Health

Mental Health on Campus: Situation Grim, but Not Hopeless

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Aug. 29, 2022 – It was summer 2019, and Jack Hellmer had just finished a successful freshman year at Florida Gulf Coast University, majoring in entrepreneurship. Then things went south. Chloe, his childhood dog of 15 years, a sweet and playful wheaten terrier who loved playing tug-of-war, died. Soon after that, an uncle Hellmer was especially close to passed away.

“I’ve never experienced grief like that, and both very sudden,” says Hellmer, now 22 and a graduate student. He was doing his best to cope, but within a few weeks, he says, “I was experiencing the physical and mental symptoms of anxiety.” His chest would tighten, his mind raced, and he had a tingling in the back of his head.

All this was added on to the usual stressors of college life. After his mother noticed he seemed “off,” he sought professional counseling and worked through his grief.

When Hellmer began talking to friends back at school, he realized many were also struggling with anxiety or other mental health issues, such as stress or depression.

While college years are often portrayed as the best years of life, new research strongly suggests they often are not – especially now, with the effects of the pandemic making the usual stresses worse.

Mental health issues among college students have increased by nearly 50% since 2013, one large study shows, now affecting 3 of every 5 students. Other researchers have found that the pandemic definitely contributed to a heavier toll on college students’ mental health.

Yet, more awareness and hope have come with the troubling statistics. Public health experts who have studied the issue are suggesting ways that campuses can better help students who need it.

Active Minds, a mental health advocacy organization for young adults, is recognizing campuses with model mental health programs. It gives awards to the top performers, providing others with a blueprint. And students themselves – including Jack Hellmer – have valuable input. He has developed a smartphone app, UBYou, that helps students assess their issues, monitor their mental health, and track their progress.

What the Research Shows

In 2021, more than 60% of college students met the criteria for one or more mental health problems, according to the latest Healthy Minds Study, an annual analysis from more than 350,000 students on 353 campuses. From 2013 to 2021, mental health issues have risen by nearly 50%, and were beginning to rise even before the pandemic, the researchers say.

“We have seen increasing numbers of students screening positive for symptoms of depression, anxiety, eating disorders, and reporting suicidal thoughts – significant increases over the past 10 years and particularly over the last 5 or 6 years,” says Sarah Lipson, PhD, an assistant professor at Boston University School of Public Health and principal investigator of the Healthy Minds Study.

In another study, researchers surveyed more than 8,600 college students before and during the pandemic and found increases in depression, eating disorders, and alcohol use.

Mental health issues during college, other research has found, predict lower academic success. Depression has been linked with double the risk of dropping out of college.

Minorities and LGBTQ students are affected unequally, Lipson also found. American Indian and Alaskan Native students had the largest increases in mental health issues in the most recent study. Students of color used mental health services the least. The inequities found in previous surveys have not improved, she says.

Open to Help, But Barriers Exist

This generation of college students, by and large, is more willing to be open to admit the need for mental health help, and to seek it, Lipson says. But not always, and not right away.

“The decreasing stigma [about seeking help] is a very good thing to keep shouting from the rooftop,” she says. But while many students don’t have an issue seeking help, some still worry about perceived stigma – what will their friends think about them going to therapy? And even students who are entirely open to mental health help may hesitate at first, Lipson says, as they think the problem will get better on its own.

Another significant barrier is the lack of services to fill the need, she says, with not enough counselors or other mental health providers. “The demand related to supply is wildly out of whack,” she says.

Solutions

Among the ways suggested to improve campus mental health access and services:

Mimic the model programs. Some campuses are models for providing mental health help, and others might learn from them.

For the sixth consecutive year, Active Minds has given its Healthy Campus Award to schools providing access to quality health care and giving equal priority to mental health.

And bigger isn’t always better. This year, one of the five winners is Barstow Community College in Barstow, CA, with 3,700 students. Christa Banton, who holds a doctorate in education, is a mental health counselor and marriage and family therapist. She oversees the school program and is the sole therapist for it. Before 2020, the college had to refer all mental health services to outside providers. A grant provided the means to begin the on-campus program.

Banton says her motto is “maximum flexibility.” She has a “crisis hour” every day, when students can call or walk in and be seen right away. For regular appointments, she extends grace.

