Listen: Colleges Navigate Students’ Digital Addictions

Generation Z, who make up a majority of today’s college students, were born into a world with smartphones and social media and have been dubbed “the anxious generation” as a result. Increased online engagement without protective measures has been linked to rising anxiety and depression rates among young people, and it can also lead to other harmful habits.

In this episode of Voices of Student Success, host Ashley Mowreader spoke with Amaura Kemmerer, director of clinical affairs for the telehealth group Uwill, to discuss how digitization has made it easier for young people to engage in unhealthy habits, including substance abuse, pathological gambling and social media addiction. Later, Kemmerer shares how higher education institutions can respond to these new challenges by pulling from existing literature regarding preventive health measures.

An edited version of the podcast appears below.

Q: Can you introduce yourself and your background?

Uwill

A: My name is Amaura Kemmerer. I’m a licensed clinical social worker by training. I’m the director of clinical affairs at Uwill, a student mental health wellness platform. My background has been spent primarily working with college students. I was at Northeastern University in the Boston area for 15 years, primarily working in … prevention and education around substance use, sexual assault prevention and mental health promotion and then ultimately also worked in administration. But my passion, and really the work I love to do is around the prevention education and mental health promotion with college students and young adults.

Q: That’s awesome. So when we talk about college student mental health, a lot of the conversation can be focused on stress and anxiety, which are very important elements of the conversation. But we also know that sometimes those symptoms or those anxieties can manifest into other unhealthy habits, like you were alluding to—substance use or other issues that need to be addressed in preventive measures. I wonder if we can just start the conversation by talking about some of the ways that students’ mental health can affect these other dimensions of their well-being and their interactions with themselves and their communities.

A: I think to start, it’s important, probably, to note that stress can be a really natural and expected response to things happening for young adults, particularly as they adjust to life in college, including new environments, new relationships, new academic pressures.

I think ultimately what we talk about is the accumulation of unchecked stress, when there aren’t strategies in place to manage those oftentimes physical, emotional and even behavioral symptoms that can come alongside the unmanaged stress, that you tend to see developments kind of on the mental health side.

For example, not implementing skills to reduce stress can lead to physical symptoms like sleep disruption, lack of concentration and then maybe more behavioral things like withdrawing socially or skipping class and spending less time studying. Ultimately, what we see is a huge range in how stress impacts college students.

We know there’s a tie to that unchecked stress, and then there can be a variety of behaviors that also develop from that. Certainly it’s not uncommon to hear things like using alcohol to blow off steam, or same for cannabis use; it can sort of be seen or experienced like a treat or a reward.

Very often, though, what we see is that, when that becomes the way to manage stress, that can lead to the inability to develop healthier coping mechanisms and then actually interfere with a student’s goals and values, really around kind of how they hope to develop as a student and a young professional.

Q: I think colleges and universities can be pressure cookers for young people, where everyone around them is working at the same high pace in an intense environment. I remember when I was a college student, I had a friend who would say, “Oh, I’m not an alcoholic. I’m just a college student.” Like, my alcohol use is not worrisome until I leave this environment, because that’s just the nature of the game. I think [college] can be a really interesting space for young people to build healthy habits and think about their future and their next steps when this current environment feels so stressful or like this is a unique situation that maybe afterwards, you won’t carry those habits with you.

A: Having worked particularly in the substance use field, one of the most common things we would hear from students was, “I won’t drink like this when I graduate,” and the sense that it would be that time-limited thing.

What we know now, though, and particularly on that topic related to substance use, is for about a third of our heaviest drinkers in college, they are looking at the possibility of lifelong challenges with alcohol.

I think one of the unique things about [student wellness support], whether it’s substance use or mental health or any other kind of behavior that when left unchecked can become really problematic, is the opportunity to intervene early. Help a young person maybe do a little reflection, think about what role they want that thing to play—drinking, cannabis use, gambling, whatever it is—and help them think about how to make small changes in their behavior when they still can, because it gets harder the older a person gets, and once they get out of college, what we know from the research is it’s really a lot harder to make changes in behavior when those patterns have become so established.

Q: So this series is focused on Gen Z and helping them navigate next steps after college. I wonder if you can talk a little bit about some of the unique challenges that young people today face that might be different compared to previous generations when it comes to navigating healthy habits or establishing behaviors that promote healthy lifestyles long after college.

A: It’s interesting. I think there’s some similarities that we see that have stood the test of time, and then there really are some changes that have led to the challenges looking much more unique to this generation.

Something like substance use in particular, where that used to be one of the most complex problems facing college students for a period of time—and it’s very much still there, not to say that that isn’t a piece of it—but I think colleges have become a little bit more invested in doing things, that the research tends to support students educationally and from a policy perspective, and we’ve actually almost seen a cooling off of the high-risk drinking among college students.

