Evan Jones's severe anxiety has made it tough to stay in school or hold a job. He's finding new hope in a program at Boston University.

College can be brutal for students with serious mental health conditions. Here, they find support their schools can’t provide

BOSTON — Evan Jones was excited when he signed up for a contemporary art class at community college. Then the professor announced the course would focus heavily on class participation.

“That was the first class that I dropped,” he said.

Jones’s persistent, severe anxiety has shadowed him for years. He’s struggled to pipe up in class and to make friends. His anxiety was so acute, he left high school; after getting his GED, he has bounced around, taking classes at three colleges over the past five years. He blamed himself every time he dropped a class.

“I’ve never really found the right place for me,” he said.

Then he found a program that promised to do what every other school had failed at: support him as a whole person, not just try to push him through credit after credit.

For the past three years, Boston University has offered one of the few programs in the nation dedicated to teaching students who have had to leave college the coping skills that will give them a shot at getting back into school or work while managing severe anxiety, depression, and other serious mental health conditions.

For Jones, 24, who has a sharp mind for technology and a striking openness about his struggles, it was much-needed shot at figuring out a future for himself.

“We were running out of options for him. This is exactly what he needed,” his dad, Jeremy Jones, said.

The semester-long program takes its name from the Latin word niteo: to thrive.

Dori Hutchinson, director of services at Boston University’s Center for Psychiatric Rehabilitation, leads a wellness seminar for the NITEO students. Kayana Szymczak for STAT

Coming to terms with a profound loss

Ten students shuffled in on the first day of classes this September and found a seat around a conference table. They played one of those classic getting-to-know-you games: say your name, your go-to karaoke song, and the last college you attended.

That last question spoke to why they were all here. They’d been enrolled in colleges and universities across the country. And then they weren’t. Some opted for medical leave or were asked by their universities to take time off after a mental health crisis. Others dropped out.

Taking time off from college for mental health problems is a loss. It’s a loss of independence, of routine, of friends, of a place, a purpose, and a clear-cut goal.

NITEO fills that gap. It gives the students a peer group and a place to go three days a week. It gives them assignments, accountability, and a personal coach to cheer them on. It gives them a path forward.

It also gives students an explanation for their absence from campus. It’s not easy to tell friends they’re home for the semester due to a mental health issue. Instead, they can say, “I’m taking classes at Boston University this semester.” And it’s true.

“They’re learning to manage a significant health condition and go to college at the same time,” said Courtney Joly-Lowdermilk, who runs the NITEO program and has worked for more than a decade in mental health and disability services in higher education.

Joly-Lowdermilk is brimming with energy when other people are still rubbing the sleep out of their eyes. One student called her “a giant ball of enthusiasm who cares about everybody.” She keeps an impressive mental Rolodex of every student’s assignments, anxieties, even their weekend plans. She runs the program along with a crew of compassionate coaches and teachers who bend over backwards to meet a student’s needs, whether that’s something as simple as sending them a wake-up text or as deeply personal as crafting a letter recommending that they be reinstated at school.

NITEO also leans on peer mentor interns, who’ve completed the program and come back to give the kind of guidance only another young person can offer.

The program isn’t right for every student, and even those who graduate continue to grapple with challenges at school and work. But the early data on alumni are promising and other colleges are now looking to replicate the program, which charges students $8,500 for the semester. Grants from the Sidney R. Baer Jr. Foundation — Baer himself had schizophrenia — covered tuition for the first four cohorts of students. Now, donations from the families of former NITEO students help cover some of the costs for those who can’t pay.

The need is substantial: More than one-third of incoming college students reported feeling anxious frequently in a survey conducted last year by the University of California, Los Angeles. Another 12 percent said they’d often been depressed in the past year. Many of those students turn to the free or low-cost counseling services on their campuses for help. But colleges have struggled to keep up in recent years as demand has spiked.

“There’s no question. The need for mental health services is increasing dramatically across the board,” said Ben Locke, the director of counseling and psychological services at Penn State University.

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That’s put a strain on many college counseling centers. A STAT investigation earlier this year found that students on many campuses were stranded on weeks-long waitlists for basic counseling services. And many schools offered only a limited amount of care — on some campuses, just two free appointments a year.

Some students end up taking medical leave, if it’s offered. But the time off school — and the transition back — can be incredibly tough. To return to college, students often have to fill out applications, meet with a counselor, and make the case that they’re ready to come back.

The NITEO program is a test run.

“We assign a paper and they feel their anxiety ratcheting up,” said Dori Hutchinson, director of services at the BU Center for Psychiatric Rehabilitation, which houses the NITEO program. “We need to provide a lab for them here to practice those skills.”

