(Content warning: This article references suicide. PTake caution when reading. If you need mental health support, consult this page for resources.)
When Peyton Morris was 16, her father died by suicide.
So when Morris started her sophomore year, she revived Walk. Support. Glow. — a student organization on campus that works to bring more awareness about mental health issues and the resources available to students.
“Once I lost my dad, it just really opened my eyes that mental illness can affect anybody and everybody,” said Morris, a 20-year-old junior from Currituck who is studying to be a nurse anesthetist.
His death really drove her to be involved.
“I had never really heard about (mental illness), especially being from a smaller town,” Morris said. “Nobody really talks about things like that.”
She is not alone in wanting students to have more information and more support while at college.
As students return to their dorms and to full class loads this fall, North Carolina universities, health officials and legislators are continuing efforts to address mental health concerns on campus.
Providing young people with the mental health resources they need is crucial, said Dan Marlowe, associate dean and chair of Behavioral Health at Campbell University, during an Aug. 24 town-hall meeting on mental health at the school.
“If we can help them develop coping strategies and (put) those public health pieces into play, you end up creating people that are not just sensitive but resilient … and that resilience builds on itself,” he said.
Along with student efforts like the Walk. Support. Glow. program, colleges are offering resources from therapy dogs and meditation spaces to peer counseling and happiness classes.
A year earlier, UNC Chapel Hill responded to a spate of student suicides there by giving students time off with “wellness days,” bringing therapy dogs to campus and making other efforts to support students emotionally.
Both colleges started the new academic year with a death on campus. N.C. State students returned over the Labor Day weekend to learn that a student was found dead outside a dorm on campus. Officials have not released a cause of death.
The fatal shooting of a UNC Chapel Hill faculty member on campus the first day of classes last week added to the mental health load for students there. Faculty are calling for a mental health task force to be formed.
The Daily Tar Heel, the student newspaper, dedicated its front page to some of the frantic and explicit text messages between parents and their children — sent while students sheltered in place for three hours as police searched for an active shooter.
Graduate student Tailei Qi has been charged with first-degree murder in the death of associate professor Zijie Yan.
Morris said it is important for students to honor Yan’s life, while also taking time for themselves to heal.
“Mental health is more important than ever here on campus,” Morris said Friday in an email. “Every student, faculty, and staff member should take the time to realize their feelings are valid.”
A rising concern
Mental health concerns among youth were rising before COVID-19. Then, the pandemic exacerbated issues for those who had been struggling with socialization skills and for those who lost out on key time learning how to connect with peers due to the isolating effects of lockdowns and masking, college health officials said.
The latest Youth Risk Behavior Survey, which reflects 2021 data, shows that mental health remains an ongoing issue among high school students, which means colleges and universities will also continue to grapple with these issues in the coming years.
The web-based Healthy Minds Study showed that 44% of college students surveyed in the 2021-22 school year experienced depression and 37% experienced anxiety.
Some 15% of students said they thought about suicide, 6% said they made a plan and 2% attempted to end their lives.
Though the COVID-19 pandemic exacerbated mental health concerns among students, it is not the only factor, according to education and health officials.
College students face unique challenges, said Eleanor Lott, a 20-year-old N.C. State student from Clemmons.
“People need to understand that college mental health and adult mental health, or young adult mental health, are still two different things,” she said. “I think a lot of people don’t realize how unique the struggles of a college student are — even outside of having to learn so much at once.”
Lott, who served on N.C. State’s task force on student mental health during the 2022-23 school year, said there’s a feeling of exasperation among students.
“They’re tired of seeing their peers suffering,” she said.
Residual pandemic stressors
Half of adults aged 18-24 reported anxiety and depression symptoms this year, compared with a third of adults overall, according to an analysis of the U.S. Census Bureau’s Household Pulse Survey by the nonprofit KFF, which focuses on health policy issues.
The data also show that young adults are more likely than adults of any other age group to experience mental health symptoms, KFF reported in March.
Charnequa Kennedy, director of the counseling center at N.C. Central University, said college-age students experienced a rise in anxiety and depression, as well as social concerns and personal disruptions, during the pandemic.
