By Dr. Amy Glaser
College-bound seniors are 18. This is the age in most states when they are no longer minors and are old enough to serve in the army, sign legal documents, and in some states vote. This is the age when they are old enough to sign consent for their own medical treatment and have the right to confidentiality about their care. So not only are they physically leaving home to enter college, they are taking responsibility for their own physicality, their own health decisions.
I think it comes as a surprise to most parents, who are paying hefty tuitions, that health care services at the college may not release information to anyone without the student’s signed consent. In fact, confidentiality plays an important role in enabling the student to talk openly about problems they might be having. Since 1998, federal law allows universities to notify parents of drug or alcohol abuse for those under 21. College policies vary on this subject and parents can question the institution’s policy that your child will be attending.
So we, as parents and as health providers, need not only prepare our young adults for the academic rigors of college, but we must transition from our supervising their health care to their assuming the responsibility of taking care of their own health issues. In addition to the health counseling about drinking, drug use, safe sex and driving, we must be sure they understand their own daily health issues. In addition to just handing them their medicine they should come to understand during their high school years: why they take various medicines; what are their side effects; what is the correct dosage; how they work; what to do if they don’t work; what are their allergies. In college, this understanding will bring them to the college health service when they need to be there.
The pre-matriculation health exam for college is more than form completion and requisite Hepatitis, and Meningococcal vaccines and tuberculosis screening, it is the symbolic and real transferring to the young adult of the responsibility for his or her own body.
Assuming this responsibility involves both practical and philosophical issues. On the practical side, it is important to recognize that many teenagers may not know which medicine to take for a fever, how to take their temperature, or how to dress a minor wound to reduce the risk of infection. In fact, some of this discussion can take place when preparing a first aid kit to take to college. It may be wise to include a list of contents and instructions on how the contents should be used.
On the philosophical side, no student should leave home without a full understanding of your family’s standards and knowledge about high-risk behaviors in college. As difficult as these topics may be to address, children should hear repeatedly about the risks of unsafe sex, drinking underage, drinking and driving, and drug use. Children may seem to brush off this advice, but they are listening even when they appear not to be. Having frank conversation is healthy for them and can demonstrate that you care. You should leave them knowing the available resources at their respective schools, knowing that you are concerned and that you will be there even if they make mistakes.
Amy Glaser, MD, a mother of two teenagers, has a private adolescent practice at 430 West Broadway, 212-941-1520. She can also be reached at aglasermd@aol.com.
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