College Mental Health: Should Parents be Involved?

The New York Times ran “Off to College Alone, Shadowed by Mental Illness” (12-08-06) and invited reader responses to the question, “Should colleges involve parents in the treatment of their child’s mental illnesses or should the privacy of these young adults be protected?” My response:

The question, “Should colleges involve parents in the treatment of their child’s mental illnesses or should the privacy of these young adults be protected?” is more complex than a simple yes or no response.

Historically, colleges have assumed responsibility “in loco parentis,” that is, not only to educate students but also to offer the guidance and protection that, under the best of circumstances, a student would receive at home. Indeed, such has been the legal argument against a university in at least one widely publicized case of a student suicide in which the parents were not informed of the student’s deteriorating mental status.

Legally and in terms of professional ethics, a mental health practitioner’s duty to protect a client from harming him/herself or others trumps privacy. In actual college counseling center practice, such cases are relatively rare. Most often, the question of involving parents can be explored as a clinical issue between a student and his/her mental health practitioner.

The clinical benefit of family involvement may then be evaluated on a case-by-case basis. While some students may benefit from the involvement of a supportive family, other students benefit from maintaining a firm boundary between the student and the family, particularly in cases where the student’s emotional condition has been exacerbated by abuse or neglect in the family.

When the student and mental health practitioner agree that family involvement would be beneficial to the student’s treatment, the student may authorize in writing a disclosure of information from the practitioner to the parents.

Parents concerned about mental health care on campus would be wise to inquire about the resources allocated to mental health care at the colleges their children attend or are considering attending. The length of the counseling center’s waiting list and the number of counseling sessions offered can be important indicators of that college’s commitment to mental health care.

Parents may wish to advocate for more of a university’s financial resources to be devoted to mental health care. Financial constraints have forced many college counseling centers to shorten treatment length to as few as four sessions. This is completely inadequate for those students with a serious emotional disorder. Mental health practitioners working in counseling centers realize this, and some end up stretching themselves to their personal limits to ensure a student in need will receive mental health treatment as long as it is needed.

Alternatively, when a student’s mental health needs exceeds the usual treatment offered on campus, referrals to mental health practitioners in the community may be an option. In either case, the point is for the student to have the necessary continuity of care throughout the college years so that he or she may simultaneously succeed in college and gain mastery over mental illness.