In January 2021, the National Academies of Sciences, Engineering, and Medicine released a report on college student mental health that put a spotlight on the concerns of the federal agencies that sponsored it. Data indicate a rise in student-reported mental health issues, and all stakeholders must take urgent, coordinated efforts to support students across the U.S.
The study, “Mental Health, Substance Use, and Wellbeing in Higher Education: Supporting the Whole Student,” led by committee chair Dr. Alan Leshner, addressed the challenges related to the shortage created by the increasing demand for services combined with the limited ability of campuses to provide clinical services. More broadly, it identified the need for academic leadership to create a culture and climate that reduces stigma related to mental health issues and fosters an environment of positive wellbeing for students.
The committee’s examination took place before the COVID-19 pandemic, the economic crisis, and the amplification of systemic racism brought on by the deaths of George Floyd and other Black Americans as a result of police violence. This triad of national crises served as the backdrop behind which the committee made its recommendations. The context for the already difficult college mental health situation was, in the short term, a heightened sense of ambient tension multiplying the impact of stressors on all students and notably on Black students, whose communities experienced more fatalities to COVID-19 as the pandemic continued.
The study began with an examination of the data. A Healthy Minds Study of more than 300,000 students at 300 colleges and universities (Eisenberg et al., 2019) showed that 40 percent of postsecondary students nationwide reported experiencing a significant mental health problem. Sixty percent say they have difficulty finding help, indicating that too many students, for a variety of reasons, are not receiving the support they need. This mirrors a larger national shortage of psychologists, which the American Psychologist Association predicts at about 20 percent of unmet need nationally.
The committee noted the distinct differences between population groups. Using data from the Healthy Minds Study, Native American and Pacific Islander students consistently reported higher rates of anxiety, depression, and suicidal ideation. In terms of utilization of services, men tend to access care at a lower rate than women. The report also highlighted the different ways colleges and universities could take into account the diversity of student identities and experiences in order to support student wellbeing ranging from Black, Indigenous, and other students of color; students with disabilities; graduate and medical students; students who have experienced trauma; student athletes; students who are sexual or gender diverse; and students who are serving in the military and student veterans. The committee emphasized that no group of students is a monolith, and each campus must assess their student body to determine how to structure programs and services.
In the end, the committee’s report recommended that colleges and universities focus on five areas to improve the emotional and behavioral health of their students: Institutional culture and policies; prioritizing mental health among financial constraints; assessing both the state of mental health on campus and the resources available; engaging all stakeholders in creating environments for emotional wellbeing; and working together to reduce the stigma that continues to keep students from coming forward.
Reducing stigma involves a strong demonstration of caring, inclusion, and acceptance on the part of every stakeholder on campus, starting with leadership all the way down to students themselves. According to the committee, change has to come from the top down, bottom up, and inside out.
Starting from the top, presidents and campus leadership must prioritize student mental health and wellbeing as a critical issue in their messages and in the resources provided. Students should receive messages from multiple sources that this is a campus that cares about their mental health and their wellbeing. For example, schools can provide hotline numbers and multiple points of contact in high-traffic areas, on student ID’s, and on syllabi. Academic affairs and student affairs offices must work together to keep mental health and substance use issues from pulling students off path.
The committee underscored the fact that clinical services alone cannot address the needs of students. As schools reduce stigma and encourage help-seeking behaviors, they need to be prepared for an increase in demand for services. Faculty and staff need to be active participants, not only in identifying students in distress and referring them to help, but in creating learning environments that are healthy and inclusive. In these times, it is incumbent on faculty to respect their students’ identities and take the time to understand the issues they are facing. In turn, faculty should receive training and departments should incentivize supportive behaviors such as effective mentorship, career support and guidance, and upholding inclusive learning environments.
Reducing stigma involves a strong demonstration of caring, inclusion, and acceptance on the part of every stakeholder on campus, starting with leadership all the way down to students themselves. According to the committee, change has to come from the top down, bottom up, and inside out.
Finally, students themselves need to understand the services that are available and know this before they show up on campus. Those with pre-existing conditions should be encouraged to make a care and communication plan with their families, understand the limits of their current providers, and learn how to receive coverage on campus. Additionally, more students are receiving training on mental health to serve as peer ambassadors, gatekeepers, and bystanders.
As this past year reminds us, an individual can’t change a whole system but individuals working together can. We hope the committee’s work to alert the nation to the mental health and substance use problems of college students will motivate this much-needed collective action.
The report “Mental Health, Substance Use, and Wellbeing: Supporting the Whole Student” was released in January 2021 by the National Academies of Sciences, Engineering, and Medicine. The report was sponsored by the Substance Use and Mental Health Services Administration, the National Institute of Mental Health, National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. The editors for the report were Dr. Alan Leshner, the report chair and CEO Emeritus of the American Association for the Advancement of Science, and Ms. Layne Scherer, the staff study director and Senior Program Office at the National Academies of Sciences, Engineering, and Medicine.