“We assign a paper and they feel their anxiety ratcheting up. We need to provide a lab for them here to practice those skills.” Dori Hutchinson, Boston University

Though most don’t count as college credits, every class is an opportunity help students confront their anxieties. An improv session is a chance to practice public presentations and prepare the students for that sickening feeling of being put on the spot by a professor. A lecture about resilience is a chance to practice note-taking.

There’s also a strong emphasis on social connection. Every Friday, the students hang out after class. They’ve gone to the Museum of Fine Arts and Boston Common, carved pumpkins and ice skated. They crushed their coaches in a students vs. staff basketball game, 36 to 24.

This semester’s participants hail from mainly from Massachusetts, though there are students who came from colleges out of state, too. Their interests range from video game design and dance to speech pathology and foreign language. Their mental health challenges range from anxiety and attention disorders to depression and bipolar disorder.

They’re a remarkable peer group — despite their differences, they each know, in a visceral way, what the others are going through. That’s a comfort to students who’ve been singled out at their own schools because of their mental health challenges.

“Everyone’s working on things and everyone’s trying their best to get past those issues,” Jones said. “I don’t feel like I’m the broken one.”

Student D’Amoura Rackard (right) participates in a coaching session with NITEO director Courtney Joly-Lowdermilk. Kayana Szymczak for STAT

‘I just kind of kick-started him’

A cornerstone of the program is personal coaching. Every student gets paired with a staffer who walks them through even minor tasks that can feel overwhelming, from filling out transfer applications to managing homework.

It isn’t your typical once-a-week counseling session. Coaches set up early morning coffee dates with students dealing with depression who have a hard time getting out of bed. They come up with healthier meal plans. They FaceTime about assignments with looming deadlines. They send wake-up texts.

Every Tuesday, Jones and his coach, Paul Cherchia, went on a run.

At the start of the program, Jones had set goals including getting his own physical wellness back on track and finding ways to be productive on Tuesdays and Thursdays, when the program doesn’t meet. So he and Cherchia — who got a graduate degree in psychology while working in admissions at BU — set up a plan to go running on Tuesdays during lunch. They wound through the back streets of Brookline, a neighborhood peppered with beautiful homes set back from the road, talking about what comes next for Jones.

One day, they jogged around the Charles River when a fierce storm rolled in. Wind whipped their faces. They kept running. For Cherchia, it’s a way to make sure that Jones sees him as part of his team — a true mentor — not just an instructor who’s trying to march him through the program.

After months of running with Cherchia, Jones feels comfortable enough to jog solo. He can run two to three miles during lunch and sends Cherchia his “Map My Run” path when he’s done. He’s also started reaching out to other students on his own to ask them to work out with him. That’s a huge step for a young man who for years has been severely anxious about forging friendships.

“I just kind of kick-started him and was there with him for a few weeks,” Cherchia said.

The question of life after NITEO has hung over Jones’s head all semester. So Cherchia came up with a homework assignment: They’d each make a list of all the possible options, then compare notes. They talked about Jones going back to community college and finishing his degree in gaming and computer simulation. He didn’t feel great about that. They talked about him going to a coding bootcamp or getting a part-time job.

Each option came with its own anxieties.

“Everyone’s working on things and everyone’s trying their best to get past those issues. I don’t feel like I’m the broken one.” Evan Jones, NITEO student

The NITEO program has tried to give Jones tools to manage his fears. In one class, he did mock interviews. With another project, PhotoVoice, students learn to capture their challenges — and their hopes — through a camera lens. And in a session of Open Studio, a class that incorporates music, comedy, and art into the idea of wellness, Jones did improv.

For someone with social anxiety, it was a bit of a nightmare. Jones and another student played a game of “Yes, and!” in front of the class. The premise is simple: Two people have a conversation, and every sentence has to start with “yes, and …”

Jones can’t remember what the scenario even was — he remembers only how anxious he felt.

“I was extremely stressed and in my head. It’s a fuzzy haze,” he said. It’s something he said he never would have done before. It wasn’t a massive milestone to him, but it mattered.

“It feels to me like a piece of evidence I can use in the future,” he said. “I can think back on [it] and say, ‘I was able to do that, so maybe I can push myself and do something else.’”

“I wished the administration at school had looked past the outside where things seemed fine and seen that I was in a lot of pain.” NITEO PhotoVoice/Boston University

“I’ve had anxiety as long as I can remember. … I’m filtered through this lens of self-doubt and hate.” NITEO PhotoVoice/Boston University

Facing discrimination that can’t be wiped away

Completing the NITEO program is not a guarantee of a smooth path ahead.

Kerry Ford was part of NITEO’s first cohort in the fall of 2014, after severe depression forced her to take medical leave from Boston University. She found the peer group particularly helpful; it was reassuring to be around people who knew the feeling of being hospitalized for mental health issues.

