What if it’s not (exclusively) a mental health crisis?

By Tiffany Steinwert and Shelly Rambo

College and university students are reporting alarming levels of anxiety, depression, and suicidality. News outlets are picking up on what is being referred to as a mental health crisis–even an epidemic—on college campuses. Incoming freshmen report lower emotional health than they did three decades ago. Suicides rates are on the rise. With more students seeking mental health services, colleges and universities are rallying to keep up with the growing demand. University administrators are directing more and more resources to counseling and mental health centers.

The crisis is felt across campus, but especially within the arena of student services. Offices of Residential Life, Diversity/Equity/Inclusion, and Religious and Spiritual Life often become what one chaplain calls the overflow offices for the counseling centers. They respond to student needs, but the relationship of these student services professionals to mental health outcomes is less clear. Their support expands beyond mental health, but the paradigm of mental health often becomes the frame under which these services are interpreted and assessed.

In our studies of chaplains, we became curious about the impact of religious and spiritual life (shorthand – “chaplaincy”) on student mental health. In a pilot survey at one liberal arts college, we asked students about their experiences with chaplains.^[1] We discovered that students who had contact with chaplains or participated in spiritual life programming reported that they were better able to integrate spirituality into their daily lives, that they feel supported in wrestling with life’s big questions, and that they experience spiritual growth.

While we expected to find a positive connection to mental health, there was no indication that engagement with chaplains impacted things such as anxiety and depression. There is some research indicating that spiritual practices, such as mindfulness, meditation, and prayer, contribute to positive psychological outcomes. And yet other studies other studiessuggest that engaging spiritual questions may have negative psychological outcomes, producing rather than alleviating anxiety and distress. The existing research is mixed.

It is clear that mental health expertise is recognized and valued on university campuses. Religious and spiritual expertise is less so. Translating religion within the world of higher education is a perpetual challenge for chaplains.

In focus groups with religious and spiritual life professionals conducted in Spring 2019, participants made inferences to their work and its impact on mental health. “We are,” one chaplain says, “considered counseling light.” One chaplain noted: “we’re like the relief pitchers for the counseling center.” A director pointed to her change in job title, as director of “Spiritual Life and Wellness.” Another chaplain referred to the students that she sees in terms of her “caseload”; she runs spirituality groups at the university’s counseling center.

With all eyes on mental health crisis, it is tempting for spiritual and religious professionals to prove themselves valuable by folding their work within a mental health model.

We think this is a losing enterprise. While we were surprised to find no connection in one area, we discovered a compelling and engaging link between chaplaincy and student struggles around meaning, purpose, and belonging. In the pilot survey, sixty-five percent of students reported feeling unsettled about religious and spiritual matters. Other studies highlight increasing feelings of loneliness, wrestling with spiritual questions, and a sense of hopelessness. These are related to mental health, but they are broader than the psychological. These point to the ever more complicated enterprise of becoming human. The symptoms of loneliness and hopelessness may be treated individually, but they are symptoms of pathological ecosystems rather than pathological individuals. Chaplaincy offices are positioned to do important work in direct response to the issues that students are reporting.

Chaplains contribute to student wellness by operating as existential guides during the formative years of a student’s higher education. Instead of tucking under the wings of mental health, chaplains can engage students in what Joshua Feigelson calls “the big questions.” They can assist students in engaging core questions of meaning, purpose, and belonging. Experts in the texts and practices of sacred traditions, they are equipped to guide students in exercises of meaning-making. They are prepared to do ‘deep dives’ into the territory of the human. They cultivate habits of mind and body and examine matters of conscience. They engage moral, ethical, and spiritual questions that are vital to generativity and collective wellbeing.

This work of existential grappling is challenging to quantify in an increasingly evidence-driven culture of higher education. But distinguishing these from mental health models is critical. It is related work. But it is not the same work. For religious and spiritual life leaders on campuses, this will take articulating what is often amorphous and misunderstood. The field lacks language for the ineffable work of existential grappling. The challenge of translating religious language into the public sphere and the academy’s suspicion of religion in all its forms has led the field to bury that which is most distinct and valuable about their work. And, so chaplains hide the theological and embodied spiritual practices that give them life and make their work valuable for confronting the epidemic of student distress on campus.

And yet, it is a good moment for this translation. Many universities are coming to understand that the crisis goes beyond diagnosable disorders. Even mental health practitioners are seeking, from within the field, a broader analysis of the problem and more campus-wide responses. To reframe the crisis more broadly calls for expertise across campuses and robust partnerships between student services professionals. They are asking: What if it’s not an exclusively mental health crisis? This “what if” provides an opportunity for chaplains to assess what they best offer to the student needs. The needs are glaring, and they are varied. Students need the medical model and they need a place to wrestle with meaning and purpose.

Tiffany Steinwert is Dean for Religious Life at Stanford University

Shelly Rambo is Associate Professor of Theology at the Boston University School of Theology.

^[1] van Stee, Elena G. et al. (2019).  “What Effect Do Chaplains Have on Students? A Pilot Study from a Residential Liberal Arts College.” Manuscript submitted for publication. The pilot survey was administered in Fall 2018. We receive a 40% response rate (N=1043). The questions focused on religion/spirituality, participation in chaplaincy programs, and student wellbeing.