It's Time to Talk

by Caroline Berens | 1/8/15 11:18pm

Stigmatizing Mental Illness
by Annika Park / The Dartmouth

In her Apr. 19, 2013 article exploring the stigma surrounding depression, “Depression: What Everyone’s Not Talking About,” Reese Ramponi ’13 says the “discussion of the issue remains scarce on campus.”

Yet the past year has seen a significant growth in discussions of mental health on campus — Dick’s House has tripled its counseling staff and Student Assembly launched its yearlong campaign, “I’m Here for You,” aimed at breaking the silence around mental illness. Is discussion of depression at Dartmouth still “scarce”?

Let’s begin by establishing the basics. If discussion has swelled, it’s because mental health on campus merits scrutiny. The American Psychological Association, citing data from the 2013 National College Health Assessment, reported that one-third of college students noted having difficulty functioning in the last 12 months due to depression. Additionally, almost 50 percent said they had experienced overwhelming anxiety.

The 2014 Dartmouth Student Health survey, administered to a random sample of half of undergraduates, indicated that within the last 12 months, 8 percent of students have been diagnosed or treated by a professional for depression and 11 percent for anxiety. More than a quarter of students — 28 percent — said that they had sought professional help from a mental health counselor within the last year.

While mental illnesses are caused by a variety of influences, some of the factors contributing to the survey’s results are specific to Dartmouth, Dick’s House psychologist Bryant Ford explained,

“Dartmouth’s shorter academic calendar can increase stress since, for example, it’s very difficult to make up work in a timely manner if you miss class,” he said. “This pressure can exacerbate preexisting issues.”

Computer science professor Andrew Campbell, who helped start an app that tracks student mental health, agrees.

“As a faculty member I’ve witnessed the high levels of anxiety during the term and I wonder, is this the best way to teach our students?” he said.

With a sample of 48 students, the app uses data from the students’ phones over a term to assess trends in their overall mental health, academic performance and behaviors. According to results published online, the study demonstrated the students’ stress growing quickly as the term began, plateauing at about 28 days into the term. The buildup of stress comes as no surprise to anyone who has weathered a term in Hanover.

Students in the sample stopped exercising frequently after the fourth week of term, and engaged in brief, “businesslike” conversations around midterm time, the study reported. In the final days of the term, conversation behaviors began to rebound as students started having longer, more frequent conversations.

The D-plan, however, isn’t the only contributing factor to fluctuating levels of mental health. Hayley Son ’15 is co-president of Active Minds, a mental health advocacy student organization. An international student originally from South Korea, Son decided to join Active Minds due to her own struggles with mental health stemming from the difficulty of adjusting to life at Dartmouth.

“I definitely struggled at first. It’s so hard to feel comfortable and at home somewhere when you have to adjust to so many things at once — it’s all so different and foreign,” she said. “A lot of international students who have never lived abroad go through the same thing, to varying degrees of severity.”

She said her own involvement in Active Minds has made her more comfortable seeking out help.

Student body president Casey Dennis ’15 and vice president Frank Cunningham ’16, who began “I’m Here For You,” both acknowledge that Dartmouth’s fast-paced academic calendar can contribute to its “pressure cooker” environment, which puts an enormous strain on students, especially during finals.

If roughly one in 10 Dartmouth students has a diagnosed mental health problem — and that doesn’t even include those who don’t seek help — and one in four sees a psychologist, this issue still receives far too little attention. What causes mental health to have a stigma at all?

English and women’s and gender studies professor Ivy Schweitzer explained that the stigma associated with mental health arises from misunderstanding.

“Mental health issues are often seen as a failure of moral will,” she said. “People sometimes think those who suffer are narcissistic, lazy or spoiled — they don’t understand that depression and anxiety are diseases, and that, like any other disease, they can become dangerous if not treated with medication or treatment.”

Schweitzer said students’ overwhelming fear of failure — what she called “the big f-word at Dartmouth” — might also prompt students to conceal their feelings to avoid weakness.

Fortunately, some groups have devoted themselves to discussing these issues, hoping to ease campus comfort in admitting that people are struggling.

For Ford, the Dick’s House psychologist, that’s the right approach to ending mental health’s stigma.

“The best way to continue destigmatizing depression is to talk about it,” he said. “Hiding, ignoring or minimizing it will never make it go away.”

Son said that Active Minds membership nearly doubled during last spring and this fall. She said the group has tried to become more noticeable through an increased number of events.

She noted the increase in the Dick’s House staff — counseling now boasts 12 staff psychologists, counselors and psychiatrists and a handful of residents and interns. Still, if one in four Dartmouth undergraduates see counseling, that means these counselors are intended to serve 1,000 students. While many students may opt for outside resources, it’s fair to wonder whether a staff of about 20 is sufficient.

Campbell, who became interested in mental health due to his experiences growing up with a younger brother who was diagnosed with bipolar disorder, is just one example of a faculty member who has demonstrated concern about Dartmouth students’ mental health.

“Recognizing depression for what it is and not something that should be hidden — not talked openly about — brushed under the rug or feared, is a great start to destigmatizing depression at Dartmouth,” he said.

Students involved in Active Minds are not the only ones who have been exposed to support for mental health. This past fall, a banner displayed in Berry featured pledges from community members to show support. A Collis event during the fall featured Dick’s House staff, so they could speak with students in a casual setting.

Although Active Minds was involved with planning and executing these events, many were spearheaded by Student Assembly.

One “I’m Here For You” campaign event involved a story-sharing discussion during the fall where seven students, including Cunningham, shared their personal experiences with depression. With approximately 300 people in attendance, Dennis and Cunningham consider it a success.

Cunningham explained that since he’s shared his story, his “friends and classmates often send [him] emails asking to get coffee, checking in to make sure [he’s] doing okay.” Several people approached Student Assembly after the talk and asked how they could become involved in the campaign.

Son agreed that the campaign saw success, noting that the Dartmouth Hall auditorium was packed with students, but she said Student Assembly should increase the campaign’s reach.

“I had the feeling that a lot of students who came to the event were friends with Frank, Casey or other Student Assembly members and the panelists, ” she said. “Although that’s the inevitable nature of these events, I think that there are quite a few students who don’t know what ‘I’m Here For You’ is all about or even that Student Assembly is doing a campaign on mental health.”

Five of six students interviewed did not know about the campaign. The sixth student who did is a member of Student Assembly.

Right before finals began, Student Assembly also orchestrated a Relaxation Fest, which featured yoga and meditation sessions, nutrition booths and therapy dogs.

Dennis and Cunningham said that although campus discussions about mental health have increased in the past fall, more work remains. After all, Cunningham noted, “Suicide is one of the top five killers of college-age students.”

So the real question remains — have things changed? Professor Schweitzer, who has worked at Dartmouth for 21 years, believes they have. In the 1980s, she said, the US witnessed a “nationwide silence” about mental health. While students still suffered, they never discussed seeking treatment, she said.

“Obviously, things are very different than when I first began teaching here,” she said. “But I have seen several changes in the public discussion of mental health at Dartmouth even in the past one or two years. And it’s nearly all student-run.”