Welcome to our new section, Thrive on Campus, devoted to covering the urgent issue of mental health among college and university students from all angles. If you are a college student, we invite you to apply to be an Editor-at-Large, or to simply contribute (please tag your pieces ThriveOnCampus.) We welcome faculty, clinicians and graduates to contribute as well. Read more here.
I became interested in college student mental health about 10 years ago when I was doing my master’s at Harvard and serving as a first-year residential proctor. As a live-in advisor to a group of 30 freshmen at Harvard, I saw first-hand how pervasive mental health problems were on campus, and the degree to which mental health affected so many other facets of my students’ lives. Inspired by this lived experience at Harvard, I then went on to do a joint Ph.D. in public health and higher education at University of Michigan, where I focused on understanding and addressing mental health needs in college populations, and opportunities for prevention and intervention. Now as a faculty member at Boston University, my work continues to focus on campus mental health and data from the Healthy Minds Study, which I lead with my colleague, Daniel Eisenberg, at University of Michigan.
The Healthy Minds Study is an annual survey study, conducted each semester at campuses across the country. The motivation behind the study is to collect the most comprehensive national data on mental health, help-seeking, and related factors in college populations — and to disseminate this research in a way that can inform practice and policy for adolescent and young adult mental health. Many campuses that participate in the Healthy Minds Study do so as a needs assessment in order to understand the prevalence of mental health symptoms among their students, rates of help-seeking, and risk factors for mental health. They then use these data to inform their work on campus.
Our most recent study provides empirical evidence to support a trend that many, particularly mental health practitioners on campus, have been observing anecdotally for years: that more and more college students are seeking help for their mental health. My research team and I have been collecting annual, population-level survey data through our Healthy Minds Study, and this paper is the first time that we have combined all years of data (2007-2017) to examine patterns in college students’ use of mental health counseling/therapy, psychotropic mediation, and lifetime diagnoses. Our data are drawn from nearly 200 campuses and include over 150,000 students. We've found the following:
As a mental health services researcher, I have two reactions to this, one is a (mostly) celebratory tale and one is a cautionary tale: The singular problem that I have been dedicated to addressing through my research and dissemination is the “mental health treatment gap,” the proportion of adolescents and young adults with clinically significant symptoms who are not receiving mental health services. The celebratory tale is that the treatment gap is narrowing (though it is still wide, especially for young people of color and others from traditionally marginalized groups); much of my work these days is around understanding and addressing the mental health needs of college students of color, in fact, and issues around belonging, identity, and inclusivity.
The cautionary tale, at a system-level, is that much of the “burden” of students seeking help is falling to college counseling centers. In our national study, counseling centers were the most common place for students to receive services, and it is important to recognize that many counseling centers across the country (like the mental healthcare system in this country writ large), are under-resourced and operate at full capacity with waitlists for much of the year. In the paper, my colleagues and I discuss opportunities to alleviate this strain through digital mental health programs, which offer the possibility of expanded treatment accessibility while circumventing barriers to traditional treatment, such as time and convenience.
We also explored changes in symptoms of depression and suicidal ideation as well as levels of stigma as potential explanatory factors for increased service use. The findings indicate that mental health continues to be a growing concern on campuses across the country, with higher rates of symptoms year-to-year. We also find, however, that stigma has decreased and that attitudes towards mental health and services are improving, which is a reflection of a broader social shift regarding mental health and the way we talk about this important topic. The state of mental health on campus is complicated and multifaceted, particularly when we think about disparities by race, gender identity, sexual orientation, and other student identities; simply put, an increasing number of students are experiencing depression, anxiety, eating disorders, and reporting suicidal ideation, but more and more students in need are seeking help.
College campuses need to think critically about how they are investing in student mental health and well-being and how this compares to other investments. In previous publications, our Healthy Minds team has documented a strong relationship between mental health and academic performance. For example, we have found that college students with depression are more than twice as likely to drop out of college. I also think mental health needs to be part of broader conversations around student retention, particularly given that marginalized students are faring worse in both mental health and graduation rates. And college presidents have an important role to play in guiding this conversation.
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