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Here are 8 key health questions that parents should ask their college-bound teen

Although preparing for unforeseeable health circumstances may feel like a daunting task, it’s crucial, explains Preeti Malani, professor of medicine in the division of infectious diseases at the University of Michigan’s Institute for Healthcare Policy and Innovation. Malani, chief health officer of the university, oversees the health and well-being of students, faculty, and staff.

Before move-in day arrives, review this list of questions with your teen to help them better understand their medical history and more:

1. Do you know your own medical history and those of your parents?

“Providers will ask about a student’s medical history and their parents’ medical histories, so it’s important to know,” says Malani, who is also a professor of medicine in the division of infectious diseases at the Institute for Healthcare Policy and Innovation. “It also allows you and your child to discuss what they’re at risk for.”

If your child has allergies, a chronic disease, a history of surgeries, or serious illnesses, they should keep a documented list with them, along with their vaccination records and a family medical history.

A family medical history list should include major diseases or causes of death of their parents and grandparents. For those who were adopted, they should be provided with any information that’s known about their birth family’s history.

Keep in mind, though, that some conditions that weren’t present during their adolescent years may suddenly appear during college, provoked by their new environment.

“Substance abuse and other mental health concerns, like depression or anxiety, are especially important to be aware of during this time in your child’s life since college can be stressful,” says Malani.

Malani also explains that this question can create an opportunity for you to discuss sexual health concerns with your child, as well as general decision making.

2. Who is your primary care doctor?

Depending how far your child’s college is from home, and their medical history, it may be wise for them to continue seeing their current physician instead of finding a provider on or near campus.

Alternatively, you may decide it’s best to identify a provider for them nearby.

“You can ask your teen if they’d prefer only seeing their pediatrician or if they’d like to also find someone on-site that can communicate with them and their physician at home,” says Malani.

3. Do you know how to make a doctor’s appointment and how often you should see your provider?

“Whether it’s your child listening to you make an appointment for them or they’re doing it themselves, it’s helpful to have them be part of the step-by-step process years before they go to college,” says Malani.

But, if you haven’t started, now is a better time than any.

Some teens need to see a health care provider more frequently, while others only receive routine, yearly appointments. In either case, help and encourage your child to schedule their next few appointments months in advance during their holiday breaks.

4. What are the names of your medications and why do you take them?

“Some teens have a complex medical history, while others only ever see their doctor once a year and don’t take any medications,” says Malani.

If your kid does take medications, it’s vital for them to know the dosage of each and how to take them.

Which leads to the next question…

5. What’s the dosage of your medications and how often do you need to take them?

“Encourage your teen to develop a system around taking their medications, such as setting up an alarm on their phone,” says Malani.

Malani recommends, when possible, that students create their class schedules around what best accommodates and tends to their mental and physical health needs. For example, morning classes may not work well for everyone.

Your child can also introduce themselves to their professors via email to ask how they can best help accommodate their individual health concerns.

Malani says this simple step can help to alleviate some stress for your teen, and that they won’t know what accommodations exist unless they ask.

“If students can anticipate their needs and proactively establish care, it not only gives their parents peace of mind, but it also helps them better adjust to becoming a new college student,” says Malani.

6. Where’s your nearest pharmacy to campus and do you know how to transfer or refill a prescription?

Scheduling a visit to your child’s college before move-in day not only gets them familiar with the area, but it’ll also allow you both to scope out the nearest pharmacy.

It’s important to be mindful about how often a prescription needs to be refilled in order to avoid inopportune moments, like running out of medication on the second day of school.

Being aware of move-in dates, as well as when every semester begins and ends, can be key in avoiding these types of mishaps.

Besides calling or going to the pharmacy to request a refill, many places offer online portals through phone apps, which can make the process less intimidating.

“Encourage and show your teen how to set up this online access,” says Malani. “These systems also allow for them to easily send notes to their providers and access their medical records.”

7. Do you know what insurance you have and what the important details are about your plan?

If you have medical insurance, it may cover your child until they’re 26 years old. Providing them a copy of your card can be helpful in expediting their billing process after a visit.

Having them understand what your plan covers is important, but it’s also important for students who pay for their own medical coverage to know. For example, out-of-pocket costs and co-pays may vary depending on the appointment.

