College students need better mental health care

This medical-model, symptom-governed, solution-focused, crisis management approach to psychotherapy might quell the anxiety of beginning clinicians, making them feel they are being productive and safety-conscious. It may also satisfy the aspirations of college administrators worried about any added liability associated with increased numbers of students on campus admitting to suicidal ideation. However, paradoxically, a therapy approach where the practitioner functions more like a medical provider and dictates the agenda in terms of symptoms, goals and solutions, can undercut clients being genuinely engaged, encountered and listened to in their moments of dire need. In fact, suicide-prevention experts, like David Jobes at Catholic University of America in Washington, D.C., would proffer that any effective suicide-prevention counseling is predicated on hearing in great detail suicidal clients’ agonizing reasons for having reached such emotional lows in their life; really settling in to thoroughly understanding their existential struggles; really entering the painful narrative they tell and struggling with them to restore hope and meaning in their life.

And, to effectively treat the depression that accounts for clients’ suicidality, short-term therapy comes up short. In one of the most well-regarded studies of its kind, Jeffrey Vittengl, psychology department chair at Truman State University, along with several colleagues, found that crisis intervention, symptom-reduction, solution-focused therapy is insufficient to treat many clients’ depression. Within a year, almost 30 percent of clients offered this approach relapse, as do 54 percent within two years.

If college counseling centers are to accomplish their mission of maximizing the mental health of struggling students to enable them to be “ready to learn,” they need to heed this message from Louise Douce, former assistant vice president of student life at Ohio State University, in the influential publication A Strategic Primer of College Student Mental Health: