I often work with parents who share in their child’s fantasy that they will turn into a completely different person when they are dropped off at college. Their child will mature miraculously before their eyes. All of the difficulties that they had in high school will immediately disappear. They will suddenly be able to manage stress in ways that they couldn’t before. They will become an independently-functioning student, no longer reliant on mom and dad to motivate or check up on them.

Having worked in four different university counseling centers, I can tell you that, unfortunately, this doesn’t happen. Many of the struggles that your teen had in high school will follow them to college.

“The child that you have is the child that you will send off to college.”

So what can be done?

Start by assessing their current level of functioning

How stable are they right now? Has their condition been stable for a significant length of time? Can they already manage all of the responsibilities associated with college life? Are they already prepared to meet the academic demands of college? Can they already handle their academic coursework independently? Will the workload be excessively stressful and risk exacerbating their condition? Are they ready for the social challenges that accompany starting at a new school? Do they already exercise good judgment when it comes to their health?

Psychological conditions should be factored into decision-making and planning, just as you would with other medical conditions.

Take your adolescent’s mental health into account when making college plans

Many different options are available to increase the likelihood of a successful transition to college:

  • Select the right school. Some schools may be a better fit for your child and their needs than others. Identify your child’s unique needs and speak to their high school counselor to get suggestions for universities that will be most appropriate.
  • Consider a nearby school. You may want to consider a college close to home so that parental support can be mobilized easily if needed. Or your child may choose to live at home and attend a local state or community college for the first few semesters in order to save money and build maturity.
  • Ivy League? Just because your child got into top-tier schools does not mean they need to go to them. If the academic rigors will exceed your child’s coping capacities, then it’s unlikely to be a wise decision to send them there. There are few things as disappointing to a student than getting into a prestigious school and then having to drop out in the first year.
  • Consider a gap year. Not every teen is college-ready at 18. Some teens cannot be trusted to exercise good judgment. Some teens cannot organize or motivate themselves academically. Some teens regularly abuse drugs and alcohol. Some teens struggle to handle social, emotional, and academic stresses. Some teens destabilize quickly when encountering difficulties. If any of these describe your child, then you may consider delaying entry into college. A gap year can be used to better prepare your child for living independently.

Help them prepare

What can parents do to help their college-bound teens prepare for the challenges of college life during their last year of high school?

  • Keep them in therapy during their senior year. Even if your child has reached a point of stability with regards to their mental health, it may still be valuable for them to remain in psychotherapy during their senior year. This time can be used to prepare them for the challenges ahead.
  • Create a self-care plan. Everyone should have a self-care plan in place, and college students are no exception. What activities will your child engage in to be proactive about their health? And how can they ramp up their self-care when symptoms flare? Help them create and practice this plan in the year before college.
  • Regularly discuss alcohol with your child. Drinking continues to be a huge problem on college campuses. Hospital transports for alcohol poisoning occur on a weekly basis at most colleges, as binge drinking in commonplace in this population. Some individuals may get into the habit of drinking often during their college years, laying a foundation for later addiction. And alcohol can create dangerous situations and impair individuals’ judgment when in them. Individuals prone to mood and anxiety disturbance need to be extra careful with alcohol. And individuals taking psychiatric medications may need to limit their drinking or abstain from alcohol entirely while on medication. Parents need to regularly discuss these complex issues with their children.
  • Regularly discuss substance use with your child. Illegal drugs are also becoming more easily available for purchase on college campuses, especially cannabis. And with the recent legalization of cannabis in many states, teens are given mixed messages about its dangers. Prescription medications are also increasingly abused on campuses. With more students taking psychiatric medications these days, there is more sharing of medications. Students often consider buying and using prescription stimulants (like Adderall, Ritalin, Concerta, and Vyvanse) from their friends during academic “crunch times,” like midterms and finals week. Similar sharing occurs with anti-anxiety and anti-depressant drugs, either for recreational or self-medicating purposes. Unfortunately, these powerful drugs are often used improperly, leading to new problems. And mixing of illegal drugs, alcohol, and medications is also common, which elevates the risk of lethality. Don’t shy away from these important conversations. If your child is not mature enough to make responsible decisions, then they may not yet be ready to be at college.

Take steps to mitigate risks when your child is at college

If you have identified risks to your child’s success while at college, what can you and your child do to mitigate them? Here are some of my thoughts:

