When Fitz Paccione ’08 was deciding where to go to college, he had a few typical requirements: strong academic programs, the opportunity to continue playing tennis as he had in high school, a chance to travel far away from his home near San Diego.
But he had more pressing considerations as well — questions that needed informed answers. Would he be able to receive accommodations to help him succeed despite his learning disabilities? Should he continue taking the medications that controlled his symptoms but made him feel depressed? When he arrived on campus, how much should he reveal to his new roommates or classmates about his situation?
Across the country, such questions are cropping up more frequently as the number of students seeking counseling or disability services on college campuses has skyrocketed in recent years.
A 2006 national survey of directors of college counseling centers showed that 92 percent have seen an increase recently in the number of students with severe psychological problems; the same percentage also reported an increase in students coming to campus already on psychiatric medication. There’s even a national grassroots organization, Active Minds on Campus, working to increase awareness of mental health issues among college students. (Willamette does not have a chapter.)
At Willamette the number of students seeking disability or learning services more than quadrupled in a five-year period, from 104 in 2000–01 to 428 in 2005–06. During those five years, Counseling Services’ client numbers increased from 248 to 373.
Autism, bipolar disorder and severe learning disabilities are among the problems counseling and disability service directors are seeing today that barely existed on campuses a decade ago. Willamette didn’t have any students with autism until nearly four years ago. This year about half a dozen are enrolled.
Part of what has led to the increase in college students seeking services, experts say, is increased diagnosis of mental illnesses and disabilities combined with better accommodation of these issues in K–12 schools. A cultural shift in the acceptance of counseling has also meant more students are willing to ask for help.
“If you look at special education and ADA [Americans with Disabilities Act] regulations in this country, it was in the 1980s that there was an explosion of services being provided,” says Deb Loers, former counseling director at Willamette. “Those students are now in college and are accustomed to having services.”
“ Because of medications and treatments,” adds Joanne Hill, director of the University’s Disability and Learning Services, “we have students in college now who we may never have had before.”
When Loers started working at Willamette in 1987, the University did not have a person dedicated to serving students with disabilities. Hill came on board in 2000. Besides helping students who have legally defined disabilities, she provides assistance to those who may be struggling to achieve academic success. Time management, study skills and sleep problems are the three biggest concerns that prompt students to ask for help.
“A lot of students come in, and they have never learned how to study,” Hill says. “They may be very intelligent and never had to study before. It’s also pretty common for college students to suffer from sleep deprivation. They study too late, or they talk with their friends until the wee hours.”
Even so, two of the most common issues Hill encounters among students are mental health problems and attention deficit disorder (ADD). It’s the former that has her working so closely with Counseling Services. A student might come to see Hill because of trouble sleeping, but further investigation reveals the insomnia is actually a symptom of depression or a deeper problem. Such a situation is quite common. A 2006 survey of 531 Willamette students showed that 21 percent reported experiencing depression in the past year. Hill refers these students to an on-campus counselor or to a local consulting psychiatrist.
Hill is the only one at Willamette working with students needing disability or learning services, and she has contact at least twice with more than 500 students in a year. Counseling Services has two full-time and four part-time counselors who dealt with around 1,700 office visits in 2005–06. Keeping up with the caseload has been challenging.
But Willamette students are better off than their peers at some small schools, where services range from few to none. “Small schools don’t have as many resources, so they struggle with how to cope with this trend,” Loers says.
Paccione was not diagnosed with a learning disability until his freshman year in high school. He was easily distracted in class, struggled to finish his assignments and took much longer to complete readings than his classmates. He discovered he had attention deficit disorder — “Everyone can be ADD at times,” he says — as well as dyslexia and problems with auditory processing. “I need to talk things out, discuss them. It’s distracting and difficult for me to do long readings, but if I get a little extra time, I can do as well as the highest achievers in the class.”
Paccione is not shy about discussing his situation with anyone who asks, but all students starting college with a mental illness or disability must make tough decisions about disclosing their struggle to those around them.
And then there’s another, possibly harder decision: whether to take medications. Paccione faced a difficult choice in whether to continue the medications that had helped him control his learning disabilities. He chose to stop taking them because of many negative side effects.
“It’s very common for students taking medications to dislike the side effects,” Hill says. “They often go off the medications once they’re used to the college environment, but then need them again when they go to graduate school. Their need for the medication is usually attached to stress.”
During his early college years, Paccione’s parents called Hill frequently to make sure their son was doing well. He admits that he “broke a lot of rules” during his freshman year. But today, as a senior, Paccione has found a successful balance between several activities — tennis, fraternity involvement, an internship last year at the Capitol — and academic pursuits.
Part of what got him to this point was the availability of accommodations for his learning disabilities. When students have legally defined disabilities, they may apply for reasonable accommodations in the classroom — from extra time to take tests in a non-distracting environment to preferential seating in class or the help of note-takers.
If Paccione has a test at 10 a.m., he goes to his professor’s office at 8 a.m. to begin. When others finish the exam, he’s usually still working on it. “I’m in trouble if the professor asks us to read something in class, then discuss what we read,” he says. “It takes about 35 minutes for me to read and understand something that takes everyone else 10 minutes.”
Hill worked closely with Paccione’s parents to track his progress, and she often meets with parents before their students arrive to describe the services Willamette offers. She also touches base with them throughout the school year if they are concerned about their student. “Some of them might call to see if their child is keeping up with his work, or they might have had a phone conversation with their child and her voice just didn’t sound right.”
But Hill has these conversations only if the student has signed a form giving her permission to do so. The issue of how much information counseling centers can disclose about a student’s illness or disability has become a hotly debated area of the law.
The Family Educational Rights and Privacy Act (FERPA) of 1974 mandated that parental rights to educational records would transfer to the student at age 18 or upon entering college. Later amendments made exceptions for drug and alcohol violations and in health and safety emergencies.
Many colleges have taken this to mean that even if a student is suffering from severe psychological problems — such as contemplating suicide, the second leading cause of death among college students — a university is not required to notify the student’s parents. In recent years, some parents have filed lawsuits against colleges, saying they should have been told their child was in danger or that the school did not do enough to prevent a suicide. Four lawsuits were filed against counseling centers in 2006; three involved student suicides.
And in the most visible recent incident surrounding student mental illness, the Virginia Tech community was horrified when a student who had been declared mentally ill and urged to seek counseling later went on to kill 32 people before killing himself. The incident reignited the debate over how campuses should respond to students who might harm themselves or others.
“Since the Virginia Tech incident, every school has been reevaluating its policies,” Hill says. “It certainly has changed the urgency for campuses that had nothing in place.”
Hill reviews case law yearly to make sure Willamette’s policies are up to date. She also works with other offices on campus to educate students on how to recognize the early signs of possible problems. Residential assistants receive training on how to respond to crises that might happen in residence halls, and all new students attend workshops during orientation to learn about issues such as sexual abuse or alcohol use.
“A lot of our referrals come from other students,” Hill says. “The students on this campus are very good about coming in and saying, ‘I’m worried about my friend. She hasn’t left the room for four days,’ or ‘She hasn’t gone to class in two weeks.’ We do all we can to raise awareness.”
The system has worked well for Paccione. The politics major has kept a decent GPA and is considering law school after graduation. “I’ve had a couple of things slow me down,” he says, “but I think I’ve done just as well as other students.”