When Kimi Skokin senses she’s about to zone out during class, her first reaction is an unusual one: she grabs a pencil.

But not to take notes — to keep her hands occupied.

“One of the big things is I’ll be like, ‘What are my hands doing right now?’” Skokin said.

This hyper awareness is because of a disorder she first became aware of in middle school: trichotillomania, an impulse disorder that causes people to pull out their hair. The hair pulling is often brought on by stress but can also be an automatic reaction, something she does when she’s not really paying attention, said Skokin, a senior psychology and neuroscience major at Syracuse University.

Being a college student with trichotillomania, commonly known as TTM, has been challenging, she said, especially since TTM also causes anxiety and depression.

Skokin is one of millions of college students who arrive on campus every year with a mental illness or mental health concerns. In the last decade, these numbers have increased dramatically at colleges across the country. In the 2014 National Survey of College Counseling Centers, 94 percent of directors reported an increase in students with severe psychological problems on their campuses.

The same trend is true for depression and anxiety, the two most common mental disorders nationally and at SU. In the 2014 American College Health Association report, nearly a third of students said they felt “so depressed it was difficult to function” and more than half said they felt “overwhelming anxiety” sometime in the past year.

Experts say the increase in mental health concerns is due to a variety of factors including colleges becoming more accessible, heightened stress levels among students and a lessening of the stigma surrounding mental health. Regardless of the reason, the increase has left the nation’s often underfunded and understaffed college counseling centers struggling to deal with the large numbers of inquiries and forced them change the ways they help students dealing with mental health concerns.

The increase has been felt at SU as well. In the last five years, student use of the Counseling Center has increased by about 58 percent, said Cory Wallack, the center’s director.

The rapid increase in students seeking mental health services, which can also be seen internationally, is difficult to attribute to just one factor, said Elizabeth Gong-Guy, president of the Association for University and College Counseling Center Directors and executive director of Counseling and Psychological Services at the University of California, Los Angeles.

Colleges today are more accessible and students who might not have pursued higher education 15 or 25 years ago are now coming to campus, Gong-Guy said. Early intervention is also more common with students seeking help for mental health concerns in high school or even younger, she said.

College students are also more stressed than they were even a decade ago. And because of a reduction in the stigma associated with mental health, more students are going to college counseling centers for help, Gong-Guy said.

But while the stigma surrounding mental illness may have lessened, it is still very much a problem, said Janelle LeMon, president of the SU chapter of the National Association for Mental Illness.

“Can I tell my friends? Can I tell my parents? What are they going to think?” she said. “People throw around the word crazy a lot but we need to think about how we’re using it.”

Skokin, the student with TTM, agrees. It took her years to accept that she had TTM and even longer before she felt comfortable talking about it.

“I was embarrassed to embrace it as part of my identity for a long time,” she said.

Not many people have even heard of TTM and few resources are available, Skokin said. She’s never been officially diagnosed and, like many with TTM, hasn’t seen a psychologist because there are only about 200 in the entire country who are knowledgeable about the disorder, Skokin said.

Although Skokin has never been to the Counseling Center, many students at schools across the country are going. To cope with the increase, many counseling centers are using technology or providing other forms of therapy besides one-on-one counseling, such as group therapy, Gong-Guy said.

Centers are also reaching out to their campus communities to raise awareness of mental health concerns and how to get help. Most colleges also offer “gatekeeper training,” which aims to educate faculty and staff about how to recognize and assist students with mental health concerns, Gong-Guy said.

The Jed Foundation, a national organization that works to promote emotional health and prevent suicide on college campuses, recently partnered with the Clinton Foundation to launch an initiative called The Campus Program that helps colleges evaluate the mental health services they offer.

Wallack, the SU counseling center director, is on the foundation’s board of advisers, but SU is not currently participating in the program.

One nearby school participating in the program is Cornell University. Cornell has cultivated a reputation as a top school for mental health services, a reputation that was added to last year when the Jed Foundation gave Cornell the “Jed Campus Seal of Approval,” an award given to colleges that demonstrate strong, comprehensive solutions to students’ mental health needs.

Part of that reputation, though, was born out of tragedy. During the 2009–10 school year, six Cornell students committed suicide, forcing the university to re-examine mental health services. The school had planned to cut mental health services funding that year, but following the suicides the university chose not to decrease the funding, said Gregory Eells, director of Counseling and Psychological Services at Cornell.

Several mental health programs at Cornell have been replicated at other schools including the “Let’s Talk” program and the Empathy Assistance and Referral Service. “Let’s Talk” involves stationing counselors at about 10 different sites around campus for drop-in hours. The EARS program is a student-run initiative that offers peer-to-peer mentoring and support from trained students.

While these programs have helped raise the level of awareness about mental health at Cornell, back at SU, Skokin is hoping to increase knowledge and awareness of TTM through original research.

These days, as she wraps up her senior year at SU, Skokin spends a lot of her free time in the Brain and Behavior Lab, located in the CNY Medical building just a block off the SU campus. She’s working on a study that examines the relationship between TTM and obsessive-compulsive disorder.

On a rainy Thursday afternoon in March, she bustled around the small lab office filled with posters of past studies as one of her study participants wrapped up a test.

“A lot of good research comes down to finding the right form,” Skokin said as she flipped through a red accordion folder before debriefing the person.

Because so little research is done on TTM, Skokin is hoping the study will help make a name for her in the TTM community. She said she hopes to continue her research and eventually get a doctorate in clinical psychology. The end goal is to be able to treat patients who have TTM like her.

“That’s a given,” she said of her end goal with a laugh. “I’m in too deep now and I can’t get away from it.”

Published on April 20, 2015 at 11:45 pm

Contact Jessica: jliannet@syr.edu | @JessicaIannetta