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A new report by TimelyCare and Active Minds indicates that loneliness is strongly associated with negative mental health among college students.

Students who say they are lonely are four times more likely to report severe psychological distress, according to the report, “Loneliness, Resilience, and Mental Health: A Call for Campus Action.” It is based on survey responses from about 1,000 students between ages 18 and 26 who are enrolled in a two- or four-year college or university. Additionally, the rate of nonstraight college students who reported feeling lonely (70.3 percent) was nearly 10 points higher than their straight peers (60.6 percent).

Addressing loneliness has been a top priority for mental health leaders inside and outside higher education; Surgeon General Vivek Murthy called it an “epidemic” last year.

TimelyCare and Active Minds also looked into how students prioritize their own mental health and the mental health of those around them. Sixty-three percent of respondents said they prioritize having good mental health and 54 percent say they prioritize taking care of their mental health. Smaller shares say they are “concerned” about the mental health of their friends’ (52 percent) and their peers’ (39 percent). A significantly higher proportion of African American respondents said they prioritize having good mental health—78.8 percent—than the general student population.

Respondents at two-year institutions were less likely than those at four-year institutions to say that students at their college were concerned about mental health or that they talked openly about it.

The report includes recommendations for higher education leaders and others in student-facing roles to address the issue.