RENEE MONTAGNE, host:
This is MORNING EDITION from NPR News. I'm Renee Montagne.
STEVE INSKEEP, host:
And I'm Steve Inskeep. Good morning. Today in Your Health, we have the second of two reports about mental health problems on campus. The number of students seeking psychiatric help is on the rise. That's true from small community colleges to elite universities. Last week we told you about the problem. Today, NPR's Deborah Franklin tells us what some schools are doing about it.
DEBORAH FRANKLIN: A new crop of freshmen arrived on the Stanford University campus in California last month. It was a blue-sky day as they stood in line outside the dorms waiting for room assignments from the student resident assistants.
Unidentified Man: You've all got your name tag and all that jazz, P.O. box key...
FRANKLIN: Looking on, Stanford residence dean Arcadio Morales. He and his family have an apartment in the dorms. And he's helped usher in every new class for 15 years. In quieter moment, Morales told us that there have always been some students who pack emotional baggage along with their laptops and books. But the mix of problems he sees have changed.
Mr. ARCADIO MORALES (Residence Dean): Early on, most of the issues that surface were roommate issues, sort of compatibility issues.
FRANKLIN: He still gets that stuff, along with anxiety over midterms. But these days Morales is seeing some more serious mental health issues too.
Mr. MORALES: We're getting students that wouldn't have been here 10 years ago, because they're on antidepressants or antipsychotic medication, and they're functioning fairly well.
FRANKLIN: But it can be a big challenge for the colleges when these students have crises, which has been happening more often at Stanford and other schools. Those middle of the night calls are very hard for any school and any student.
Ms. AMANDA GELENDER (Student): I was just going through a depression, but it was a depression that was getting worse and worse.
FRANKLIN: Amanda Gelender, now a Stanford senior, has bipolar disorder with symptoms that are mostly evened out with medication. But that night in the dorm two years ago, the bottom fell out and she called a family member.
Ms. GELENDER: I was in hysterical tears. I was making remarks - you know, what's the point, you know, just things that a depressed person would say. Just very - I was really sad.
FRANKLIN: But not suicidal, she says. She just needed to vent. After that, Amanda hung up the phone and went to sleep. She had no idea her family was worried enough to call 911.
Ms. GELENDER: And about an hour later there's banging on my door. I go to the door, there's two armed police who barge in and they're talking about, you know, Where are your pills? Where are your pills? And they start ransacking through my entire room. They're opening drawers. They're going through my shelves.
And I'm half-naked. I'm dressed for bed, and you know, they're like, Are you going to kill yourself? Are you going to kill yourself? I'm just like, No, I'm not going to kill myself. And they're threatening to take me to the psych ward, and they've got their handcuffs in their hands. And I don't know what you say to convince someone that you're not going to kill yourself besides, No, I'm not going to kill myself.
FRANKLIN: The police phoned the psychiatrist on call, and after some back and forth, they left. But the whole experience left Amanda horribly shaken. She understands the police have been asked to deal with suicide threats this way. It's protocol. She doesn't blame her family. They just wanted to keep her safe.
Ms. GELENDER: But that's the option that loved ones have. If they fear for someone, they have to call the police.
FRANKLIN: Of course figuring out on the spot who's a risk to themselves and who's not isn't easy for anyone. Stanford's Arcadio Morales helps train student residence assistants in the dorms.
Mr. MORALES: And I always tell the RAs, better to have someone angry and alive than dead and - and dead.
FRANKLIN: Everyone agrees - it's much better to get help for a troubled student before they're in crisis. All across the U.S., concerned colleges, students and parents are trying to do just that. Amanda Gelender started a theater project to bring mental illness into the light.
And down the street from Stanford, a former Palo Alto mayor and his wife - Vic and Mary Ojakian - became mental health advocates after their son Adam died by suicide at the University of California, Davis in 2004.
Ms. MARY OJAKIAN: We determined that he became very anxious due to a certain situation - what's called a triggering event. And it was ultimately severe depression that caused his death.
