A new urgency for college students' mental health

Jesse Brownell said she felt lost last spring, when the coronavirus pandemic upended her freshman year at Dartmouth College. But in the months that followed, the 19-year-old regained her footing. She moved into a house near campus with friends this school year and restarted practices with the women's squash team.

Then, earlier this month, she contracted the coronavirus and had to spend more than a week in isolation housing. She couldn't be around friends and was barred from playing sports. Alone, she consumed herself with schoolwork.

"I felt like I was spiraling," Brownell said. She says she doesn't think she'll feel comfortable being alone for a while: "I just didn't expect the mental impact. I definitely am still feeling a little more mentally down, mentally fuzzy."

Across the country, some school leaders and experts say the pandemic has brought new urgency to a mental health crisis that had been unraveling on college campuses for years. From social isolation to heightened feelings of inadequacy, students say it has made it harder to concentrate on school and put a strain on families and friendships.

Young adults between the ages of 18 and 24 for years have struggled disproportionally with mental illness compared with older groups, and experts cite such underlying factors as high expectations, social media and financial pressures. Now, evidence shows college students experienced higher rates of anxiety, depression and suicidal ideation in 2020 than in 2019.

Despite the promises of vaccines and a return to normal in the fall, students are still stressed, overwhelming campus counseling centers with requests for treatment. Unable to see most students in person, school counselors have responded by developing self-help tools and hosting virtual therapy sessions.

Many students, whether they've contracted the virus or not, are reeling from the last year of uncertainty and wonder when they'll recover.

'What am I doing wrong?'

When senior Cameron Nolan returned to Morehouse College for the spring semester, he was not the person he was a year ago, when he hurriedly packed his belongings and moved back home with his mom in Jackson, Miss.

Nolan had just been elected student body president at the Atlanta college when the pandemic took hold in the United States. Morehouse closed its campus and, suddenly, the 21-year-old could not lead in the way he had imagined.

"I'm such an in-your-face, extroverted leader," said Nolan, an economics major. "I was at a loss. I literally lost the human connection, and, for a moment, I had no clue how I still wanted to make my goals come true."

Nolan picked up a job at Walmart and managed to stay on top of his schoolwork, but being away from the life he built at school was tough, he said. In high school, he worked hard to secure the scholarships, test scores and GPA he needed to succeed at Morehouse.

"All that felt like it was in vain when you have to go back to your hometown," he said.

Nolan said he started crying more at home, just to release his pent-up emotions. Morehouse offers counseling and other services, but Nolan said he coped by keeping in touch with his friends from school, what Nolan calls his "band of brothers."

"Black men have to be hypermasculine at all times," Nolan said. "It is perfectly okay to feel your emotions. It is perfectly okay to be sad."

He also spent a lot of time journaling, anxiously outlining his future for when he could finally restart his life. Returning home made Nolan feel like his life had stopped but, online, it seemed like others were still moving. He would scroll through Instagram and see people taking trips, getting new jobs and buying cars.

"Although those things are positive experiences, you're looking at yourself like, 'What am I doing wrong?' " Nolan said. "When you have this overload of positivity, you always feel like you're behind."

What Nolan was doing - scrolling and comparing - isn't unusual, said Ryan Patel, a psychiatrist in Ohio State University's counseling center and chair-elect of the American College Health Association's mental health section. The popularity of social media is one of the factors leading to higher rates of anxiety among young people and increasing the pressure they feel to achieve.

"This is the first generation of students that have spent their entire adolescence on smartphones and social media and things like that," Patel said. "Especially with those kinds of technologies, they may be comparing their average self to the shining moments on social media, and falsely thinking that everybody is like that in all aspects of their lives."

The perils of isolation

Grace Zopelis feels a twinge of disappointment when she scrolls through social media and sees her classmates hanging out in small groups outside of school.

The American University freshman had high hopes for college. She went to high school in a tiny Connecticut town and didn't have many friends. The pandemic disrupted her senior year - she graduated in a drive-through ceremony and, as salutatorian, recorded her speech in an empty library. By the time summer vacation started, she was burned out.

AU, like many universities, told incoming students the campus would partially reopen in the fall after shuttering last March. But as conditions changed, the school announced in July it would operate online and close the residence halls.

"The one thing keeping me from absolutely losing my mind was just taken away," Zopelis remembers thinking. She abandoned her hopes of living in a dorm and found an apartment about a mile from campus.

She's made connections with a few other students but, overall, the 19-year-old said she's felt lonely and overwhelmed by the demands of school. She doesn't expect to maintain the 4.0 GPA she had in high school.

"I'm this recluse living in my apartment by herself," Zopelis said.

AU reopened some residence halls this month, but many students had tried to replicate communal living in nearby apartment buildings, houses and even hotels - forming friendships in the process.

Zopelis, who decided over the summer to live on her own, didn't realize she would be missing so much.

"It's been kind of tough," she said. "I feel like I'm missing out on a lot, socially."

The isolation Zopelis and other students are experiencing feels unnatural, said Michael R. Lovell, president of Marquette University in Milwaukee.

"College is the most social time of your life," Lovell said. "When you are isolated in a pandemic, it's very, very difficult for students to navigate a time when they do feel pressure and stress."

Counselors at AU have offered services to students including anonymous mental health screenings, virtual workshops and group therapy sessions. But, wary about pursuing counseling, Zopelis is trying to manage the feelings on her own. She adopted a siamese cat named Toby, which she said has helped.