  • Speak to the Office of Accessibility Services. Most colleges have an office dedicated to helping students with disabilities succeed while at school. Often this is called the Office of Accessibility Services, but sometimes goes by different names, such as Disability Support Services. With the proper documentation in place from psychological and/or medical professionals, this office can put in place classroom accommodations, assignment accommodations, and examination accommodations that teachers must adhere to. They usually can also coordinate alternate living arrangements on campus, if necessary. If your child’s symptoms can be expected to interfere with their academic functioning at times, then consider getting them registered with this office prior to the start of their school year. No student should be punished for things beyond their control.
  • Make therapy a requirement while at college. If you do decide to enroll your child in a college far away, consider contacting local clinicians who can work with your child throughout their college years and secure these contacts prior to the school’s start date. Start appointments on Day One. Don’t wait until a crisis to get your child into counseling. Prevention is much more effective than treatment. And get a release to speak to your child’s therapist regarding their attendance and mental status. Most university counseling centers will have caps on treatment and are increasingly staffed by trainees, so seeing an experienced off-campus provider is usually a better option. Also, make sure your child has full medical benefits in the state in which they will attend college or costs could add up fast.
  • Think twice about discontinuing medications prior to and during the college transition. I have seen many students decide to go off of their medications when they leave for college. Many hope to start a new chapter in their lives, and consider leaving behind psychiatric medication. However, I have seen this end badly for many students who underestimate the stresses associated with the transition and the difficulty of managing discontinuation symptoms while undertaking new academic and social challenges. Consult with their prescriber about all medication decisions.
  • Locate a nearby medication provider and pharmacy. If your child takes psychiatric medication, then I would suggest you identify a local psychiatrist to use while your child is at college. Students may need to make adjustments to their medications while at school and delays can exacerbate problems. Also, it is sometimes difficult to get prescriptions transferred or filled across state lines. Save yourself the hassle and find a local prescriber. Also find a nearby pharmacy for your child to use.
  • Ease into the coursework. Does your child really need to take the hardest classes offered at the college in their first semester? And do they need to take a full course load right out of the gates? The first semester is often a rocky one, given the amount of transitions that your child will experience. Consider making it easier on them.
  • School should be their only job. If your child has difficulty juggling responsibilities or is prone to getting overwhelmed, then they definitely should not have a job while a full-time student. It’s fine to expect your child to work during the summer months when they are not taking classes, but most college courses these days are too rigorous to balance along with other work commitments. If money is an issue, consider tuition when selecting a school. And apply for scholarships. Look into Scholly, a large database of scholarships.
  • Hire a tutor. If your child has struggled with academics or motivation in the past, it may be wise to arrange for them to see a tutor or executive functioning coach while at college. My suggestion is to find an experienced tutor off-campus. Many parents assume that the school’s academic help centers will be sufficient, but in my experience they usually do not offer frequent enough support for students who tend to struggle academically.
  • Plan regular parent trips to town and child trips home. If your child is prone to homesickness, then you may want to budget for a certain number of trips to visit them and for them to come home. This may be an added expense early on, but will most likely become more unnecessary as your child acclimates to the school environment. And if it prevents a mental health crisis, then it is well worth the money.

Handling crises

Sometimes, for all our best planning and intentions, crises still arise. Fortunately, planning to handle them prevents a bad situation from becoming much worse. Here are some things to consider when making a plan:

  • Avoid calling peer listener lines. Some colleges organize peer listeners to field calls from other fellow students in need of support. These are usually well-intentioned and compassionate volunteers, but they are also undergraduates who have received only minimal training in dealing with mental health issues. Steer clear. Better options exist.
  • Call a professional crisis hotline instead. Many schools have a dedicated phone number that students can call to receive urgent support from licensed mental health professionals trained in crisis intervention. Calls are either handled by local counseling center staff or by an outsourced company, and the hotline is usually available around the clock 365 days per year. If no such hotline exists at the university, then consider using the National Mental Health Hotline: 1-800-273-8255.
  • Reduce the academic course load as needed. In the past, when sailors encountered very rough waters, they would throw the least important items overboard to lighten the vessel. They called these items jetsam. Similarly, students should consider reducing their course load if a particular semester has turned out to be unexpectedly difficult. Options include auditing a course, switching a course to Pass/Fail, dropping a class, withdrawing from a class, taking a medical leave from the semester, and withdrawing from the semester. Using one of these options can salvage a bad semester, or at least preserve the student’s academic standing. Students should understand their school’s Academic Calendar and the semester deadlines for each of these options. Because each option may have different implications for a student’s GPA, scholarships, etc., it would be wise for students to consult with their academic advisors and the Office of Financial Aid before making a final decision.
  • Consider tuition refund insurance. College costs are extremely high these days. But so are the associated stresses. Sometimes taking leave from a semester to tend to one’s mental health is helpful or necessary. However, I have seen many young adults struggle with the decision to prioritize their health because of the costs already sunk into the semester’s tuition. Fortunately, insurers have come up with a solution to this problem. One such company is called A.W.G. DEWAR, Inc. They protect a family’s investments in education by refunding a portion of semester tuition, room, and board lost because of a covered medical withdrawal. Student loans are also covered under the plan.
  • Space it out. Does your child really need to graduate right “on time” in eight semesters? Or would an extra semester or two reduce the stress of their experience and lead to a better GPA?

Final thoughts

Perhaps the most important thing you can do as a parent is to encourage help-seeking when needed. It is not a sign of weakness to ask for help. Life is hard. We lean on others. And they lean on us. It’s how this all works. Children need to understand that parents will not be upset if things go sideways and they need assistance. Setting this expectation early and often will prevent more serious problems. Instead of becoming angry or expressing your worry, praise your child when they reach out for help. This reinforces their help-seeking behavior. Then engage in collaborative problem-solving and decision-making with them. Children will be more likely to ask for help in the future if this process goes well.