By Hector De La Torre, Executive Director, Transamerica Center for Health Studies
If you are a grandparent with a grandchild in college, you may have noticed that the amount of pressure placed on young people to succeed is growing at an alarming rate. College students report feelings of anxiety and depression at much higher rates than previous generations. Eating disorders and substance abuse also affect many college students at higher rates than other groups. Whether or not the spike is a result of a decrease in the stigma around discussing mental health issues or our increasingly stressful lifestyle is up for debate. What is clear is that many young people need support during their college years.
Research conducted by the National Alliance on Mental Illness on the state of mental health on college campuses found:
- One in four students have a diagnosable mental health illness
- 40 percent do not seek help
- 50 percent are so anxious that they struggle in school”
- 80 percent drink and 50 percent binge drink
The good news is that several recent laws have gone into effect to make mental health services more available; the challenge is knowing when to get help and how to get it. Under the Affordable Care Act (ACA), often referred to as Obamacare, everyone must have health insurance coverage. This includes the estimated 11.2 million students in America’s two-and four-year colleges.
College students can obtain health coverage through their school, stay on their parents’ health plan until age 26 or buy their own individual plan. Many universities and colleges offer a health plan called a Student Health Insurance Plan (SHIP). Four-year schools are more likely to offer SHIPs than two-year schools, and the coverage is often included in the regular schedule of tuition and fees that students’ pay at the beginning of a new semester. Most schools enroll students into their SHIP and require that students opt-out if they want to get coverage elsewhere. This basic coverage is usually linked to the college providers nearby.
In addition to the ACA, the 2008 mental health parity law requires that health plans must provide parity protections between mental health and substance abuse benefits, as well as medical and surgical benefits. Therefore, coverage limits for mental health and substance abuse services cannot be more restrictive than coverage limits for medical and surgical services. The parity protections include:
- Financial – deductibles, copayments, coinsurance and out-of-pocket limits
- Treatment – limits to the number of days or visits covered
- Care management – pre-authorization of treatment
Collectively these laws help make mental health care accessible to all students. The services, include behavioral health treatments such as psychotherapy and counseling. They also include mental and behavioral health inpatient services and substance use disorder treatment. Additionally, many colleges provide on-campus mental health services to their students at no cost. Some examples of these services are peer support groups, counseling centers, counseling hotlines, stress relieving programs and social activities.
College can be a wonderful time in a young person’s life. Talk with your grandkids to make sure that they know how and where to get the help and support they need to flourish as they prepare for productive lives.
At the same time, it’s not just your grandchildren who should know about available resources. Many seniors are also afflicted by a mental or neurological disorder, such as dementia or depression. According to the World Health Organization, “more than 20 percent of adults aged 60 and older suffer from a mental or neurological disorder (excluding headache disorders) and 6.6 percent of all disability (disability adjusted life years-DALYs) among those older than 60 is attributed to neurological and mental disorders. These disorders in the elderly population account for 17.4 percent of Years Lived with Disability (YLDs). The most common neuropsychiatric disorders in this age group are dementia and depression.” Symptoms of clinical depression can be triggered by other chronic illnesses later in life, such as Alzheimer’s disease, Parkinson’s disease, heart disease, cancer and arthritis. 
Most seniors living in the U.S. have access to Medicare, which provides coverage for a range of mental health services. Medicare Part A is hospital insurance, which covers mental health care for hospital inpatient services like a hospital room, meals, nursing care and other related services. Medicare Part B is health insurance, which helps cover mental health services for doctor visits and services that you generally get outside of a hospital, such as visits with a psychiatrist, a clinical psychologist, or a clinical social worker. Medicare prescription drug coverage (Part D) helps cover medications you might need to treat a mental health condition. 
Whether it’s for grandparents or grandchildren, there are many options for accessing health care services for mental illness. The key is to stay informed and weigh all of your options so that you can make the best health decisions for you and your family.
 World Health Organization: Fact Sheet Fact sheet N°381: Mental health and older adults. September 2015 https://www.who.int/mediacentre/factsheets/fs381/en/
 National Institute of Mental Health: “Depression Shares Symptoms with Other Medical Conditions.” Accessed September 1999. Netscape: https://www.nimh.nih.gov/depression/senior/shares.htm.
 Centers for Medicare and Medicaid Services: Medicare & Your Mental Health Services. https://www.medicare.gov/pubs/pdf/10184.pdf