Skip to main content

Advertisement

SpringerLink
Log in

Be True to Our Schools—Models of Care in College Mental Health

  • Complex Medical-Psychiatric Issues (MB Riba, Section Editor)
  • Published:
Current Psychiatry Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To review and synthesize the previous, current, and proposed models of care in college mental health in order to identify best practices that will address the mental health needs of today’s students. To highlight data that supports existing or proposed models and describe areas where more data is needed.

Recent Findings

Despite the potentially appealing attributes of integrated care, empirical evidence supporting these systems and structures in campus settings is mixed. Recent surveys show less than half of campuses have an integrated mental health care model. Overall, there is only partial consensus on optimal models of campus mental health care.

Summary

Mental health needs in college student populations are greater and more complex than ever. While the resources available are vast and varied, there is limited evidence to support which models and programs can best meet students’ needs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Hussar WJ, Bailey TM. Projections of Education Statistics to 2022 (NCES 2014-051). U.S. Department of Education, National Center for Education Statistics. Washington, DC: U.S. Government Printing Office; 2013.

    Google Scholar 

  2. Choy, S. Access and persistence: findings from 10 years of longitudinal research on students. Educational Resources Information Center (ERIC) Digest. Washington, DC: American Council on Education, 2002.

  3. Raghavan R. Improving the identification of mental health need on college campuses. J Adolesc Health. 2014;55:598–9. https://doi.org/10.1016/j.jadohealth.2014.08.007.

    Article  PubMed  Google Scholar 

  4. Blanco C, Okuda M, Wright C, Hasin DS, Grant BF, Liu SM, et al. Mental health of college students and their non-college-attending peers: results from the National Epidemiologic Study on Alcohol and Related Conditions. Arch Gen Psychiatry. 2008;65:1429–37. https://doi.org/10.1001/archpsyc.65.12.1429.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Eisenberg D, Hunt J, Speer N, Zivin K. Mental health service utilization among college students in the United States. J Nerv Ment Disord. 2011;199:301–8. https://doi.org/10.1097/NMD.0b013e3182175123.

    Article  Google Scholar 

  6. • Turner JC, Keller A. College health surveillance network: epidemiology and health care utilization of college students at US 4-year universities. J Am Coll Heal. 2015;63:530–8. https://doi.org/10.1080/07448481.2015.1055567. Data from over 800,000 college students show trends in utilization and the importance of primary can behavioral health care services on campuses.

    Article  Google Scholar 

  7. Perou R, Bitsko RH, Blumberg SJ, et al. Mental health surveillance among children—United States, 2005-2011. Morb Mortal Wkly Rep (MMWR) Surveill Summ. 2013;62(2):1–35.

    Google Scholar 

  8. • Olfson M, Blanco C, Wang S, Laje G, Correll CU. National trends in the mental health care of children, adolescents, and adults by office-based physicians. JAMA Psychiatry. 2014;71:81–90. https://doi.org/10.1001/jamapsychiatry.2013.3074. Examines over 440,000 national ambulatory medical care surveys and finds that by 2010, visits resulting in a mental disorder diagnosis increased significantly faster for youths as compared to adults.

    Article  PubMed  Google Scholar 

  9. Jennings KS, Cheung JH, Britt TW, Goguen KN, Jeffirs SM, Peasley AL, et al. How are perceived stigma, self-stigma, and self-reliance related to treatment-seeking? A three-path model. Psychiatr Rehabil J. 2015;38:109–16. https://doi.org/10.1037/prj0000138.

    Article  PubMed  Google Scholar 

  10. • Sontag-Padilla L, Woodbridge MW, Mendelsohn J, D’Amico EJ, Osilla KC, Jaycox LH, et al. Factors affecting mental health service utilization among California public college and university students. Psychiatr Serv. 2016;67:890–7. https://doi.org/10.1176/appi.ps.201500307. Online survey data for over 33,000 students and 14,000 staff are compiled and reveal that more campus-based clinics are needed.

