geoff: Higher education is facing a student mental health crisis. That's the focus tonight of our series, "Rethinking college" and our reporting on "Early warnings: America's youth mental health crisis." We start with Yale university, which earlier this year, settled a lawsuit following the death of a student by suicide in 2021. According to the agreement, the university will now allow students more flexibility to take lighter course loads and to keep their health care while on medical leave. Yale agreed to the policy after a group of alumni and students sued the school, arguing the policies discriminated against students with mental health issues. Willow Sylvester is a Yale graduate who was part of the lawsuit. She explained what things were like before the settlement. >> When I started at Yale, had to stop seeing my therapist, and I felt super isolated. Fast forward to my senior year, I was a freshman counselor I'm working directly with first-year students, and almost every single one reported the same feelings of feeling isolated on campus. Mental health justice at Yale was founded in the immediate passing -- of death by suicide of a first your student. She didn't feel like she had the help she needed. She had spoken publicly about feeling this need to move down to a part-time courseload, and if she could move down to part-time courses she would be able to get on top of her mental health, but that was not an option at Yale. Another thing that was related is maintaining access to Gail's health insurance when you are are on leave our withdrawal. She had gone home and taken a leave from her middle health, she would've lost access to Yale health resources and yell mental health resources while she was home. She knew that she needed both of those. Students on leave and maintain access to their Yale health insurance and they can go down to a part-time courseload. We absolutely should not have to lose alive to get these changes rolling. Geoff: Last year, North Carolina state university saw 14 student deaths including seven by suicide, leading to concern and criticism about the level of student support. In a statement to the newshour, North Carolina state said it has expanded mental health resources and access both on campus and to the broader community. That includes nearly 30 more counselors and clinical positions in recent years, additional wellness days, greater peer support and new telehealth options. Ireland white is a student who started a mental health support group called "The self-love club" and wants to see even more changes. >> I started the club in January of this year because of the recent suicides on campus. I thought one of the easiest ways I could get back to my community was to start a club. >> We're just trying to build a community of people who, you know, want to focus on themselves and, you know, try to do something as a collective and create a safe space for people on campus to talk. >> There's a lot of anxiety with students today of like not being cool enough, not fitting in, not belonging. >> I also think that schoolwork and just the amount of pressure there is for deadlines in college really contributes to this feeling of anxiety. Not only are you missing out socially, you're missing out academically. And then there's also, you know, who is doing the best in the class. And this kind of competitive aspect that you don't even realize takes a toll on how you feel about yourself and your self-esteem. >> It was really strange to just get an email saying, like, all these students had passed away instead of like, having a big community meeting or like a community gathering where we could actually discuss about how we can go about this and how people are feeling. They just kind of introduced them. Student mental health task force and kind of called it a day. >> Doubling the amount in counselors does not translate to people are getting more help. >> No matter what you're doing on any day of the week. State has an event that's going on right now that you could just go to later tonight or in the morning. There's always something going on. >> But there's an absence of people really talking about mental health and how it affects them. Geoff: Let's hear more about what schools need to do Dr. Jessi gold is an assistant professor of psychiatry at the Washington university in St. Louis. Dr. Gold, what is the main thing you hear from students you work with in terms of what they are struggling with? >> I mean, college students have always struggled, it's nothing new. The pandemic has definitely made it worse. But you know, I see anxiety I see depression. College is also a time of exploration. So we see substance use, we see trouble with concentration. And then obviously all of that is compounded by all of the changes that have happened in the pandemic and then all the changes that continue to happen in the world. So it's just been really hard and college students feel things and feel things really strongly. Geoff: Well, rates of anxiety, depression, suicidal ideation on college campuses have never been higher. What accounts for that? Is this a generational thing? I mean to your point, there's something about attending college that is inherently stressful. That's always been true. What's different about the current moment? >> I wish we could pinpoint one thing and blame that one thing because I know people would love to blame things like social media and say it's just social media. And that someone difference. -- That is the one difference. And I don't think that's true. I think we definitely can say that has to be a factor because we didn't have social media before. And that affects our mental health. And we're looking at news more often more. And the information we're taking in is different and the way that we're thinking about things is different. But then there's also like, the way that we are interacting with each other and socializing is also different. And there's a lot of loneliness and that's contributing. I think that we talk about mental health more and sometimes that leads to like over pathologizing, meaning that we're calling things depression and anxiety with a big deal and a big a meaning like the diagnosis as opposed to the symptom. So I think it's good that we talk about it more, but it might mean that people associate with the actual diagnosis as opposed to just the symptom. So we're getting in this situation where it's hard to know is the person just struggling with the actual feelings or are they actually struggling with something where they need to come see me? Geoff: So what more can universities and colleges do to address the academic pressure, the loneliness that students are feeling? Is this a structural thing that colleges have to address? >> There's definitely struggle -- structural points to it. So we talk about how his mental health included in everything that we're working on in college campuses, right. So things like leave policies, if someone's really struggling, how do we make sure that when they leave, they feel comfortable asking for help, that they feel comfortable coming back on campus that they're able to do that? That's really important. There's mental health and everything that we're doing, but it's also how do students feel comfortable talking to faculty to begin with to know that those faculty feel comfortable even talking to those students because I see faculty too, and they don't. They haven't had training in mental health. They're not psychiatrist, and they're often the first people that come to students and they're supposed to support them through their mental health experiences as coaches as faculty members, as administrators, and they need the support to be able to do that too. So how do we make it easier for faculty to talk to students for students to feel comfortable talking to faculty for them to notice stuff so they get seen earlier so then they come to me, and they can talk to each other earlier too. Geoff: We've heard how students say they want more transparency. School administrators obviously have to abide by health, privacy and confidentiality laws. There might be concerns about reputational damage to the colleges and universities. Some administrators have a concern that the more they talk about suicide, that that might in some ways encourage or might lead to more deaths by suicide. How should university and college leaders, how often should they talk about this and how should they talk about it? >> So there's no evidence that the more we talk about things, and the more we asked about things, the worse it is. So as a psychiatrist, we're encouraged to always ask our patients about suicide, it doesn't mean that we're going to make patients then think about it. We don't implant those ideas. In fact, we support people by asking about those things. So it's important for us college to be a safe place to have those conversations. And for students to feel safe from the minute they get on campus to talk about mental health, from prevention to intervention, and the only way you do that is to change the culture of how we talk about these things and you can't be scared to talk about it. And we can't be just super reactionary, where the only campuses that are doing things are the campuses where something really bad happens. Geoff: The campuses that are getting it right, what are they doing? That the schools that help students do their best and feel their best? >> I wish I could tell you there's one good example and that that's the one that emulate across the country. And I don't know that we have like a perfect college yet and I think that's because every college is probably a little bit different. And so I think colleges need to figure out exactly what their population looks like and what their population wants. So instead of just making a cookie cutter mold of what everybody wants and should be doing, we need to do that. I think we need to have available resources, of course, so that if people need care, they can get it. But that can't be the only thing we're doing right. We can't just say the answer is more therapists because you can always have more therapists and people will always use more therapists but you will run out of that as a resource. So you have to start earlier with peer support with supporting faculty and staff and helping students earlier with helping students feel comfortable talking to each other and noticing signs and symptoms in themselves. That sort of thing is really easy, and it's not that expensive and can make pretty big changes to how we talk to each other and how we make changes on campus. Geoff: Dr. Jesse gold, assistant professor of psychiatry at the Washington university in St. Louis, thanks for your time. Thanks for having me. >>Thanks for having me. Geoff: If you or someone you know is in crisis or may be considering suicide, call or text the suicide and crisis hotline at 9-8-8.