But after the program, Ford, now 24, began to struggle with alcohol addiction and continued depression. She was hospitalized several times. With support and intensive outpatient therapy, Ford eventually started to ease back into a routine.

She signed up for a single class at State University of New York, Purchase College, in the fall of 2016.

“It was scary and it felt very high-stakes.” Kerry Ford, NITEO graduate, on re-entering college

“It was very scary and it felt very high-stakes,” she said. Ford picked up the pace slowly, and is currently taking three classes. She is set to graduate in the spring of 2018 and has been working at a high school for students in special education. She often thinks of the lessons she learned at NITEO when working with those teens.

“It’s great to be able to put that knowledge to good use in that way, too, and to be a part of anyone else’s journey in the way that NITEO was part of mine,” she said.

NITEO surveys alumni about four months after they graduate and has found that 83 percent are either back in college, working, or both. Students reported having better emotional ties, stronger academic skills, less anxiety and depression, and a healthy amount of hopefulness. And the coaches remain available to help graduates after the program ends.

NITEO has its limits, though. It can give students much-needed support — but it can’t wipe away the discrimination they may encounter when they leave.

Amanda, a NITEO student who asked to be identified by a pseudonym, was in the fall semester of her sophomore year when she was diagnosed with bipolar disorder in 2016. She also experiences depression and while at school, experienced a manic episode brought on by antidepressants.

Last fall, Amanda had to leave school. She withdrew from all her classes. She had to leave her internship. She moved out of the apartment she shared with friends. The abrupt departure from college was particularly tough for her because her strength at academics has always been an essential part of her identity.

Suddenly, her diagnosis became core to her identity, too.

Amanda, now 21, spent a year getting treatment and trying to find medication that would help. A social worker in a hospital where she was receiving treatment recommended NITEO. For her, it was the right next step.

“It was about knowing that I was in a place where I was healthy enough to focus on school and not swing too high or too low,” she said.

Halfway through the semester, she started working on transfer applications for two colleges. The essay prompt: describe your reasons for transferring. In her mind, there was only one answer.

“When you’ve had to leave school for something that has as much stigma as leaving for mental health issues, it’s hard to think up another reason for leaving,” she said. “It’s like getting hit by a truck.”

But when she showed her draft to some of the NITEO staff, they suggested she avoid delving too far into the details of her mental health crisis. An admissions office wouldn’t necessarily know what to do with that kind of information. Amanda tweaked her essay so it more generically described the challenges of that semester.

It was a tough edit to make. She’d worked hard to understand the destructive role that shame had played in her own mental health. Now, she felt she had to gloss over her story because the truth could hurt her chances of going back to college.

The program can’t do anything about that.

Students take classes that aim to build their confidence and help them prepare to return to school or find work. Kayana Szymczak for STAT

Making it through one shift, and then another

Jones’s anxiety has made it difficult for him to get through an interview or hang onto a job. He’s had to leave two jobs in the first few hours. So the idea of giving work another go scared him. But in December, with the encouragement of his coach at NITEO, he started a part-time job at a local bookstore.

He couldn’t sleep the nights leading up to that first day of work. He was overwhelmed with apprehension.

“I was feeling really bad about it, whether I could do it at all,” he said.

He turned to the NITEO staff for some help managing that anxiety. They shot him texts throughout his first shift, encouraging him and checking in to see how he was doing.

He called his dad when he made it through the first day — and the second.

“I am thrilled for him. That alone is a huge step,” his dad said. Jones still feels anxious about his upcoming shifts. But each shift that passes, each interview he does, each application he sends off, is another piece of evidence.

“I am still extremely nervous. But I know I can do it,” he said.

Amanda got her own good news right after Thanksgiving: She’d scored a place as a transfer student at her first-choice school. She starts classes in January.

“I feel like my life is coming together again,” she said in an email to STAT.

“I feel like my life is coming together again.” Amanda, NITEO student

Another six students were also accepted back to school. Two more decided their next step would be part-time classes and work. One student will return to Boston University next semester to spend more time at the center prepping for college classes. And Jones was working at the bookstore.

But they had all made it through the NITEO program. And last week, with their families and coaches cheering, they graduated.

Parents who came to the ceremony saw a highlight reel from that student-vs.-staff basketball game. And they saw the support system that had cushioned their children all semester.

One at a time, each coach shared a story about working with a particular student. One called out young woman’s leadership potential. Another praised a student for making all his peers feel at home in the program.

Jones’s coach praised him for having pushed himself beyond what he thought was possible: He had showed up to nearly every single social event.

After the graduation, Jones headed home. He’ll be back at the bookstore this week.

And he just learned that he’s been selected as a peer mentor for the NITEO program. He’ll start advising other students in the spring.