The Wake

April nights always seem colder when you want to die.

The metallic cold of the pistol in my mouth chilled my gums. I sobbed uncontrollably into the barrel and prayed for the courage to pull the trigger. A single shell lies in the chamber, like a brass key, waiting to explode open the door to death – to release.

I had never felt so withered and sapped of life as I did sitting in my car on a country road that night. My very being was morose and tired; desperate for relief. I had confessed to my mother some days before that I felt my mental moorings fraying. I was leading an exhausting existence that swung from extreme energy, optimism and hyper-sexuality, to abysmal depression and withdrawal. Here the mantra of suicide nagged at me each day, begging, pleading, rationalizing with me to let go and drift into nothingness.

After I was placed in handcuffs by an intervening state trooper and taken to the nearest psychiatric hospital, I would learn that I was bipolar and begin a life of regimented medication and a series of doctors.

It was over a year ago now that initiated me into the burgeoning clan of the college mentally ill. My weeklong stay at that hospital and subsequent diagnosis placed me on the crest of a rising national wave of the collegiate mentally ill that over the past few years has come crashing into the offices of campus mental health clinics in record numbers.

Hara Estroff Marano, an editor at Psychology Today, in her May 2002 Blues Buster newsletter says that college counseling clinics have become the front lines in the war against mental illness.

Colleges nationwide are failing “terribly” in managing a growing mental health crisis, according to the magazine. Increases are being seen not only in the number and scope of diagnosed mental illnesses, but also in suicide attempts, hospitalizations, substance-abuse problems, and even obsessive criminal behaviors like stalking, Marano says.

Moreover, many more students are also arriving at colleges already on mental health prescriptions or are in need of mental health monitoring. All of this is leading to a secondary crisis: how to pay for it. Students are often under-insured or uninsured, according to 2000 census numbers. Many of the colleges that offer health benefits to students do not offer the sort of longer term, financially demanding coverage a mental health patient requires. Students are left to ration their medication, find alternative ways to pay for it on an already meager budget, or in the worst-case scenario, go without.

The Loony-Bin Legacy?

My first morning at the mental hospital, I woke-up on the floor because the wing I was on was full, wearing white, rough cotton pajamas two sizes too small, it was official: I was now mentally ill. Whatever diagnosis – or lack thereof – oozed forth from a doctor’s pen my period of hospitalization will follow me like a file of felonies for the rest of my life.

I joined the schizophrenics, the manic-depressives, and the self-harming, in the line that filed past a pudgy nurse with a platoon of small white paper cups. Inside them were a whole galaxy of multi-colored uppers, downers, stabilizers and tranquilizers. I had joined: “Generation Medicated.”

Statistics from a 2003 survey of campus counseling centers by Robert Gallagher of the University of Pittsburgh shows the taxed and swollen state of college mental health clinics. The rise of psychiatric problems continues to be the number one concern of those surveyed. Increases over the last five years were present in every category of mental illness, according to a 2003 survey of campus counseling centers. Alcohol and drug abuse, eating disorders, self-injury and illicit drug abuse saw increases at those institutes surveyed.

Research by the National Alliance for the Mentally Ill, in Arlington, Virginia, shows that suicide continues to be the second-leading killer of college students ages 18 to24. A 10,000-student campus can expect at least one student suicide a year, according to Psychology Today magazine.

Rise of the Wimps? One Theory

While the data may show an increase in the number of psychiatric cases seen at clinics, experts still differ on the causes for the rise. Experts do agree that it is too complex a problem to explain away with one thesis. The intricacies of human genetics and their influence on the psyche, along with social and environmental conditions must be taken into account in any form of treatment or in the implementation of any plan to combat the current trend.

The flow of mentally ill flowing into campus clinics is fed by a myriad of streams and cannot be slowed without a holistic solution, Marano says. Part of the problem is that parents and society have conditioned students into mental fragility by being hyper-vigilant about their children’s success, and because of a general lack of accountability for students, she says. It is the result of years of emotional over-management.

