Be Proactive with the College

Be Honest

To help the school give your child the best care possible, you must be honest about your child's mental health history. It is a common, but mistaken, idea that not mentioning previous mental health problems on college health forms affords an incoming student a "fresh start." Coming to college is a fresh start, but the burden of having these problems and keeping them secret ironically often makes them worse. The student feels more isolated and gets the sense that she is different and must hide her problems.

Let the college know if your child has had psychological difficulties or needs any special services. This is an ideal opportunity to be proactive. You might say, "Our daughter has had panic attacks in the past, and we'd like to know what resources you have to help her if this happens again." She will not be singled out due to this information, and she will not suffer any academic consequences or discrimination. But she will know that there are people at the college who can help her, and she will be given the information she needs to manage her own mental health.

College is not a fresh start from mental health issues. They come with the student and need to be acknowledged and cared for, especially since the stress of college can make them worse, not better.

You can also be proactive and work with the school's counselors if you notice symptoms of a mental health problem (like those discussed in Chapter Four and listed previously in this chapter) after your child is enrolled in school. Although your child is an adult and you cannot make the counselors contact your child, you can call and explain your reasons for worry and ask about available support services. This may irritate your child, but if you explain that you're a thousand miles away and are worried, he will most likely come to see that the call was made out of love. You can then pass on the information you obtained and encourage your child to follow up at the counseling center.

Getting parental permission to admit and treat mental health problems is psychologically very important for many students. They don't want to admit they aren't strong and independent, but if those who love them give the message that seeking help is not a sign of weakness but rather a sign of maturity, they are far more likely to take care of their emotional self.

Know Confidentiality Rules

You may be paying your child's tuition bills and medical insurance costs. You may stay involved in your child's life and be proactive about his or her health and education. But it's very possible that you will be left in the dark if your child seeks mental health services at school.

When eighteen year olds got the right to vote in 1972, new federal privacy regulations made students the guardians of their own academic, health, and disciplinary records too. This has had positive and negative repercussions. An article in the New York Times Magazine noted that across the country, state courts have found that colleges are not obliged to protect adult students from their own stupidity. As an example, the article states: "In Colorado, courts concluded that it wasn't a university's duty to keep trampolines off frat-house lawns to prevent drunk students from falling off them. In Louisiana, the courts found that a university had no special obligation to prevent students from sledding downhill on garbage-can lids and crashing into light poles."⁹ These rules made many states and college administrators assume that the common law doctrine of in loco parentis (legally standing in the place of the parents) was dead.

But uncertainty remains. If the student is responsible for himself or herself, does the school have an obligation to tell the student's family about physical or mental problems? Of course, college counselors want to have contact with families to provide a better support network for students, but at the same time we recognize this would have a chilling effect on students' willingness to seek care if they can't depend on confidentiality. At this time, the rules of medical confidentiality are quite stringent and clear: unless students are in imminent danger of hurting themselves or others or are completely unable to care for themselves, doctors and psychologists cannot share clinical information with anyone, parents or college officials, without permission from the students, assuming they are over age eighteen.

Still, college counselors are often caught between a rock and a hard place as we await the outcome of the yet-undecided Shin case, which may change the existing privacy and confidentiality rules. The Shins' $27 million lawsuit alleges that MIT was negligent for not telling them that their daughter, Elizabeth, was suicidal. If they win their case, the rules of confidentiality could change.

But at this time, do not assume that you will be told if your child is given a prescription medication for depression, or if your child is regularly seeing a therapist to address an eating disorder, or is seeking psychiatric consultation for any other reason. This is why it is so vitally important that you develop a strong system of communication with your child so that he will be able to tell you himself if he needs help.

Student Thoughts

"What do I wish my parents had done? I would have liked them to reiterate that they thought I was fabulous and would still have thought I was fabulous even if I did poorly in college; that the reason they thought I was fabulous was not related to the fact that I was smart or accomplished; that I was not to blame for any emotional problems that I was having; and that they would help me and be supportive of me getting the best possible care. That's what I wish."