Entering college is a challenge that can instigate or exacerbate a mental health issue. Today, far more students than perhaps in years past are finding the entry into higher education difficult, troubling or both.

Almost half of all college students report overwhelming feeling stress and anxiety — and nearly 10 percent say they have seriously considered suicide in the past year, the latest National College Health Assessment found. Depression is at an all-time high. The latest numbers show one-third of students have experienced debilitating depression.

One-third of [college] students experienced debilitating depression.

It’s a unique transition. Just as college students enter new environments, larger institutional structures, and changed living arrangements, they also feel greater pressure to succeed without the familiar support systems they have marked their lives thus far.

Sean Martin of Irvine, California, is a content marketing manager at Directive Consulting now. But he’s also a recent college graduate who describes his college experience as “four years of severe clinical depression and mental instability.” He attended Hamilton College in Clinton, New York.

“American university culture constitutes what I consider to be a form of structural depression,” he told LifeZette. “They expect unattainable levels of success, coupled with a low threshold for mistakes and a meaning-based-on-merit evaluation process.”

Related: Anyone Can Have Mental Health Issues

He believes few universities accept accountability for the institutional mindset that discourages students from seeking help in the first place.

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“The greatest threat on a college campus and at home is the individual not feeling safe or welcome when expressing their feelings,” he said. “That is what drove myself and many close friends to the edge of suicidal tendencies. We are easily overwhelmed creatures, especially in isolation at a formative time in our lives. We need to be welcomed into institutions of learning, not tossed into the work grind like a baptism by fire.”

Research psychologist Dr. Frieda Birnbaum of Saddle River, New Jersey, said colleges are simply not equipped to handle students’ mental health issues.

Birnbaum believes students should have mandatory courses on finding support systems.

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“They are absolutely not addressing the problem,” she told LifeZette. “They need professional psychologists who are assigned to all students as part of the curriculum. New students are going into a different developmental stage. They are finding their autonomy and they find themselves without parental support.”

Birnbaum believes students should have mandatory courses on loneliness, on change, and on finding support systems — because even if they get past the stigma and discomfort of reaching out for mental health services, troubled students are often put put on a waiting list. Students can also get the impression, if they don’t have an actual diagnosis of mental illness, a physical handicap, or a learning disability, that they are not “qualified” to receive help.

Tammy Adams (not her real name) found herself in a college dorm atmosphere at an Illinois university that emphasized socialization; but she was shy and studious. She described her freshman level engineering courses as “very tough,” and she felt a lot of pressure, since college was costing her parents a hefty price.

Within six weeks of entering school, she found herself depressed and anxious, although she had never experienced those symptoms before. When her midterm grades arrived, they were lower than she expected. Her hair began falling out and her weight plummeted.

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“It was super scary,” she told LifeZette. “I suddenly felt I couldn’t confide in anyone. My parents were busy with my brothers and sisters and in another state. I was supposed to be an adult. When my roommate complained about my ‘moping,’ the residence hall assistant suggested I contact health services. They ascertained I wasn’t suicidal and gave me an appointment for the next January. I didn’t feel like I was going to make it to January.”

Universities don’t want the liability involved in providing counseling services — or the negative publicity they associate with mental health issues among their populations, according to Dr. Lauren Costine. She is with BLVD Treatment Centers in Beverly Hills, California, and an adjunct professor at Antioch University.

“From a public relations perspective, stigma still plays a major role in how mental health issues are handled, and some universities will move swiftly to have a student withdraw from their program if a suicide attempt or psychiatric hold is made rather than help them,” she told LifeZette. “They do not want the public to know that a percentage of their students may have mental health issues.”

Related: Depression is Now Part of the School Day

Parents should investigate the mental health approach of any university their children enroll in and educate themselves on mental health issues, including advocacy techniques, said Costine. Among the organizations she suggests parents investigate are the local chapter of National Alliance on Mental Illness (NAMI), rape crisis centers, and Alanon for parents of addicts.

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Besides universities and families, there’s another source for change — the students themselves. Active Minds, Inc., a non-profit advocacy organization, seeks to involve students in reducing stigma and fostering discussion. It was founded at the University of Pennsylvania by Alison Malmon after her brother committed suicide — and has spread to many other campuses.

Gutless and Grateful is a Broadway-like performance program that Amy Oestreicher, of Westport, Connecticut, created and presents at colleges. It combines musical theatre with creative mental health advocacy and sexual assault prevention. The actress and playwright has survived many of the challenges students face, including sexual abuse and post-traumatic stress disorder.

Related: Is Exercise the Best Drug for Depression?

“I’m interested in using storytelling to elucidate not only our shared struggles, but the life skills that can be used in the face of adversity,” she told LifeZette. “It allows students to take an active role in reducing stigma and promoting mental health.”

Pat Barone, MCC is a professional credentialed coach and author of the Own Every Bite! bodycentric re-education program for mindful and intuitive eating, who helps clients heal food addictions.