"I don't know if I'm going to have a positive experience or not," Zopelis said about counseling. "It's hard to open up about personal issues, especially with someone you don't know."

An outlet is gone

Brownell, 19, didn't seek mental health services, either. Dartmouth's counseling center offered resources during the sophomore's 10-day stint in isolation housing, but she said she felt uneasy about discussing her mental health with the school.

Instead, she relied on phone calls with her girlfriend, friends and family to cope with the mental strain that came with being kept inside for days on end. Brownell doesn't know how she contracted the virus, but there was an outbreak on campus in late February and early March, and she was among those sickened. Then, she was rushed away to isolation, bringing only a backpack and laptop, along with some clothes, toiletries and an essential oils diffuser.

She sustained her connection to the outside world through online classes and daily conversations with a campus nurse. Otherwise, there was little to do, so Brownell buried herself in school work.

"I felt guilty when I wasn't doing schoolwork in isolation," she said, adding that she felt more pressure than normal to excel academically. "It made me feel inadequate as a student."

Brownell is used to Ivy League expectations but, as an extrovert, relieves that stress by spending time with other people. Suddenly, that outlet was missing. Unable to go outdoors, she saw other people only when she stepped outside her room to retrieve meals from a common area inside the isolation dorm.

Brownell, who plans to major in government and art history, said she became lost in her thoughts. She was worried about the toll the virus would take on her health and nervous about falling behind in school.

While in isolation, she was battling symptoms - bad headaches and fatigue - as well as looming deadlines and loneliness. The entire ordeal has had lasting effects.

"My anxiety about schoolwork is definitely still raised," she said.

The challenges came amid a particularly challenging year on the Hanover, N.H., campus of about 6,600 students. In November, freshman Beau DuBray died by suicide, the campus newspaper, the Dartmouth, reported. Another first-year student, Connor Tiffany, died "unexpectedly" on March 14, school officials said.

"It's been rough on everyone," Brownell said.

'It's demoralizing'

For Patrick Peralta, a government and politics major at the University of Maryland at College Park, the last 12 months have produced a different type of anxiety - one that can be harder to describe.

Peralta, who is part of U-Md.'s Asian American Student Union, has monitored the unprovoked attacks against Asians and Asian Americans: A man's face was slashed on a subway train, a woman was mugged and injured near her home, an 84-year-old man was pushed violently and later died.

The U-Md. student organization has been vocal on social media about the rise in anti-Asian violence, condemning the attacks and vandalization of Asian-owned businesses. But, the students warned, "words aren't nearly enough."

Then, a gunman opened fire on three Atlanta-area spas, leaving eight people - six of whom were Asian women - dead.

"We're anxious and we're terrified of what's going to happen to us and our families," Peralta said. "We live in this constant state of precarity, and this perpetual state of fear because we don't know what's going to happen to us."

Sagar Matharu, another AASU member, said racism and the anxiety that comes with it have been part of his life for as long as he can remember. At his high school in Frederick, Md., Matharu said someone he once called a friend said he was "dirty" and accused him of having a disease.

"That's something that really crushed my mental health for a very long time," said Matharu, who is Indian American. The experience made him feel lonely and betrayed. "That loneliness translated into anxiety, depression, a whole myriad of mental health consequences."

The recent spa attacks unearthed the feelings Matharu had in high school. But his community at U-Md. keeps them from becoming overwhelming.

Separated by the pandemic, grieving has been relegated to Zoom.

Students also are supporting each other through traumatic events via text, instead of face-to-face. It has made a tense year even more strenuous, as students of color deal with waves of violence and social upheaval. Black students made similar sacrifices last summer as the world reacted to the police killing of George Floyd and demands for justice for Breonna Taylor and Ahmaud Arbery.

"It's demoralizing," Matharu said. "It hurts. But when I do talk about it amongst my community, I don't get that feeling of loneliness that I once got."

Moving through crisis

On campuses across the country, counseling center staff are "busier than ever," Patel said. Not only are more students requesting help, but their needs are more varied.

The pandemic also introduced the unique challenge of delivering mental health care across state lines. When students scattered to their homes across the country, on-campus health providers suddenly faced a hodgepodge of licensure laws that determined where they could and couldn't practice. Dozens of states have relaxed their restrictions, but 60 percent of students still say the pandemic has made it more difficult to access mental health care, surveys show.

To fill in the gaps, counselors are producing self-help videos, sharing advice on social media and using computer-assisted therapy programs that can be just as effective as in-person treatment, Patel said.

Joan Gabel, president of the University of Minnesota, is ramping up an effort to bring together the five campuses that make up the state university system to understand the mental health crisis through data and research.

The idea for the initiative came around the time Gabel arrived at the university in 2019, when she consistently heard from students that they needed more mental health support.

"That was almost three years ago, and it has only worsened," Gabel said. Officials within the university system hope to develop a framework that can be replicated at other institutions.

"This isn't an area for competition. We want all our students to be successful," Gabel said. "When students are well, particularly when their mental health is well, they persist better."

Leaders at Marquette University are also trying to learn from the pandemic and the way it has affected students. Some of the measures installed in recent months, including efforts to train students to identify the signs of a mental health crisis in one another and deploying counselors into classrooms to share resources, have had a positive impact, Lovell said.

Officials also scattered mental health days throughout the semester, when classes are canceled and professors are discouraged from assigning work.

"It's really important for us to provide resources and tools for students so they don't get to that point where we're in crisis," Lovell said. "The pandemic has really extenuated the pressures we feel to help students with mental health."