October 2019
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Mark Moran Published Online:30 Jul 2019https://doi.org/10.1176/appi.pn.2019.8a5

In the absence of increased resources for college mental health, a university psychiatrist urges parents to advocate for their college-aged students, to recognize when they are having problems that require attention, and to urge them to seek treatment.

Adam is 19 years old and studies night and day—sometimes going without sleep—because he is worried about his grades and losing his financial aid. Jennifer is 21 and expects to graduate with student loan debt in excess of $50,000. Michelle, an 18-year-old freshman, has over 750 Facebook friends and more than 1,000 Instagram followers, but she has no one with whom she feels comfortable confiding in.

These are the faces of the American college students who are presenting in growing numbers to college mental health services—depressed, lonely, anxious, and financially and academically stressed.

Certainly, that doesn’t characterize all or even most college students; and college continues to be, for millions of young people, a unique period of independence, growth, and expansion of one’s horizons. But recent research and anecdotal accounts from psychiatrists in college health centers indicate that mental illness is on the rise among America’s college students.

“There has been a dramatic increase in mental health problems among college students,” Marcia Morris, M.D., a member of the APA Caucus on College Mental Health, told Psychiatric News. She is the associate program director of Student Health Care Psychiatry at the University of Florida (UF) Counseling and Wellness Center in Gainesville, Fla. “One of the biggest stressors is for students who are in college and on their own financially. Their parents may be unable to provide any financial help, and so the students are under enormous pressure to do well or risk losing their scholarship or financial aid. These are the students I see who can have the most serious problems. They don’t have financial backup and have to perform in school.”

Morris is also an associate professor in the UF Department of Psychiatry and co-chair of the College Mental Health Task Force of the National Network of Depression Centers.

Morris and two Department of Psychiatry colleagues—Michael Shapiro, M.D., and Andres Pumariega, M.D.—compared UF enrollment data with the number of psychiatric hospitalizations among students presenting at the UF Student Health Care Center. They found that between 2013 and 2017, enrollment rose by just 11.5%, while hospitalizations nearly tripled—from 17 in 2013 to 49 in 2017 (see chart).

Chart: Enrollment and Hospitalizations

They published their findings as supplemental material accompanying a letter published in the June issue of Psychiatric Services. The three UF psychiatrists were responding to a report in the January issue of Psychiatric Services that found that among U.S. college students, the rate of treatment for a mental disorder increased from 19% in 2007 to 34% in 2017, while the percentage of students with lifetime diagnoses of mental conditions increased from 22% to 36%.

That study, by Sarah Ketchen Lipson, Ph.D., Ed.M., of Boston University School of Public Health, and colleagues also reported a decrease in mental health stigma among college students and speculated that diminishing stigma may be contributing to the rise in service utilization.

In their response, Morris, Shapiro, and Pumariega suggested that increases in the prevalence and severity of mental illness are more likely the culprits. They asserted that research data on mental health stigma among young people are mixed and that rates of stigma differ dramatically by geographic region.

In comments to Psychiatric News, Shapiro said, “Our data tell me that it’s not just more college kids asking for help; it’s more young people with mental illness going to college. What concerns me is that if we believe there is less stigma when there really is not and we don’t recognize the increasing severity of mental illness among our college students, then we are not going to deal with the real problem: How do we support more mentally ill college students?”

Shapiro, a child and adolescent psychiatrist, is not affiliated with the UF Counseling and Wellness Center but is affiliated with the university and sees a number of college students in his practice in the community.

“I have several patients who have become young adults that I have tried to follow since starting college,” he said. “Reading the article by Lipson and colleagues, I was not surprised to know that more college students were seeking mental health treatment. I continue to see kids who go to college because very often they are very reluctant to initiate treatment with a new professional at their school, but they still struggle with mental illness and the need for treatment.”

Meera Menon, M.D., co-chair of the APA Caucus on College Mental Health, said that as the acuity of the mental health needs of college students increases, so does the need for psychiatrists practicing within this field. The Caucus supports college psychiatrists in entering this field and is currently creating a mentorship program for medical students, residents, fellows, and early career psychiatrists to connect with more experienced college psychiatrists (see box).

Read More …


Young couple (a man and a woman) wearing NAS t-shirts, next to purple quote with text

Among the many services the National Autistic Society offers for autistic people, the Moving Forward with Cashback for Communities programme in Scotland. It helps young autistic people who have been disadvantaged by unemployment, lack of education or training. It offers coaching, work experience opportunities, and support to apply for jobs and prepare for interviews. We caught up with Amy, a prospective college student and young autistic person on the programme, to have a chat about the project.

