With teen depression and anxiety exacerbated by the pandemic, more high school students are undergoing treatment for mental illness. Often, mental illness is intensified during major life transitions—such as going to college. 

According to the National Institute of Mental Health, one in eight US adolescents aged 12-17 (about 2.9 million) had at least one major depressive episode with severe impairment in 2020. A 2021 national poll by the CS Mott Children’s Hospital at the University of Michigan (Mott Poll Report, March 15, 2021) revealed that up to 36 percent of parents noticed new or worsening anxiety in their teens.

Across the country, colleges are facing a huge increase in the number of students who need ongoing counseling and support services. Many schools are not prepared to handle the demand for on-campus mental health counseling, medication evaluations, and ongoing academic support programs. This is concerning since students with current mental health issues who do not receive services are at risk for failure. According to the National Alliance on Mental Illness, 64 percent of students who drop out of college do so because of mental illness.

As students with mental illness prepare for college, it will be critical to place mental health at the center of their college search and create a proactive transition plan. Students should not rely on college counseling centers to take over their treatment; they are typically meant only for short-term intervention rather than ongoing treatment. Below are important aspects to consider in working with the student on the college list, college decision, and transition away from home.

College List Considerations

When creating the student’s college list, it is important to identify the level of support that each college can offer by evaluating the medical services, counseling center, and office of accessibility services. Discussing support needs with the student’s current therapist or other professionals working with the student can help independent educational consultants (IECs) ensure that the list of colleges offers appropriate access to resources. Parents will need to sign a consent form to allow an IEC to talk to these individuals.

Will the student need to keep the current treatment team? If so, colleges closer to home may be necessary, at least to start. Keeping with the current support professionals (academic and mental health) offers the student a sense of stability. 

Does the student’s current therapist offer virtual sessions? Licensing requirements differ from state to state so a family should discuss the therapist’s ability and/or willingness to treat the student out of state. If virtual sessions are an option, and if the student feels comfortable with that, it may mean that being close to home is not as important. Students also have the option to start with a new therapist in the community where a college is located.

Will the student have a car to be able to drive to therapy appointments and pick up prescriptions? If not, is a car-ride service readily available or might public transportation be a practical option for the student? If not, exploring colleges with resources within walking distance (or accessible with campus shuttles) may be critical.

The College Decision

As students consider their college options, it is important to explore the following questions: 

Is there access to mental health support that fits the student’s needs? Either the family or the therapist can contact the college counseling center to see if it offers referrals for nearby therapists. Finding out if there is a disability support coordinator with mental health experience can also be helpful for the transition process. 

How will the student refill prescriptions? It will be important for the student to ensure they are taking their medications as prescribed, and access to a pharmacy can be a big part of making that happen. 

What is the climate of mental health support on campus? What accommodations will the student be eligible to receive through the accessibility services office? Is there an Active Minds club or other mental wellness offerings? What resources does the counseling center at the college offer? Reaching out to these resources is a good way for students to understand the available support.

What is the academic learning environment? Some colleges offer a more collaborative and inclusive environment than others. The type of learning environment can have an impact on students when the fit for their personality is considered. Speaking with current students at a college and consulting other resources can help a student understand the student experiences at each college they are considering.

Transition Considerations

It is important to ensure that the student’s mental health is assessed for success in the transition to college through contacts with the therapists, the family, and other community-based resources. An IEC is in a unique position to support the student’s mental health team by offering guidance on what makes a successful transition to college, including the following:

• The student understands their mental health diagnosis and can discuss their needs with the appropriate staff (counseling service, disability office, RA, professors, etc.).

• The student independently takes their medication and can manage their prescriptions.

• The student is building the skills to be able to identify when they need help and independently access available resources.

• The student understands the importance of attending classes regularly and is open to building the study skills they will need for success in college.

• The student has previously demonstrated success in being away from home.


High school students who have mental health challenges often have assistance from one or more family members. If the family provided a significant amount of support during high school, it could be difficult for the student to take over this role all of a sudden. Families can help the student manage their mental health challenges if they begin allowing the student to take the lead in these areas, including refilling prescriptions, setting doctors’ appointments, and learning how and when to ask for help. Every student will develop these skills at their own pace and working together as a team to determine the appropriate next steps is how IECs can guide each student through their unique situation.

By Regina Gerrato, MA, IECA (CA); Julie Richie, MFA, IECA (TX); and Marci Schwartz, LCSW, PhD, IECA Associate (CA)