    Article  PubMed  Google Scholar 

  11. • Downs NS, Alderman T, Schneiber K, Swerdlow NR. Treat and teach our students well: college mental health and collaborative campus communities. Psychiatr Serv. 2016;67:957–63. https://doi.org/10.1176/appi.ps.201500465. This selective review provides best practices for the psychiatric treatment of college student populations.

    Article  PubMed  Google Scholar 

  12. Kraft DP. One hundred years of college mental health. J Am Coll Heal. 2011;59(6):477–81. https://doi.org/10.1080/07448481.2011.569964.

    Article  Google Scholar 

  13. Barreira P, Snider M. History of college counseling and mental health services and role of the community mental health model. In: Kay J, Schwartz V, editors. Mental Health Care in the College Community. West Sussex: Jonn Wiley & Sons, Ltd; 2010. p. 21–31. https://doi.org/10.1002/9780470686836.ch2.

    Chapter  Google Scholar 

  14. Reetz et al. The Association for University and College Counseling Center Directors Annual.Survey. Reporting period: September 1, 2015 through August 31, 2016: 1–118

  15. Considerations for Integration of Counseling and Health Services on College and University Campuses. J Am Coll Heal 2010: 58; 583–596. DOI: https://doi.org/10.1080/07448481.2010.482436.

  16. • Francis PC, Horn AS. Counseling services and student success. Midwestern Higher Education Compact Research Brief. 2016:1–22. The findings of multiple national surveys are reviewed to estimate the prevalence of mental illness, describe prevention and treatment programs, investigate improvements in academic performance associated with counseling and improve the effectiveness of counseling services on-campus.

  17. Chaudhary A, Salinas E. The college mental health caucus survey. APA Annual meeting 2011. http://www.mhec.org/sites/mhec.org/files/201602counseling_services.pdf

  18. Wyman PA, Inman J, Guo J, Brown CH, Cross W, Schmeelk-Cone K, et al. Randomized trial of a gatekeeper program for suicide prevention: 1-year impact on secondary school staff. J Consult Clin Psychol. 2008;76(1):104–15.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Sokolow BA, Lewis WS. Second Generation Behavioral Intervention Best Practices: NCHERM White Paper 2009: 2–13. DOI: https://doi.org/10.1037/0022-006X.76.1.104, 76.

  20. Morrill WH, Oetting ER, Hurst JC. Dimensions of counselor functioning. Journal of Counseling & Development. 1974;52(6):354–9. https://doi.org/10.1002/j.2164-4918.1974.tb04041.x.

    Article  Google Scholar 

  21. Pace D, Stamler V, Yarris E, et al. Rounding out the cube: evolution to a global model for counseling centers. Journal of Counseling & Development. 1996;74(4):321–5. https://doi.org/10.1002/j.1556-6676.1996.tb01874.x.

    Article  Google Scholar 

  22. Blau GM, Caldwell B, Fisher SK, Kuppinger A, Levison-Johnson J, Lieberman R. The building bridges initiative: residential and community-based providers, families, and youth coming together to improve outcomes. Child Welfare. 2010;89(2):21–38.

    PubMed  Google Scholar 

  23. College Mental Health Program Retrieved November 17, 2017, from http://www.mcleanhospital.org/programs/college-mental-health-program

  24. Atkins MS, Frazier SL. Expanding the toolkit or changing the paradigm: are we ready for a public health approach to mental health? Perspect Psychol Sci. 2011;6(5):483–7. https://doi.org/10.1177/1745691611416996.

