Within a week of arriving on campus this semester, University of Maryland junior Grace Freund felt the familiar symptoms of a depression creeping up — ones she knew to address quickly, lest they slip from her control.
The 21-year-old psychology major called the counseling center on the College Park campus soon after to set up an appointment. However, she said, her request was rebuffed.
"They said, 'Call back next week. We can't even schedule an intake appointment today,'" said Freund, a graduate of Mount Hebron High School in Ellicott City.
Across the state and nation, college students — an age group particularly prone to mental illness — report similar frustration. Campus counseling centers often have insufficient staff and long waiting lists, mental health professionals say. In Maryland, counseling center directors say they are nearly overwhelmed with the ballooning numbers of students requesting services.
Last month, a graduate student at the University of Maryland shot and killed one housemate and wounded another before turning the gun on himself, police say. The family of Dayvon Green told police that he had been treated for a mental illness in the previous year.
Hours after the shooting, Maryland President Wallace D. Loh said the university had increased mental health resources in recent years to address the needs of troubled students.
But students and others at College Park paint a different picture — one of poor access to help and few resources at their fingertips — that appears to be more in line with national trends.
Ninety-two percent of campus counseling centers surveyed last year said the number of students seeking help had increased in recent years, according to the American College Counseling Association. Eighty-eight percent said the increases in demand and in the number of clients with "more serious psychological problems" had "posed staffing problems."
Reasons for increases in demand vary, according to professionals. Awareness of mental health on campuses has grown in recent years. Centers have advertised their services more heavily since campus shootings by troubled students at Virginia Tech and elsewhere.
And more students are also showing up to college already on psychiatric medications.
"In general, there's a little bit of a sea change going on right now in recognizing that overall success in college has a lot to do with a student's mental health and well-being," said Alison Malmon, founder and executive director of Active Minds, a mental health nonprofit that works on college campuses. "But there's not additional money going to mental health on campuses."
At a campus vigil after the shooting at Maryland, Loh followed his comments about increasing resources on campus by saying the shooting presented "lessons to be learned, policy questions to be discussed, changes to be made."
The university has employed part-time, contract counselors in recent years, and had posted a job opening for a new staff psychologist a few weeks before the shooting.
But that position hadn't yet been filled when Loh spoke, and the posting followed years in which full-time staffing at the campus counseling center remained flat.
The number of students seeking help at the counseling center for stress, depression, anxiety or other mental health problems rose from 1,466 during the 2007-2008 school year to 1,986 last year — a 35 percent jump.
During the same period, the number of full-time counselors remained steady at 12.
"One of the things that we're working on is increasing our staffing," said center director Sharon Kirkland-Gordon. "Of course, we have an economy where there were no hires, there were job freezes."
Kirkland-Gordon said students who call or show up at the center with a health emergency can be seen within hours. Others often have to wait up to two weeks for an initial assessment.
The Baltimore Sun asked a spokeswoman for Loh about the apparent contrast between his statement that the university had "significantly increased" its counseling staff and the fact that the full-time staffing had remained flat over several years.
"We continue to assess and meet the needs of our students requiring mental health services," spokeswoman Crystal Brown responded in an e-mail. "We are currently conducting a search to add an additional staff psychologist at the center, which is a direct response to the increased demand we are seeing."
Similar staffing limits challenge campus counseling centers elsewhere in Maryland.
Staffing levels at Towson have remained steady, said Jaime Fenton, director of clinical services at the university's counseling center, with nine psychologists supported by doctoral interns and part-time psychiatrists.
The number of students receiving services has jumped, she said, but not nearly as much as it would if staffing levels weren't limiting the number of appointments that can be scheduled.
"We are doing our best to do more with less to meet the needs of our students," Fenton said.
Smaller campuses are seeing similar jumps in demand.
Donelda Cook, director of the counseling center at Loyola University Maryland, said her center has seen a 30 percent increase in student requests for counseling this fall compared with last.
Insufficient staffing "makes the work more frustrating, clearly," Cook said. She said online counseling software aimed at giving today's plugged-in students more options has been used nearly 2,700 times since November 2011.
There is no waiting list at the Johns Hopkins University, which has increased staffing and recently opened a new counseling center. But it can still take up to two weeks for a student to be seen, director Michael Mond said.
That's in part because students have their own scheduling conflicts. Increasing demand at the Homewood campus is also a factor.
Officials at Morgan State University did not provide the exact number of students seen at the campus counseling center per year, but center director Nina Hopkins said the number has risen in the past five years. Between 350 and 550 students have been seen each of the last five years, out of about 6,000 students enrolled, she said.
Center directors throughout the region say students who need emergency counseling can get it right away, regardless of waiting lists.
But students tend to downplay their symptoms, students and mental health professionals say, and won't always describe their needs as urgent, even if they are.
Students say they wish more attention were paid to the struggles thousands of their peers deal with on a regular basis.
Freund said the status quo is discouraging.
"It seems often the only way you can get help is if you have this very extreme situation," she said. "But mental health issues are so common and everyday, and it's frustrating that it's not treated as such."
The problem, Maryland sophomore Selena Roper said, is that the most common mental health struggles that students have are "insidiously boring" — and so don't attract the attention they deserve.
"It's not like you're sitting in the bathroom crying with dramatic music playing and your friends banging on the door saying, 'We want to help you!'" said Roper, 19, who has battled depression since she was a student at Broadneck High School in Annapolis. "It's more laying in bed watching Netflix all day."
Malmon, of Active Minds, said universities and colleges "like to come in after the fact when there's been a tragic incident and talk about how to prevent that tragic incident, but these are issues that impact many more people."
"If we did more on the early side, we wouldn't have to get to that tragic situation," she said.
Richard Kadison, co-author of the 2005 book "College of the Overwhelmed," said colleges are talking about student mental health — from discussions about their legal ability to remove troublesome students from campus to asking whether investments in mental health services will also improve their bottom lines.
Kadison, a former chief of mental health services at Harvard, said studies show that greater investment in mental health services leads to higher retention and graduation rates.
Much of it still seems like lip service to Maryland junior Madison Higgins, who leads a student-run hot line for students in crisis.
Higgins, who has suffered from an anxiety disorder since she was a child, said the HELP Center has been rejected in the past for funding from the Office of Student Affairs.
The group applied recently for emergency funding from the Student Government Association to pay its phone bills — about $2,400 a year — after its initial budget was slashed. A request for advertising dollars was denied entirely.
After the shootings last month, Maryland's Student Government Association gave the HELP Center $1,500 so the center could increase its advertising.
Center members said they appreciated the money, but added that its timing was typical of how mental health issues are addressed on campus.
"We are putting so much effort into this, and we are asking for phone bill money, and it's so hard to get it," Roper said. "Until someone dies."
By the numbers
The number of students requesting psychological, emotional and personal counseling at a sampling of university and college counseling centers in Maryland:
University of Maryland, College Park (Total enrollment: 37,631)
Loyola University Maryland (Total enrollment: 5,978)
Towson University (Total enrollment: 21,960)
Johns Hopkins University (Total enrollment: 7,047)