More Than Grades: Examining Mental Health Support Systems for Postsecondary Students and Beyond.

Nicklas Bara is a third-year medical student at Michigan State University’s College of Human Medicine and owner of Nucleus Tutoring, a therapeutically-focused tutoring company serving students in Michigan.

College can be an exciting time for student growth and development, however, it also poses opportunities for stress to take hold. Within historically competitive degree specialties like pre-medical and pre-law studies, engineering, physics, or computer science, this stress can be exacerbated, worsening mental health conditions such as depression or anxiety.¹

The path to medical school is especially daunting. To be accepted, students must maintain a strong GPA while simultaneously completing hundreds to thousands of hours of volunteering, shadowing, clinical experience, and research. To be competitive applicants, students are encouraged to pursue leadership roles, author published works, and obtain strong letters of recommendation. Another hurdle is tackling the MCAT, a notoriously challenging eight-hour exam; a competitive score starts at the 75th percentile. To say this is a stressful degree path would be an understatement. The key to perseverance is finding ways to stay afloat amidst the chaos and pressure.

Utilize Advisers
In my experience as a pre-medical undergraduate and current medical student, the most beneficial stress-reducing resource my school provided was a benevolent adviser. Studies show that having a capable, kind mentor has significant, positive effects on student stress.² I was lucky to have experienced this first-hand. As the first in my family to pursue a career in the medical field, I had no connections and no idea where to start my research or clinical experiences. I felt lost at sea without a paddle and my mental health followed suit. My soon-to-be adviser caught onto this during my freshman year orientation week. We made a plan to meet monthly so she could help me adjust. At each meeting, we’d discuss sources of academic stress and anxiety and how I could realistically work to resolve them. We’d talk about study schedules, extracurriculars, and how to avoid burning out, as many pre-meds unfortunately do. Advisers significantly help their students’ chance of success by being someone who can empathize with student stories to find a unique path to degree completion.

Reduce Financial Aid Fears
Colleges can also help mitigate student stressors by providing information on sources to help alleviate financial stress. Studies show that minimizing financial worries can reduce student stress, anxiety, and suicidal ideation.³ For example, extracurricular commitments that bolster medical school applications can also add to financial woes. Promoting opportunities such as the Gilman Scholarship, which helps fund study abroad trips, would make the pressure to pursue extracurricular experiences less financially daunting. Applying to schools costs upwards of $2,000-4,000; at the time I had about $400 to my name. Luckily, my adviser introduced me to the AAMC’s Fee Assistance Program which aided me during my application cycle. Unfortunately, I know students who would have significantly benefited from the program but missed out. For students who struggled financially during their undergraduate years, like I did, access to financial support such as grants, scholarships, and the Fee Assistance Program aids with periods of financial stress. Without my adviser’s insight and guidance, I doubt I could’ve gotten to where I am today.

Talk it Out
In addition to prioritizing friends, family, healthy habits, and hobbies, utilizing campus resources like therapy sessions can be a significant boon in preventing the all-too-common mental breaks seen in pre-med students.⁴ Commonly, schools offer some degree of emotional or mental support. For example, Michigan State University offers three free psychiatry appointments for all students, in addition to three free physical health appointments. Some schools also have crisis helplines, available to support students going through acute stress periods. Institutions such as Wayne State University provide therapy to students who may not have health insurance, providing a larger degree of aid to those who wouldn’t otherwise have access to mental health resources. The University of Michigan offers MiTalk, a database of information to help manage specific mental health conditions, which is available to students free of charge.
Moving Forward
There is always room for expansion and improvement in these programs.  Increasing the allocation of free therapy appointments for students would help provide more comprehensive care over time. Studies show that consistent therapy sessions are most effective in aiding mental illnesses such as anxiety and depression during school.⁵ Providing unlimited or 4 to 5 years’ worth of therapy appointments would maximize the benefits of these sessions. Telehealth therapy sessions are a great option for students who might be either physically or mentally unable to leave their living spaces.⁶ Telehealth services typically offer more flexibility in scheduling, making therapy more accessible to students with disabilities, those with accelerated coursework, adult students, and the entire student body. Unfortunately, these services can be expensive, potentially making them a less attractive option to implement. Regardless, the more accessible free therapy is, the better. Schools that can provide widely available therapy services may find a greater-utilized mental health system, and hopefully establish a healthier and more persistent student population as a result.

In conclusion, medical school and other stressful, competitive pathways in postsecondary education can cause significant, debilitating stress in college students. Having social, academic, and financial support can make or break student success and attainment. Improving and expanding current student mental health support systems may take time and effort, but it is worthwhile to ensure degree completion.

References

1. Fang, Daniel Z., et al. "Depression in premedical undergraduates: a cross-sectional survey." The Primary Care Companion for CNS Disorders 12.6 (2010): 26234.

2. Cureton, Debra, Jenni Jones, and William Foster. "The impact of mentoring on stress in higher education." (2011). 

3. Hassan, Mehdi, et al. "Impact of Financial Stress, Parental Expectation and Test Anxiety on Role of Suicidal Ideation: A Cross-Sectional Study among Pre-Medical Students." International Journal of Mental Health Promotion 26.1 (2024).

4. Gautam, Manaswi, et al. "Cognitive behavioral therapy for depression." Indian Journal of Psychiatry 62.Suppl 2 (2020): S223-S229. 

5. Goldin, Philippe R., et al. "Trajectories of change in emotion regulation and social anxiety during cognitive-behavioral therapy for social anxiety disorder." Behaviour Research and Therapy 56 (2014): 7-15.

6. Travers, M. Fallon, and S. A. Benton. "The acceptability of therapist-assisted, internet-delivered treatment for college students." Journal of College Student Psychotherapy 28.1 (2014): 35-46.