    Article  PubMed  Google Scholar 

  25. National College Depression Partnership. Retrieved November 17, 2017, from https://collegehealthqi.nyu.edu/ncdp/

  26. The Jed Foundation and EDC. (2011) Retrieved November 17, 2017, from https://www.jedfoundation.org/wp-content/uploads/2016/07/campus-mental-health-action-planning-jed-guide.pdf

  27. Home - Set to Go: A JED ProgramSet to Go: A JED Program. Retrieved November 17, 2017, from https://www.settogo.org/

  28. Home Page JED Campus. Retrieved November 17, 2017, from https://www.jedcampus.org/

  29. The Healthy Minds Study. Retrieved November 17, 2017, from http://healthymindsnetwork.org/research/hms

  30. Equal Chance at Mental Health Framework Retrieved November 17, 2017, from http://www.stevefund.org/mental-health-framework/

  31. McAleavey AA, Youn, S, Xiao H, et al. Evaluating routine practice and evaluating the methods of evaluation: How effective are routine practices for different symptom types, and what can different methods tell us? Paper presented as part of a panel at the conference of the North American Society for Psychotherapy Research (NASPR), Memphis, TN. 2013.

  32. Eisenberg, D, Golberstein, E, Hunt J. Mental health and academic success in college. BE Journal of Economic Analysis & Policy 2009: 9(1) (Contributions): Article 40.

  33. Wilson SB, Mason TW, Ewing MJ. Evaluating the impact of receiving university-based counseling services on student retention. J Couns Psychol. 1997;44:316–20.

    Article  Google Scholar 

  34. Minami T, Davies DR, Tierney SC, Bettmann JE, McAward SM, Averill LA, et al. Preliminary evidence on the effectiveness of psychological treatments delivered at a university counseling center. J Couns Psychol. 2009;56:309–20. https://doi.org/10.1037/a0015398.

    Article  Google Scholar 

  35. Snell MN, Mallinckrodt B, Hill RD, Lambert MJ. Predicting counseling center clients’ response to counseling: a 1-year follow-up. J Couns Psychol. 2001;48:463–73. https://doi.org/10.1037//0022-0167.48.4.463.

    Article  Google Scholar 

  36. Lockard AJ, Hayes JA, Graceffo JM, Locke BD. Effective counseling for racial/ethnic minority clients: examining changes using a practice research network. J Coll Couns. 2013;16(3):243–57. https://doi.org/10.1002/j.2161-1882.2013.00040.x.

    Article  Google Scholar 

  37. • Locke BD, Bieschke KJ, Castonguay LG, Hayes JA. The Center for Collegiate Mental Health: Studying college student mental health through an innovative research infrastructure that brings science and practice together. Harvard Review of Psychiatry. 2012;20(4):233–45. https://doi.org/10.3109/10673229.2012.712837. This review examined 10 studies focused on college student mental health using data collected from multisite counseling center clients or staff. These studies suggest that students’ presenting concerns are changing, that students who identify as ethnic minorities experience slightly more distress than their white counterparts, and that matching students and counselors relative to ethnicity does not improve outcomes. The authors discuss the importance of establishing an infrastructure that helps researchers elucidate trends, effective treatments, and risk factors that will be useful to clinicians treating this population.

    Article  PubMed  Google Scholar 

  38. American College Health Association. Considerations for integration of counseling and health services on college and university campuses. J Am Coll Heal. 2010;58:583–96. https://doi.org/10.1080/07448481.2010.482436.

    Article  Google Scholar 

  39. • Brunner JL, Wallace DL, Reymann LS, Sellers JJ, McCabe AG. College counseling today: contemporary students and how counseling centers meet their needs. J Coll Stud Psychother. 2014;28:257–324. https://doi.org/10.1080/87568225.2014.948770. This article examines literature about the characteristics and concerns of today’s college students along with how counseling centers are responding to student needs. They describe findings from surveys by the Association for University and College Counseling Center Directors and American College Counseling Association, which revealed counseling center collaboration and consultation activities across campus. The survey also indicated a variety of administrative and structural arrangements in how counseling centers are situated on campus. The authors suggest a framework for planning, executing, and evaluating counseling center and campus initiatives.