What were you doing before Moving Forward with CashBack for Communities?

I was supposed to go to college for a childcare course – a subject I wasn’t passionate about but felt I had to do. I had quite a bad experience at school and it put me in a dark place, having just left school I felt like I was going to be doing something else I hated. It really impacted my mental health.

How did you find out about the programme?

My mum works at a Glasgow café where one of the National Autistic Society groups meet. So, when I was getting diagnosed, my mum went over and introduced herself so that I would have support after my diagnosis and when I left school. I first met with Billy who told me about the project and encouraged me to join so I could start working towards finding something I actually wanted to do.

Most people do a work placement on the programme, but you did a college course. How did you find that and what are your plans now?

The programme helped me get onto an eye enhancements course, which involved learning how to deal with eyebrows and eyelashes, doing things like tinting and shaping. I really enjoyed it and found out that I was actually really good at it! I ended up getting 100% in my assessments, even the theory work. I now have a place on a full-time course to study make-up and beauty in August and I’m looking to get a part-time job while I study.

Some people on the programme get support from a mentor, but you were supported one-to-one by staff. How did you find this?

I’m really happy working with the staff. They’ve all continued to help me and have given me some of the best advice I could have ever asked for.

They’ve given me the confidence I needed to go and do what I wanted and have pretty much changed my life for the better.

What have you learned from the preparation for employment in terms of moving on after college?

I’ve learned how to communicate with a potential employer, received tips on how to behave during an interview, and actually have the confidence to apply for jobs in the first place. I now can update and change my CV accordingly to suit different jobs I apply for. Before I wasn’t confident with any of that!

What was the biggest benefit of doing the scheme?

The biggest benefit has been the big improvements with my mental health. I also have this new-found confidence I didn’t know I could ever have!

Tell us about the recent fundraising gig you organised…

I really wanted to say a huge thank you to the National Autistic Society for the help they have given me. My boyfriend is a musician and he had done charity gigs before, so we discussed doing that for the charity.

We got it organised and found the perfect venue which was the Ice Box Arts and Music Centre. They staff were so kind and helpful, and they had pretty much all the equipment we needed for the acts which made it easier to organise. The acts we had on were all unique and different in their own ways and helped us to almost sell out which was a first for the venue!

Not only did we do the charity gig, but Rock N Roll Tattoo also hosted a walk-in day. All the tattoos were done by apprentices, who had also designed them. The designs were all ideas relating to the autism spectrum and every penny went to the National Autistic Society!

In total we raised £1,500 from the charity gig and the tattoo walk-in day. And there’s hopefully more events and fundraising to come!

People at a music gig

Gig goers enjoying the music at Amy’s fundraising event

Find out more about this employment service


NASAT Trustee members visiting the Vanguard School construction site - group photo

Our new Vanguard School in Lambeth is one step closer to opening after the Department for Education signed the school’s funding agreement last week. With construction on the building going well, as seen by trustees of the NAS Academies Trust on a visit last week, the Lollard Street School is all set to open in January 2020!

This is a huge moment for us, the local council and all the parents who’ve been working together to make the school a reality.

The free school is being purpose-built for children and young people from Lambeth and surrounding boroughs who are on the autism spectrum and looking to go on to further education and employment. It will eventually cater for up to 78 students, aged between 11 and 19. It will grow gradually, with a phased intake of students, starting with years 7 and 8.

As well as high-quality learning facilities, the two-storey building (which was designed by Pozzoni Architecture and built by Galliford Try) will also contain a multi-use hall, which will be shared with the local community out-of-hours. The building will also contain a kitchen, storage spaces, and community break-out areas.

Its development reflects the local authority’s recognition of the need for more specialist education provision in the borough, especially for students who can access a mainstream curriculum. It will help autistic children get the education they need closer to home, reducing the numbers having to travel to schools outside the borough and giving parents more choice.

Although every autistic child is different, many can become overwhelmed in school environments by bright lights, loud noises or the unpredictable behaviour of other children. Some children on the autism spectrum are able to excel in mainstream schools with limited help, while others require more specialist support, like that offered by our Vanguard School. Without the right support and understanding, it can be almost impossible to learn and can even lead to children missing out on an education altogether.

Fleur Bothwick, Chair of Vanguard School Governors and NAS Academies Trust Board Trustee, said: “For me and other parents in the borough, this has been a long journey, with a great outcome. Bringing the expertise of the National Autistic Society in to our borough will be life changing for many children and young people on the autism spectrum and for their families. It will also benefit the local community, other schools, services and employers.”