“For graduate students who may longer be on their family’s plan, I recommend exploring if there are any graduate insurance packages offered to them by their university,” Malani says.

8. What resources does your campus offer for managing your physical and mental health?

Have your child do their research, or better yet, do it with them. College campuses generally have student-focused resources that cater to the most common challenges they could face.

It’s likely that various well-being classes and activities are available on your child’s campus, too, so encourage them to attend ones that interest them most.

Also, as a parent, you may be eligible to receive emergency alerts about any major incidents or health hazards that arise on campus.

In all, Malani emphasizes that this is an important population to have addressing their own physical and mental health, and a process that you can also join in on and support.

Source: University of Michigan


6 forms you really want signed before your student enrolls in college

https://www.iser.com/resources/forms-for-college.html

6 Forms You Really Want Signed Before Your Student Enrolls in Collegeby Joanna Lilley, MA, NCC, founder of Lilley Consulting
Find LD College Programs across the United States...

When your young adults goes off to college, it's imperative that you understand that even though you are the parent, if they are over the age of 18 you can be denied access to their educational records, mental health records, and any medical healthcare in an emergency situation. You are probably trying to decide whether this feels invasive having your young adult sign a few forms before anything happens. If anything, you might subscribe to the mindset of "if you will it, and it will happen." If that is the case, you can rest easier knowing that when the crisis does arise, you'll at minimum be informed.

You'd be shocked to know how many parents felt helpless during an emergency where they were told absolutely nothing because there was no release. This applies even if your young adult is on your insurance plan! They're of legal age. If releases are not signed, you are out of the loop. Period.

Now, this article is being written under the impression that you understand the differences between the Federal Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA). If you are not familiar with what each of these is and what it does, you may want to start with this article. In a nutshell, US privacy laws protect the educational and health records of young adults while they are on and off campus. If your young adult doesn't sign release forms to allow you access to their records, you have no way of knowing or seeing any of their records. No matter how angry or how much pleading you do, unless they have signed the forms preemptively, you will not be informed.

What are the Critical Release Forms that Your Child Should Sign for His Protection?

  • First, you will want a FERPA release authorized. Having your young adult log into their University platform and fill out the FERPA waiver will allow you access transcripts, GPA, academic probation, any disciplinary records, and all things that fall under financial aid.This release form also allows you to speak with any professional on campus about your young adult's educational records. Prior to speaking with you, each staff member will log online to check that the FERPA release in the student's files. Upon confirmation, they will speak with you about any questions or concerns you may have. To be blunt, this release is not necessary for a parent to have. Most parents requesting this are interested in grades, helping with paying tuition, and speaking with an Academic Advisor.
  • Secondly, you'll want HIPAA authorization. You can find a HIPAA form online and have your child fill it out before they enroll. If your student is attending college out of state, make sure you have a form signed for each state. Additionally, each University will have their own school HIPAA form for a student to sign. They use this as an extra measure to protect the privacy of students. It may seem like overkill, but in the end the university and medical providers legally are protecting themselves by protecting the rights of the students. If you log onto the Student Health website, you will most likely be able to find their form online. If not, have your student fill it out on campus as soon as they get there. You will want them to scan and email you a copy of the release for your own records. Having a HIPPA release allows you to speak with providers and have access to all medical records. You'll really want to have this! It's very important!Keep in mind that if your young adult is seeking a therapist, they can request a "limited release" for family members. A student who would do that might ask their therapist to speak to their parents only about depression and how often they're coming in for therapy, but might also ask specifically not discuss a sexual assault or substance use. The student will have such requests in writing with the Mental Health Professional they're meeting with.Assuming your young adult is on your insurance plan, you will also want to speak with an Insurance representative to ask if there is a HIPAA form they specifically need on file as well. Depending on if your student is studying in-state, you will also need to make sure you mention this as their coverage and forms may vary depending on location. Again, it's better to have it and not need it than not have it and to need the signed form.
  • The Psychiatric Advanced Directive: If at the time your student is enrolling in college he already has a psychiatric diagnosis and is on medication for it, you will want to create a Psychiatric Advanced Directive. This is a third form I would recommend to parents of college students. You can find these forms online as well. If your student is attending college out of state, you'll want to have one on file in your home state and the in the state where their college is located. Each state varies in what is included within this Psychiatric Advanced Directive.The purpose of creating and filing out this document is to ensure that if/when your young adult has a psychiatric emergency, the person they assigned (you, in this case) will be able to make healthcare decisions on their behalf. Most importantly, it allows your young adult to identify their treatment team for coordination or care during a crisis, and what types of care the young adult wants.An example of this could be identifying a specific hospital that your young adult would or would not go to in a psychiatric emergency.
  • A fourth form you will want is a Health-Care Proxy, also referred to as Medical Power of Attorney (MPOA). Having this will allow you as a parent to make medical decisions on behalf of your young adult if they are not able to. An example would be if they were unconscious or in a coma. If you do not have this in advance, you will not have access to knowing or contributing to the medical care of your young adult. It's better to have this form signed and never to need it, than to need it, and not have access to participate in an emergency! Please note that you don't need a lawyer to create this Health-Care Proxy. You will, however, need a state-specific form for for the state where your your child is studying out-of-state.
  • A fifth document would be the Durable Power of Attorney (DPOA), not to be confused with the Medical Power of Attorney. This form allows you access to bank accounts, credit cards, file a tax return, renew a car registration, etc. Not having this form would be most detrimental if your young adult studies abroad. The idea is that you are granted access because your young adult is unable to take care of such matters. The hope is that you would not need access to any of this, however it's better to have this form signed in case of emergencies.
  • The sixth and final document would be a Living Will. If your young adult has assets (car, pet, outdoor gear, etc.) you will want to make sure they have a legal document stating who receives these assets in case of death. This will ensure that their belongings will not be seized. This will also state whether your young adult is an organ donor, in case they cannot find any identification. You can find a generic Living Will template online. Your young adult will need to have this form notarized to have this document be official.

