Many college students are facing a major mental health crisis at the same time they are transitioning to adulthood. In the average college classroom of thirty students, 9 are dealing with a mental illness and about 2 have seriously considered suicide in the past year.
According to a national survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) in 2010, thirty percent of young adults between the ages of eighteen and twenty-five experience a mental illness – the highest rate among the surveyed age brackets.
This same survey found that this age group also experiences the highest rates of serious thoughts of suicide – six percent of this population versus 4.3 percent of adults ages twenty-six to forty-nine.
According to a national survey by Gruttadaro & Crudo (2012), three-quarters, or seventy-four percent, of those with a mental health challenge experience their first episode by the age of twenty-four.
According to the SAMHSA survey (2010), forty percent of eighteen to twenty-five year olds attending college and experiencing a mental illness never seek help. Gruttadaro & Crudo (2012) found that of the students who drop out of college, sixty-four percent drop out for mental health reasons. This same survey (2012) concluded that stigma is the greatest barrier to college students seeking help.
With half of America’s youth attending postsecondary educational institutions, the problem of mental health stigma needs to be addressed in order to increase mental health help seeking behaviors and keep young adults in college and on track for independence in adulthood.
Paradoxically, according to Eisenberg (2009), self-stigma is a greater barrier to seeking help than public stigma. Eisenberg’s research has shown that ninety percent of college students would not think less of a peer if she sought out mental health services.
College is a stressful time for many and if students get the message that reaching out more for help is OK, then perhaps this will increase the likelihood that students will successfully complete college.
Efforts directed at addressing self-stigma would directly address the root barrier to help-seeking behaviors. Addressing self-stigma among college students would challenge perceived norms, increasing self-efficacy, decrease fear, and increase familiarity with mental health.
Help-seeking behaviors, as defined on the website of the National Alliance on Mental Illness (NAMI), include:
calling a crisis hotline
seeking out a therapist or psychiatrist
relying on family and friends for support, among other behaviors
The desired behavior outcome of addressing self-stigma is difficult to measure as it includes many variables. The Transtheoretical Model (TTM) of change as well as the Integrated Behavioral Model (IBM) assumes that the process of lowering stigma is complex and unique for each individual. The TTM posits that individual change is nonlinear and unfolds over time (Prochaska et. al., 2008) and the IBM posits that there are various determinants, or individual motivational factors, that bring about an intention to perform a specific behavior (Montano & Kasprzyk, 2008).
Efforts around reducing self-stigma among college students should target those in pre-contemplation and contemplation phases of anti-stigma behavior and should play upon the individual attitudes, subjective norms, and perceived control around ones mental health.
Any efforts should involve the processes of conscious raising, helping-relationships, and counter-conditioning in order to move those at different stages of change forward. The ultimate desired behavior outcome is to lower stigma, increase familiarity with mental health, and increase empathy towards those with a mental health condition, all in an effort to increase help-seeking behaviors.
College is a challenging time for many students, both academically and emotionally. The increased pressures coupled with low help-seeking behaviors leaves many college students vulnerable to overwhelm and having to drop out. Having a mental health diagnosis and having to drop out of college can effect an individuals vocational prospects, relationships, and quality of life for years to come.
Stigma of mental health challenges is a complex social problem with many variables. A majority of studies point to self-stigma as the single greatest barrier to seeking help for mental health issues. Variables that increase stigma of mental health issues are fear, lack of familiarity, lack of empathy, and perceived, negative social norms.
As with almost all mental health issues, the individual is the agent of change for decreasing stigma and, more specifically, self-stigma.
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