Help Your Teen Prepare for Mental Health Challenges at College

Your child is preparing to start college soon. They probably have all kinds of questions and concerns: What should they pack? What will classes be like? Will they get along with their roommate?

“Going to college is a big step,” says UNC Health psychologist Samantha Pflum, PhD. “It’s exciting and a great accomplishment, and there can also be a lot of challenges.”

All the change and expectations can result in stress and may exacerbate mental health struggles. College students are part of a mental health crisis affecting young people, and students are reporting record-high levels of anxiety, depression and suicidality.

One study found that during the 2020-2021 school year, more than 60 percent of college students met criteria for at least one mental health problem.

Even teens who don’t have a history of mental health problems may struggle when they start college. They’re going from what probably feels like a secure, comfortable setting to an unfamiliar, challenging place.

“There needs to be recognition that high school and college are very different environments,” Dr. Pflum says. “It’s normal and understandable for teens to have mixed feelings about starting college. They’re eager but also nervous and maybe overwhelmed.”

Parents can help by talking with their teens about what kinds of issues may be worrying them.

“Maybe they’re thinking they need to figure out some adulting skills,” she says. “‘How do I cook my own food? How do I do my laundry? How do I keep my space organized? How do I manage appointments or communicate with professors?’ Parents can help young people identify what they need to feel supported and capable of taking the next step.”

Ideas for Starting a Conversation About Mental Health with Your Child

Many parents are unsure how to talk about mental health issues with their children. Start with curiosity and avoid judgment, Dr. Pflum says.

“Parents can start with something like, ‘You’re going to be living away from home for the first time. What questions do you have? What information do you need to make decisions about what to do when you get to college or before you go?’”

Ask your child how you can help and support them but demonstrate confidence about their abilities to navigate this change.

“You don’t want them to think, ‘My mom doesn’t think I’m ready for this,’ or, ‘My parent doesn’t think I can handle being on my own,’” Dr. Pflum says.

Some high-achieving students might feel pressured to excel. It can be helpful to talk to your child about your expectations—your child needs to attend class, study and get adequate sleep—but make clear that their GPA isn’t everything.

“College is about so much more than grades,” Dr. Pflum says. “It’s a time to develop independence, their own values and goals, how they will become their own person.”

Your teen might benefit from talking with an older sibling, cousin or neighbor who has gone through the same transition recently. Your child can ask what was most important to them as they started college life and get advice about what things were most helpful: how they met people, clubs they joined or resources they used.

“Someone in their network who has been through this before can help them know how to be better prepared,” Dr. Pflum says.

Encourage Your Child to Use Campus Resources

Young people don’t always realize how much help is available, particularly on a college campus. Tell your child that reaching out is a sign of strength, Dr. Pflum says. Encourage them to become familiar with campus resources of all kinds, including counseling, peer support and academic help. You can help them research these options, which they should hear about during orientation but might not remember.

“Many schools have peer listening groups, a place they can go to talk about things that are going on,” Dr. Pflum says. “There are formal and informal resources. They’ll find out they aren’t the only one feeling the way they do. Suggest they keep an open mind and be curious about what options might be available for them.”

Empower your child to help themselves face their anxieties about college. For example, if they are worried about finding new friends, suggest they check out clubs, volunteer opportunities and intramural athletic teams where they can meet others with similar interests.

“Encourage students to try out different things,” she says. “Let them know it’s OK if something doesn’t stick or if they don’t have the bandwidth to do it all. College is a wonderful time to develop interests and learn something about oneself along the way.”

Talk Openly About Alcohol, Drugs and Sex

College is also a time when young people face temptations, including alcohol, drugs and sex. Parents can be supportive without condoning activities that could be harmful or illegal.

Again, the key is to be curious and nonjudgmental, Dr. Pflum says. “Say, ‘I’m here for you. I don’t want you to feel like you can’t approach me because you’re afraid of how I will react.’ Acknowledge that risks are there. Blanket statements like ‘don’t do that’ are not effective at stopping it.”

Help your child make a plan for helping themselves or others if they are in trouble. For example, you could talk about how to get medical care if someone drinks too much alcohol, and the fact that saving a life is always the most important thing.

“You’re not condoning underage drinking,” she says. “You’re being realistic and telling your young person to keep themselves safe or know how to get help.”

Keep the Lines of Communication Open

Keep checking in on your child’s emotional well-being after school begins, but try to balance your concern with respect for their independence and privacy. It can be a tricky part of parenting a young adult.

The good news is that today’s young people are often more open about these struggles than previous generations.

“In a positive way, adolescents and young adults are so much more willing to talk about mental health,” Dr. Pflum says. “They’re more willing to see mental health care as a way to get help and are more willing to access resources.”


If you or your teen has questions about mental health, talk to your doctor, or find one near you.