But we have seen changes in other areas, like a huge explosion with gambling, particularly online gambling.

I think the other common denominators are things related to technology. Access to technology has created really a lot of challenges around social media use and how much time young people spend on their phones, particularly on social media, and the related mental health effects we know that can have things like porn use—again, access to technology has kind of opened up some doors and we do see some concerning trends there that a lot of these behaviors get established in the college years.

I think the key is how we think about helping to intervene earlier, provide education, provide access to services so that they don’t become problematic down the line.

Q: Speaking of online gambling and addictive behaviors when it comes to sports betting, I saw a stat from the Siena College Research Institute that almost half of American men have online betting accounts. And the University at Buffalo found one in 10 college students is a pathological gambler.

This perpetuation of gambling and the ways that it can just be infused into students’ daily lives, I think, is so interesting, and particularly because they’re betting on college sports as well. And there’s kind of, again, that environmental element where it feels like this is more normalized, or part of the college experience. I wonder if you can comment a little bit on that.

A: I think this is an area where we’ve seen, to your point, absolutely explosive growth over the past 10 years, and really even the past couple of years—particularly, I would say, tied to that 2018 Supreme Court ruling where every state essentially was given permission to legalize and regulate [sports gambling].

Anytime we see something like this in the literature, to be honest, where there’s a level of legalization, we tend to see a couple of things follow. We tend to see the acceptability of the behavior go up, so it becomes something that people in general feel like is more acceptable to do. And then, of course, availability. If it’s legalized, there are so many options to, your point, from just online gambling options, that I think we’re all constantly being pushed ads. Whether I’m listening to a political podcast, a news podcast or, like, a health and wellness, I am getting inundated with gambling advertisements right now.

Whether it’s online gambling options, lotteries, fantasy sports leagues, even the gambling that’s happening among college student athletes, I think the advertising and the access there has really opened doors for huge increases in prevalence, particularly among people in their 20s, particularly among men. Gambling has always been something that’s been there, but it looked a little different. People would have to go to a casino or [elsewhere]. It’s just so easy to access, and we really are seeing concerning trends in students who, I would say, meet criteria for pathological or problematic gambling.

Q: You mentioned cannabis earlier. I’m a Washington State native, so I grew up in a state where it was legal, that access element was there for people once they turned of age. And so that’s something, too—I think we’re seeing Gen Z has this familiarity as well with these, with access. It’s online. You can get it on your phone; you can DoorDash alcohol to your dorm. There’s just so many new and different avenues for young people to engage in these behaviors that I think being responsive and timely in how we’re intervening and helping students reflect and consider what it means to engage in these behaviors is becoming a lot more difficult for colleges, universities and others in this space, because it is so immediate and at their fingertips.

A: I think you’ve hit something really important there. Anytime we look at data, we look at something called the Monitoring the Future study out of the University of Michigan, and that gives us a glimpse of particularly substance use among college students, but then also younger students. It’s a great way for us to kind of look at the state of the state with college students, but what might be coming our way on college campuses.

They have long said kind of exactly what you said, which is when there was legalization, it tends to increase that perception that something is safe and it’s acceptable, and we inevitably see increased use. And then it really does become incumbent on colleges and universities to think about, what does it look like to educate, support, intervene, try to help prevent this from becoming problematic in young people’s lives?

Q: Historically, colleges and universities have been a little slower to react when it comes to student health concerns. I’m thinking about suicidal ideation and suicide prevention on campuses that, historically, has been something that colleges would say, “This is a situation where a student needs to remove themselves from higher education.”

That can still be true, but I think now being more in the preventive space and engaging students early is a lot more incumbent on the institution. I wonder if you can just talk about how colleges can be more responsive when it comes to understanding student wellness needs and being proactive and engaging them in those conversations.

A: Not to lean too much on the substance use, because I want to speak to the suicide prevention piece, too. But I think particularly what’s happened in our field, the substance use piece has been kind of around the longest in terms of being the thing that interfered with college students’ [success].

We really are at a point where we actually have decades of research to show what works. There are things we should be doing; there are things we shouldn’t be doing. I think colleges can, and many do, lean on a lot of the framework of what has tended to be effective around addressing high-risk behaviors among college students, looking at the literature about approaches with substance use as a brief example.

When everybody got really concerned in like the late ’80s, early ’90s about drinking on college campuses, everybody felt like we had to do something to help prevent problems. You might see things like colleges would bring in speakers who would tell their addiction story, or maybe they would display a crashed car in the quad, and it was supposed to be sort of a drunk driving situation. What we found is that it would maybe scare people a little bit, students would feel sad from seeing that, but it had zero impact on behavior. It didn’t change any behavior.