Lott said COVID-19 played a big role in mental health for college students, and it likely will have an effect for a long time to come.
“I think that students didn’t realize how upsetting quarantine really was,” she said.
Kennedy said N.C. Central is still seeing students dealing with general stress, along with concerns about relationships and problems with sleeping because of time-management issues.
Being away from home for the first time can affect students differently, said Brittany Locklear, a counselor with UNC Pembroke’s counseling center.
“We’re very family-oriented,” Locklear said of members of the Lumbee Tribe, who make up a large portion of the university’s student population. “And so being away for the first time and not living at home can be really hard being away from your family.”
At UNC Charlotte, about 40% of students are the first in their family to go to college, said Erica Lennon, director of the university’s Counseling and Psychological Services. They can struggle with navigating the nuances of being on a college campus because they don’t have family members who can share experiences with them, she said.
Added to all those new experiences, students who breezed through high school might find themselves struggling academically in college, Locklear said.
They also may not have realized how parents advocated for them when issues arose at school, she added.
“Now they have to do that,” Locklear said. “And so, there’s all these new challenges that come with college life.”
For some LGBTQ students, recent discussions in the state have driven them to seek support and counseling, said Danielle Reagan-McGirt, who served as a counseling intern at UNC Pembroke before getting her master’s degree this spring at the university, where she now works as a counselor.
“We have seen some clients who, because of the changing political landscape, have been worried for their rights,” she said. “It’s a tough situation, because being in a helping profession, you want to make everything better.”
All counselors can do is listen, offer support and empathy, and help with coping, she said.
Republican lawmakers voted Aug. 16 to override vetoes by Democratic Gov. Roy Cooper on three bills, which are now laws, that restrict transgender youths’ access to health care, participation in sports and exploration of gender identities in K-12 schools.
Lisa Zapata, a senior associate vice chancellor at N.C. State, said she believes social media has added to mental health issues for young people.
The National Alliance on Mental Illness warns that social media can stymie social skills in young people by limiting in-person interactions where people learn about others through their facial expressions, tone of voice and reactions. Social media can also expose youth to bullying and idealized depictions of life that can create stress.
For college students, NAMI says it’s important to prioritize mental health. The group suggests that students look for on-campus supports, social connections and opportunities to engage with their new community.
Care and connection
In the wake of last year’s suicides, wellness programs at N.C. State now run the gamut from playing with therapy dogs to planting trees.
“We have been trying to be creative for years now,” Zapata said. “So, we’re doing all kinds of things, and we have been trying to reach students where they are.”
The UNC System is funding various programs individual schools can use that are geared toward helping students find the help they need.
One of those programs, Mental Health First Aid, trains people to recognize and respond to signs of mental illnesses and substance use disorders. NCCU has at least eight Mental Health First Aid instructors and trained about 200 students last year, including residential advisers and graduate hall coordinators, Kennedy said.
UNC System funding is also paying for the QPR program, which teaches participants to question people about their mental health, persuade them to seek help and refer them somewhere to get help. NCCU’s student group Active Minds offers a peer counseling program called VAR, which stands for “validate, appreciate and refer.”
“And we do include other peer supports, recognizing that sometimes that’s where students are most open to engaging,” Kennedy said.
One of the popular supports provided for UNC Pembroke students is meditation spaces, Locklear said. The school received a grant to add more of them this year, with a dedicated spot on each floor of one of the freshman dorms, said Reagan-McGirt.
There’s also a dedicated Collegiate Recovery Community space that includes snacks, books and other resources. Students can use that space to look up information, seek someone to speak with or quietly unwind.
UNC Charlotte is looking to offer restorative yoga, which can address the tension and other manifestations of trauma in the body.
Along with increased outreach and communication, UNC Chapel Hill has added QPR suicide prevention training for faculty, staff and students.
The university also is partnering with the on-campus theater venue Playmakers to bring the one-person play “Every Brilliant Thing” to campus in January and February. Each show, which follows a man’s experience with mental illness in his family, will be followed by a discussion by trained professionals about mental health and well-being.
While many of the programs can be — and often are — used across campuses, sometimes there are unique needs to be met.