All these forms should be signed before before your child heads off to college. You will also want to make sure they as well as you have hard copies as well as copies online because you need to have a way to easily present the documentation to any health care providers!

These are very uncomfortable topics to discuss with your soon-to-be college student, yet the reality is you want to make it known that should anything happen while they are away they can be at peace knowing their family can communicate with anyone involved and ensure they are taken care of.

Joanna Lilley, MA, NCC is a Therapeutic Consultant, Behavioral Healthcare Navigator, and Young Adult Advocate, specializing in working with struggling young adults and their families nationally and internationally. See her site at: www.lilley-consulting.com, contact her by phone at: (970) 218-9958, or email at: joanna@lilley-consulting.com.


Is your child emotionally ready for College?

https://www.wsj.com/amp/articles/is-your-child-emotionally-ready-for-college-11566490377

 

 

August brings the familiar ritual of parents and soon-to-be college freshmen packing up for move-in day. Amid the final flurry of preparations, there’s one task that shouldn’t be overlooked: anticipating and discussing the challenges ahead. Despite their academic talents and extracurricular achievements, many teenagers now headed to college lack the emotional maturity for their first real encounter with adult independence.

Parents may feel confident about the transition because their teen has gotten this far; perhaps the family has teamed up to navigate the arduous path to success in high school and in the college application process. If the new collegian is headed to a school that’s a good fit, the hard part may seem over.

But the ascent from high school to college is filled with new complications, and the more that parents have done along the way to help their teens prepare, the less ready their offspring may be to handle problems without their help. Parents will face a new dynamic in trying to understand from afar when best to intervene and when to hang back. And colleges, whose privacy rules about students’ academic and health information can often keep parents in the dark, can’t be relied on to step in as watchdogs or caretakers.

Last year, fully a third of college students received treatment at campus counseling centers.

As parents of former college students ourselves and as mental-health professionals dealing with this age group, we have observed the rising rate of mental illness on campus with growing concern. Both of us have seen young patients with crippling anxiety, depression, bipolar disorder, eating disorders and even incidents of self-harm who have been unable to adapt to the demands of college life.

More than 85% of college students described feeling “overwhelmed,” and 51% reported feeling at some point in the past year that “things were hopeless,” according to the American College Health Association’s annual survey in 2018. Last year, fully a third of college students received treatment at campus counseling centers, according to the latest annual Health Minds Study, a web-based student survey of 155,000 students from nearly 200 campuses.