We are so grateful to the National Autistic Society and the Department of Education for sharing our vision and turning it in to a reality.

Kirstie Fulthorpe, Managing Director for the NAS Academies Trust, said: “This is a huge moment for our charity, the local council and, especially, all the parents who’ve been working hard to make the school a reality.”

We’re very much looking forward to working together to realise the high ambitions we have for our school – and to giving local autistic children the best possible chance in life.

To find out more about the National Autistic Society’s Vanguard School and to sign up for updates on the school’s development, visit their website here.

Visit Vanguard School


Anne Hegerty with students

Two weeks ago, National Autistic Society supporter and star of ITV’s The Chase, Anne Hegerty, visited Clarendon School in Twickenham. The school won a visit from Anne by signing up to take part in World Autism Awareness Week in April, this year.

Greeted by a cheering school assembly, Anne spent the whole morning answering questions from students and touring the school to see the great work the teachers, support staff and students are doing.

John Kipps, Headteacher said, “During World Autism Awareness Week, we used the excellent learning resources provided by the National Autistic Society. Many of our pupils have an autism diagnosis and to have such a positive role model in the school has been amazing.”

Anne was particularly moved by one young student’s film about what it is like to be autistic. Anne told the assembly she could relate to many of the sensory issues the young man described.

Asked what advice she would give to young autistic people, Anne said,

You can learn to deal with the sensory issues. And don’t expect too much of yourself. Give yourself breaks, give yourself time but do expect you can probably do more than people think you can.

Watch Anne’s ‘Thank you’ message in the video below.

You can find Secondary, Primary and Early Years learning resources on autism, here, including a film from Niall Aslam, autistic man and Love Island contestant, and the Trummies, our colourful bunch of animated characters who live on the autism spectrum.

World Autism Awareness Week is back next year from Monday 30 March to Friday 5 April. Get the date in the school diary today and help create a society that works for autistic children and adults.



This past weekend, mass shootings in El Paso, Texas and Dayton, Ohio killed at least 30 people and injured over 50 more. These mass shootings, the 16th and 17th in the United States this year this year, took place amidst a continued crisis of white supremacism in the US; while the administration promotes xenophobia and the President calls immigrants less than human; and in a political climate in which we have repeatedly failed to address the prevalence & availability of deadly firearms. Our hearts are with the victims, their families, and their communities. 

Speaking this morning about these mass shootings, President Trump said that mass shootings are carried out by “mentally ill monsters” and claimed that in order to prevent them, we must “reform our mental health laws to better identify mentally disturbed individuals who may commit acts of violence and make sure these people not only get treatment but, when necessary, involuntary confinement.” These remarks are a blatant attempt to target and scapegoat people with disabilities in order to distract from the active role our President himself has played in inciting anti-immigrant sentiment and white supremacist violence. ASAN calls on policymakers and the American public not to be taken in by this dangerous rhetoric, but to insist on real, meaningful change. 

Blaming mass shootings on people with mental health disabilities has become so routine that yesterday, the American Psychiatric Association issued a statement warning against blaming mental illness for “a public health crisis of gun violence fueled by racism, bigotry and hatred.” As the APA points out, people with mental health disabilities are far more likely to be victims of violence than to be perpetrators. The overwhelming majority of gun violence is carried out by nondisabled people; we cannot fight gun violence or racism by monitoring and institutionalizing people with disabilities. We urge everyone to educate themselves on this issue so that we as a nation can stay focused on working towards real solutions. 

When we examine the evidence, it is easy to see that enacting legislation making it easier to surveil and institutionalize people with mental health disabilities, as the President has suggested, would not prevent gun violence. Instead, it would threaten the civil rights of the 1 in 5 Americans with mental health disabilities. People with disabilities have fought for decades for our right to live in our communities and make our own decisions about our housing and health care. As centuries of failed U.S. policies demonstrate, denying us these rights means abandoning us to abuse, neglect and segregation. The results of the President’s proposal would be catastrophic; not only for the disability community, but for our nation as a whole, because it would allow gun violence to continue unchecked.

When the President of the United States scapegoats the disability community instead of reckoning with white supremacy, he knows exactly what he is doing. He knows that his talking points, reprehensible as they may be, line up with common societal prejudices which allow him to distract from the issues at hand. It is incumbent upon all of us to refuse to play along. We must educate each other; denounce white supremacy; stand up for our friends, family & neighbors with mental health disabilities; and advocate for real solutions to gun violence, racism and xenophobia. We call on our elected officials at all levels of government to do the same. 

