Public Health Conversations

‘We Can Do Better and We Need to Do Better’ to Address Student Mental Health

During a Dec. 12 Public Health Conversation, health experts discussed the unique stressors that college students experience today, and the support that schools, parents, peers, and healthcare providers can offer to improve students’ well-being.

Academic pressure. Financial strain. War overseas, mass shootings at home, and the omnipresent threat of climate change. These are just a handful of the issues that are driving a worsening mental health crisis on college campuses across the United States. 

On Tuesday, December 12, the School of Public Health hosted a Public Health Conversation to identify and explore solutions to the dizzying array of stressors that are uniquely affecting today’s generation of students. The online event, titled “College Mental Health: Challenges and Opportunities,” drew a panel of health experts and scholars in counseling, psychology, and public health for a wide-reaching discussion moderated by Kate Hidalgo Bellows, reporter for The Chronicle of Higher Education. 

College students’ mental health has been declining for years, but the well-documented impacts of the COVID-19 pandemic accelerated this pace, leading to increased rates of depression, anxiety, fear, and loneliness among young people, the panelists said. More than 60 percent of college students met the criteria for at least one mental health problem in 2021, according to the Healthy Minds Study, an ongoing, nationwide assessment of student mental health.  

“We can do better. And we need to do better,” said panelist Khadijah Booth Watkins, associate director of the Child and Adolescent Psychiatry residency training program at Massachusetts General Hospital. “And so how do we begin to think about creating a culture of health and well-being, and about equipping students, caregivers, faculty, and staff with the education that they need and the tools they need to support themselves and to support other students who are in need?”

At BU, there are a range of university-wide mental health services for students, such as therapy and psychiatry treatment, support groups, long-term care referrals, and a 24/7 emergency hotline.

“I always think very intensely about how I have a four- to five-year window to build a safety net for our students,” said Jason Campbell-Foster, BU’s dean of students and a panelist at the event. “What can I do in those four years to educate them for a lifetime of being able to meet their goals, to excel in their lives, and to have the skills that they need to weather any future storms?”

On top of academic and financial pressures, college students are dealing with family and job responsibilities, relationships and other social challenges, and the often jarring transition to college itself, he said. Colleges and universities should assess their particular campus climate and the specific challenges that their students are facing, and tailor responses to what works for their community—which could include mental health training for faculty, peer support development, partnerships with external organizations, and personal skills workshops for students.

“What has been our guiding principle is developing services where everyone feels, seen, heard, and served,” Campbell-Foster said. 

Trauma, particularly traumatic experiences around childhood emotional abuse and sexual violence, is a particularly prevalent cause of distress for today’s college students, said Brett Scofield, associate director of the Center for Counseling and Psychological Services and executive director of the Center for Collegiate Mental Health (CCMH) at Penn State University. CCMH tracks and analyzes data of students receiving therapy treatment and advocates for more efficient mental health services. This data shows that, among students receiving clinical care nationwide, the percentage of students who reported experiencing traumatic events rose from 31 percent in 2012 to 47 percent today.

The landscape of collegiate mental health nationally over the last 10 years “really is crisis-oriented,” Scofield said. “There’s a lot of students who need services and the supply of services available to treat those students is just not able to accommodate that.” To respond to the demand, counseling services are often forced to shift their operating models and offer “rapid access services,” for example, to accommodate demand.

He also linked identity-based discrimination to student distress. “Students who have one or multiple areas of discrimination are significantly more likely to be more isolated, have more suicidal ideation and more distressed across the board.”

Panelist Sasha Zhou also studies the effects of discrimination on student distress as an assistant professor in the Department of Public Health at Wayne State University and as a coinvestigator of the Healthy Minds Network, which administers the Healthy Minds Survey. Past studies from the survey have shown that while the rates of therapy have increased for all racial/ethnic groups, Asian Pacific Islander Desi American students have remained among the lowest or the lowest utilizers of mental health treatment across racial and ethnic minority students, she said, noting that LGBTQ+ students similarly lag far behind other groups in these areas.

“About 43 percent of AAPI [Asian American Pacific Islander] and LGBTQ+ students with mental health symptoms are not being currently connected with any type of formal treatment services,” Zhou said. These students are a “unique group of young people that are vulnerable to mental health challenges which we know from the literature can really negatively impact academic performance and cause physical health complications.”

Opportunities to protect student well-being and advance equity are, in many ways, at the system-level, said Sarah Lipson, associate professor of health law, policy & management at SPH, and who helped organize the event. She is also principal investigator of the Healthy Minds Network, and has studied college student mental health extensively.

“Some of the most important opportunities for improving mental health in college student populations require seeing campus systems, policies, and structures as first, drivers of inequalities, and second, as being mutable—things that can be changed by higher ed decision makers and communities,” Lipson said. “Attention to the topic of college student mental health is reflective of a broader national dialogue emphasizing the public health urgency and opportunities for improving mental health at a population level.”