Before I went to college four years ago, my parents and I had a “work hard in class” talk and a “safe partying” talk. But we didn’t discuss what to do if stress morphed into anxiety or depression. We should have.

Instead, that summer almost every conversation I had with an adult included some variation on: “These are going to be the best four years of your life.” So I was prepped for highs. And when the lows hit, I thought I was alone.

I wasn’t. The 2017 Healthy Minds Study — a survey of 50,000 students at 54 schools — found that 39 percent reported struggling with some mental health problem. The study, conducted by researchers based at the University of Michigan, also found that 14 percent had major depression, 10 percent suffered from severe anxiety and 11 percent had thought about suicide.

Perhaps this should not be a surprise. In 75 percent of lifetime mental health cases, the first onset was by age 24. Navigating mental health issues — your own or a friend’s — is a pivotal college experience for many students, but isn’t acknowledged as such. It certainly wasn’t on my radar when I was 18. Now as a recent college grad, if there is one issue I hope parents, teachers and student counselors talk about with college-bound teenagers, it is mental health.

Absent some sort of foundational conversation, students can be apprehensive about opening up to their parents about depression or anxiety — or seeking the treatment they need. Even now, one of my close friends wants to start seeing a therapist, but she is covered by her parents’ health insurance policy and worries what they will say when they see the bill. (Though rules vary by state, in California patients can request that insurers keep medical treatments confidential from policy-holders.) Another friend who goes through periods of depression downplays the extent of it when talking to her mother. She worries her mom would freak out, especially because they are so far away from each other. It’s understandable. For a 20-year-old, it’s hard to appreciate how much lived experience your parents have, or to imagine that they probably faced or helped others through dark times.

At the same time, parents should know that many colleges are ill-equipped to meet students’ mental health needs. Large campuses have, on average, one licensed mental health provider per 3,500 students, and 30 percent have no psychiatrist available on campus. A few years ago, my college’s counseling center had five-week wait times for therapy intake appointments. The situation has since improved, though students still talk about the difficulty of getting appointments. A recent survey of 50 colleges found that at most campuses, students will wait 10 days to three weeks for an initial intake exam. To an adult, that may sound reasonable, but for college students without family or trusted friends nearby, a bad mood one day can turn desperate the next.

If parents start a conversation about mental health before college, some feelings of isolation might be headed off. Parents should explain that there will be ups and downs in the next four years. If they’ve ever experienced depression, anxiety or other mood disorders, this is a good time to share that, too. During college check-in calls, parents should also ask kids if they know about their college’s counseling center, and if they are developing friendships.

It’s not just parents who can initiate these discussions. High school teachers and counselors who are already talking about success in college should work in mental health. To this day, my high school friends and I reference a speech a beloved chemistry teacher gave at our senior breakfast about his experience with depression during college. It wasn’t the pre-graduation pep talk we were expecting, but it was valuable to see that someone we knew and admired had gone through such a rough period and come out the other side.

Thankfully my own rough patch in college was relatively short-lived, and I was able to talk to my parents about it. But these conversations don’t always come easily. The National Alliance on Mental Illness offers a guide for parents and students, but here’s one place to start this crucial conversation: “30 percent of college students say that at some point in the last year they felt so down that it was difficult to function. Let’s talk about what to do if that happens.”

Grace Gedye, a recent graduate of Pomona College, is an editorial intern at Washington Monthly.

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