To the Point: Experts offer advice to students in distress

Oct 13, 2010

(PhysOrg.com) -- Recent news headlines across the United States have shed light on mental health concerns among teens and young adults in distress -- whether questioning their sexual orientation or dealing with an unhealthy relationship -- where others resorted to bullying, harassment and other violence against them. The most visible recent incidents involved four male teens who committed suicide in September, in separate incidents, after enduring homophobic bullying or harassment from peers.

Experts from Penn State's Counseling and Psychological Services (CAPS) and the Center for Collegiate Mental Health (CCMH) answered questions about the effects of peer bullying and discrimination, and what and their friends and loved ones can do to support students who may be demonstrating signs of distress, anxiety or depression.

College students often have an adjustment period to their newfound freedoms as individuals living away from their parents' rules. Some students struggle with homesickness, while others experiment with alcohol, sex and other behaviors previously inaccessible to them. What are the most common kinds of issues you see from students seeking help from counseling services?

Ben Locke: Based on data we collected examining more than 28,000 college students receiving mental health services at 66 institutions across the country, top clinical concerns include anxiety, depression and academic distress. We also have data on more than 20,000 students not receiving , and these students evidence , eating and academic concerns. When you look at what differentiates between treatment seekers and non-treatment seekers, the largest differences are found on items relating to depression and to a lesser extent, anxiety. In addition, students in the treatment-seeking sample are clearly more distressed about their .

Though students who identify as gay, lesbian, bisexual or questioning evidence unique patterns of distress, all have significantly higher family distress than their heterosexual counterparts. This finding is consistent with existing research that documents that family members’ responses to sexual minority students can vary widely, from complete acceptance to total rejection, to something in between.

Have you seen any changes over time at CAPS that indicate that today's students, whether identified as LGBT or not, are suffering from mental health issues in lesser or greater numbers? What trends concern you most?

Dennis Heitzmann: Nationwide, counseling center professionals are increasingly concerned that both the prevalence and the severity of college mental health problems are increasing. For many years, surveys of counseling center directors at universities across the country have underscored the increasing demand for psychological services represented by a significant segment of our student bodies. More recently, the growth area in campus-based services has been psychiatric services, with the advent of improved psychotropic medication to ameliorate a variety of symptoms. Moreover, CAPS statistics indicate that a significant segment of students seeking services have already received psychological and/or psychiatric treatment before they arrive on campus. Interestingly, 8 percent of students seeking treatment in the CCMH pilot study are sexual minorities, roughly double the national estimated prevalence of sexual minority status.

As recent headlines have brought to light, some students who may have already been questioning their sexual orientation in middle school and high school have experienced bullying and harassment from their peers. Is bullying a significantly reported issue among college students who seek counseling? What about other forms of harassment?

Kathy Bieschke: While we don’t have data on bullying per se, we did ask participants in the pilot study whether they had “experience harassing, controlling, and/or abusive behavior from another person.” Approximately 34 percent of all students indicate that they had experienced such behavior either before or during college. Further, about 20 percent report unwanted sexual experiences. For those students who identify as gay, lesbian, bisexual or questioning, the rates of harassment and unwanted sexual experiences go up considerably. About 50 percent of this group report some type of harassment before or during college and 35 percent report unwanted sexual experiences. Students who identify as transgender report the most harassment (56 percent) and about the same percent of unwanted sexual experiences as do those who identify as sexual minorities (32 percent).

The first pilot study by the Center for the Study of Collegiate Mental Health noted findings that "students who reported that they were questioning their sexual orientation reported average suicidality scores that were twice as high as heterosexual students, and significantly higher than non-questioning gay, lesbian and bisexual students," and that those same students were assessed with high rates of symptoms for depression, social anxiety and eating concerns. What resources and forms of support are available to students displaying those health concerns?

Bieschke: Penn State's Center for Counseling and Psychological Services is a valuable resource for students with these health concerns. Staff members at CAPS are able to provide those questioning their with services that are supportive, affirmative and responsive. In addition to individual counseling services, groups specifically targeted towards this population are available.

