In an excellent piece of research, my friend Richard
Scheffler has shown convincingly that American college students are
experiencing an epidemic of increasing anxiety.
Here is the telling graph:
Percent of Students Diagnosed or Treated with Anxiety
Disorder in the past 12 months, 2008-2016
This second graph is also useful:
Percent of Students Diagnosed or Treated with Anxiety
Disorder in the past 12 months by Gender and Race, 2008 and 2016
Richard’s coming article gives evidence that these alarming
rates are true and not artifacts, and are, if anything, understated. Last Thursday he presented the findings at
our home campus, UC Berkeley, to a largely student audience with a panel that
included both the Chancellor and the director of student health services. Richard’s figures seemed quite believable to
audience and panel alike.
Why is this happening?
There are guesses. Many students
lack money in the present and are heavily indebted for the future; they face
insecurity of their housing (some are even technically homeless!), and a surprising
number experience food insecurity. Many
students are actually on food stamps, and many visit food banks. Even with the evident dysfunctionality and
inequality of wealth in the United States, this is hard to imagine, but it is
fact. Students also report that they
work “too hard,” and compete in how hard they are working and how much sleep deprivation
they are experiencing. This could be
construed as a cultural element.
Faced with these problems, many of the students are
understandably anxious. They feel
helpless and don’t know what to do about it, or where to turn for help. They do access health care services for
counselling in increasing numbers, taking it as a personal problem, which it
undoubtedly is, even if there are systematic forces that conspire to produce
their individual problems.
In addition to their insecurities about their present situations,
it’s hard to imagine that they are not also insecure about what will happen to
them in the future. Some majors can lead
immediately to jobs, but others not, and as we know, even if the economy as a
whole thrives, many individuals suffer, especially in the recently-graduated
population. The crisis in student debt
has been well documented, and it would be a dull student indeed who would not
be aware of that future burden.
The university student population has always been subject to
anxiety. It can be a fraught time of
life. It is often their first time away
from home, the first time dealing with so many issues on their own, including
deciding on their own evolving personal identity, their increased work load and
the consequent need for internal academic discipline. But Richard’s findings clearly depict that
the current students are not in the same situation their parents and
grandparents found themselves. The new
anxiety is not like the old anxiety in either form or extent.
What is to be
done?
What does one do with this research finding? Understandably, there are calls to find the
“root cause” of the epidemic. Where is
our Dr. John Snow to discover that the Broad Street Pump is the source of the
cholera epidemic, and fix it with one dramatic move?
Alas, the causality diagnosis is unlikely to come quickly,
if at all. The cause is probably
multi-factorial, involving influences that vary from nationwide to regional to
local to individual, from hard economic facts to softer cultural ones. And while it’s always good to have an idea of
causality, the search can often provide a basis for inaction – the so-called analysis
paralysis. The common cry of “we need
more research” can lead to steps that benefit the research community more than
the afflicted.
Those of us who have held executive positions are familiar
with needing to act under conditions of imperfect information. What we try to do in such situations is to
take a best guess at what will help and pursue that course, while being sure to
continue to collect information that will help to correct our course, and to
suggest other steps we should consider.
At Richard’s presentation, with the Chancellor and the
director of student health services and all the students and student
representatives present, all minds naturally gravitated to the Cal campus. That’s where my mind turned also. I thought, what would I do if I ran the UCB
zoo?
I think of two different requirements for action: how to organize
it, and what to do for initial remedial steps.
Organizationally, it is the responsibility of the leaders to
establish priorities, not just by fiat, but in consultation with the membership
in the organization. (I would stay
“stakeholders,” but I hate that cliché.)
I would gather the major campus forces – students, faculty, administrators, parents,
alumni, others – and tell them that I propose to declare student anxiety a
major problem that needs to be addressed as a very top priority, but would wait
briefly for their feedback. Just that
declaration would be important, as the consequences would be substantial.
Personally, I would opt for an Anxiety Czar and an advisory
board with political weight and professional knowledge. (Just as a plug for my profession of
pediatrics, I would include on the board a doctor or two who specialize in the
health of adolescents and young adults.)
A high priority job needs a highly qualified leader, highly qualified
participants, high visibility to the Chancellor and other university and system
leaders, and a generous budget. Unlike
what Obama did with the ACA website rollout, I would ensconce an “A Team” from
time zero rather than waiting for a crash and have to fix it. That’s what a high priority means. The Anxiety Czar himself or herself would be
the most important appointment, and would need to be someone who really knows
how to move a large bureaucratic organization with many different centers of
power and many different agendas, and who would know how to raise the priority
of student welfare, since students frequently reside at the bottom of the
list.
