The symptoms of most chronic mental illnesses, such as anxiety, bipolar disorder, and depression, first emerge between ages 16 to 24, according to the National Alliance on Mental Illness (NAMI).

It is not a coincidence that symptoms arise during the adolescent years; experts concur that mental illness is triggered by a combination of developmental, environmental, and genetic factors.

If you are a parent of a high school student who has been diagnosed with a mental illness, or are a high school student dealing with this challenge, know that you are not alone: the past decade has seen more students entering freshman year with pre-existing diagnoses of mental illnesses than ever before.

But not all colleges are equally well-equipped to handle students dealing with these difficulties.

A student with a mental illness must take additional steps than a student without this consideration. She must find a mental health-friendly campus, and plan ahead to locate on-campus support and structure.

Questions to Ask While Researching Colleges

# How Capable is the College Counseling Center (CCC)?

Most colleges and universities have a CCC, but that’s where the similarities end. Some CCCs are well-funded, fully-staffed, and student-friendly. Others (even at top, brand name universities) are not. Just because a university is highly selective or has outstanding academics, do not assume it gives equal priority to the mental health of its students.

You will need to investigate and dig deeply into the school’s website, and/or visit the CCC in person during a college tour to get answers to the following critical questions:

• Staffing: How is the CCC staffed? Are psychiatrists (needed for medication management) easily available? How many therapists are on staff? Are they psychologists, social workers, and/or graduate students?

• Scheduling: Does the CCC have long wait times? It’s hard to believe, but even at the most elite universities in the U.S., there are significant wait times of one week or more to get an initial intake appointment with a therapist. Imagine if your child is struggling with an episode of depression, only to be told it will be two weeks before she can be seen for the first time.

• Hours: Does the CCC have limited hours? How are after-hours emergencies handled: through trained campus police, or through a referral to a local hospital (and how qualified is that hospital at dealing with psychiatric emergencies)?

• Limits: Are there limits to the number of therapy sessions a student may have? Most colleges are not set up for and do not encourage on-campus, long-term therapy. If you or your child will require ongoing therapy, the college may refer the student to a local therapist or psychiatrist. But what if the college’s surrounding community is rural, with more cows than people? And even if the university is in a large town, or a city, the student will have to find a provider who takes her insurance and arrange transportation to get to the appointment.

# Planning Tip

If you know you or your child will need ongoing therapy, the time to find a provider and set up a recurring appointment is before the school year begins. The same goes for medication management if it can’t be done on campus.

It might be preferable, and even necessary, for some students to look off-campus for mental health treatment, medication, and therapy.

_For more information on this, and for more of Nancy Wolf’s advice on starting college with a mental illness, see part two of this article._