Picture this: You’re a college student cramming for finals in a campus lab late one Sunday night when you see a lanky, 6-foot-2-inch, long-haired man striding toward you wearing a red polka-dotted hat and carrying a tower of pizza boxes. You could be excused for thinking you’ve ingested one too many cups of coffee and that you’re finally hallucinating. But if you’re a student at the Savannah College of Art and Design (SCAD), you shriek with delight because the Pizza Fairy has arrived.

“We thought you were just an urban legend!” students tell Pat Mooney, who takes “flight” as the Pizza Fairy three times a year. Otherwise, Mooney can be found working as a counselor with SCAD’s Counseling and Student Support Services. Though slightly nontraditional, the Pizza Fairy is one of the counseling center’s most effective outreach initiatives.

Because SCAD is an art school, many of its students can’t sit in the comfort of their dorm rooms to study and complete projects, Mooney explains. This leaves them up late at night working in buildings spread across campus. So at 11:30 on the Sunday night before finals, Mooney hops in his van, picks up 73 large pizzas and distributes them to hundreds of lucky (and overworked) students. For every group of roughly 10 students that Mooney comes across, he delivers a pizza as well as a flier that reads, “You have been visited by the Pizza Fairy, whose motto is, ‘The road to good mental health is paved with pizza!'” The flier also contains information about how to access SCAD’s counseling services.

Mooney says the director of the counseling center first proposed the idea of taking pizza to studying students approximately seven years ago. When Mooney, a member of the American Counseling Association, volunteered for the job, he decided to make the outreach effort a little more fun, and soon it morphed into the Pizza Fairy concept. In retrospect, pizza turned out to be a wise choice, says Mooney, who notes that the “Arugula Fairy” probably wouldn’t possess the same cachet. “We [the counseling center] also sponsor Donut Divas, who do their thing in the morning,” he adds. “Some other departments, such as residence life, have picked up on the concept and take other kinds of snack foods around on nights when the Pizza Fairy is sleeping.”

But if the local Pizza Hut delivers, why does Mooney go to all that trouble? For one thing, Mooney says, it’s fun and uplifting, both for the students and for him personally. Delivered in this way, the pizza also seems to entice the students away from their computers, even if only for a few minutes, to talk with their peers and to feel a sense of connection. But the larger goal of the initiative, Mooney says, is to reach out to the campus community and remove the stigma of utilizing the counseling center.

“For years, various agencies and organizations have been making efforts to ‘destigmatize mental illness,'” says Mooney, who is also a member of the American College Counseling Association, a division of ACA. “We didn’t feel that quite hit the mark in terms of the message we wanted to get out. Though destigmatizing mental illness is certainly a good thing to work toward, we felt that there was a certain stigma to even coming to the counseling center or seeking therapy in the first place. That’s what we began to focus on in our discussions of how best to serve our students, and the nature of our outreach changed as a result.”

SCAD’s counselors still engage in many traditional outreach activities, such as depression, anxiety and eating disorder screenings, Mooney says, but they try to focus even more on fun activities. “We want to connect with students in such a way that if they run into problems that they’re having trouble solving utilizing their regular resources, they’ll think of us and not hesitate to contact us. We take great pains to not have a waiting list and to be a resource 24/7/365. Our sense is that in terms of service to the SCAD community, we’re able to do a better job because more students come to us before things get out of hand.”

When students get help early on, it might help them head off larger problems down the road, Mooney says. “People will try to solve their own problems, but when that begins not to work, we want folks to see us not as a place of last resort, but as a first stop. If they come to us initially, we might be able to prevent further deterioration.”

New low for mental wellness

Nationwide, more pizza fairies might be needed. A recent study by the Higher Education Research Institute at the University of California, Los Angeles puts the emotional health of college freshmen at its lowest level in 25 years. “The American Freshman: National Norms Fall 2010″ surveyed more than 200,000 full-time students at four-year colleges and universities and found that the number of students who reported their emotional health as above average had declined 3.4 percent since 2009 and 11.7 percent since the survey began tracking emotional health in 1985.

The survey’s results are on par with what many college counselors are seeing on their own campuses. Although Central Wyoming College’s once-rising enrollment leveled off for the first time in four years this year, Lance Goede, director of counseling and career services at the two-year community college, says his caseload has almost doubled. Meanwhile, at SCAD, Mooney and his colleagues have had conversations about how stressed the students seem in comparison with past years.

The economy is one likely factor, Mooney says. “Not only is the current situation with many students and their families stressful, [but] the prospects for new grads aren’t as rosy as they have been in the past. More students are having to work at jobs” — in addition to attending school — “and work longer hours to make ends meet, expenses are rising, family economic support is dwindling, competition for jobs is increasing and so on.”

“Consequently,” Mooney continues, “I think it’s more important than ever to help our students develop life skills that will serve them well when the chips are down. Deliberately paying attention to and acting in ways that promote good mental and physical health is important. Being able to think and solve problems creatively and with flexibility is useful, as is being able to collaborate, connect and network. Being able to tap into and maximize personal assets while compensating for deficits is helpful, too.”

