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Towards a State of Wellness

Results of the Stanford Student Mental Health and Well-Being report

Problem sets, papers, midterms,

and finals—most would agree these make up the standard drudgery of the college experience. But meeting deadlines and passing classes are not all the hurdles a college student has to overcome. Involvement in student groups, work-study commitments, and varsity athletics, among others, also factor into the delicate balance of a college student’s life. Throw in a few personal statements, and very quickly the “ideal” college experience can spiral into a frenzied battle against fatigue, stress, and in the most extreme cases, depression and suicide.

Mental Health at Its Worst

Such focused interest in the mental well- being of Stanford students stems from a much broader nationwide concern—that of the overly competitive, overly stressed adolescent. “It’s gotten a lot of attention from students, administrators, the media, and parents because I think there’s some concern that the question of student well- being is not in a good place right now,” remarked Dr. Ira Friedman, Associate Vice Provost for Student Affairs, Director of Vaden Health Center and committee co-chair of the Mental Health and Well-Being Task Force.

Sadly, the demanding lifestyle of today’s college students often places mental health low on students’ list of priorities, and the Stanford campus is by no means immune to this trend. In the fall of 2006, Stanford officials formed a task force to seriously re-evaluate the campus’s mental health status in hopes of identifying and improving weaknesses in providing for student well- being.

The culmination of the task force’s two-year study is the Stanford Student Mental Health and Well-Being Report, released in October 2008. Drawing from surveys of almost 700 students and focus studies conducted by representatives of various community centers, academic departments, and student affairs offices on campus, the Report examines the aspects of student mentality and university policy that contribute to the overall mental health climate of the campus and, based on those findings, sets forth recommendations for bettering the available support system on campus.

The unrelenting pressure to succeed has caused today’s generation of young adults to show an increase in mental and emotional illness rates. Research by the Centers for Disease Control and Prevention found an eight percent increase in suicide rates for adolescents in 2004, in spite of a decrease of twenty-eight percent over the past fifteen years. “The young adult age group has the peak incidents of several mental health conditions: bipolar disease, schizophrenia, anxiety, depression,” noted Friedman.

College students in particular are prone to developing mental health problems during their transition to a new living environment. “We’re talking about high stress levels and distress, some students have mental health conditions that either preexisted when they were in high school or have emerged when they were here,” Friedman explains. Indeed, a random survey of Stanford students in 2007-2008 found that 23.4% experienced depressed mood with 3.2% meeting the diagnosis of major depressive disorder.

experienced depressed mood with 3.2% meeting the diagnosis of major depressive disorder. Credit: sxc.hu volume VIII

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Credit: sxc.hu ETHICS + POLICY “[M]any students have been brought into this belief that [academics] is

“[M]any students have been brought into this belief that [academics] is why they exist” - Ira Friedman

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stanford www.stanfordscientific.org scientific

“I think we are seeing more students in distress, not just us in the clinical setting, but also staff in residences and faculty, so that is a driver for our concern,” Friedman concludes.

The Campus Climate:

Ducks Under Pressure

As part of their examination of the university mental health environment, the task force looked at the campus climate and student culture with regard to emotional well-being. As Friedman detailed, “What features of the campus climate have to do with stress and performance? How is it helping students? How is it mitigating stress? How is it maybe aggravating students’ stress and distress?”

The task force found that one of the significant, but perhaps unsurprising, contributors to student stress is the reputed “Stanford Duck Syndrome.” In this analogy, students are likened to ducks on a pond:

though they appear calm on the surface, they are actually kicking furiously to stay afloat. “The way I see it is the extra wear and tear of needing to appear like everything is effortless and under control when in fact many students work very, very hard,” Friedman adds.

Whether students experience the Duck Syndrome as a sense of clandestine competition among themselves or a fear of showing weakness or failure, the internalization of stress and emotional discomfort should begin to burden a student and affect his or her academic performance—or so one may think.

According to the findings of the study, academic success is actually not always reflective of a student’s state of emotional health. “Many students are able to achieve and perform fine academically because they’re so used to doing that, but internally,

they’re not doing very well,” remarks Friedman.

