The winter holidays are right around the corner, and Thanksgiving kicks the season off: since many college kids come home for Thanksgiving Week, that makes it a perfect time for parents to do what we’ll call an informal mental health check-in with their college student.
If your child is away at school and coming home for the first time since August, we’re sure you want to know how they’re handling the challenges of their first semester.
This can apply to young adults living away from home, too: I’s not exclusive to college students. If you have young adult children and they come back for Thanksgiving, whether for the whole week or only a couple days, you can take the time to assess their mental health and offer help if you think they need it.
First things first: only a mental health professional can diagnose a mental health disorder and refer your college age/young adult child for formal treatment. Your role here is to assess what’s going on based on what you know. You’re in a great position to observe any changes that may have occurred since you last saw them, and note any concerning developments in their behavior, appearance, personality, and overall mood and manner.
Mental Health Disorders: Age of Onset
It’s important to check in with young adult/college student mental health regularly. Research shows the age of onset – i.e. when many mental health disorders first appear – of most common mental health disorders falls between adolescence and early adulthood. Consider the age of onset for the following mental health disorders:
Anxiety Disorders
- Panic disorder, generalized anxiety disorder, and post-traumatic stress disorder: Age 15 and over
Mood Disorders/Personality Disorders
- Depressive disorders:
- Between ages 14 and 19
- Bipolar I, bipolar II, cyclothymic disorder:
- Between ages 14 and 17
- Borderline personality disorder (BPD):
- Between adolescence and adulthood.
- BPD rarely occurs in teens but may develop during adolescence
Psychotic Disorders
- Schizophrenia/schizoaffective disorder:
- Between ages 15 and 35
- Psychosis/other psychotic disorders:
- Late adolescence to mid-20s
Early detection of problems can save significant energy and valuable time. The earlier a person with a mental health disorder gets the treatment they need, the better the outcome. Clinical mental health disorders rarely resolve without treatment, and untreated disorders can escalate and create significant challenges in all areas of life, including relationship problems, impaired academic and work performance. It’s also important to understand that some mental health disorders include an elevated risk of suicide and suicidal behavior.
Warning Signs: What to Watch For
You can align your mental health check in with the warning signs for mental illness. Here’s something to remember: your check in can happen over time, through conversation and observation. It doesn’t have to happen all at once.
Here’s how to do it.
There are several warning signs that are common to almost all mental health disorders. When your college student comes home for the holidays, use these warning signs to guide your conversation:
Warning Sign:
Declining participation in activities they used to love.
How to check:
Ask them direct questions about their activities, how they’re going, and if they still enjoy them.
Warning Sign:
Withdrawal from friends and family.
How to check:
First, through observation: are they still talking to you and other family members regularly? Next, ask them direct questions about how their friends are doing too.
Warning Sign:
Daily feelings of sadness, hopelessness, or worthlessness.
How to check:
Ask them questions about the semester so far, with a focus on their daily mood. If general questions don’t work, you can get specific, and ask questions related to mood, such as, “Were there any day you cried?” or “Were there any days you were too sad to go to class?”
Warning Sign:
Displays anger, irritability, or frustration every day.
How to check:
You can check this through observation: is your college age child angry and irritable every day? Do they express this emotion outwardly? If so, follow up, and ask them how long, and how often, they feel anger, irritability, or frustration: this information will help a mental health professional later, if your child needs support.
Warning Sign:
Sleep problems: too much or too little.
How to check:
First, by observation: do they look tired? Are there bags under their eyes that weren’t there before? Second, also by observation when they’re home: are they staying up all night and not really sleeping during the day? Are they sleeping all day and all night? Third, by asking: inquire about whether they’re getting good sleep while they’re at school.
Warning sign:
Declining academic or work performance.
How to check:
For college students, you can check their transcripts or ask how their grades are. For young and employed adults, check in about how things are going at work: ask about the results of performance reviews, possible promotions, and their overall level of satisfaction.
Warning sign:
Recurring minor physical problems/ailments, like headaches/stomachaches that don’t respond to typical remedies.
How to check:
For this phenomenon, it’s a matter listening and paying attention. If they come home and complain of [headaches/stomachaches] every day, ask how long it’s been going on, and ask what helps.
