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Mental health in higher education faces a sort of paradox. On the one hand, most campus counseling centers are overwhelmed and can’t meet the demand for services. On the other hand, many students do not seek counseling, even if they’re in great distress. Higher education institutions need to meet the mental health needs of students who refrain from seeking help.
My recognition of these issues—and experience working full-time at a campus counseling center—contribute to my enthusiasm for proactive programs that extend beyond the counseling center. As a clinical psychologist, research scientist and educator specializing in self-criticism and self-compassion, as well as an adjunct faculty member at Seattle University and at the Icahn School of Medicine at Mount Sinai, I recently attended the Depression on College Campuses conference for the first time.
Held at the University of Michigan in March and focused this year on student mental health in a hybrid world, the conference drew researchers, clinicians, university staff and students to the University of Michigan. Here are some key takeaways from the conference.
1. Universal mental health prevention programs in higher education now have a well-established research literature.
Most students report mental health concerns; however, data indicate that 45 percent perceive public stigma about seeking mental health treatment. An effective and ethical approach is to offer evidence-based programs that proactively address students’ well-being. Ideally, such programs are integrated throughout colleges and universities, including academic spheres, rather than relegated only to counseling centers or student development programs. Programs should include supervised skills practice, as mental health awareness campaigns or didactic lessons alone are much less effective.
Institutions can partner with organizations such as the Hope Center to consider intersections among learning, retention, mental health and students’ basic needs (e.g., food, transportation, childcare, housing and digital access).
2. Institutions need a digital mental health strategy as they expand their digital mental health services to external products and providers.
That advice comes from Lindsey Mortenson of the University of Michigan in the keynote session. This should include an interdisciplinary committee (e.g., mental health providers, administrators, technology faculty and staff) as well as a specific process for vetting digital mental health products such as apps, wellness programs, coaching and psychotherapy. The vetting process should assess the quality, safety, accessibility and efficiency of the product, as well as the way the data will be stored and retained, including the role of any third-party software organizations involved in the product’s architecture and maintenance. The strategy should also involve testing the products before purchasing them and offering them to students, as there are many unregulated digital well-being products that are marketed efficiently.
Research shows that students are concerned about the privacy and confidentiality of their mental health data gathered by digital tools. Mortenson recommended establishing a single “digital front door” through which students access virtual care.
3. Mental health emergencies—including suicidal behavior, sexual assault and those involving alcohol and other drugs—often occur after working hours or on the weekend.
Mental health care may be outsourced during those times to campus security, housing or external virtual services. Although such resources can play an important role, institutions should carefully consider whether students are able to access high-quality mental health care during evenings and weekends.
Students may be best served by campus-affiliated mental health professionals who know its culture, calendar, landmarks and resources, such as the CAPS After Hours program at Wayne State University. Feedback from that program has been quite positive; for instance, one student noted, “It helps to know I can call you in the middle of the night. That’s when my urge to cut overwhelms me.”
Another advantage of an integrated after-hours (“night CAPS”) approach is its “seamless care”—that is, mental health providers on duty can easily schedule students for follow-up appointments or include notes summarizing crisis interventions that are easily accessed by students’ daytime providers.
4. Students of color report diverse needs, preferences and challenges regarding mental health care and related resources.
However, these students are less likely to receive mental health treatment than are white students, with Asian and Asian American students obtaining the lowest levels of treatment. Marcia Liu and David Rivera advised institutions to:
- Build trust through racial trauma–informed leadership that acknowledges systemic problems and racial trauma both on and off campus.
- Foster a collaborative approach to engaging with students of color that emphasizes listening (e.g., “what do you need?”).
- Engage faculty and staff in creating “third spaces” for healing, belonging and well-being.
- Prioritize mental health as an investment.
Institutions can also partner with organizations such as the Steve Fund that work to improve mental health for students of color in ways that are most appealing, accessible and equitable.
5. Community colleges are often underserved when it comes to mental health, with only 70 percent of community colleges offering some type of mental health services and larger student-to-counselor ratios than other institutions of higher education.
Community colleges also have more low-income, first-generation, minority and part-time students; in addition, data indicate that their perceptions of institutional support differ from those of university students. According to University of Michigan doctoral student Amy Rusch, community college students prefer a hybrid model of mental health care that they can access without disrupting their jobs or caregiving responsibilities. Financial stress predicts poorer mental health and serves as the largest barrier to obtaining treatment among community college students.
To address the current gaps in care for community college students’ mental health and related needs, broad-based programs may best support students’ mental health and well-being.