“If a student comes in 20 minutes late, I’m going to see them.” She doesn’t cut off students who skip appointments, either. She reaches out. “It usually means they are not in a good place.”

In a typical week, she does up to 25 hours of therapy directly to students and calls on community resources in the summer and whenever else is necessary.

Another 2022 winner is the University of South Florida’s St. Petersburg campus, with about 3,500 students. Jonathan Mitchell, PhD, assistant director for clinical services and a psychologist there, says their immediate pivoting to telehealth therapy at the pandemic’s start is one reason for their success. “We don’t operate on a wait list,” he says, though they have just four therapists working. “Most are seen in less than a week.”

Other 2022 winners are Auburn University, Stevens Institute of Technology, and Virginia Tech.

“The pandemic really forced the need for colleges to think about how they are addressing student mental health,” says Amy Gatto, director of research and evaluation for Active Minds. The organization was formed in 2003 by Alison Malmon after the suicide of her brother, Brian, a college student who had depression.

Among improvements, Gatto says, are a rise in telehealth services, more training and awareness of faculty and staff about the need for mental health care, and letting students be innovative and express what they need.

Make everyone part of the mental health team. Faculty and staff who work outside of mental health services can be trained in basic skills, like how to recognize warning signs of mental health issues and how to reach out to those students, Lipson says.

Her research suggests most of these staff are more than willing to help, but they need training. While it doesn’t need to be extensive, it does need to be ongoing, she says.

The goal? To make it so that a math teacher, for instance, might be as likely to notice and reach out to a struggling student as a psychologist in counseling services.

Some of her other suggestions on how faculty and staff can promote mental health are simple. For instance, Lipson tells professors that making assignments due at 9 a.m. increases the chance of students pulling stressful all-nighters. “If assignments are due at 5 p.m., students can eat dinner and get a good night’s sleep.” Being flexible on deadlines, as much as possible, can help reduce stress, too, she says.

Listen to students, and let them lead. There are more than 600 Active Mind chapters on college, university, and high school campuses, Gatto says, with students leading conversations for advocacy and change.

When Hellmer returned to school after a lockdown, and his talks with friends made him realize his issues were not unique, he got to work on a mental health app.

The app asks users questions, such as how their day is going. An algorithm tailors suggestions based on those responses. If the student makes an appointment with university counseling services, the staff can look at the information already entered into the app to gain valuable information.

Hellmer, who used to sell his old toys as a kid to make extra money, worked and reworked the app. He got seed funding from the university’s Runway Program, a business incubator. In time, after a few improvements, the university’s president, Mike Martin, PhD, saw the potential and gave the app his blessing. The app will be rolled out this fall semester campus wide.

Hellmer wants to perfect its use on his campus and hopes to make it national.

The app helps with a variety of issues, say students at the university who have tested it out.

“I was recently diagnosed with ADHD,” or attention deficit hyperactivity disorder, says Allison Sanchez, a junior environmental studies major at Florida Gulf Coast University. She went to therapy and is working with the university to get accommodations, such as having extra time to do math class problems. To manage the stress of learning with a diagnosis of ADHD, she turns to the meditation and breathing feature on the app, among other features.

The app allows students to enter information privately and then choose to share that with counselors, reducing the time spent in the counseling office. That’s another benefit, says Matthew Morey, a 20-year-old graduate student who describes himself as shy. For some students, he knows, “it’s very dauting to go to psychological services at school and run into people you know.” He entered the university as a freshman at 16 and looked young for his age. “Walking into a classroom a couple minutes late, with everyone seated, would make me so self-conscious,” he says. Exposure therapy helped him come to terms with that, he says. But for students as shy as him, having the app to enter information privately is a plus, he says.

From Mentally Stressed to Flourishing

As dismal as some of her research findings are, Lipson tries not to forget the positives. Even though more than half of students are now coping with a mental health issue, and those who are flourishing have decreased some over time, over a third were flourishing in spring, 2021, her latest statistics show.

With more attention on correcting the inequities, efforts to enact system-wide changes, and doing it all with a sense of urgency, she is hopeful that more students will be flourishing soon.

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