ACCA President Brian Van Brunt agrees that the economy is a major factor in increased stress on campus. “Many college students are struggling with the idea of college being worth the investment on the other end,” says Van Brunt, who serves as director of counseling and testing at Western Kentucky University. “I think they often worry about having a job after college and if spending upward of $30,000 on a college education is something they will earn back over time. This can be particularly difficult for students who are watching their friends enter the workforce after high school and earning a paycheck while they are saving and working their way through college.”

But an alternative way of looking at the results of “The American Freshman” study, Van Brunt says, is that school counselors have grown more effective at supporting students in high school, enabling struggling students who wouldn’t have gone to college in the past to now achieve that goal. “We’ve supported more at-risk students to reach for college in ways they never have before,” he says. “Part of why they’re struggling [in college] is because they’re reaching higher than they have in the past.”

At Central Wyoming College, the student population is split equally between traditional students and those returning to school at a later age. Goede, a member of ACA and ACCA, has noticed an increase in students coming to campus with learning disabilities, particularly straight out of high school. He acknowledges there is a push in high schools to give students as many options as possible. Adding to that, Goede says, Wyoming has an open-door policy dictating that state community colleges must admit any Wyoming high school graduate who applies.

When students aren’t properly prepared to meet the demands of college classes, it leads to a buildup of stress and frustration, Goede says. To help alleviate that, Goede works in conjunction with disability services to assist struggling students. He also offers career counseling services so students are aware of their choices. For instance, if a particular student is focusing on a career that requires calculus but is struggling with basic math, Goede helps the student look at alternatives and set realistic goals.

Age-old issues

Looking beyond the economy and learning disabilities, counselors say the issues college students bring with them to the counseling center run the gamut. According to Van Brunt, some of the most prominent issues tend to be depression, anxiety, relationship problems and academic stress. “I think the age-old problems of school are still first and foremost on college students’ minds,” he says. “They worry about paying for college, about trying to [strike] a balance between finding enough time to study and to have fun, and there is that old fear of finding Mr. or Mrs. Right. While many of the ways college students experience stress have changed” — for instance, having to decide whether to invest in a life coach to choose a college, being bombarded with marketing from different schools and dealing with the added pressures of social media — “the underlying issues remain the same.”

In his experience at SCAD, Mooney has found that certain issues seem to ebb and flow throughout the year. For instance, in the fall, there’s a fair amount of homesickness and anxiety over time management and balancing the workload. In the second quarter, students aren’t generally as anxious about the adjustment, but the winter blues can set in. Mooney also points out that many mental disorders, such as bipolar disorder, schizophrenia and depression, often rear their heads during the college years and begin to interfere with daily functioning. There are various ideas about why this happens, Mooney says, but it’s one of the reasons they encourage students not to wait until things get dire before coming to the counseling center.

In Wyoming, Goede has noticed a consistent theme regardless of the students’ ages: relationship problems. “There’s a lack of communication between husbands and wives, boyfriends and girlfriends,” he says. “It seems like everything goes to an argument. Everything goes to an emotional response.”

Goede consistently hears from his student clients that they tend to react emotionally rather than analyzing the issue and considering how best to communicate. While the younger students sometimes have yet to develop more mature communication skills, the older students often need a refresher on those skills as well, he says. When Goede sits down with clients to help them analyze their situations, they often have “aha” moments in which they recognize that their significant others might have responded on the basis of something they said or didn’t say. “More than anything, it’s getting them to talk about what they are doing and giving them some insights about other ways to think about things or act,” Goede says.

College students experiencing relationship problems might not be aware there are options beyond yelling or making sarcastic remarks, Goede says, so he works with them to come up with other ways of reacting and then asks them to test drive these alternatives as homework. He says cognitive approaches can be effective in helping student clients analyze their thinking patterns, identify where they got off on the wrong track and see how they ended with an emotional rather than a rational reaction.

A fair number of Goede’s clients present with substance abuse issues. Many of these students are referred to him after violating rules in campus housing. Most of the issues stem from alcohol abuse, and Goede acknowledges it’s sometimes a matter of kids simply being away from home and pushing the boundaries. “But it’s definitely impacting their schooling,” he says. “There are definitely effects of substance abuse on their success.”

When students are referred to his office, Goede often uses one of two programs — eCheckup to Go (e-CHUG), an online program in which students answer a variety of questions and the program reports back on the physiological and mental health effects of alcohol on their lives, or Choices, a journaling program that helps students analyze how their behavior is affecting them personally. Both programs also include statistics that can help students realize they are in the minority as heavy drinkers, not the majority, Goede says.

