It can be difficult to pinpoint a particular group of people who are clearly more depressed or stressed than others.

It’s easy, though, to find the groups who are less likely to seek help.

Depression and mental illness often come with baggage, more for some communities than others. More than one study has shown that immigrant communities and some minority groups are less likely to seek help for mental health conditions, even though they may have more stressors than the average population.

In 2005, Daniel Eisenberg, an associate professor in the School of Public Health, headed a research team that launched a survey called the Healthy Minds Study. Participants were given a small financial incentive to fill out a 10-minute-long questionnaire. About 2,840 University undergraduates responded.

The study identified about 13 percent of women screened and 12 percent of men screened as depressed. And while the University boasts one of the best mental health care programs at any college, and despite the sometimes long waits at Counseling and Psychological Services, the study showed that the University’s resources go under-recognized by the student body. Less than 50 percent of students that the survey identified as seriously depressed had received any kind of mental health care in the last year.

Part of this is because not everyone knows counseling is available through the University – or that it’s free. Another factor is the social barriers that restrict students from seeking help for mental ailments.

For example, students who identified as Asian or Asian-American reported higher levels of stigma about mental health care. And while there’s a popular myth that black adults have negative associations with mental health care, black students were found to perceive less stigma about depression prevention than other groups.

The University has been fairly diligent about responding to such findings.

“The counseling center has a tradition of paying attention to health disparities,” CAPS Director Todd Sevig said. “Most of all, we listen to what we’re hearing from students.”

But addressing the needs of such diverse groups can be tricky, especially given the dearth of new research on the topic of depression and the cultural stigma surrounding health care. To make sure students of different groups are being served equally, counselors try to match group statistics to the larger University population and look for inconsistencies in the numbers.

Recently, CAPS found that far fewer international students were seeking mental health care compared to the larger student population, even though they generally reported the same rates of depression.

“What we did with that was we looked at the disparity in the data, talked to students and created an outreach campaign that targeted the concerns reported by international students,” Sevig said. Since the campaign, CAPS has seen an increase in international students at counseling centers. He emphasized that the higher levels of international students coming for help didn’t mean that there were higher numbers of international students who needed help in the first place.

“Does it mean they’re worse off now? No,” Sevig said. “More students know about available services now than did before, and they’re using them.”

The University has numerous social, recreational and service groups to address the needs of the diverse student population and give its members a venue to express pride in their heritages. CAPS Interim Associate Director Stacey Pearson holds a luncheon for women of color, Nourish YourSELF, four times a semester. The casual environment allows women, who identify with a range of groups, a supportive community to discuss stress agents and potential mental health triggers like relationship problems, stereotyping and stress.

“It’s about looking at values and traditions,” Pearson said. “Knowing what depression looks like for different groups.”

African and Caribbean-American males tend to be less likely to seek health care on college campuses. Students in these groups also tend to have a different physical experience of depression, Pearson said.

“Generally, African-American students tend to somaticize depression,” she said, that is, they could be more likely to convert anxiety into actual physical ailments.

Awareness of the ways that different cultural, ethnic and religious groups experience depression is a goal of CAPS’s staff, Pearson said.

“It means having the knowledge and skill base to help students in different constituency groups recognize and understand their symptoms,” she said.

A few years ago, Pearson recalled counseling students of color during the U.S. Supreme Court affirmative action cases in 2003. That spring, the University was the focus of a larger debate about using race in college admissions. “At that time, students of color felt they had to perform better…to prove to the people questioning them that they deserved to be there,” she said.

Counselors stayed updated about the case and set up stands in the Michigan Union to talk with students who felt frustrated and upset.

“It’s a big part of having cultural competency to understand and help students,” Sevig said. “It’s about awareness of socio-historical context, which is always fluid.”

Six years ago, John Greden founded the University of Michigan Depression Center in response to the increasing numbers of suicides among college students. He’s subsequently singled out another campus group unlikely to seek help on campus – men, regardless of background or race.

The center, which taps experts from different disciplines across schools, tailored a program called Real Men, Real Depression to the college community in an effort to destigmatize mental health care for men. The program was created and was first launched by the National Institute of Mental Health in 2003 as a public education campaign.

While males and females tend to experience mental health illness equally, men are far less likely to seek counseling. American men especially, Greden said, tend to suffer from stigma about masculinity. Greden believes that outreach efforts tailored to specific groups, like college-aged males, may be one way to better make students aware of mental health care resources.

By all accounts, the program has met with considerable success. But despite the University’s outreach programs, not all groups are fully served.

Eisenberg’s study found that students with less money were the

least likely groups to seek help for depression or mental illness. But students who reported growing up “poor, (with) not enough to get by” reported higher stigmas about depression and mental illness than those who identified as “well off” or “comfortable.”

The trend seems to mimic findings of studies of the population at large. Recent surveys have shown that, on the whole, adults with lower income levels are significantly less likely that those of higher income levels to seek care for mental problems like depression and bipolar disorder.

“You would think that (socioeconomic) disparities would go down on a college campus because services are free,” Eisenberg said. But that doesn’t seem to be the case.

The reason why isn’t exactly clear, but it is clear that the University hasn’t been able to do much to combat it. There are no luncheons or ad campaigns targeted at low-income students with depression.

Maybe there should be. Poverty can create stress and low social support and, as Eisenberg’s studies have found, strongly correlates with higher reported levels of mental illness. So what can the University do to help these students? Can posters, discreet brochures and events to promote awareness really destigmatize a disease that comes with so much baggage in so many circles? Maybe. But even if the University does its part in reaching out to these groups, perhaps the first step is teaching students that the service is free and anonymous or, even better, where the counseling offices are located, room 3100 of the Michigan Union – a detail CAPS says more than half of students, rich and poor, white and otherwise, don’t know.

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