The Autistic Self Advocacy Network is a 501(c)(3) nonprofit organization run by and for autistic people. ASAN was created to serve as a national grassroots disability rights organization for the autistic community run by and for autistic Americans, advocating for systems change and ensuring that the voices of autistic people are heard in policy debates and the halls of power. Our staff work to educate communities, support self-advocacy in all its forms, and improve public perceptions of autism. ASAN’s members and supporters include autistic adults and youth, cross-disability advocates, and non-autistic family members, professionals, educators, and friends.

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The Autistic Self Advocacy Network condemns Sesame Street’s decision to further stigma against autistic children and adults in their new Public Service Announcements. 

For several years, ASAN consulted with Sesame Street on their See Amazing project and the development of their autistic character, Julia. Until this summer, the content Sesame Street produced showed parents that their autistic children could live great lives, and taught autistic and neurotypical children ways to become friends. Through this approach, See Amazing successfully encouraged the inclusion of autistic children in their communities, and had a widespread positive impact.

Sesame Street has now decided to undo that progress. Its latest PSAs featuring Julia promote Autism Speaks’ “Screen for Autism” initiative and their resource for parents of newly-diagnosed autistic children, the 100 Day Kit. Like much of Autism Speaks’ recent advertising, these PSAs use the language of acceptance and understanding to push resources that further stigma and treat autistic people as burdens on our families. The 100 Day Kit encourages parents to blame family difficulties on their autistic child (“When you find yourself arguing with your spouse… be careful not to get mad at each other when it really is the autism that has you so upset and angry”) and to view autism as a terrible disease from which their child can “get better.” It recommends compliance-based “therapies” and pseudoscientific “autism diets,” but fails to educate families about communication supports. It even instructs parents to go through the five stages of grief after learning that their child is autistic, as they would if the child had died.

We discussed with Sesame Street, repeatedly and in great detail, what this decision would mean for the autistic community. We explained to them how these ideas harm autistic children and our families, and reinforce societal prejudice against autistic people. Our contacts acknowledged that the Autism Speaks resources were harmful and portrayed autistic children in a negative light — yet they were unwilling to reverse course in their plans to promote them. As a result, we have formally ended our partnership with Sesame Street. 

Too often, parents of autistic children are bombarded with terrifying messages. They are told that their autistic child will destroy their marriage and their nondisabled children’s lives. They are told that their child’s happiness — and their own — depends on the child “getting better” by hiding their autistic traits, and to work toward this goal above all else. They are told to grieve for the hypothetical nondisabled child they had imagined, rather than to love and connect to the autistic child in front of them. These messages hurt autistic people, scare our families, and encourage our communities to fear and exclude us. Autism Speaks has played a central role in developing them.

The See Amazing initiative was groundbreaking because it offered an alternative to these stories. It let families know that their autistic children are amazing, can live happy lives, and are deserving of love. Now, Sesame Street has decided to let See Amazing become just another vehicle for Autism Speaks to spread the same old toxic ideas.

Decision-makers at Sesame Street understand the position they are in. For fifty years, Sesame Street has created content with the explicit goal of impacting the real lives of children and families. It is too late to pretend that Sesame Street can amplify harmful messages without causing harm. We call on Sesame Street to recognize the damage they are doing, end their partnership with Autism Speaks, and commit to producing and promoting only content which increases the inclusion, acceptance and well-being of autistic children.

The Autistic Self Advocacy Network is a 501(c)(3) nonprofit organization run by and for autistic people. ASAN was created to serve as a national grassroots disability rights organization for the autistic community run by and for autistic Americans, advocating for systems change and ensuring that the voices of autistic people are heard in policy debates and the halls of power. Our staff work to educate communities, support self-advocacy in all its forms, and improve public perceptions of autism. ASAN’s members and supporters include autistic adults and youth, cross-disability advocates, and non-autistic family members, professionals, educators, and friends.

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Dear Readers,

Wishing you a very Merry Christmas and a safe and happy 2019!