What explains the emotional fragility of today’s college students? Many factors have contributed to the problem. Family life in the U.S. has come to feel less stable in the face of globalization, the home and job losses of the Great Recession, income insecurity and significant rates of divorce. The 1990s saw the emergence of the internet and, soon afterward, the deeply unsettling influence of social media.

In response to these and other rapid social changes, American parents have moved away from the traditional emphasis on encouraging childhood independence, seeking instead to exert ever more control over their children’s lives. The pitfalls of this approach include over-preparation, which can place academic achievement at the center of a child’s self-esteem; over-protection, which keeps children from making their own mistakes and learning from them; and over-investment, when parents try to meet their own needs by pushing a child forward in their image.

The result is what we now see on campus: a generation of young people who often lack the maturity and resilience to deal with the emotional ups and downs of early adulthood and the constant striving expected of them as they face an uncertain future.

There is no Advanced Placement class for emotional readiness, but research has shown that it is the best predictor of whether a student will adjust successfully to college life. In our own work, we’ve found that readiness is best defined by a student’s ability to overcome three common negative mind-sets: a fear of not belonging, a fear of not making it academically and unrealistic expectations about performance and success. All three can exacerbate a host of underlying psychological problems.

Fear of not belonging can arrive quickly in the initial rush to make new friends. Far from home and familiar social supports, many incoming students struggle with feelings of loneliness. Parents may find themselves fielding worrisome calls or texts: “I can’t find the right club”; “Not clicking with roommate”; “I got dropped from rush.”

For some students, a single less-than-stellar grade feels like the harbinger of an inevitable fall.

When social life fails, college often fails. If students become socially detached, they grow less inclined to pursue their academic goals. That happened with Dr. Hibbs’s own son, Jensen. After a successful first semester socially and academically, a harsh rejection by his best college friend precipitated a depressive spiral. Jensen coped by isolating himself, even eating alone in his room to avoid encounters in the dining hall. As his depression deepened, he missed classes and assignments. He saw a college counselor, but no one from the college notified his parents of any concerns.

Fortunately, Jensen eventually told a friend and then his parents that he felt suicidal. That helped to lead the way to some solutions, including therapy. He took a medical leave, transferred to a college close to home and completed a degree. Most problems of belonging are not as consequential, but loneliness is often underestimated in youth and can be a sign of trouble ahead.

The fear of not making it academically can prove the most difficult adjustment for students used to doing well in high school: “I’m in over my head”; “I bombed my first Chem exam”; “I’m just wasting your money.” The angst induced by receiving disappointing grades, with so much at stake, can lead to unjustified shame, premature discouragement and an inability to bounce back. For some, a single less-than-stellar grade feels like the harbinger of an inevitable fall.

One such student’s fears appeared absurd to those familiar with her stellar K-12 academic record. But at a campus party, trying to drown her distress over a recent C+, the former valedictorian drank too much, barely escaped rape, returned to her dorm and intentionally cut her left wrist. The blood shocked her into getting help from her dorm’s resident adviser, who took her to the emergency room for 15 stitches. The next day she sought treatment, soon entered our care and remained in school.

Share Your Thoughts

How did you handle your freshman year of college? What advice would you give to students about navigating stress? Join the conversation below.

Having unrealistic expectations can lead students to respond to even ordinary stumbles with profound disappointment and self-blame. In its extreme form, it becomes destructive perfectionism, the distorted belief that one has to be perfect in every endeavor. The greatest danger occurs when students experience such struggles but don’t share them with others.

A few years ago, an aspiring track star with a scholarship to a large university saw Dr. Hibbs for depression prompted by a hamstring injury in his first semester that prevented him from competing and isolated him from his teammates. To cope with this setback and worries about his scholarship and his future, he retreated into silence and began smoking marijuana every day. Failing a drug test was what got him help; his coach made therapy a condition of rejoining the team. Students who haven’t faced such adversity before are usually the least prepared for it and the least likely to seek or receive help.

In the face of today’s veritable college mental-health epidemic, students, parents and schools each need to embrace unaccustomed roles.