    Article  Google Scholar 

  40. Masters KS, Stillman AM, Browning AD, Davis JW. Primary care psychology training on campus: collaboration within a student health center. Professional Psychology: Research and Practice. 2005;36:144–50. https://doi.org/10.1037/0735-7028.36.2.144.

    Article  Google Scholar 

  41. Tucker C, Sloan SK, Vance M, Brownson C. Integrated Care in College Health: a case study. J Coll Couns. 2008;11(2):173–83.

    Article  Google Scholar 

  42. Westheimer J, Steinley-Bumgarner M, Brownson C. Primary care providers’ perceptions of and experiences with an integrated healthcare model. J Am Coll Heal. 2008;57:101–8. https://doi.org/10.3200/JACH.57.1.101-108.

    Article  Google Scholar 

  43. • Funderburk JS, Fielder RL, DeMartini KS, et al. Integrating behavioral health services into a university health center: patient and provider satisfaction. Families, Systems, & Health. 2012;30(2):130–40. https://doi.org/10.1037/a0028378. This study described an Integrated Behavioral Health Care program within a university health center and assessed provider and patient acceptability and satisfaction with the program. Providers and patients found the program beneficial to clinical care. The authors concluded that integration helps support regular screening for mental and behavioral health issues and increases access to needed mental health treatment.

    Article  Google Scholar 

  44. Butler M, Kane RL, McAlpine D, et al. Integration of mental health/substance abuse and primary care. Evidence Report/Technology Assessment. 2008;173:1–362.

    Google Scholar 

  45. Alschuler K, Hoodin F, Byrd M. The need for integrating behavioral care in a college health center. Health Psychol. 2008;27:388–93. https://doi.org/10.1037/0278-6133.27.3.388.

    Article  PubMed  Google Scholar 

  46. Chung H, Klein MC, Silverman D, Corson-Rikert J, Davidson E, Ellis P, et al. A pilot for improving depression care on college campuses: results of the college breakthrough series–depression (CBS-D) Project. J Am Coll Heal. 2011;59(7):628–39. https://doi.org/10.1080/07448481.2010.528097.

    Article  Google Scholar 

  47. • Lipson S, Speer N, Brunwasser S, Hahn E, Eisenberg D. Gatekeeper training and access to mental health care at universities and colleges. J Adolesc Health. 2014;55(5):612–9. https://doi.org/10.1016/j.jadohealth.2014.05.009. This is a randomized control trial of the gatekeeper-training program, Mental Health First Aid. In a study on 32 campuses, the training was found to increase trainees’ self-perceived knowledge, self-perceived ability to identify students in distress, and confidence to help, but there were no apparent effects on utilization of mental health care in the student communities.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Lipson S. A comprehensive review of mental health gatekeeper-trainings for adolescents and young adults. International Journal of Adolescent Medicine and Health. 2013;26(3):309–20. https://doi.org/10.1515/ijamh-2013-0320.

    Article  Google Scholar 

Download references

Acknowledgments

We appreciate the help and support of the National Network of Depression Centers (NNDC) college mental health work group, in particular, Susan Hinton and Drs. Leigh Anne White and Michelle Riba.

Author information

Authors and Affiliations

  1. Department of Psychiatry, UC San Diego, La Jolla, CA, USA

    Nancy Downs & Elyse Galles

  2. Department of Psychiatry, University of Massachusetts, Worcester, MA, USA

    Brian Skehan

  3. Department of Health Law Policy and Management, Boston University School of Public Health, Boston, MI, USA

    Sarah Ketchen Lipson

Authors
  1. Nancy Downs
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elyse Galles
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Brian Skehan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sarah Ketchen Lipson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nancy Downs.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Complex Medical-Psychiatric Issues

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Downs, N., Galles, E., Skehan, B. et al. Be True to Our Schools—Models of Care in College Mental Health. Curr Psychiatry Rep 20, 72 (2018). https://doi.org/10.1007/s11920-018-0935-6

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11920-018-0935-6

Keywords

Search

Navigation