‘I didn’t need to pretend anymore:’ the fading stigma of mental illness at college

Yellow flags for suicide prevention decorate MIT’s campus.
Yellow flags for suicide prevention decorate MIT’s campus. –Photo via MIT Active Minds

Wendy Chang’s friends could recognize her laugh from a distance. Even if they didn’t see her right away, they knew from the boisterous sound that echoed down Harvard’s hallways that Chang would soon appear, her head thrown back and nose scrunched up with mirth.

Lanier Walker thought Chang’s constant laughter was a sign that she was happy. But Walker later learned that Chang hid what pained her most. The 22-year-old Harvard senior hung herself in her dorm room in 2012.

Walker was shocked and horrified that the life her friend lived didn’t match the image that she portrayed. Then she realized that her friends and peers didn’t know much about her own personal struggles, either.

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After another Harvard student died by suicide in the spring of 2014, Walker felt overwhelmed by the need to do something. She wrote an op-ed for The Harvard Crimson called “We Need to Talk’’ about her own struggles with depression and anxiety. By her sophomore year, Walker was having four to five anxiety attacks a week.

“Harvard doesn’t always make it easy to talk about ourselves,’’ she wrote. “It’s a place that demands perfection, and as a result, we feel compelled to present perfect versions of ourselves. We don’t talk about what’s really going on.’’

Walker’s letter ended with a call to her peers to start talking, and to let others know they were around to listen. After the letter was published, she needed to take her own advice.

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Mental health professionals agree that the stigmas against mental illnesses are fading, even if only slightly. A recent survey by the American Foundation for Suicide Prevention found that 90 percent of Americans value mental and physical health equally.

Nationally, an average of one in 10 students will visit their college’s counseling center before they graduate. And more students are coming to college with pre-diagnosed conditions, which means they’re seeking help before they reach the university level.

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Still, a 2014 report from the Center for Collegiate Mental Health found that most students who use campus counseling centers have never been diagnosed with a mental health condition. Getting undiagnosed students to admit they need help remains a challenge.

That’s why, in recent decades, the number of mental health advocacy groups on college campuses has risen. Active Minds, which was founded at the University of Pennsylvania in 2000 to combat the stigma against mental illness, now has more than 400 branches on college campuses nationwide.

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Lorraine Wong, an MIT junior, is a member of the school’s Active Minds group. She joined her freshman year because she lost a high school friend to suicide and wanted to prevent others from feeling like they didn’t have options.

Still, it took Wong almost a year to go to the counseling center. She was quick to refer other students she knew were struggling. But, even though she lived a few steps away, she couldn’t bring herself to go.

“I knew MIT had mental health and counseling services on campus, but I didn’t want to need it,’’ she said. “And I didn’t know if I needed it as much as other people needed it.’’

Many counseling center directors know students will hesitate before scheduling appointments, even if they’re aware of the services on campus. But schools also struggle to accommodate all of the students who do request appointments. To reach as many students as possible, most counseling centers operate on a short-term model, which means they only plan on seeing students for a limited number of sessions before referring them to counselors off-site.

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Some under-resourced centers have turned to group therapy as a way to reach more students. It allows professionals to treat a large number of students simultaneously, and gives them a network of peers to whom they can turn for support.

This is where the lingering stigma surrounding mental illness wreaks havoc. It can be awkward if the person who sits next to you in Spanish II is the same person who sits next to you in a “coping with anxiety’’ group therapy session.

“It can be hard on a small campus to get groups going,’’ said Magi McKinnies, director of the counseling center at Lesley University. “People don’t feel like it’s as confidential.’’

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Mental health advocates understand why some people want to keep their treatment private. But they also want to eliminate any shame that might be associated with talking about mental illness. Walker believes that sharing personal stories can help.

“When the ESPN article about Madison Holleran came out in May, a lot of people were sharing their own stories with mental illness and posting the quote that said ‘It’s okay to not be okay,’’ Walker said. “And that was so powerful. But the second part of that quote is the most important to me. It said, ‘It’s okay to show you’re not okay.’’’

A year after she published her own article, Walker does make an effort to show she’s not okay. When she can’t make plans because she has a therapy appointment, she says so, rather than using the euphemism: “I have a doctor’s appointment.’’

“I’m not ashamed of needing help and try to talk about it as openly as possible now,’’ she said. “I have a file on my computer of all the messages I got after publishing my article, and I think about all the people who told me that they’d never been able to express how they were feeling before. It’s still a problem. Writing my story made me feel like I didn’t need to pretend anymore.’’

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