Warning sign:
Stops caring about personal hygiene.
How to check:
Observation: simply look at your child. Remember this is not about their personal style or fashion choices, but rather, about health and wellness. You may not love pink dreadlocks or nose piercings, but those aren’t warning signs of a mental health disorder. What you’re looking for is real hygiene: whether they bathe regularly, brush their teeth, keep their body clean, change clothes appropriately/when they need to, and maintain the basics of acceptable appearance.
Warning sign:
Increase in risky behavior related to cars, sex, alcohol/drugs.
How to check:
Risky behavior is not as easy to check in about as the other items on the list. You may need to deduce or infer indirectly, also through observation: when they come home for Thanksgiving, do they spend all their time out with friends? Do they come home smelling like alcohol after they borrow the car? Are their eyes bloodshot and glassy? Indicators of risky behavior involving cars may also come from unwanted sources, such as the police, and indicators of risky sexual behavior may come from a physician.
That’s the end of our list: those are the basic warning signs/indicators of an underlying mental health disorder, alongside our suggestions for how check in on/explore the origin of that particular warning sign. While many things on this list overlap with typical college-age/young adult behavior and life changes, the chronic presence of emotions like anger and sadness, combined with poor sleep, phantom maladies, and declining academic/work performance, all may indicate the presence of an underlying mental health disorder that may require professional support.
Why Worry? Are College Age People and Young Adults at Increased Risk?
Yes and no. As we can see above, the typical age of onset for most mental health disorders is during adolescence or early adulthood. Therefore, we need to recognize that risk, and keep checking on our kids throughout adolescence and early adulthood. We shouldn’t worry so much as become actively aware of the risks, know the warning signs, and know what to do if the warning signs accumulate and we think our child needs professional support.
If you go through the mental health checklist above, and learn your college student/young experiences negative emotions like sadness/hopelessness or anger/irritability every day for two weeks or more, and those experiences are accompanied by a decline in academic/work performance, we encourage you to arrange for a psychiatric assessment administered by an experienced, qualified, mental health professional: they can confirm the presence of a mental health disorder, and offer referrals for evidence-based treatment.
If your college student or young adult does develop a mental health disorder, they’re not alone. The “American College Health Association (ACHA): Academic Year 2023-2024 Report,” published annually, shows the following data for the last school year:
Mental Health Among College Students: 2023-2024
Stress Level in Past 30 days:
- Moderate: 49.2%
- High: 28.8%
Suicidality in the Past Year:
- Serious thoughts of suicide: 20.4%
- Considered suicide more than once: 31.4%
- Said it’s “likely/rather likely/very likely” they’ll die by suicide: 3%
- Attempted suicide: 2.3%
Mental Health Treatment:
- Ever received: 48.7%
- Past year: 32.9%
Received Medication for Mental Health:
- Ever received: 28.6%
- Age upon receipt: 73% before college / 27% after starting college
Received Counseling for Mental Health:
- Ever received: 37.2%
- Age upon receipt: 74% before college / 26% after starting college
Ever Received diagnosis for:
- Anxiety: 5%
- Depression: 24.1%
- Posttraumatic stress disorder: 7.0%
- Eating disorder: 5.8%
- Bipolar disorder: 2.4%
- Personality disorder: 1.3%
- AUD/SUD: 1%
- Schizophrenia/psychosis: 0.4%
The numbers tell the story: college students feel high levels of stress, close to a third have a diagnosis for anxiety, close to a quarter have a diagnosis for depression, and far too many seriously considered suicide. That’s why it’s important to check in on your college age kids: they need your help and support now more than ever.
After the Mental Health Check In, What’s Next for Your College Student?
If you complete your mental health check in with your college student or young adult and you think they need professional support, please call us here at BACA.
You can also use these online resources to find help:
- The American Academy of Child and Adolescent Psychiatry (AACAP) is an excellent resource for locating licensed and qualified psychiatrists, therapists, and counselors in your area. Their treatment finder is convenient and easy to use.
- The National Institute of Mental Health (NIMH) maintains a page for youth, adolescent, and family mental health
- The National Alliance on Mental Illness maintains excellent resources for families
Remember: when a person with a mental health disorder gets the treatment they need when they need it, they can learn to manage their symptoms and live a full, productive life.
