National Trends in College Mental Health

Abstract

Many college campuses are currently confronting the challenges of needing to increase mental health services to meet increased demand, and also of attending to students with higher acuity needs. The most extreme manifestations of students’ mental health problems may result in sentinel events—campus mass shootings, suicide clusters, and sexual assaults, to name a few—that may also be publicized in the media. There may also be lawsuits from parents examining culpability, as well as student complaints about inadequate or lacking mental health resources for students. College campuses have been responding by critically assessing their mental health services and, in extreme cases, completely overhauling them. In searching for best practices and consensus guidelines for student mental health care, they find this to be historically difficult, as the variation in campuses is vast, and includes private colleges, large publicly funded state colleges, community colleges, and trade/specialty schools. Even when comparing similar campuses—for example, similarly sized small liberal arts colleges—one may find that one campus does not provide any psychiatric services at all and refers students to resources in the community, whereas another campus may provide quite extensive mental health care, including psychiatric care, on campus. In a sense, each campus runs its own somewhat enclosed health-care system funded by the university and student fees, and there is immense variation in their approaches. This has made it difficult for campuses to understand the best approaches to providing student mental health care, especially in the setting of increasing need. In this chapter, we review the national trends in college mental health care. We examine the increased demand for services and potential reasons for this; the current epidemiology of student mental health problems; the systemic challenges in recruitment, retainment, and funding psychiatric services; the needs of specific populations of students; and strategies for improving access and services for students. We will also give specific examples from universities that have adopted these strategies.