Interestingly, this paradox may be a consequence of the campus climate at Stanford. “There is such an overwhelming emphasis on academic accomplishment that it displaces other forms of personal pursuit,” Friedman explains, “and many students have been brought into this belief that [academics] is why they exist.”

In addition to a greater need for balance in their lives, the Report notes that students tend to experience anxiety when their expectations of the university are not met. Unrealistic expectations of advising, academic support, and faculty-student interaction often lead to disappointment, which, in the opinion of one student survey respondent, is “a horrible source of stress.”

University Policies: Change from the Top

Despite some students’ sentiments that university resources are not up to par, the Report found that the mental health support system on campus is very strong in many ways. Residential education, from the variety of student staff to the programming in student dorms, helps to foster an important sense of community and belonging that can mitigate the effects of high stress. Several facilities and resources dedicated to promoting mental health and well-being, from the Bridge Peer Counseling Center to the Counseling and Psychological Services (CAPS) referral system, provide students with necessary services.

Nevertheless, there is room for growth. One of the areas for improvement identified by the Report is academic advising, mentoring, and support for both undergraduates and graduate students. Expanding the scope of an academic advisor’s role to that of

ETHICS + POLICY “There is such an overwhelming emphasis on academic accomplishment that it displaces


“There is such an overwhelming emphasis on academic accomplishment that it displaces other forms of personal pursuit,” - Ira Friedman

a mentor and further encouraging the utilization of academic support resources are among some of the recommendations proposed for this area of concern.

For graduate students, it may be useful to provide a second advisor separate from the primary academic advisor to whom students can turn for non-academic guidance. This way, as Friedman explains, “students can know that they can go to someone for help or to share information about themselves that they would otherwise want to protect because they fear it would be seen as a negative by someone who is evaluating their progress.” This practice has already been adopted by the Stanford School of Medicine and, if adopted by all academic departments, would be a major step forward in addressing student mental health and well-being.

Another identified area for improvement is strengthening the already robust safety net of resources for students. A major criticism of CAPS was that it was, for a long time, understaffed and therefore unable to meet the increase in student demand for services. However, the shortage of counseling staff has already been resolved by an increase in available positions. Furthermore, the recent establishment and accreditation of a pre-doctoral psychologist training program at Vaden Health Center will contribute to the growing pool of mental health care providers on campus.

Student Mental Health as a Student Initiative

But what good are the improvements in university policy and practices if students do not begin to recognize the importance of their own mental well-being? Dr. Friedman gives several of his own suggestions. First is a change in collective campus culture regarding mental health. “The student

culture will survive here and it will be shaped largely by students,” Friedman asserts. In reference to the Primal Scream, a Stanford tradition in which students across campus scream at the stroke of midnight the week before final exams, Friedman remarks, “None of us invented that, but it’s an indication of what students are experiencing.” More efforts to encourage open expression of emotional hardship could potentially alleviate the stress associated with the Duck Syndrome.

Another healthy change would be a shift in mindset from academic all-stars to emotionally and spiritually whole human beings. “I’d particularly like to see more emphasis on the balance issue,” Friedman notes. Students should be encouraged to talk with each other more about non- academic interests and leisurely pursuits. “Those are de-stressing things, and only students can create the communities that are supportive of each other.”

Though the Student Mental Health and Well- Being Report focuses largely on changes at the administrative level, students should not take its findings for granted. “I really do believe a large piece of this is in the hands of the students,” Friedman states, “and what’s exciting about this document is that it gives us a platform from which we can say, ‘This is what we think—what do you think?’” Through proactive collaboration and a willingness to confront the issues surrounding mental health, it will be possible for students to achieve a state of wellness at Stanford—not simply to help each other but to help themselves.

simply to help each other but to help themselves. To Learn More For more information, visit

To Learn More

For more information, visit the Stanford Student Mental Health and Well-Being group’s website at http://www.stanford.edu/ group/mhwb/index.shtml.

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