For students, a key first step is acknowledging how difficult the transition may be and the possibility that they may need help. A 2013 report on an intervention program published in the American Journal of College Health found that participants’ top reasons for not initially seeking counseling were “My problems are not serious enough to warrant assistance” (66%), “I don’t have enough time” (27%) and “I prefer to manage my problems on my own” (18%).

In many cases, students simply lack the information or insight to recognize their own problems. But the onset of most mental health disorders occurs between the ages of 14 and 26, when the developing brain is undergoing hormonally driven change. College freshmen are especially at risk for developing several of them, including anxiety disorder and depression.

Students navigating their new environment must also manage an adolescent-to-young-adult brain that is wired for thrills and risk taking. At this age, the limbic system, where drives and emotions originate, is outpacing the maturing of the frontal lobes, where executive control arises; the accelerator overtakes the brakes. This imbalance puts freshmen at particular risk for excessive alcohol and drug use, reckless driving, unwanted sexual activity, sports-related injuries and addictive internet usage. Students need to understand that self-restraint is one of the best ways to avoid derailing a college career.

How can parents promote successful adaptation to college while simultaneously trying to let go? They need to talk to their children about the risks of college life, but they must learn to listen, not to lecture. Parent-child communication skills should shift in tone at this juncture from advice-giving or rule-setting to collaborative problem-solving. If parents are able to accept a child’s lapses without judgment or blame, their implicit message becomes: “You can recover. This is part of growing up.”

Perhaps the hardest emotional milestone for parents to achieve involves the promotion of a child’s autonomy. As the psychoanalyst Anna Freud, Sigmund’s daughter, famously said about the nature of parenting, “Your job is to be there to be left.” Though many parents provide emotional and financial support long past college, it remains their job to promote true independence, partly by volunteering to reduce their control.

Parental guilt is a frequent emotion when the transition to college is especially difficult, but it is important to remember that a rocky start can be a useful experience for a young adult. It’s a reminder that life takes many turns and isn’t linear.

For their part, colleges need to become more active in addressing the needs of vulnerable students and offering freshmen enough resources for the transition. One of the most important implications of an 18th birthday is that parents no longer have legal authority over the student as a patient. Many parents are confused—and sometimes indignant—when they first learn about the federal privacy laws governing a college student’s medical and mental health treatment and their educational records as well.

College administrators often cite these restrictions, which they are legally bound to observe, as reasons for not informing parents about their child’s adjustment difficulties. They could instead do a better job of explaining to parents that they can discuss these restrictions with their children and ask them to agree to waive them, in their own self-interest. Students can grant permission for campus academic advisers and health-care providers to communicate directly with parents should significant problems arise. Without it, college counselors find themselves unable to help when fielding frantic calls from parents: “I sent a happy kid to college—what happened?”; “How could my daughter be so depressed that she needs medication?”

Colleges are increasingly teaching students to recognize the signs of stress and mental illness in themselves and their peers, and they are working to reduce the stigma of using mental health services. Many are instituting programs that emphasize the importance of a healthy lifestyle and teach skills like mindfulness. More colleges now recognize the value of student mentoring for vulnerable groups, like underrepresented minorities. And the idea of “parents as partners” is beginning to become an accepted framework for promoting a successful transition to college; most schools now provide parent orientation programs that emphasize how to effectively support their student’s independence.

A cultural shift is beginning to take place, replacing the old “sink or swim” philosophy of college survival with one that recognizes the diverse needs and vulnerabilities of young people. But when these resources aren’t enough, colleges should make it easy for students to take a leave (for academic, medical or personal reasons) with a minimal amount of stigma, embarrassment or financial loss. A setback doesn’t mean they don’t belong in college. It means they should seek support.

A young person’s passage from home to college requires dramatic changes on the part of both generations, and we are all learning to handle it with more sensitivity and forethought. So as the big day approaches, with clothes and bedding and cherished mementos piled high, take a few minutes to sit down with your child and look ahead. Healthy attitudes and better coping skills can make these sometimes stressful years the best of their young lives.

—Dr. Rostain is a professor of psychiatry and pediatrics at the Perelman School of Medicine at the University of Pennsylvania. Dr. Hibbs is a marital and family psychologist. They are the authors of “The Stressed Years of Their Lives: Helping Your Kid Survive and Thrive During Their College Years,” published last April by St. Martin’s Press.


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