As college students around the country returned to campus this fall, the start of the semester came with an ongoing set of challenges during a pandemic, including academic stress, lack of social and emotional support, and moving to a new place, all of which affects students’ mental health.       

But some students haven’t been on campus since the COVID-19 pandemic shut down universities across the region and the country in March 2020 and find themselves returning to campuses still lacking the resources necessary to support students during a challenging time.                                          

As of the beginning of October, a little over 55 percent of the country has been fully vaccinated, a number that has remained relatively stagnant over the last few months. Yet, many rural parts of Appalachia are experiencing some of the highest COVID infection and hospitalization rates they’ve seen so far as the delta variant, a more contagious form of the virus, spreads rapidly.      

Amid this troubling trend, many universities dusted out their dorms and college towns threw open their doors to welcome returning students this summer. Many students felt ready to return to campus but were wary of additional mental and physical health concerns. In addition, mask mandates, social emotional support, and modifications to campus life vary by school, leaving college students in Appalachia to navigate chaotic conditions that impact how they feel day-to-day. 

“Having to be in these closed environments with a lot of people is very strange after like 18 months of not doing it,” said Bo Kuhn, a senior journalism major at Ohio University. “It does feel nice to be back in the old routine of how things used to be, but at the same time, it’s a very different world now, so it comes with new anxieties.”

Kuhn has already had COVID-19 twice, which has had long term effects on his health. “Getting it a third time is very scary to me,” he said.

Ohio University and the city of Athens, where the school is located, have mandated masks indoors, and the university has required all students, faculty and staff to be fully vaccinated by November 15.

For some, there’s a certain amount of risk that they’re willing to take. Makaylia Ray, a junior communication sciences and disorders major at Appalachian State University in Boone, North Carolina, said that she is okay with attending classes, especially because her university has a      mask mandate, but large gatherings are a different story. She said that she went to a Luke Combs concert held by Appalachian State in the beginning of September that was attended by 30,000-40,000 people and immediately went to get tested afterward.

“I wished I wasn’t there,” she said. “And the more people kept walking in, the more I wanted to leave. No one was wearing a mask, and everyone was shoulder to shoulder.”

Fear of catching coronavirus and stress related to the pandemic is even more significant for students whose schools don’t have mandated safety measures. The University of Georgia, in Athens, Georgia, does not require masks, social distancing, or vaccines to attend in-person classes and events, although it “strongly encourages” vaccination and masking.

Kate Foral, a fourth-year student working towards a dual bachelor’s and master’s degree in public health at UG, described normal activities like taking on-campus buses as frustrating and stressful. She said buses get crowded between classes, with students packed “like sardines, shoulder-to-shoulder,” and few people wear masks. It’s the time of year where everyone is sick, anyway, Foral says, even if it isn’t COVID. “Even though I’m wearing a mask, I know it can only do so much. I know I’m going to get sick of something, whether it’s COVID or not,” she said.

Isabella Killius, a senior studying sociology at the University of Tennessee Knoxville, said that between classes, there are “hordes of people outside” who take off their masks immediately after leaving a building.

 “Right now, it just doesn’t feel like I have autonomy in what’s going on,” she said. “I can’t control how people live their lives and whether they’re vaccinated.”

Killius said the University of Tennessee Knoxville has a lack of available mental health resources for students as well.

“We have the Student Counseling Center, which is good because paying for therapy or counseling without insurance can be very expensive, so a lot of people turn to the university. But that’s not helpful if it’s booked up for weeks or months,” she said. “When you actually try to access these resources, it’s really difficult.”

Mental health resources in Appalachia are often scarce, especially in rural areas and areas with other health professional shortages, said Stephanie Maccombs-Hunter, a staff counselor at Ohio University.

Of the students who sought mental health services at Ohio University during the 2020-21 school year, 35 percent said they were seeking services “due to stress related to the pandemic,” according to Paul Castelino, the director of Counseling and Psychological Services at OU. Most who were seeking support for other reasons reported that they had been negatively impacted by the pandemic. The impacts could range from increased academic stress, loneliness, loss of motivation and concerns about future careers. 

Maccombs-Hunter noted that the lack of access to mental health care services “undoubtedly” impacted students’ mental health during the pandemic, but access to telehealth services has actually increased. “This shift in service delivery has opened doors for many people to engage in services who otherwise would or could not have.” 

But Kuhn feels that students at OU are not being given enough universal support, which ends in “a lot of students having to fill in the gaps for themselves with physical and mental health.”

Appalachian State student Makaylia Ray said that one of her biggest concerns for this school year is that Appalachian State University will send students home again, and that in addition to the anxiety she was already feeling at the beginning of the new school year, she is left with a lot of what-ifs. 

“What if we get sent home again? As an [resident assistant], I don’t get paid if the school shuts down, so how will I pay my bills? What happens if I get COVID?” she said. 

Despite the common feelings of stress, for students who are able to do so safely, some mental health experts are recommending a slow and measured return to in-person activities, which could help with some of the issues of loneliness and lack of motivation caused by the pandemic.

“It’s important that each student finds something outside of class and work to feel a sense of connectedness,” Mental Health Support Coordinator Paige Klatt at Ohio University said. “We each come with different levels of comfortability, and we deserve to give ourselves some grace during this transition.”

Kurt Michael, a psychology professor at Appalachian State University, said that navigating fears of the pandemic can be difficult, but he advised students to think about the level of risk that they’re comfortable with.“First, get vaccinated,” he said. “Don’t take unnecessary or super dangerous risks, but to the extent to which it’s feasible and that you can move back into more in-person living, we should probably all try to do that.”

Joining a student group, intentionally socializing with family, friends and colleagues, getting outside and exercising are all recommended by mental health counselors to help with some of the stress and anxiety for students on college campuses.

While many campuses in Appalachia have worked to increase access to mental health resources and are encouraging students to get back out there in order to cope, for some, it isn’t enough. 

“The only way to reduce the stress that all of us feel is to mandate vaccines, mandate masks, or allow professors to accommodate us through different teaching formats,” Foral said. “Do something that’s actually going to protect our health instead of just putting a little Band Aid on the problem by offering us mental health services. You can fix the source of the problem so easily.” 

Morgan Spehar is a senior studying journalism and environmental studies at Ohio University. Her work covers science, research, health, and technology, and she has previously written for The Athens Effect and Health online. 

This story is part of our Appalachian Youth Creators vertical. Support the work of young people across the region and help pay them for their writing under by donating here.

Creative Commons License

This article was originally published by 100 Days in Appalachia, a nonprofit, collaborative newsroom telling the complex stories of the region that deserve to be heard. Sign up for their weekly newsletter here.