Voices of students in crisis : a two-part exploratory study of college students hospitalized for psychiatric distress

College students with psychiatric disabilities, particularly those with severe distress, have an increased risk of attrition from higher education. Highly distressed students may be hospitalized for psychiatric crises if there is potential risk to their safety. Although the severity of pathology in incoming college students has increased over the last decade, hospitalized students remain an under-researched group at risk for attrition, trauma, suicide, and disconnection with their universities. The present study sought to explore the characteristics and experiences of hospitalization college students at the University of Texas at Austin through a lens of student retention theory, Self-Determination Theory, emerging adulthood, and institutional betrayal. The study purpose was addressed in three ways: (1) Fisher’s test comparisons of demographic and variables in the hospitalization sample compared to a 5-year average of the entire student body; (2) cross-tabulations and chi-square tests of independence of demographic, academic, and clinical variables and hospital admission status (voluntary or involuntary); and (3) qualitative interviews about students’ experiences with psychological services prior to hospitalization, the hospitalization process, the hospitalization itself, and post discharge. The quantitative portion included a total of 880 students hospitalized between Spring 2016 and Spring 2021. The qualitative portion included semi-structured interviews with 10 current or former students who had been hospitalized between Fall 2017 and Spring 2021. Data was analyzed using a content analysis approach. Results showed several groups of students who may be at risk for psychiatric hospitalization, including African American/Black, Asian/Asian-American, and multiracial students; female, transgender, and LGBQ+ students; undergraduates as a whole and sophomores; and Liberal Arts, Fine Arts, and Undergraduate Studies majors. Interview participants had complex and nuanced experiences with hospitalization. Themes included neutral experiences with psychological services pre-hospitalization, trust/distrust, powerlessness, interpersonal connections, uncertainty, negative perceptions of the university, academic supports, and shifts in perspective. Future clinical and research implications are discussed.