“One thing that I’ve stressed heavily is that each school needs to look at its individual culture and needs to look at what its students need,” Lott said.
At UNC Pembroke, it has been especially important to offer support for alcohol and drug addiction because addiction is “really high and rampant” in the Lumbee community, Locklear said.
Last semester alone, the university offered eight outreach efforts, many of them culturally focused. For example, a two spirit (an indigenous term used to express sexual, gender or spiritual identity) shared their recovery story and how to incorporate traditional healing practices into recovery. Other sessions taught students about soap making and creating medicine bags.
Kennedy said schools can show students what healthy looks like for them while also showing them what good mental health services should look like in case they need them later in life.
“The more that we’re able to provide that education at this level, the better prepared and more likely our students are to continue seeking care, because they’ve already been exposed and have had … access to quality care, which is what we are intentional about providing with our students,” she said.
At N.C. State, the student mental health task force made about 50 recommendations.
Some of those have already been put into practice, from adding wellness days on the calendar to expanding the clinical services team at the counseling center, according to Mick Kulikowski, the university’s director of strategic communications and media relations.
The university is continuing its partnership with AcademicLiveCare to provide teletherapy services at no additional cost and no limit on visits.
Students new to campus will get more education around mental health during orientation, and wellness programs will be widely promoted to the community as the school year begins.
The university is also embedding counselors in each of its colleges on campus. Most have one dedicated counselor, although a few have two counselors and a few will share a counselor, according to Zapata with the university’s Division of Academic and Student Affairs. That’s on top of drop-in clinicians who have been available for years, she said.
“We’re … making it as easy as humanly possible for a student to seek assistance and get that support,” she said.
Lott’s especially excited about the embedded counselors.
“I think students having someone that they already know who their person is to go to, I think that’s going to be exceptionally helpful,” she said.
Students took part in the task force, and they are part of the steering committee tasked with figuring out which recommendations are feasible and how to implement them.
The task force released its report in February, and the steering committee started its work this summer. They will kick into high gear this fall, Zapata said.
She called the report comprehensive and aspirational.
“We have always and will always strive to help improve our students’ mental health and sense of belonging,” Zapata said. “Research shows when students do feel a sense of belonging, they will be more successful. So that’s really a focus for us.”
Schools are putting all of their mental health resources in one spot online so students can easily access them. Here’s where you can find help at the universities included in this article:
N.C. Central: Health and Wellness
N.C. State: Wolfpack Wellness
UNC Chapel Hill: Heels Care Network
UNC Charlotte: Health and Wellbeing
Find out more about what programs the UNC System is offering: Student Behavioral Health Initiatives
Locklear said UNC Pembroke and the UNC System have done a great job to reduce some of the stigma and fear around talking about mental health.
While Lott believes there is still a stigma around seeking and getting care, she agrees with Zapata and Kennedy that more people are recognizing that they need help and seeking it.
Lennon said that when she first arrived about 14 years ago, the counseling center at UNC Charlotte had to do a lot of outreach to let students know services were available. In recent years, even before the pandemic, more students started coming there for help.
“I do think that we are not only more aware, but I think the conversations are happening more frequently,” she said.
In this case, social media may be a positive influence, Lennon said. More celebrities are using social media to share their experiences with mental health issues, which may be helping young people to recognize and seek help for their own issues, she said.
“Every student’s important, and we want to be able to support every student with what it is that they’re facing,” said Laurel Collins, director of counseling and psychological services at UNC Pembroke. “And we just want them to know that they are heard.”
UNC Pembroke also is launching this year the “Togetherall” app, a peer-to-peer mental health support community that provides tailored self-help courses on such topics as depression and anxiety.
Morris, the UNC Chapel Hill student, said younger generations seem to be more willing to seek help but she worries that a lot still gets “swept under the rug.”
“But the more people speak about it … the better things are gonna get,” she said. “Because if you keep putting the stigma around mental illness and suicide … it’s never gonna get better.”
North Carolina Health News is an independent, nonpartisan, not-for-profit, statewide news organization dedicated to covering all things health care in North Carolina. Visit NCHN at northcarolinahealthnews.org.