APA Expert Opinion
An APA expert answers common questions about college mental health

This month, Jerald Kay, M.D., Professor and Chair of Psychiatry, Wright State University Boonshoft School of Medicine and chair of the American Psychiatric Association's Corresponding Committee on Mental Health on College and University Campuses, discusses questions about college students and mental health.

My son is starting college in the fall and is currently in therapy and taking medication. How can I help him transition into care at his school?

It is important that you are thinking about this in advance. Increasing numbers of students just like your son are entering college with histories of mental health treatment. Continuity of care is critical in maximizing your son's chances of success. Although beginning college is exciting, it also brings additional stress to nearly all students who must adjust to new living arrangements and developing new relationships, to name a few. 

I encourage parents of incoming students to reach out to the school to get help maintaining psychotherapy sessions or obtaining refills of medications.  Once at school he can meet with a physician or mental health provider at his school’s health center. He should also request a copy of his medical records to be sent to the school.

Campuses vary in their ability to provide mental health services to students. If his school does not have a psychiatrist on staff, he can contact the local psychiatric society, community mental health center or medical school to locate a local psychiatrist. Information on locating a psychiatrist can be found here.

Ever since the Virginia Tech tragedy I am worried that this can happen on my campus. Can you tell if someone is going to be violent?

Tragedies like this are very rare, and administrators are more aware than ever about the need to keep campus communities safe.  If you feel your worry is excessive, please talk to your campus health center staff. 

In most cases it is possible to identify young people with problems and help them get appropriate mental health care.  To date, most of the adolescents and young adults who have carried out violent attacks in school settings have had long histories of emotional and behavioral problems. However, what we have also learned is that many of these troubled youths were not receiving adequate care – and some were not receiving any mental health care – at the time of their violent acts.

Watching for early warning signs can help.  They include:

• intense anger, irritability, agitation, depression; or suicidal thoughts or actions;
• prolonged low self-esteem, recent loss, disappointment or rejection;
• history of abuse or neglect, social isolation, or family problems;
• drug or alcohol abuse;
• bullying, impulsive/aggressive behavior or cruelty to animals;
• stealing, fire-setting, or other interactions with law enforcement;
• or preoccupation with violent or morbid themes or fantasies, or excessive interest in weapons or explosives.
    

It is best for you to tell an adult or a school authority when you believe someone needs help even if you have promised not to tell anyone. 


I am thinking of coming out to my friends and am scared about how they will react.

Coming out is not a one-time event, but rather an evolving process of identifying  yourself as gay, lesbian or bisexual to family, friends and other significant members of your social world.

Each person’s experience in coming out is unique and the process always stimulates anxiety as well as challenging possibilities for personal empowerment and emotional growth. There are generally many campus-wide resources available to help people coming out.

APA has posted a question-and-answer page on gay, lesbian and bisexual issues here.


I didn’t realize college would be so hard. I feel stressed out all the time and am taking sleeping pills every day to cope. Can they be addictive?

It is important that you are aware of your potential problem.  Check with your student health center; most campuses have organized programs to assist you with this type of problem.  

Sedatives are highly effective medications prescribed by physicians to relieve anxiety and to promote sleep. Unfortunately, harmful effects can occur when they are taken in excess of the prescribed dose or without a physician’s supervision, (such as when they are obtained illegally on or off campus). Most sleep aids can be addictive.

Combining sedatives with alcohol or other drugs greatly increases the sedative’s effects and can lead to even more serious consequences. It sounds as though you are self-medicating to deal with your concerns.  Please talk to your primary care provider, a psychiatrist or your health center right away.

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