A safe place

Heading off to college is a pivotal point in many people’s lives, and the nature of the transition can introduce or magnify issues of adjustment as young people reach independence and adulthood, Van Brunt says. The larger philosophical questions of “Who am I?” and “What am I living for?” often take center stage. “This transition phase from ages 18 to 22 is a significant one full of energy, questions, struggles and potential pitfalls — suicide, alcohol and drug problems, and balancing work and social needs,” Van Brunt says. “As with a young child, problems left untreated and needs left unmet can lead to lifelong difficulties in relationships and playing catch-up in certain developmental areas. College students are similar. Powerful relationship losses, abuse of alcohol and drugs and lack of hope and meaning during these developmental years can lead to cyclical broken ways of interacting with others and creating a happy life. College counselors are in a unique position to smooth over some of these rough spots, keep problems in perspective and, most important, inspire hope for a brighter tomorrow when things may look dark and without purpose.”

The counselor’s office should serve as a place where students can vent their frustrations and express their worries and fears about the future, Van Brunt says. “We help them place their concerns in a normative context, can often help reframe problems so they seem less overwhelming and assist students in obtaining a foothold to begin their climb out of the hole they find themselves in,” he says. “College counselors also offer direction and guidance in terms of managing stress, making decisions about medication and how to best manage symptoms of mental illness. Mostly though, we provide a caring, nonjudgmental place to work on their problems and worries. We listen, we care and we offer them support.”

At SCAD, Mooney works as a solution-focused therapist, which he says is particularly well suited to college students. Oftentimes, students actively want to solve their own problems, he explains, and solution-focused methods build on the assets they already possess. Mooney says he often can tell within the first five minutes of talking with student clients which of their skills will help them most in solving their problem.

In the case of one recent client, the solution was hidden in his athletic experience. The student came to Mooney expressing anxiety about the speech class he was required to take. He was very tall, a little self-conscious, and he would lose focus speaking in front of groups and end up talking in circles. Mooney asked the student a little more about himself and found out he was a swimmer.

Mooney told the student to imagine the moderate level of anxiety he might feel before a swim meet as opposed to the high level of anxiety he was experiencing before a speech. Mooney then encouraged him to try to plateau at that moderate state before a speech. Next, Mooney talked about how the student swam laps at meets and how he could use that concept to structure his speeches into a sequence rather than talking in circles. By working with Mooney and building on his existing skills, the student learned to manage his anxiety and went on to earn a good grade in the speech class.

Motivational interviewing (MI) and motivational enhancement therapy (MET) also tend to work well with college populations, Van Brunt says. “These approaches start with a therapist working with a student where they are and trying to help through harm reduction strategies. For example, if a student comes in and wants to cut back [his or her] drinking, an MI or MET therapist would start with where the student is currently drinking and help look at ways to cut back slowly. They would not frustrate or challenge the student but instead roll with any resistance and find ways to support the student’s successes and overcome any obstacles.”

Another of Van Brunt’s favorite tools is the humanistic existential approach to therapy. “Here, the therapist takes a stance related to the students’ humanity and essential ability to face obstacles and overcome challenges. The therapist engages students through rapport building, supports their choices and creates a safe place for them to explore and wrestle with dilemmas they may be struggling with.”

Van Brunt offers the example of one of his clients who has faced multiple suicide attempts, difficulties with her family and early childhood trauma. “Many think she doesn’t have what it takes to be successful on campus,” he says. “[But] home is worse for her, offering little support, and will likely lead to the worsening of her illness. The hospital holds no answers for her — she is in and out several times a semester. Her medications help stabilize her but don’t fix the underlying problem.”

As her counselor, Van Brunt focuses on giving her a place where she feels cared about and secure enough to talk. He advocates for her with different groups on campus, assists her with academic requests for accommodations on the basis of her illness and interacts with the conduct office on her behalf. “I help by giving her a stable, consistent place to come and talk when she needs to,” Van Brunt says. “This simple caring and understanding — and, dare I say, love — is what many college students are looking for. Therapy provides them a place to work through their problems in a nonjudgmental atmosphere with a therapist whose main goal is to help them feel more balance and peace in their lives.”

It’s important for college counselors to be broadly knowledgeable in varied techniques, Mooney says, because while cognitive behavior therapy might help with one student client, another might call for family systems or object relations work. “The thing that is key in my mind is that you tailor the approach to what the student needs,” he says. It’s important to skip a pathology-based focus, Mooney emphasizes, so that no matter what techniques counselors use, they look at the glass as being half full and focus on the client’s assets.

Van Brunt offers similar words of wisdom to counselors working with college students. “The main advice I would give is the importance of not overpathologizing problems that may be environmental and contextual in nature,” he says. “Many of the issues we see students for are related to struggles they are having with the normal, developmental adjustments to life away from home and moving toward independence.”

Van Brunt also acknowledges that college counselors will inevitably encounter more serious mental health problems that might require assessment, medication and ongoing treatment. In those cases, he says, it’s important to offer the same type of supportive and nurturing care and to understand that these students are often scared. Says Van Brunt, “Counselors and psychologists should always offer hope — the promise that tomorrow will be better.”

To see a video of the Pizza Fairy in action, visit http://vimeo.com/20717590.

Lynne Shallcross is a senior writer for Counseling Today. Contact her at lshallcross@counseling.org.

Letters to the editor: ct@counseling.org