Students seek more treatment

Trevor Jones was diagnosed with Obsessive Compulsive Disorder around the time he started… Trevor Jones was diagnosed with Obsessive Compulsive Disorder around the time he started high school.

Since then, the fourth year Pitt junior has been on and off medication, seen multiple therapists and failed nearly two entire semesters at Pitt because he was too anxious to attend class.

“It’s a terrible dysfunction,” Jones said. “Many times, I don’t feel under my complete control.”

Jones is currently taking three prescriptions for OCD. He sees a therapist every two weeks and a psychiatrist every three weeks.

Jones is just one example of what experts say is a nationwide increase in the number of college students with severe psychological problems.

According to the National Survey of Counseling Center Directors, the number of colleges reporting students with severe psychological problems has increased 36 percent since 1988. In the past 10 years, the number of students on psychiatric medication has nearly tripled.

In that same time span, college counseling centers reported steady increases in the number of students taking psychiatric medication.

College counselors are divided as to whether these medications are the best form of treatment, while at the same time they struggle to deal with the increasing demands on the counseling centers.

“Most campuses need more psychiatric hours available,” Robert Gallagher, lead researcher on the survey and former director of Pitt’s Counseling Center, said.

Cynthia Valley, a psychologist and director of the Counseling Center at Carnegie Mellon University, said CMU has doubled its counseling resources and still has a full year-round schedule.

“We used to hit our peak in November and April,” Valley said. “Now we hit the ground running in September and keep it up all year.”

The increase in demand has forced both Pitt and CMU to seek outside help in treating students. According to Valley, CMU has used outside contractors for the past decade to help treat students. Gallagher said that Pitt has sent students to Western Psychiatric Institute and Clinic if needed.

“Our No. 1 goal is to create access for students when they need it,” James Cox, current director of Pitt’s Counseling Center, said.

While counselors agree that the number of clients has increased, they disagree about the reasons.

“It’s something that gets discussed a lot,” Valley said. “We don’t know for sure. Some people think there’s something about the disillusionment of the American family. I’m not so sure about that.”

Dr. Duncan Clark, a psychiatrist at Western Psychiatric Institute and Clinic for 16 years, said the increase in clients doesn’t necessarily signify an increase in the number of people with disorders.

Clark said improved diagnostic techniques have helped identify patients who may have gone undiagnosed in the past.

“We more frequently recognize a problem than we did 10 or 15 years ago,” Clark said. “It’s not necessarily a bad thing.”

Gallagher said there is less of a stigma associated with seeking treatment today than before.

“There’s much more openness to seeking help than there was in the past,” Gallagher said.

Another reason for the growth may be increased use of psychiatric medication. Gallagher said psychiatric medications allow students to function in a college environment, while they may not have been able to in the past.

“Students who wouldn’t normally come to college can because of these medications,” Gallagher said.

According to Gallagher, 95 percent of Counseling Center directors report students are entering freshman year already on medication.

“It’s more prevalent in our society,” Cox said. “People are being medicated earlier. More children are being put on medication.”

Cox said that nearly 20 percent of the Counseling Center’s clients are on some kind of psychiatric medication.

“Since the time I began practicing nine years ago there has been an increase in their use,” Alyce Jacob, a pharmacist at Pitt’s Student Health pharmacy, said. “We fill quite a number of them.”

Valley saw the increase as a positive step.

“I think it’s a great thing that these students can come to college and succeed,” Valley said.

Cox was less enthusiastic.

“No school that I know is looking for an increase in mental health problems,” Cox said.

While there is no conclusive link between the increased used of psychiatric medication and the increased demand for counseling services, the use of prescription medication to treat mental illness is the subject of debate among experts.

The frequency with which medication is prescribed is especially controversial.

Si Hyun Kang, a pharmacist at Eckerd on Forbes Avenue, said psychiatric medication is the third most popular prescription, behind pain and heart medication. Approximately one out of five prescriptions is for psychiatric medication.

“Most of them are for college students,” Kang said.

According to Gallagher, medication is sometimes used too early in treatment.

“Across the board, it’s probably being prescribed too easily,” Gallagher said. “For college students, talking first and learning to deal with their emotions is helpful.”

Cox agreed. He said there are “definitely instances” where psychiatric medication is prescribed too quickly.

“People think it’s a quick fix,” Cox said.

Valley said the college environment justifies the use of psychiatric medication.

“I think it makes sense because you need students up and running,” Valley said.

Clark also did not agree that psychiatric medication was being prescribed too early.

“I don’t really see that. I don’t think so,” Clark said. He added that there probably were some people on medication that could benefit from talk therapy instead.

“For each person, I think there’s an approach that’s best for them,” Clark said. “I would hate to see [mental illness] go untreated because of biases about different types of treatment.”

Clark also pointed out that antidepressants, a popular psychiatric medication, are usually prescribed by personal physicians and not psychiatrists. He described this as a “helpful development.”

Jacob said that it was important to note that antidepressants have been linked to an increased likelihood of suicide in children and adolescents.

She said Pennsylvania law now requires pharmacists to distribute a medication guide when dispensing antidepressants that warns of the link between antidepressant use and suicide.

According to the 2005 National Survey of Counseling Center Directors, 39 percent of students who committed suicide had been on psychiatric medication.

Overall, the suicide rate for people ages 15-24 has more than doubled since 1950. In that same period, most other age groups experienced significant declines in their suicide rates.

While college students are less likely to commit suicide than their counterparts not in college, the Web site for the Jed Foundation, an organization devoted to lowering the number of college suicides, states that every year 1,100 college students commit suicide.

In the 2005 National Survey of Counseling Center Directors, more than 300 schools nationwide reported 154 student suicides. Of those, only 27 had been clients of their respective counseling centers.

“Most of the students who did commit suicide never sought out help,” Gallagher said. “There’s still a lot of stigma about seeking psychiatric help. They think they should just suck it up and take it, that counseling is a sign of weakness or something.”

Trevor Jones, who currently attends the counseling center at Pitt, said people should not be ashamed to seek out counseling or medication.

“It’s important to understand that getting help is OK,” Jones said. “It just shows you’re human.”