Mental health is a growing issue nationwide and in our University community. In fact, a 2013 survey found that almost a third of college students had experienced depression so severe it interfered with their ability to function. Looking at these statistics, the conclusion can be drawn that as a nation and particularly as a community we should seriously consider whether we are doing our best to inform and treat our peers with mental disorders. At the University, given the tragic suicides we’ve seen in the last few semesters, we need to step back and reorient the ways University counseling services and our student body think about and diagnose mental illness.
This issue is playing out at a national level as psychiatrists continue to alter their classifications of mental illnesses. While the rest of the medical community has moved away from symptom-based treatment, psychiatry has stuck by it, defining each disorder and condition by a broad range of symptoms highly dependent on each doctor’s interpretation. This has resulted in significant problems with the way the psychiatric community diagnoses and treats people with mental illness. Part of this problem is intrinsic to psychiatry — diagnoses and the definitions of mental disorders have to be formed by a broad consensus about groups of symptoms due to the lack of availability of any objective measures. This diagnosis and treatment follows a categorical approach, which provides two possible diagnoses — the patient has an illness, or he does not.
This may work well for most health issues, but for mental disorders the line that separates someone with a disorder from someone without is not one that can be drawn objectively. What is needed is a transition to a dimensional approach in counseling offices and in the many student groups at the University that focus on informing and assisting students with mental disorders. A dimensional approach broadens the spectrum of diagnoses to allow for different degrees in severity of a disorder. This would also allow doctors to tailor their treatments for each individual patient, determining the types and levels of care based on the causes and severity of the disorder.
Mental illness needs this new approach because of the complexity involved in its creation, and because of the fact that research has not been able to single out a defining factor for any one disorder. Sometimes there may be an obvious cause, but more often a unique variety of biological, environmental and lifestyle factors combine to produce the outcome. Because of the complexity in cause, there also has to be complexity in diagnosis and the realization that treatment really shouldn’t depend entirely on the symptoms but on what caused them. Treating someone who has an ingrained chemical imbalance in the brain with just talk therapy will not do much to help, while using medication to treat someone might be addressing a problem that isn’t there.
The push toward a new style of treatment exists at the national level, as the National Institute of Mental Health has launched a new project called the Research Domain Criteria to incorporate multiple levels of information like genetics, brain imaging and cognitive science into their classification system for mental disorders. But this doesn’t mean action at the local level can’t make a difference. Increasing knowledge of the nature of mental health will allow students to become more aware of the root causes of their problems and also how their everyday choices may be contributing to the quality of their mental health. Lifestyle habits like alcohol usage, eating patterns and lack of sleep — all significant problems among college students — can be both the cause of and a symptom of mental disorders, acting in a vicious feedback cycle as each causes the other to worsen. Counseling and Psychological Services, though limited locally by financial and personnel constraints and nationally by the slow growth of research on mental health, can also make adjustments to how it provides service. For example, the current cap on the number of sessions a student can have with their doctor could be raised, giving doctors more flexibility in how they provide care. Small steps like this will not fix the larger problem, but some added flexibility can help alleviate the pressure until wider changes can be made.
Alex Mink is an Opinion columnist for The Cavalier Daily. He can be reached at a.mink@cavalierdaily.com.
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