I feel my son is somewhat fragile mentally and worry about his transition college. What kind of mental health services are available at college, and how do I make sure he gets help if he needs it?

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Nedda Gilbert, MSW, Educational Consultant, and Author

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You've asked the million dollar question: will my child be okay at college, and if not, will he get the help he needs. College is a time of breaking away from parents, home, old friends and everything that is familiar, comfortable and rote. At the same time college students are particularly vulnerable. They not only have to navigate new independence, but new territory as well. It can result in homesickness, loneliness, isolation, depression and a sense of displacement.

For most students this is a passing phase, if even a phase at all. Some kids quickly adapt to the college environment. But for a good majority, adjusting takes some time. It's a big change. Occasionally, the process leads to something more serious that requires intervention or counseling.

I don't know if your college-bound son is currently working with a counselor, but it sounds as though you consider your child to be vulnerable and possibly at risk of being unhappy at college, or facing some unique struggles. It may be worth engaging the services of a licensed therapist, or having him work with the high school counselor to prepare for the transition and develop coping strategies. If he has some tools going in, he may fare better.

Once your child sets foot on campus he will be protected by the Family Educational Right and Privacy Act, (FERPA) which applied in your case basically limits you from having any communication about your son with the school, even if he has visited the school counseling or medical center. Fortunately, most schools offer some waiver of this act. You both fill out some forms, and you can have the more open exchange of communication you really should under the circumstances.. I would advise you to reach out to the school as soon as possible, and well before your child arrives to learn of your options in modifying the impact of FERPA.

As for knowing when your son needs help and how he may access it, this is dicier. One of the biggest challenges in reaching out to and helping struggling college kids is they don't let anyone know they're in trouble. The facade of "I'm okay" to their peers is critical to maintain. The biggest gift you can give to your son is to message this: he needs to tell you when he feels he needs help, can't handle it anymore, or can't control his feelings. And that this is not an act of failure, but an act of courage. If you can dialogue with your son about this critical step, and get him to recognize the importance of reaching out to you, or someone at the school - you will have likely averted a situation that could be more concerning.

Mental health services vary at colleges. Generally a minimum of four counseling sessions will be offered to a student. Some schools go up to ten. I will be honest, I don't think the practitioners in these college health centers are always the best, unless they are volunteering and have thriving private practices. My experience is they tend to be more junior level practitioners. And there is a study that suggests bad therapy is worse than no therapy at all. There are cases of college students who worsened, rather than benefited after meeting with a college based therapist and that lost opportunity for timely intervention resulted in a tragic turn of events.

I don't want to disparage the efforts of any college counseling office, or trivialize how hard many administrations are working to address this Achilles heel of student mental health. But I do want to suggest vigilance and oversight. If your son does decide to meet with a school therapist I might ask the following. Is the therapist licensed in that state? This is critical for you to vet. Has you son benefited from the counseling session? What are next steps? Will he see this individual twice a week, once a week? One option is for you to work with the school to have your son referred to an outside practitioner who is a fit for your son and his issues as soon as possible, This may be covered under your private insurance, or the school's health plan.

For those colleges that offer more than four therapy/counseling sessions (in-house), the opportunity to work with a therapist for a longer period of time amount brings up another concern. If your son can get the help he needs within a more generous number of sessions, (but still with a tight cut-off), I am all for it. However, part of what makes therapy work is the process of becoming attached to the therapist in a therapeutic relationship. This is where a patient attaches to this therapist as guide, mentor, friend, role model and well, someone who cares. It's tough to work with someone for two months, get into a groove, share deep issues and then have to it end abruptly at the ten session mark. And pick up with someone new. If you feel you son will benefit from ongoing therapy that far exceeds the sessions offered by the school, this needs to be addressed. And early on. It may be best to utilize those first free sessions to diagnose your child, and then transfer him to an outside therapist. Either way, given your concerns, it may be a good idea to familiarize yourself with what you son's college offers for counseling.

My greatest hope is that your son arrives at college feeling positive, strong and with the tools to weather a storm or two. If not, I hope the above is helpful. I wish you and your son the very best.

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