FRANKLIN: Mary Ojakian and her husband didn't know their son was depressed. He never talked about it. But after Adam died, they interviewed his friends, people in the counseling center, police, professors - even the chancellor. And that's when they learned about the shortage of therapists on college campuses and about how little training most faculty and even police get in how to recognize and handle mentally ill students.
Ms. MARY OJAKIAN: We realized - and they realized - that there was a lot that could be done to change the situation on campus.
FRANKLIN: The whole situation just makes Vic Ojakian angry.
Mr. VIC OJAKIAN: Guess what? What's going on right now isn't acceptable. We took a look at our situation and we said to ourselves, we don't want another good human being dying...
(Soundbite of crying)
Mr. OJAKIAN: ...and we decided to do something about that - not to sit back, not to do another study. We decided we were going to go save lives.
Ms. OJAKIAN: Yeah. Someone's got to draw the line.
FRANKLIN: Someone else has drawn the line - or tried to. The International Association of Counseling Services recommends that in order to keep students safe and healthy, a college campus should have a minimum of one therapist for every 1,000 to 1,500 students.
When you fall short of that - and many colleges do - the wait lists for students seeking help can very, very long. And research shows that students who get stuck on these wait lists are more likely to drop out of school.
Mr. OJAKIAN: When you have an illness, most of us want to be treated immediately. If you break your arm, you don't want somebody saying to you you're going to have to wait two to six weeks.
FRANKLIN: But that's the sort of wait time Stanford students faced last year, until the university hired six more therapists. At the same time, it introduced a new system to triage phone calls so that the neediest students could get in to see a counselor right away.
The university hired psychiatrist Dr. Ron Albucher to head the counseling center.
Dr. RON ALBUCHER (University of Stanford): It was a pretty intense trial by fire when I first got here. There were quite a few things going on at the same time.
FRANKLIN: Psychiatric hospitalizations were up - so were the number of students who needed medication as well as therapy, and most students who want or need long-term counseling still have to be referred to therapists off-campus.
Dr. ALBUCHER: Because even with that many counselors, we're still incredibly busy.
FRANKLIN: When Stanford's endowment took a big hit last year and the school had to slash its budget, it chose not to lay off therapists. It did add a new fee for all students - about $500 a year - with most of that money going to mental health services.
Daniel Eisenberg is a mental health researcher at the University of Michigan. He says in these very tight financial times, some other universities and colleges are making tough choices.
Professor DANIEL EISENBERG (University of Michigan): College campuses see their central mission as being education, and so I think there's sometimes a question about whether mental health services really fits into that central mission.
FRANKLIN: Vic and Mary Ojakian, whose son died in the midst of a deep depression, think society doesn't have a choice. Some big fixes will cost big money and they think it's a good investment, given the statistics. Half of all cases of mental illness first show up in the early teen years, and 75 percent by age 24.
Vic Ojakian says college is prime time to intervene and get these young adults on a healthy path. He also has ideas for high school seniors and their parents.
Mr. OJAKIAN: For parents, they need to look at a college not just in terms of its academic credentials, they need to make sure that the mental health service they provide on campus, they need to get an idea of what they're doing and how well they're doing it.
FRANKLIN: Asking about the number of counselors and what services they have for students after hours. That's just a start, he says. Some other mental health tools are just as important and cheap enough that even financially strapped colleges should have them in place.
Mr. OJAKIAN: How do they communicate their services? Because that's a critical thing. You know, how do they use their Web - some of these social networking tools? Do campuses have peer support groups?
FRANKLIN: Amanda Gelender, who was so depressed two years ago, says support from friends, family and her doctor, along with a change in her medication, were all crucial to helping her get back on track.
Ms. GELENDER: Now every day's a struggle, but I have more hope. I'm applying to a lot of post-graduate programs. I'm actually excited about my future.
FRANKLIN: Bipolar disorder is still a part of her, Amanda says, but it doesn't define her.
Deborah Franklin, NPR News.
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