, even if we are surrounded by folks that we don't really know? What does that look like?

  KS: One of the coolest things that I've experienced is part of my job is helping students to realize how much more capable and competent they are than they even realized. It's not uncommon for me to ask about, “Okay, so generally, we all experience some things that are difficult or challenging. We might call them coping skills or coping strategies. What do you typically do to try to cope?” And it's not uncommon that I'll get a response from students saying, “I don't know.” And then when we get into it, and we start talking about different situations, I will be remarkably impressed at how resilient and how they managed to get through that.

  Also, I think we want to be thinking about how have strategies that have worked up until now maybe started to not be as functional. So that adaptation, that malleability has served them before, may no longer serve them when they don't have those same mentors and guides to proactively answer every question help, clear every path that falls in front of them. And so seeing that that coping strategy of malleability and following along with authority has been helpful in certain environments, in certain circumstances, may not be useful to them now, may need to start to grow and change a bit.

  BHA: Kelly, earlier in the episode, you said that clinicians, health care, mental health providers and psychologists on college campuses really consider them specialists because of their area of expertise about this period of development. And just hearing from both of you, I could not believe that must be so, so true. The experience you have with this population in particular, and your ability to serve them as they learn about themselves, and grow, and discover those coping skills, and work on those with the support of folks like yourselves, it's a really neat place to be. And I'm sure our students believe themselves to be very lucky to have each of you in our counseling center. Thanks again to both of you for being a part of this important conversation today.

  KS: Thanks for having me.

  LB: Thank you.

  BT: And thanks to all of our listeners for tuning in. If you are a fan of the podcast, please take a moment to rate subscribe and share this episode with the parents, families and students in your life.

  BHA: We'll be back with another new episode in two weeks. In the meantime, send your questions, comments and episode ideas to podcast@bucknell.edu. We read every note you send.

  BT: We also invite you to follow Bucknell on your favorite social media apps. Just look for @BucknellU on Instagram, Facebook, Twitter, YouTube and TikTok. You can also follow our student run Instagram account which is @iamraybucknell.

  BHA: Until next time, keep reaching for your dreams and your dream school.

  [END]