Whatever solution there may be, Marano says, it should no doubt involve a permanent change in the way universities approach mental health and even in how they teach their curricula, making them more intellectually engaging and using them to promote social interaction instead of allowing students to be passive sponges of information. Others believe campus mental health clinics must be more engaged in preventative care, to include the education of students on the management of college life stressors.

One approach to discovering the root causes of mental illness is found in one of Marano’s most recent articles for Psychology Today, which in part states that the hyper-concern of parents has made the college population more emotionally fragile by removing the normal bumps and lumps a person must have on the path to adulthood.

“Armed with hyper-concern and micro-scrutiny, parents are going to ludicrous lengths to take the lumps and bumps out of life for their children,” Marano says. “However well-intentioned, their efforts have the net effect of making kids more fragile. That may be why the young are breaking down in record numbers or staying stuck in endless adolescence.”

In a Fall 2004 article for Leadership[ital] magazine, Marano writes:

“Many children are overprotected. Hovering parents contribute directly to the development of psychological problems in their children by overprotecting them and keeping them from learning to cope with frustration or any kind of adversity … Today’s parents, bombarded with news reports of kidnappers and sexual predators, seek to create a world that is as risk free as possible for their children. As a result, many children have been protected from struggles in their own young lives even though the struggle toward a goal is neurologically and psychologically necessary for happiness.”

Whatever change is made to parenting in an effort to roll back the steady stream of mentally ill collegians, it will have to educate parents on mental illness itself. Research shows that though the stigma of having a mental illness is fading, ignorance of its causes remains strong.

When I left the psychiatric hospital worrying about stigmas was a primary concern of mine. There was a new psychiatric vernacular to my life. Words like: mentally ill, suicidal, psychiatric commitment, will dog me the rest of my days. The statistics indicate that the stigma barrier is still strong and it is one more stressor added atop an already-fragile college populace.

Once diagnosed, students must now deal with not only an often understaffed and overworked mental health staff, but the ignorance of mental illness by a society that seems to perpetuate the problem.

The Uninsured and Unprepared

Keeping a doctor has always been a terrible problem for me. In my first months of diagnosis I saw four different doctors, each one with a completely different view of how I should be treated for my disorder. After my diagnosis I began a difficult time of medication management.

I found myself changing jobs and going to school at the same time, which left me either under-insured or uninsured altogether. I was too old to be placed on my mother’s insurance, not working enough to be insured by an employer, and my school’s student insurance at the time was too expensive and did not cover psychiatric medications.

Upon my arrival at the University of Minnesota I was once again uninsured. I had come to my new home with only a small supply of medication and was forced to ration it before my first appointment with a psychiatric doctor.

I talked with several students on campus and they all said that at one time they were left without insurance or did not have enough money to pay for medications needed to regulate their illnesses. This led to rationing or buying medications from other students.

Although the University of Minnesota has a reasonable student insurance plan that covers a great swath of medications, the benefit for each student is only $1,500, which students on newer psychiatric drugs can burn through in a matter of a couple of months.

Of the 41.2 million U.S. residents that went uninsured, the largest proportion were college-age students, according to recent census numbers.

Dr. Christenson of the University of Minnesota says he has seen more student medication rationing over the last year, but does not see it as a significant problem at the University of Minnesota. Because many psychiatric drugs are entering the market as generics, patients pay less, Christenson says. State drug programs and even discounted or free medications from major pharmaceutical companies also help students fill their medication gaps, he says.

Worse Before Better

Both Marano and Christenson are hesitant to predict how the next generation of college students will affect the campus mental health network. Although they differ in opinions on the cause of rising mental illness, they both doubt that it will reverse itself anytime soon.

What seems clear to me is that universities must adapt otherwise student mental health care will continue to suffer under the growing number of mentally ill students. What is also clear is that students will – and must – take a more active role in their medication and therapeutic management. They cannot afford to lay their mental health in the hands of already overworked mental health professionals. Students must also educate themselves on preventative measures for mental illness, disease and medication management through social action.

We are a generation medicated. The answer to the question of how long this trend will continue lies squarely in the hands of students who in the end decide whether they will face the trials and tribulations of life head on or will face them on medication.

Matt Gruchow is a university student and welcomes comments at office@wakenews.org.