In addition to the advisory group over the Anxiety Czar, I
would also have an intermediate group between the Czar and the individual
groups, where group leaders, students and administration and health and
other professionals could share their insights and experiences with one
another, and forward information to the Czar above, and to the individual
groups below. Intermediate groups can be
powerful, so long as they are not agents of the power above.
I could go on about organizational requirements, how the Chancellor
should think seriously about how she could and should be personally involved,
but I won’t. Except to say that I would
make myself personally visible in meeting individually with student groups, and
I would insist that administrative and faculty leaders do the same. Vulnerability to visible failure is often a
motivating force. Otherwise, I probably
don’t know enough about the campus to opine, and specific knowledge of the players
is essential.
Operationally, it’s important to think about anxiety
both generally and specifically. Anxiety
involves a sense of insecurity, focusing mostly on the future. It helps the anxious person to feel that
someone cares about them, and it’s even better if that someone has some power
to act. At Berkeley specifically, it’s
useful to remember the ever-present legacy of the Free Speech Movement. Behind the ideology, if you listen to the
rhetoric, you hear, “no one cares about us.”
One of the most famous speeches in American history – no exaggeration,
imho – is Mario Savio’s, and what is he saying?
No one cares about us; we are product to them. But we are human beings!
It’s hard not to think that feelings of being overlooked and
not cared for, especially in the first years away from home, are endemic to a
large university. And truthfully, it’s a
fine line to walk between giving care and intervening unduly, as most parents
know. “Being cared for” is not something
that will be fixed by posting signs around campus: “We Care!” It can be demonstrated by overt steps to
solve problems, like housing and food.
But probably most effective will be honest old-fashioned and probably
expensive human person to person contact.
I would recommend especially small group contacts, where
students can be reinforced in their feelings of not being alone, where caring
relationships can develop, and where at the same time information can be
obtained to inform actions from above.
My own plan would be to ensure that each student had at least one small
group where he or she would be member.
The leadership of the group would have to be carefully chosen and
groomed – leaving groups to pure self-help could be both destructive and
ineffectual. If there were a central
unit that would act both for organizing and training group leadership, and also
receiving feedback from the groups so that leadership could get better
information of where anxiety seemed to come from, and what steps might be
working and which ones not, then progressive honing in on effective responses
would be enabled. I would make the
network of information flow very visible, and publish continuous summaries on
line of what information is flowing, and I would make sure that it is not just
information qua information, but
information that can lead to action.
Then, I would publish exactly what actions are being taken
on the information. Students don't just
want sloppy kisses of love, they want actions.
An antidote to anxiety is agency.
Is the information being translated into action? That's the responsibility of the
Administration. In retrospect, wouldn't
the administration of Clark Kerr have wished they would have known what the
problems in the student body were beforehand, and moved to solve them? Studying history can lead to improved
actions.
The reports of food insecurity are
very credible.
If I ran the zoo, I would
declare that food insecurity is not an individual problem, but a systematic
one, and that the system would be taking responsibility.
There are many ways to get people food.
I would use them.
The housing problems are well known. If I ran the zoo, I would declare that
housing is not just an individual problem but a systemic one. I would make it the University's responsibility
to ensure that decent housing would be available to all at a decent price. It might involve a severe system change,
including University housing registration and allocation of privately held
places, and reduced enrollment when sufficient housing could not be located.
Yes, both of these steps on food and housing might be viewed
as decreasing student responsibility and learning how to cope in the modern
world. They might be socialistic in
tone. On the other hand, to my way of
thinking, it should never have gotten to this stage in the first place. Is their a better solution?
Medical services have already been decentralized, we heard
at the panel discussion. Counseling and
medical attention to mental health are important. It would be useful to combine the group efforts
with these medical efforts and have a continuum of general group, therapeutic
group, and individual therapy for anxiety, and for other conditions that
warrant attention. Medical administrators
know the difficulty of categorical programs, and how they need to be integrated
with comprehensive services. This common
medical administrative problem would be a good reason to include a clinical
administrator on the leadership team.
Richard and his group have done a service for UCB and for
the university communities nationwide in documenting and highlighting this now
apparent epidemic of anxiety in their midst. There are many research avenues to pursue;
further facts would be important.
But it is important to act now.
It is the time for administrative excellence.
One can only hope that the problem is seen clearly and the
challenge accepted.
We shall see.
Budd Shenkin
