Educators Addressing Need for College Psychiatrists
The public is well aware of what in recent years has come to be known as“ campus tragedies”—the Virginia Tech shootings, for one—but another type of campus tragedy is not as well publicized: the increasing incidence of mental health problems and the relative shortage of psychiatric treatment available to students.
A survey conducted by the American College Health Association in 2006 revealed that 14.8 percent of 94,806 students at more than 100 colleges and universities said they had been diagnosed with depression sometime in their lives. Of those, 36.6 percent were taking an antidepressant, and 9.3 percent had considered suicide during the last school year.
Findings from a study led by Carlos Blanco, M.D., Ph.D., and published in the December 2008 Archives of General Psychiatry examined the prevalence of mental health problems among people aged 19 to 25. Blanco and colleagues analyzed the findings from two subsamples of the 2001-2002 National Epidemiological Survey on Alcohol and Related Conditions—those who did and did not attend college during the previous year.
Blanco found that about 20 percent of those who attended colleges or universities met DSM-IV criteria for an alcohol use disorder, compared with 17 percent of the participants not attending college.
He also found that college students were significantly less likely to receive past-year treatment for alcohol or drug use disorders than were their peers not attending college.
According to Jerald Kay, M.D., chair of APA's Committee on Mental Health on College and University Campuses, these and other data point to the fact that there are not enough psychiatric services available to students with mental disorders. “Treatment resources [on college campuses] are not forthcoming,” he told Psychiatric News.
Just a little more than half of U.S. colleges or universities have even one psychiatrist working with students on campus, he noted, and most of those have a psychiatrist working only part time due to a lack of funding. Wait times for students seeking psychiatric treatment on campuses has increased over the past decade or so, Kay noted, and some students may not get treatment when they need it.
Kay is professor and chair of the Department of Psychiatry at Boonshoft School of Medicine at Wright State University.
He proposed that psychiatry residency training programs rotate PGY-4 and PGY-5 residents through campus counseling centers both to alleviate the shortage of psychiatric treatment available to students and to expand training opportunities available to residents. College mental health rotations would provide residents with the chance to work with younger and higher-functioning populations, he noted, and provide a contrast to training in the public sector, for instance.
“Many residency training programs are struggling with how to meet psychotherapy requirements for residents—if you have really ill patients who drop out of treatment, it may be difficult for residents to meet their requirements,” he noted. However, “residents who work with college students learn how to administer medications and provide brief psychotherapy.”
Yale University rotates PGY-3 psychiatry residents through its Counseling and Mental Health Center and has for decades, according to Lorraine Siggins, M.D., chief of psychiatry at Yale's Mental Health and Counseling Center. Siggins credits the rotation for providing psychiatry residents with a well-rounded training experience.
“They get a good grounding in developmental aspects of late adolescence and young adulthood,” she noted, and they also get to work with students with significant mental health problems such as bipolar disorder, anxiety disorders, and eating disorders.
During the rotation, trainees also teach undergraduate residential advisors to recognize the early warning signs for mental illness in their peers.
“Specialized training in college mental health is an essential part of residency training,” she noted. ▪
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Published online: 21 August 2009
Published in print: August 21, 2009
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