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Content warning: This story includes a brief anecdote from a student of mine who struggled with alcohol addiction, and also passing references to suicidal ideation in college students.
"Actually, I’m an alcoholic. I started drinking again when the semester started."
When I was a new teacher, this is what one of my students said to me. He was probably about 18 years old.
He had recently missed class and had requested a meeting to review course material. But during that conversation, he said something that sounded off. “Maybe I’m not ready for school right now.”
“You don’t need to tell me anything personal,” I responded. “But it would be helpful to know if it’s a school-specific issue, such as not knowing how to study effectively, or something outside of school, because my advice will be different.”
That’s when he decided to tell me about his alcoholism.
I asked his permission to discuss medical resources. I’m not a psychiatrist, so I felt that referring him to campus and community resources would be appropriate. It turned out that he wanted psychiatric help, but didn’t know that specialty addiction care exists, and couldn’t find a psychiatrist to take his insurance.
Navigating the health care system while addicted is the kind of institutional nightmare that could overwhelm anyone. It’s even harder for students who are teenage or college-age and still learning to advocate for themselves.
I hope your child won’t experience mental health problems or addiction. But if they do, they need to know how to find help. Here are 10 steps to take as a family.
I’ve seen so many depressed and anxious students posting on Reddit about appetite loss, apathy, hopelessness and suicidal ideation. They all have the same question: “What do I do?” Some of them think they just need to “study harder” or “be more motivated.” Recognizing that hopelessness and lack of motivation is a mental health issue is the first step.
In addition to discussing conditions like depression and anxiety, make sure to review signs of lesser-known health conditions like OCD, PTSD, bipolar disorder, schizophrenia, addiction and eating disorders. Websites for top medical hospitals are a good place to learn more, as is your child’s physician or mental health care provider.
Some students don’t realize that wanting to die can be a psychiatric emergency. What sounds obvious to you right now might not be clear to them in a crisis.
An active, specific suicide plan indicates an acute crisis. Seek care at your local emergency room immediately. Never assume that your student will improve on their own.
Students should call 911 or go to their local emergency room. They should not try to “tough it out.” Normalize the idea that emergency medicine includes psychiatric emergencies, too.
Make sure your student has easy access to these numbers:
988 Suicide & Crisis Lifeline: Dial 9-8-8
Crisis Text Line
This can include things like counseling and psychological services or student health primary care (for medication or help navigating the medical system). Some campuses also have resources such as a Women’s Center or centers for sexual violence.
If your student is already at college, you can assemble this information now. If you get stuck or are feeling too burned out to compile this information, calling student health is a great place to start. You can also search your student’s college website for official university health resources.
Be aware that many universities are not able to provide long term care. For example, it’s common for schools to limit the number of appointments per student. I have also seen university mental health centers that don’t treat certain mental health conditions such as ADHD. For these reasons, if your student already has mental health difficulties, a local mental health provider can often provide more stable access to long term care.
Find some names of local mental health providers, and check if they take your student’s insurance. During the pandemic, much of this treatment has moved online, but if the provider does in-person treatment only, you should also discuss transportation with your student to make sure they can actually get to the clinic.
If you are struggling to find names of local providers, you might appreciate Psychology Today’s directory of mental health professionals (look for “find a therapist” on the top navigation bar). You can also usually get referrals to community mental health professionals through student health at your student’s university. A third option is to contact your student’s insurance provider for names of local providers that are in-network.
They should know what a copay is, how much an appointment will cost, and what in-network vs. out-of-network means. For example, you might review your student’s plan, and explain the copay rate for an in-network provider. It can feel tough to talk to high school and college students about money, but some students have heard that therapy is extremely expensive and avoid treatment for this reason.
If cost is a barrier for you, research free or sliding scale clinics, which can sometimes provide very low-cost mental health treatment.
If you are a U.S. citizen and are uninsured, don’t forget to check the Healthcare Marketplace to see if you qualify for free or reduced cost insurance. Insurance access has improved significantly since Obama’s 2010 healthcare reforms, so don’t automatically assume you aren’t eligible if you had difficulties accessing insurance when you were growing up.
Building community and maintaining social contact is crucial. Talk to your student about how they will stay connected with others. While it’s normally important to try to make friends at college, social distancing has made this much more difficult. It can be valuable for your student to maintain contact with their high school friends, who are most likely feeling isolated, too.
LGBTQIA+ students may also benefit from connecting with their school’s center for sexual and gender diversity or a student pride association. These organizations don’t offer mental health treatment but having a safe community can be beneficial. Trans students may also benefit from the Trans Lifeline, which provides trans peer support:
International students might wish to join their university’s international house, international dorm or relevant student clubs. These types of groups can sometimes create a secondary sense of home and belonging.
Black student groups and alliances can also be a source of pride, community and professional networking. If this interests your student, check the university website to see what clubs and unions are available.
Discussed all these ideas? Great. Now write them down on a single sheet of paper and have your student save it somewhere easily accessible. Depression can make people feel like they have no options, and developing a mental health care plan can help encourage the idea that there is always help available.
Part of destigmatizing mental health is talking about it. Even if your teen doesn’t seem like they want to listen, they will notice that you are brave enough to have this discussion, and they may be more open to seeking treatment if they need it.
It’s hard to discuss mental health, but your choice to have this difficult conversation with your teen or college student can help protect them when they need it most.