We now know there are strategies, there are ways to work with students using evidence-based conversation styles that help them assess what they’re doing and then help move them along the change spectrum to make small changes in their behavior.

For example, suicide prevention, in some ways, the frameworks are similar. There are environmental-level interventions that need to happen; we need to look at things like restricting access to means so that there are things in the environment that would make it really hard for a student get access to doing something to harm themselves.

But we also need to look at individual-level interventions—assessment, brief intervention, access to mental health care. In some ways, the same combo of things is there. And again, I think it can probably feel a little bit overwhelming to some colleges and universities given the long list of things we’ve already talked about, right? But I think we have a great framework, and it’s not reinventing the wheel for every topic—there are threads we can pull out there that really work.

Q: Absolutely. A lot of the research that I’ve read has to do with peer interventions and peer supports. I wonder how we can leverage the student voice and experience to help one another on college campuses, but also just open up that line of communication that this is something that colleges can support and address.

A: I think peer intervention and peer support is a huge piece of the equation. The peer-to-peer delivery of information, we know from the literature, can oftentimes be more relatable. Students can hear it differently when it’s delivered student to student.

It does take some investment of time among campus health and wellness professionals to do adequate training to put students in the right position to be knowledgeable on these topics, but it is a solid and sound strategy that can work.

I think the other benefit is that peers in this role can really become experts in the resources and can be ambassadors for sharing those resources. We still hear from students very often when they’re struggling, they don’t know what’s available to them. They had no idea all the great resources that they could access as they were managing stress, or whatever is going on in their life. I think involving peers not only has the benefit of increasing that education and awareness but really making sure all students on campus know what’s available to them as well.

Q: That’s something we see a lot in national surveys, that students just don’t know what all is on their college campus. I think part of that can be due to the fact that institutions are siloed, and departments exist on different parts of campus, and finding everybody together can be difficult. But some of these topics can also feel very taboo or shameful. I’m thinking gambling or porn addiction or substance use. How are some of the ways that colleges and universities can either address the stigma or just make these conversations more open on campus?

A: There’s a couple of things that I think are happening right now. One is that I think many colleges are doing more to infuse these topics into curriculum.

One of the biggest challenges I had in working with college students on these kind of complicated topics was, honestly, to get them to show up to things outside of the classroom. What we learned was that if there was an opportunity in certain curricula to infuse some of these topics, whether it’s a little bit of education or things that could ideally help a person, let’s say, manage impulses around these topics, mindfulness, coping skills, time management. A little bit of education, in particular on things like substance use, gambling, preventing sexual violence and sexual harassment, making sure students know about resources.

A big initiative has been actually, to get more of this in the classroom, particularly in that transitional first-year seminar type of programming, and that’s gone a really long way. It’s also gotten faculty and staff on board, I think, to be more in the know about what’s going on and be willing to at least listen to what’s going on for students and be ready to refer them to support when they’re struggling.

Q: I also love interventions that happen within required coursework, because we know not every student will show up to co-curricular, but it also means that every student will get this information and that they will have it because they’re passing through those gates of a required course, and they’re engaging with those faculty members who are teaching them. I think it’s a really nice way to make sure that we’re capturing the entire student body without requiring something additional or additive.

A: That’s exactly right.

Q: Sometimes people push back on health and wellness [work] on college campuses, saying that’s not the job of the institution, or that’s not within the bounds of what higher education should be doing. I wonder if you have any thoughts on the value of addressing these topics for young people’s wellness, beyond a retention or persistence model, and why this is something that higher education should care about.

A: I think it’s a great question. And I will say, in my experience, the biggest hook for administrators, presidents, really has been that academic impact piece.

There’s so much data now to show that when there’s untreated mental health problems, when there’s untreated substance use or other behavioral addictions, it leads to poor academic performance, discontinuous enrollment, delayed graduation, failure to graduate.

But some of the newer studies actually show it impacts students far beyond that. Maybe not surprisingly, you see underemployment, lower lifetime earnings. I think there has been a real motivator, not just around, like, “Well, we got to keep our retention numbers up.” But I think when colleges and universities look at the missions of what they’re doing, the people that are there care about college students holistically and want to see them succeed. So I think, to be honest, there’s been really great data in this area to paint a much more comprehensive picture of what it means for a young person when we think about long-term mental health and well-being, certainly being able to persist in college, reach goals, identify employment, make a decent amount of money—like, these are all things I think we can agree on, why we want to support college students.

So I think retention is still a piece of the puzzle, but we’re at a point now that there’s so many more long-term reasons to support the health and wellness strategy that we really are seeing a lot of traction. And it was really just maybe two or three years ago that college presidents identified mental health as their top priority, when we look at surveys. That was unheard-of 10 years ago in the space. Mental health maybe would have been five or six, and it’s now No. 1. So I do think there’s been a bit of a sea change there.

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