By Stephen Mateka, DO

The idea of going to college for both teenagers and caregivers tends to include some combination of excitement and anxiety, with newly found autonomy and independence being the driving factor for these feelings. Teenagers are experts at underestimating the difference between the idea of something and the reality of it. They are old enough and have enough sense of self to form a semi-informed opinion, yet lack adequate life experience or brain maturity to realize their opinion is only semi-informed. This is primarily no fault of their own. Their brain is biologically driven to take risks and the portion of the brain responsible for tasks such as planning/prioritization, self-restraint, organization, time management, defining/achieving goals, and stress tolerance is not fully formed until the age of 25. In addition, it is developmentally appropriate to seek an identity at their stage of life and will appropriately include an approach of guessing, testing, and revising. This makes transitioning to college a truly formative experience. Some efforts can be taken to make it more likely that it is a positive experience.

Most importantly, if the teen has a mental health history, they must be familiar with how to access student health services and awareness of available on and off-campus behavioral health resources. Ideally, they would be aware of this information before the first day of classes. This is an appropriate time to encourage the start of accepting their own healthcare management. Also, be sure to acquire any information needed for educational accommodations and what that includes. It is encouraged to involve any current providers to help navigate this transition.

Once there is a confident approach to addressing mental and medical health needs, it is appropriate to shift the focus towards efforts to close the gap between the teenager’s idea of going to college and the reality of it. Pertinent topics to discuss include setting realistic expectations around academic workload and the skills required to balance that demand with a social life in the face of more work with less structure. Starting with basic foundational building blocks of healthy sleep and eating habits, as well as physical activity will set them up to handle bigger challenges. They will also need guidance on addressing the more independent activities of daily life such as money management, errands, chores, and transportation in a new area.

The impending exposure to greater independence that teenagers typically crave at that age comes with not only the freedom to do what they want to do but also what they must do to successfully and safely complete the college experience. It is widely understood that college is associated with a time of increased exposure to such things as drugs, alcohol, dating, and sex. Do not bury your head in the sand about this reality, and instead create the space to have an open and judgment-free conversation with the young adult about their perspectives on these topics and how they intend to handle them. Then seek to address the academic portion which highlights the responsibility of knowing their class schedule, deadlines, study materials, balancing educational with recreational screen time, and the potential consequences that come with their increased autonomy.

Transitioning to college brings about many emotions for both the student and the caregiver. It drives home the fact that we cannot make these young adults do anything. The best chance they have to be reasonable, logical, and safe decision-makers with their increased autonomy is to clearly and realistically establish goals, undesired consequences, and most likely decision-making that will lead them towards what they want and avoid what they do not. I encourage you to give them grace as mistakes are inevitable. Hold them accountable when required, celebrate them when earned, support them when needed, and allow them the opportunity to realize what comes with all of that new freedom. It’s all part of the experience.

Author Profile:

Steven Mateka, DO
President, New Jersey Psychiatric Association (May 2023-May 2025)
Board-Certified General and Child & Adolescent Psychiatrist