200506
College and University Mental Health
POSITION STATEMENT
Approved by the Board of Trustees, December 2005
Approved by the Assembly, November 2005
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"Policy documents are approved by the APA Assembly and Board of Trustees… These are …position statements that define APA official policy on specific subjects…" -- APA Operations Manual. |
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A Presidential Task Force on Mental Health on College Campuses was appointed by the American Psychiatric Association (APA) in 2005. An earlier group, the 1972 APA Task Force on College Mental Health, issued a statement focusing on the need for psychiatrists working in college settings to understand the special nature of work in colleges. While we agree with the general thrust of these comments, changes in both psychiatric practice and the college student population necessitate a new policy statement:
The need for mental health services on college and university campuses is increasing. More students enter college already taking psychiatric medications and most colleges report increases in medications being prescribed at their mental health services. Further, most colleges report seeing increases in students with binge drinking, substance abuse, and severe psychopathology. Suicide is the second leading cause of death in college students. Going to college is often very stressful for late adolescents when faced with more intensive grade pressure, separation from parents and friends, and the continuing formation of one’s identity. In addition, several disorders begin during late adolescence and early treatment is necessary.
There are institutional benefits to providing excellent mental health care on college and university campuses. Data show that treatment for mental health problems results in higher rates of student retention and graduation.
It is the position of the APA that all colleges and universities should:
1. have an established arrangement for timely access to necessary and appropriate psychiatric services for all students in need of mental health services. Such arrangements may include employed and/or consulting psychiatrists, as well as referral arrangements with local private practitioners. Arrangements should be in place for care to be coordinated in an appropriate manner.
2. ensure that psychiatrists have authority commensurate with their responsibility. This should include significant participation in assessment and treatment planning for students served in college and university mental health settings.
3. assure that the treating psychiatrist role is clearly separated from the role of psychiatrist as practitioners, hospitals, university health services and/or community mental health centers. When students are referred out of their student health systems, care should be taken to minimize the risk of confidentiality breeches and professional ethical conflicts.
4. offer health insurance coverage programs to students that provide comprehensive coverage for mental health, including substance abuse treatment.
5. provide students, parents and staff with easily accessible and culturally sensitive orientation information and ongoing education regarding wellness, general health, and mental health issues (including information about accessing emergency services). This should include problems associated with re-entry of students who have had to interrupt their education.
6. educate student health personnel about recognition of mental health problems.
7. have comprehensive suicide risk reduction and substance abuse prevention programs.
8. establish clinically informed policies that are responsive to and consistent with the ADA (Americans with Disabilities Act).
9. work with psychiatric residency training programs to increase educational opportunities in college and university mental health services. Consideration should be given to the establishment of post-graduate fellowship programs in college psychiatry.
10. work to educate the public as to the challenges and risks related to the college years, in partnership with the appropriate agencies (such as NIMH, NIDA, SAMSA).
11. work toward de-stigmatization of psychiatric illness and helping young people and their families make thoughtful choices about college.
12. support the expansion of research endeavors around college mental health issues and exploration of factors relating to prevention and resiliency.
Prepared by - The Task Force on College Mental Health, May, 2005
Revised by the Council on Children, Adolescents & Their Families, September 2005
Revised by the Joint Reference Committee, October 2005