She could be anybody's model kid.

        A high school graduate. A trumpet player who earned a music scholarship. A student working in the dean's office.

Growing demand for campus counseling

The National Survey of Counseling Center Directors has been conducted since 1981.     The 2001 survey includes data provided by directors of 274 counseling centers, representing institutions from 47 states, Washington, D.C., and four Canadian provinces.     Among findings from the last five years:     • 85 percent reported an increase in severe psychological problems.     • 33.2 percent reported said there were more concerns about on-campus sexual assault.     • 44.5 percent noted more alcohol-related problems.     • 49 percent cited a jump in illicit drug use.     • 71.3 percent reported more students with learning disabilities (includes any condition that hinders a students' ability to learn).     • 37.6 percent noticed more eating disorder cases.     • 51.2 percent reported more self-injury incidents (including students who either cut themselves or pull out their hair to relieve anxiety). It does not include suicide attempts.

        But after one semester at a college in a new city, and a failed attempt to get the help she needed at the student counseling center, Debbra Hammel came back home to Cincinnati.

        Ms. Hammel is one of thousands of college students nationwide who increasingly are being shuffled to waiting lists or finding visits limited when they seek counseling for problems ranging from severe depression to how to fit in.

        “I was scared, and I didn't know how to handle it,” says Ms. Hammel, 20, a New Richmond High School grad. “So I said, "Forget it. I don't want to do this anymore.'”

        Student demand for counseling has jumped dramatically at the nation's colleges and universities, and so has the severity of problems that counseling centers face, a variety of surveys show.

        Tristate colleges are part of the trend:

        • Counselors at the University of Cincinnati report a 55 percent increase in the number of students seeking counseling in the past six years. Counselors say more students are needing psychiatric medication.

        • Counselors say they had to immediately intervene in severe student crises that soared 70 percent in 2001 over 2000 at Northern Kentucky University.

        • Counseling visits were up 40 percent last year over the previous year at Xavier University. Most common problem: depression.

        • Demand for counseling is so great at Miami University that students are on a four- to six-week waiting list after an initial session.

        The administration at Miami increased funding for psychological services by $35,000 for next fall.

        It will allow the center to double the time a psychiatrist is on duty each week from 10 to 20 hours. But school officials are still looking for that hire.

        “We're seeing a lot of eating disorders, anxiety, panic attacks,” says Kip Alishio, Miami's director of Student Counseling Services. “It's really increased dramatically.”

        More students have withdrawn from school because of emotional problems, and more are taking advantage of stress-management programs, he says.

        But the most grim is this: Two Miami students committed suicide last year, though they were not on campus.

        “Before that it hadn't happened for about a decade,” Dr. Alishio says.

        There's plenty of debate among social and clinical psychologists about why the demand for counseling is so high. One theory is that stronger psychotropic drugs are enabling students who might not have otherwise been able to attend college to make it there.

        Other young adults may be more comfortable seeking help for drug and alcohol abuse and even conventional problems like choosing a major and adjusting to a new place.

        A survey last year by the National Survey of Counseling Center Directors found that 274 counseling centers representing institutions from 47 states, Washington, D.C., and 4 Canadian provinces reported jumps in counseling for self-injuries and learning disabilities.

        “It's hard on us because we sense there's an unmet need,” says Oliver Birckhead, director of Xavier's counseling center. “If you decide to call a counselor, it's a big deal.

        “People on the fence might not decide to come back if they have to wait.”

        That's what happened to Ms. Hammel in her first semester at the University of Louisville in 1999. She had problems with depression before she headed off to school, but had plenty of support from friends.

        When she arrived on campus, that support faded. And when she expressed to a university counselor that she might need more than the 10-session limit per academic year, she says, the counselor wanted her to go outside the university for treatment.

        The problem? There would be a $35 co-pay for each session, which Ms. Hammel couldn't afford.

        “In Louisville, it was either stay on campus or come back to Cincinnati,” she says. “How many college students have $35 a week?”

        Now, Ms. Hammel is back in school working on a music degree at Northern Kentucky University. She's also back in counseling, but this time, it's with the help of her dad's insurance and outside the university setting.

        “I don't really care that people know that I go to a therapist,” she says. “A lot of people would benefit even if they only go a few times.”

Debbie Hammel sings in a voice lesson with Gail Sheard-Grout at NKU. Debbie left the UofL because she couldn't get the help she needed. (Craig Ruttle photo) | ZOOM |

        While Ms. Hammel needs counseling for more conventional problems, many students need help with severe emotional troubles.

        The counseling center survey, prepared at the University of Pittsburgh, found that 85 percent of counseling center directors reported an increase in the severity of students' psychological problems in the past five years.

        Robert Gallagher, who has prepared the national survey since 1981 and served as the counseling center director at Pittsburgh for 25 years, cites an extreme case in point: One university counselor, whose school he won't identify for confidentiality reasons, had 24 open cases in one week.

        Six were incest victims, three had drug and alcohol problems, two were pre-psychotic, two were rape victims, one was the victim of physical abuse, two had depression, two had eating disorders, one was a schizophrenic in remission, one was the child of an alcoholic parent, one was a grad student struggling with his sexuality and three were traumatized by broken relationships.

        “Demand has been increasing gradually over the years, and it's reached a point now where a lot of people are struggling,” Dr. Gallagher says.

        Many counseling services limit the number of sessions, he says, and some have created group sessions students can attend until private ones become available. Others are hiring part-time help.

        With national attention on a couple suing the Massachusetts Institute for Technology for failing to prevent their daughter's suicide, the issue of counseling is a hot topic.

        Xavier's Dr. Birckhead says schools are becoming increasingly aware of their liabilities.

        “God forbid if we knew someone needed help, and we put them on a waiting list and something happened,” he says. “These cases are prosecuted in civil court, and people are found liable so we have to be aware of that.

        Barbara Sween, director of Northern Kentucky's health and counseling services center, says many students aren't prepared for the rigors of college. And parents sometimes don't realize that the pressures are much different than they were 20 years ago.

        “There are these incredibly high expectations, and most of us cannot meet them. Literally,” Ms. Sween says.

        Meghan Duncan, a 19-year-old student from Carthage knows all about pressure. She decided to see a counselor after she started taking classes at Cincinnati State Technical and Community College.

        “There wasn't anything big,” she says. “There were a lot of things that just added up over a year and a half. I had three family members die over the summer, and I had questions like, "What am I going to do in college? Am I doing the right thing?'”

        “I think it was just having somebody tell me I'm not going nuts.”

        Dr. Alishio says the increased demand for counseling may say something about American society as a whole.

        “These sorts of problems are a canary in the mine shaft of the culture,” Dr. Alishio says. “What are we doing to these young people? What do they need that they're not getting?

        “We have enough data to show this generation is paying for it.”

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