The number of University of Minnesota students with diagnosed mental health conditions has jumped sharply since 2015, making it the top health issue on campus, according to a student survey released this week.

The survey also revealed that nearly two in five female students have experienced sexual assault in their lifetime.

The survey, directed by Boynton Health, is conducted every three years to help the student health service address key concerns affecting students on the Twin Cities campus.

More than 42 percent of the students responding to the survey reported a mental health diagnosis in 2018 — a 29 percent jump from those surveyed in 2015. The increase was higher for female students, with nearly half (48 percent) reporting a mental health condition in their lifetime — a 39 percent jump from 2015.

Twenty years ago, one in five students had been diagnosed with a mental health condition, said Gary Christenson, Boynton Health’s chief medical officer. Now it’s two in five, with anxiety and depression as the most frequent diagnoses.

The increases have meant a steady demand for mental health services. In 2017, the Boynton mental health clinic logged 4,846 therapy visits from the first day of class through Nov. 19. That number hit 6,059 during a similar period this year — a 25 percent increase.

To accommodate the rising numbers over the last decade, Boynton Health has doubled its mental health staff — and it now outnumbers the primary care staff, Christenson said.

The survey doesn’t pinpoint the reasons behind the increases in diagnoses. It could be that awareness of mental health issues has increased while the stigma decreased, so more people seek help, Christenson said. In addition, he said, it could be that more students with mental health conditions can now navigate college.

Stress could be a factor

Stress, however, might be contributing to the increase. Two in five students responding to the survey said they’re unable to manage the stress in their lives. Of those students, 14 percent had been diagnosed with depression, compared to 6 percent among those who say they can manage their stress.

Lucas John, a 22-year-old biology major, said he believes the increasing expectations and rigors of college have pushed some students to the edge. Pressure often starts in high school, he said, as students strive to meet rising standards to get into college. They aim for high grades while ticking off boxes for extracurricular activities, leadership positions and volunteering.

“There’s this pressure to go above and beyond and be the perfect student,” said John, who served as a Boynton health advocate and now serves as a mentor for the program. “Kids are cracking under that pressure. I’ve seen it. I’ve experienced it. You become overloaded with goals and deadlines to meet.”

For many students, the rising cost of college has added to the stress. “Some students work three to four jobs in addition to being a full-time student,” John said. “They don’t have any time to manage their stress or enjoy their lives. They’re too busy trying to stay afloat.”

Other factors sometimes blamed for the rise in stress include higher divorce rates among their parents and the barrage of social media posts that make it appear that “everyone’s life is better than mine,” Christenson said.

In the survey, some of the top recent stressors students cited include conflicts with roommates or housemates, the death or serious illness of someone close to them, the end of a personal relationship and excessive debt other than credit card debt.

Pat the bunny

In addition to counseling services, the U has launched stress-relief initiatives such as its PAWS program, which has trained handlers bring in dogs, bunnies and even chickens for students to pet. “An animal gives you unconditional love,” Christenson explained. “And a seasoned handler, who often is the age of a parent or grandparent, can give encouragement and comfort.”

A “de-stress” program provides peer counseling for stress management, and a food pantry provides fresh and healthy food for students who struggle with their grocery bills.

“At college, there’s a lot thrown at students,” said Brianna Lundgren, a 22-year-old psychology major and a coordinator in the de-stress program. “You need a job to pay the rent, you have to be in good standing academically, you have to maintain relationships, you have to think about life after college.”

For some students, it helps to set priorities and create to-do lists, Lundgren said. She also advises self-care, which could be as simple as going to the gym, taking a walk, meditating or even tending to personal hygiene like taking a shower or brushing teeth.

“It just goes back to finding that balance,” she said.

Over the years, the wide-ranging student survey has also covered topics such as tobacco, alcohol and drug use; personal safety; financial health; nutrition, physical activity and sexual health. The 2018 survey added questions about sexual harassment and found that 74 percent of students said they had experienced some type of sexual harassment, such as being told a sexual joke or story.

Some 39 percent of women in 2018 said they had been sexually assaulted in their lifetime, compared to 32 percent in 2015. The number of female students who said they had been sexually assaulted in the previous 12 months increased from 9 percent in 2015 to 11 percent in 2018.

It may be too early to explain the increase, said Carolyn Porta, a professor in the School of Nursing and a sexual assault nurse examiner for the last 22 years.

“Do we think more people are being assaulted and harassed? Maybe,” she said. It’s also possible that recent news coverage and the MeToo movement have helped people recognize unacceptable behavior, she said.

“I’m not so much surprised by the data as much as I’m being reminded that we have … too many young adults being harassed and experiencing violent acts at such a vulnerable developmental period of their life,” Porta said.