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Collegiate Mental Health During COVID-19 - What Colleges Need To Do

Many universities suddenly suspended in-person classes and forced evacuations of students as a response to the COVID-19 pandemic. Seniors had their graduations cancelled. Medical school admissions has changed their requirements; graduate school tests have been moved online. Students studying abroad were sent home, some with one days notice. This has created a whirlwind of emotions and frustration that has swept across the world.

One in five of college students worldwide have experienced at least one diagnosable mental disorder (1). College students are facing an immense amount of pressure and challenges in the wake of the pandemic as it is escalating the welfare of human beings globally. This public health threat has generated widespread fear. This fear has led to a spectrum of psychological consequences ranging from anxiety, depression, substance abuse, difficulties sleeping, and stress eating (2). Our current health, political, and economic climate can exacerbate collegiate mental health issues.

1 in 5 college students have a psychological disorder 

College students often experience compounded negative emotions during school closures (3). Many students find their campuses homelike, especially if they have troublesome family relations at home. Colleges in America especially work to improve equality and acceptance for all students which some may not receive at home. Thus, when campuses closed so suddenly, most schools giving no prior notice to students before making the announcement, many harbored intense feelings of frustrations, anxiety, and betrayal towards their institutions. Many may struggle with loneliness and isolation while sheltering in place due to disconnections from friends and partners that they relied on during school and summer activities that were also cancelled.

For those who receive free counseling services on campus, they can no longer attend therapy sessions without paying the fee of a registered psychological expert. This exacerbates their existing psychological symptoms and increase a student’s risk for suicide and substance abuse.

As universities transition into remote learning and the entire world has hit the pause button on normal life, many students have gotten a cancellation on their research projects and internships. These disruptions jeopardize their program of study, delay graduations, and undermine their competitiveness on the job market which in turn fuels more anxiety amongst college students (4). On-campus and work-study jobs have been lost during the evacuation and the issue of room and board fees not being resolved in a similar fashion amongst different colleges can aggravate financial and mental health outcomes. The fear of infection and transmission of COVID-19 to family members at home, especially those who are older and have compromising conditions adds an additional layer of concern and anxiety amongst returning college students (5).

cars at emory moving out
Packed-up cars line up at Emory as campus abruptly closed at the end of spring break

What should happen?

Universities have a critical role to take accountability for the health of their students during and after the evacuation. Students have expressed disapproval and lack of motivation while attending remote learning sessions since this transition creates a lot of acute stress among some students due to lack of time for adjustment and isolation from peers. However, remote learning allows college students to sustain their academic routine which is found to benefit mental health and psychological resilience in the long run (5). Students have expressed, however, that there has not been an active effort from their colleges for mental health help. It is essential that universities address public health concerns, but also mental health. Here are some suggestions based on psychological research:

1) Face-to-Face Interaction with Professors and Advisors: In addition to remote education, professors and advisors should increase telecommunications that are face-to-face rather than just a phone call. Facial cues are an important means of communication that can give reassurance to stressed students that go beyond academic help. Requiring all students to turn on video during Zoom meetings can encourage more interaction and connection between the class and instructors.

2) Telemental Health: University counseling centers should set up options to provide counseling services at a distance. Telemental health has been found effective in treating anxiety and depressive symptoms (6). Implementing telemental health will facilitate dealing with pressing mental health concerns (7).

3) Online Support Groups: College counseling centers can provide options for online support groups which will enable students to share common concerns and receive social support. Additionally, the departments should develop and pass public health messaging onto students dealing with coping resources and how to protect their mental health. This has been shown to increase comradery and less stress during the pandemic in China (8)

Mental health services have a crucial role in combating this epidemic. Universities have a unique role in this time. They have ability to get thousands of students access to the care they need to vent and deal with their anxiety and sadness from the challenges during this time. It is becoming increasingly clear that we need to take care of our health and psychological resilience. Universities need to build awareness of mental health needs and concerns to empower students to seek help and support during this unpresented disaster.

A usually bustling woodruff circle at Emory is now empty

(1) R.P. Auerbach, J. Alonso, W.G. Axinn, P. Cuijpers, D.D. Ebert, J.G. Green, I. Hwang, R.C. Kessler, H. Liu, P. Mortier, M.K. Nock, S. Pinder-Amaker, N.A. Sampson, S. Aguilar-Gaxiola, A. Al-Hamzawi, L.H. Andrade, C. Benjet, J.M. Caldas-De-Almeida, K. Demyttenaere, S. Florescu, G. De Girolamo, O. Gureje, J.M. Haro, E.G. Karam, A. Kiejna, V. Kovess-Masfety, S. Lee, J.J. McGrath, S. O'Neill, B.E. Pennell, K. Scott, M. Ten Have, Y. Torres, A.M. Zaslavsky, Z. Zarkov, R. BruffaertsMental disorders among college students in the World Health Organization world mental health surveys Psychol. Med. (2016)

(2) N. Liu, F. Zhang, C. Wei, Y. Jia, Z. Shang, L. Sun, L. Wu, Z. Sun, Y. Zhou, Y. Wang, W. LiuPrevalence and predictors of PTSS during COVID-19 outbreak in China hardest-hit areas: gender differences matter Psychiatry Res. (2020)

(3) T. Van Bortel, A. Basnayake, F. Wurie, M. Jambai, A.S. Koroma, A.T. Muana, K. Hann, J. Eaton, S. Martin, L.B. NellumsPsychosocial effects of an Ebola outbreak at individual, community and international levels Bull. World Health Organ. (2016)

(4) Yusen Zhaia,⁎ , Xue Dub a Department of Educational Psychology, Counseling, and Special Education, The Pennsylvania State University, University Park, PA, USA b Department of Food Science, The Pennsylvania State University, University Park, PA, USA

(5) Wang, C., Cheng, Z., Yue, X.-.G., McAleer, M., 2020. Risk management of COVID-19 by universities in China. J. Risk Financ. Manag

(6) Brenes, G.A., Danhauer, S.C., Lyles, M.F., Hogan, P.E., Miller, M.E., 2015. Telephonedelivered cognitive behavioral therapy and telephone-delivered nondirective supportive therapy for rural older adults with generalized anxiety disorder: a randomized clinical trial. JAMA Psychiatry.

(7) Dorsey, E.R., Topol, E.J., 2020. Telemedicine 2020 and the next decade. Lancet. https://

(8) Rollman, B.L., Belnap, B.H., Abebe, K.Z., Spring, M.B., Rotondi, A.J., Rothenberger, S.D., Karp, J.F., 2018. Effectiveness of online collaborative care for treating mood and anxiety disorders in primary care: a randomized clinical trial. JAMA Psychiatry

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