Help Your Teen Transition to College with a Mental Health Diagnosis

By Lisa Lewis

If your teen is heading off to college with a diagnosed mental health condition, they have something in common with many of their peers. It’s estimated that three in every five college students have a mental health diagnosis, and it’s likely that many more are living with an undiagnosed condition. 

There is also a greater awareness of—and support for—mental health conditions on college campuses now. That can help ease the transition for students and alleviate the concerns of caregivers. Here’s what parents and caregivers should know about planning for college, identifying resources, and selecting a school that can meet a student’s mental health needs.

Make Mental Health Services Part of the College Search

Just like checking out whether a school has the majors your teen is interested in or the kind of social scene they want, the quality of a school’s mental health services should be a factor in your teen’s college search. As part of the college application process, encourage your teen to be honest with themselves about their mental health and the level of support they may require. Here are some things to keep in mind:

• Help your teen identify what resources are available at the schools they are interested in. This article, “Choosing a College When You Have a Mental Health Condition,” includes information to look for on a college’s website, as well as a list of good questions to ask admissions staff, current students, and the counseling center.  
• If your student had an individualized education plan (IEP) during high school, it will no longer apply in college. Encourage them to check out the website for the office of disability services, and visit the office if they take a campus tour to find out what accommodations may be available for them.
• If your teen is in therapy, encourage them to talk with their therapist about the schools they’re considering and discuss the pros and cons as part of determining which school will be the best fit.

You can also work with your teen to choose a college that’s aligned with their interests and identity and will be a comfortable landing place. Examine things such as: 

• The school’s physical environment. Consider the size and location of the school  and choose an environment that will be comfortable and not overwhelming.
• School inclusivity. For students who identify as part of a specific population, such as LGBTQIA+, determine if the school has dedicated dorms or affinity groups that can provide a supportive environment. Some schools offer summer bridge programs for certain groups of students to help them acclimate.
• Nearby support. Determine if the school is near family members who can be a source of support, as well as whether there are mental-health support services in the local community.

Look Into Health Insurance Options

Because most schools require proof of health insurance, you’ll want to determine the best option for coverage. Things to consider:

• Many colleges and universities offer coverage that can be extended over the summer and require that you sign up for their plan or show proof of coverage. Some colleges provide financial aid packages that cover some or all of the cost of their health insurance plan.
• If your teen isn’t currently covered by insurance, the school’s plan is most likely more affordable than getting insurance through the federal insurance marketplace or a state exchange. 
• If your child is currently on your plan, that may be the most cost-effective option. You will need to check whether there are in-network providers where your child is headed, however, and you will need to show the school proof of coverage to avoid being charged for the school plan.  

Share this in-depth article on health insurance with your teen so they understand this too

Revisit Their Treatment Team

If your student is currently in therapy and is going away for school, find out if they want to continue with their current provider via telehealth or find a new local therapist. Telehealth licensing varies by state, so check directly with the provider.

Reasons to keep the current treatment team:

• Treatment is going well.
• Your teen is comfortable with them and would rather not change. 
• It can provide some stability in a time of change. 

Reasons to find a new team where they are going:

• Your student feels that they’ve outgrown their current therapist.
• The provider is geared toward pediatric patients. 
• Telehealth can feel less personal than in-person sessions. 

Check out “Establish Your Mental Health Resource Team in College,” and share it with your student

Have a Plan for Managing Medications

If your teen takes prescription medication: 

• Find out if their hometown provider will continue to authorize refills and monitor the prescription. If your teen is attending college in another state, they should talk with their provider to find out if they can prescribe their medication from out of state. 
• Help your teen come up with a plan for how they’ll get their prescriptions refilled. It may include getting refills through the campus health center, a nearby pharmacy, or a mail-order service that can send refills on a set schedule.
• Make sure your teen knows about their current medications—names, dosages, side effects, and any rules for taking them. 

Share these tips to help your student take charge of their treatment before going to college

Prepare for the Transition

• Have a conversation about how you can support your teen. Once your child turns 18, they are in charge of who has access to their medical records. In order for you to see them, your child will need to sign a form allowing you access. 
• Encourage them to connect their providers. Current and former providers should be introduced to each other, and your student can sign forms enabling them to share information about treatment. 
• Brainstorm and write down resources your student can turn to if they are struggling.

Share “Planning for Mental Health Challenges on Campus” with your student to help them realize what kinds of support may be available

Make a Communication Plan

Work with your student to create a plan for when and how you will communicate with each other if their mental health worsens. Things to consider together:  

• How would they like to communicate with you about their mental health? Do they feel comfortable having you check in on a regular basis? If so, how often? 
• Compromise if you disagree. For instance, will your teen feel more comfortable checking in by text rather than by phone? Is there a day or time of day that’s less busy and more private? Asking them to set mutually agreed-upon parameters can help ensure their buy-in, especially if they resist these types of check-ins.
• Ask what would help your student feel comfortable sharing with you. If it’s hard for them to tell you when they are struggling, ask what might make it easier. This may include having an intermediary whom they agree can inform you when things are tough.
• Make a list of red-flag signs. Talk together about what kinds of behaviors or thoughts tend to be early indicators that your teen’s mental health is declining. You can all use these as a guide to know when to reach out to each other.  
• Be clear about when you will involve professionals on campus if you are worried.

Check out “Caring for Your Child’s Mental Health From Afar” for tips on how to support your child and when and how to intervene when you are worried

What If You Think Your Teen Isn’t Ready?

Sometimes the best thing you can do is provide your student with time and space to get well and prepare for a transition as big as going to college. Talk with your teen and their providers about whether they think a mental health gap year is a good idea. It may be if your student has: 

• A new diagnosis
• Symptoms that are not well managed or interfere with their daily life
• Just recovered from a crisis

Delaying college by a year or taking an alternative path, such as community college, as a stepping stone to a four-year school may be a better fit based on your teen’s mental health treatment plans. This will help ensure a healthy, successful outcome, which is the most important goal of all.