Students also can contact the LGBTA Student Resource Center at Penn State, at 101 Boucke Building and www.sa.psu.edu/lgbt/ online. The LGBTA Student Resource Center strives to create an inclusive campus community for all members of the LGBT community. The LGBTA Resource Center sponsors many students groups and programs and facilitates a mentorship program that matches students who are exploring their sexual orientation with students who are more accepting of their sexual orientation.

CAPS has an excellent relationship with the LGBTA Student Resource Center and staff in either office can direct students to other community and national resources. Recently, these two offices worked together to sponsor a community forum in response to the recent suicide at Rutgers. Students, faculty and staff were able to support one another in the midst of this tragedy and exchange ideas for how to reach out to those who might not be aware of the supports available both at Penn State and in the community.

The CCMH pilot study also reported that LGBT students who were not questioning their sexual orientation and had good family of origin relationships showed significantly reduced depressive symptoms. Does this mean that having family support negates the effects of harassment?

Andrew McAleavey: Our data indicate that having good support from one’s family of origin was related to lower depression scores for all sexual minorities. Unfortunately, family can act as a protective factor, or a destructive one, depending on which family you look at. As a result, gay men and lesbian women often have social support networks largely comprised of non-family members. These individuals (commonly referred to as allies) play a crucial role for those who identify as a sexual minority given that these lesbian, gay, bisexual and transgender individuals are often uncertain or fearful of the reactions they might receive from family members. Also, regardless of family and friend support, the process of questioning one’s sexual orientation or gender identity creates additional distress, probably due to the widespread social prohibitions against sexual minorities.

What kinds of outreach exist for LGBT and questioning students who are struggling with thoughts of suicide or exhibiting signs of great emotional distress? Do many students who seek counseling tend to be familiar with the organizational and mental-health resources, such as support and advocacy groups, available to them?

Bieschke: Though there are many resources available to students, such as Penn State’s LGBTA Resource Center, the coming out process can complicate knowing about and accessing such resources complicated due to fear of disclosure. Often students struggling with their sexual or gender identity seek out online resources such as Matthew's Place (matthewsplace.com), run by the Matthew Shephard Foundation. Here students can find resources about such topics as coming out friends and family as well as information about how to join an online community. Another such resource is the Trevor Lifeline, a 24-hour, national crisis and suicide prevention lifeline for gay and questioning teens (1-866-4-U-Trevor, thetrevorproject.org).

What recommendations do you have for students who may be questioning their sexual identity but are afraid to come out? What advice do you have for friends and family of students who may be questioning?

Bieschke: Students in the midst of questioning their sexual identity can find it difficult to see past the immediate challenges to a satisfying and fulfilling future. Certainly, talking with someone at either CAPS or the LGBTA Student Resource Center can be helpful to identify what one’s romantic attractions are, solidify a sense of self, and cope with adverse circumstances.

Given that sexual minorities can’t look at a person and assume the kind of reaction they will receive, allies must signal their support in some meaningful way. At Penn State, faculty, staff, and student allies can join the Lesbian, Gay, Bisexual, Transgender Support Network and display a symbol that signifies support and a safe haven for members the LGBT community. Go to www.sa.psu.edu/lgbt/network/index.htm to learn more about and join the support network. I’ve displayed this symbol for more than 15 years and know from firsthand experience that displaying the Support Network symbol can signal safety and support to those in the midst of questioning their sexual and/or gender identity.

For those friends and family members of students who are questioning, demonstrate your acceptance by simply listening and seeking to understand their experience. PFLAG (Parents and Friends of Lesbians and Gays, www.pflag.org) offers resources for those who are striving to be supportive to those who are questioning their sexual identity.

Do you have any additional thoughts or suggestions for students who may be afraid to seek counseling or other forms of support?

Bieschke: Complicating the situation for many of these individuals is an inability to identify accessible role models or supportive friends and family members. In addition to the resources already mentioned, students may want to visit YouTube. Dan Savage, a noted sex commentator, recently set up a YouTube channel entitled “It gets better” to provide a forum for individuals to reach out to those who are questioning and provide some hope. The YouTube channel has more than 1,000 messages of hope for those who are questioning. For those that are anxious or fearful about reaching out to those in their lives, viewing this channel can provide real-life accounts of how others in similar situations have successfully navigated through this stressful period in their life.

Explore further: Early exposure to antidepressants affects adult anxiety and serotonin transmission

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