The Kids Are All Right—Kind Of

According to Trinity psychologist Richard Reams, Ph.D., the media has overstated the impact of COVID-19 on college students’ mental health. And he has the data—at least on Trinity students—to prove it.

“This semester, compared to two years ago, students are not reporting more intense depression,” the director for Counseling Services says. “They’re not reporting more intense anxiety. They’re not reporting more intense distress. Symptom severity is not up compared to pre-COVID among our clients.” Counseling Services also did not see the increase in clients they had anticipated during the first month of this semester.

Reams explains that, in general, Trinity students aren’t citing COVID-19 as a primary reason for seeking counseling this semester. Instead, the effects of the pandemic are residual. Students might need help brushing up on their rusty social skills, or they want to discuss newfound self-awareness resulting from expanded time for self-reflection during their quarantines.

“Of course, there are certainly individuals who are really struggling,” Reams says, especially those who were already working through pre-existing health conditions.

“But, broadly speaking, the kids are all right,” he says. “Or, I should say, they’re about as distressed as they were before COVID.”

And that clarification reveals a world of difference.

Zoom out to look at the bigger picture, and you’ll find that the pre-COVID level of distress was high—very high—for students nationwide. Study after study indicates students are more burdened by pressure than ever before, with perfectionism and expectations—from themselves, from their family, from society—rising for several decades, as psychologists Thomas Curran and Andrew P. Hill reported in their 2019 review of 25 years of research on perfectionism. At Trinity, Reams conducted a survey in early 2020 (pre-pandemic), randomly sampling more than 400 Trinity undergraduates about dozens of stressors, including perfectionism. More than 80% of them were moderately or highly stressed by their own perfectionist expectations and high standards.

In this same survey, Reams also found that news and current events were a major source of distress for Trinity students.

“COVID is the latest current event. But before that, Trinity students were worried about mass shootings, deportations at the border, climate change, the future of the planet, et cetera,” Reams says. “In the panoply of stressors they’ve got, COVID is just one more thing.”

Richard Reams, Ph.D., at his desk in Counseling Services

Reams has been at Trinity for 27 years, so he’s personally seen this shifting burden with college students. In Reams’ first 15 years with Trinity, he says, Counseling Services steadily saw about 10% of Trinity students a year. But for the past 10 years, that percentage has slowly risen. He anticipates Counseling Services seeing about 20% of the student body this academic year.

To keep up with this rising trend, Trinity has added more staff to Counseling Services over the past five years. Most recently, the University funded Counseling Services to add a half-time counselor for this academic year. Early in 2022, the University will launch a national search to turn the part-time position into a full-time role. The staff expansion has allowed counselors to increase support groups from one pre-pandemic to three now. Interestingly, there was insufficient interest in a fourth group focused on COVID-related stress.

This investment in Counseling Services is part of a commitment to support holistic student health. Trinity promoted University physician Dr. Marcy Youngdahl into a new role as director of Integrated Counseling and Health Services. This role is meant to deepen the relationship between Health Services and Counseling Services because, as Reams explains, “that’s the way we human beings work,” referring to the relationship between the two spheres.

“Multidisciplinary collaboration lets us focus on the whole person—not just their physical health, and not just their emotional health, because each can affect the other,” Reams says. For example, a student who visits Health Services with gastrointestinal issues might find the root of their issue is underlying anxiety. Or a student with depression might need blood work to see whether there is a medical cause. Youngdahl’s new role helps intertwine the two offices to work even more collaboratively on treating the student, not the symptoms.

To have the bandwidth to do more of this collaboration, Health Services has also expanded. The University hired staff to work specifically on the COVID-19 Health Team, monitoring testing, contact tracing, and treatment of patients. That frees up space for the rest of Health Services to do what they do best: preventive care, acute care, phlebotomy, and vaccine administration. Health Services is currently searching for a new full-time prescribing provider, too—a position Youngdahl says will be a game-changer for some students.

“One thing that I’m really excited about is that we are going to reduce some stress for our students with chronic illnesses,” Youngdahl says. In the past, these students would often need to maintain a relationship with a local primary care provider to manage their illnesses. “Now with increased availability of a prescribing provider, we’ll be able to provide chronic disease care within our scope of primary care, which is huge. It’s going to really help reduce a barrier to receiving care, since locating an available primary care physician and going off campus for services can be difficult.”

Youngdahl says that once the worldwide pandemic is no longer in the foreground, the two offices will look for more ways to integrate, such as collaborating on app-based population health management, as well as for more opportunities to work with other areas in the Division of Student Life.

“Everything we do in the Division of Student Life supports student wellness. It’s a lot more than just mental and physical health,” Youngdahl says. “Our work at Trinity helps our students develop into people who understand that they need balance in their lives. We know their success depends on them leaving Trinity understanding there are multiple areas they can focus on to help them achieve a fulfilling life: mental health, physical health, financial health, spiritual health, and career satisfaction. Maintaining a balance of those things are what we want them to leave here understanding and having developed during their time at Trinity.”