Julie & Co


Snowy trees

Dear friends,


As the year draws to a close, we’re taking a moment to look back at everything we’ve achieved since January. This has been a year of nonstop advocacy – answering our action alerts, you have written comments on regulations, talked to your elected officials, and constantly gotten the word out on social media about issues impacting our lives. Over the last year, you’ve put a lot of work into making the world a better place, and we’ve been grateful to work alongside you every step of the way. Here are just a few of the ways we’ve made a difference together:

  • During the spring and summer of this year, we organized the #StopTheShock campaign to end torture at the Judge Rotenberg Center. Thanks to your engagement, the FDA was flooded with calls and we were able to deliver over 290,000 signatures calling on them to ban electric shock devices. We are not done advocating on this crucial issue, but thanks to your advocacy, we have begun to see results: this fall, the FDA announced plans to finalize the ban.
  • We worked together to get out the vote by spreading the word, sharing resources, and making sure voters with disabilities got everything we needed to access the polls.
  • We showed the administration that disabled immigrants are welcome here by speaking out against the proposed “public charge” rule. After a successful campaign, the comment period closed with 210,000 submitted comments opposing the discriminatory regulation – which the government must now respond to before it can move forward with the proposed rule.

Even when we’re not reaching out to you to take action, you are part of everything we do at ASAN. We depend on the support of our grassroots to keep our offices open and allow us to run programs and produce resources. Here are some of the ways your donations have helped us support the community this year:

  • We promoted autistic student leadership on college campuses via our 8th annual Autism Campus Inclusion leadership academy.
  • We published an anthology documenting the experiences of people who learned that they are autistic as adults. This book will be a critical resource for many adults who are just coming into our community, letting them know they are not alone.
  • We released an Easy Read toolkit on Employment First policy. This toolkit is part of our ongoing efforts to make policy advocacy accessible to people with intellectual and developmental disabilities.

Together, we are changing the world—and none of it would be possible without you. Here are some ways you can help us do even more in 2019:

Thank you for your hard work, for your activism, and for believing that advocacy is for everyone. With your help, in 2019 we can make sure there is Nothing About Us, Without Us!

Best wishes,

Zoe Gross
Director of Operations
Autistic Self Advocacy Network


There are many benefits to having a fulfilling job – and when we have the supports we need, disabled people can succeed at jobs that pay well and bolster our self-confidence. There are policies in place to help disabled people find and keep good jobs, like Employment First. But there are also policies that have kept us stuck in low-paying jobs away from our communities.


It’s important for self-advocates to understand employment policy and how things could be different—so that we can effectively advocate for an end to policies that hurt us, and for the adoption of policies that help us. That’s why we’re pleased to announce our latest plain language toolkit, Real Work For Real Pay: A Self-Advocate’s Guide to Employment Policy.


This toolkit explains:


  • *What Employment First is
  • *What sheltered workshops are
  • *What the minimum wage is
  • *The law that lets some companies pay disabled workers less than minimum wage
  • *How we can solve problems disabled people have with employment
  • *What work requirements are, and why they are a bad idea for people with disabilities


The Employment toolkit is available in two versions: an Easy Read Edition and a Plain-Text Version. Both versions are written in easy-to-understand language and are screenreader-friendly.

Real Work For Real Pay: A Self-Advocate’s Guide to Employment Policy is the latest entry in ASAN’s ongoing series of accessible toolkits covering important policy issues. These toolkits aim to help people with disabilities become active participants in our democracy. We encourage you to share this toolkit widely so that we can give as many self-advocates as possible the tools we need to advocate for policies that help us get real work for real pay!

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Red and orange-leafed trees line a path
Dear friends, 


In our last newsletter, we urged you to take action against Brett Kavanaugh’s nomination to the Supreme Court. Together, we have kept that fight going all through September. Earlier this month, we sent a letter to the Senate Judiciary Committee about our grave concerns about Judge Kavanaugh’s nomination to the Supreme Court – specifically, his proven record of supporting the right to strip disabled people of their self-determination and bodily autonomy. Since we sent that letter, many more horrifying elements of Judge Kavanaugh’s past have come to light. Despite this, the Senate Judiciary Committee has voted in favor of moving Judge Kavanaugh’s nomination to the Senate floor for a vote – and that’s exactly where we’ll #StopKavanaugh. 


We also released a statement opposing this Administration’s proposed “Public Charge” regulation, which discriminates against disabled and low-income immigrants and makes pathways to American citizenship contingent upon wealth and the absence of disability. 


Finally, we’ve just announced the first of this year’s gala award recipients: DJ Savarese, writer and co-producer of the documentary Deej. Our annual gala will be held November 15th at The Hamilton in Washington, D.C., and we hope you’ll join us to celebrate self-advocacy, self-advocates, and the continued triumphs made possible by our community. 


Zoe GrossDirector of OperationsAutistic Self Advocacy Network 

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