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A new report examining peer mental health supports on college campuses found that such programs are popular and useful, though they also raise some concerns.

The report, “Peer Programs in College Student Mental Health,” commissioned by the Ruderman Family Foundation and produced by the Mary Christie Institute, was based on interviews with 22 peer counseling and mental health experts and survey responses from 57 college counseling center directors.

It found that the vast majority of counseling directors expressed interest in some sort of peer support program, though that interest varied considerably by program type. The most popular by far were peer education programs—defined as trained students providing mental health information, resources and referrals to their peers—in which 94 percent of respondents said they were “interested” and 59 percent “very interested.”

Peer counseling garnered the least support, with just 30 percent of counseling directors expressing interest and 7 percent saying they were “very interested.” Perhaps not coincidentally, 81 percent of respondents rated peer counseling as the most challenging to implement out of five types of programs, which also included peer listening programs (in which trained students practice one-on-one “empathetic, active listening” with their peers), short-term mental health coaching and peer mental health support groups.

The report also examined the counseling center directors’ reservations about peer support, with virtually all (98 percent) citing personal risk to the students providing support as an important consideration. Ninety-six percent said the same about personal risk to the students receiving peer support, and 93 percent cited risk to the institution. (Majorities called each a “very important” consideration—70 percent, 79 percent and 61 percent, respectively.) Nearly half (47 percent) named a lack of standardized guidelines for peer support options as a very important consideration.

“Practitioners are eager to understand how peer support can be part of meeting student mental health needs on campus, but to offer these programs with confidence, we must have a greater knowledge of best practices and some level of standardization around critical dynamics like training,” said Zoe Ragouzeos, executive director of counseling and wellness services at New York University and clinical director at the Mary Christie Institute, who co-authored the report.