The State of Mental Health on College Campuses: A Growing Crisis

In a December 19 article, the New York Times reported on a phenomenon that colleges across the country are all too familiar with: the rising number of students grappling with serious mental health problems that are seeking treatment at campus counseling centers. The article brought attention to an alarming and growing trend that began in the early to mid-1990s. At that time, university and college counseling centers noticed a shift in the needs of students seeking counseling services from more developmental and informational needs, to more severe psychological problems.

In the past decade this shift has not only solidified, it has reached increasingly higher levels. In the 2010 National Survey of Counseling Center Directors, respondents reported that 44 percent of their clients had severe psychological problems, a sharp increase from 16 percent in 2000. The most common of these disorders are depression, anxiety, suicidal ideation, alcohol abuse, eating disorders, and self-injury. In a 2010 survey of students by the American College Health Association, 45.6 percent of students surveyed reported feeling that things were hopeless and 30.7 percent reported feeling so depressed that it was difficult to function during the past 12 months.

While depression and anxiety consistently rank as the most common mental disorders treated at college counseling centers, an often overlooked but equally serious problem is the rising number of students struggling with eating disorders, substance abuse, and self-injury. According to the aforementioned 2010 National Survey of Counseling Center Directors, 24.3 percent of college counseling center directors have noticed an increased number of clients with eating disorders, 39.4 percent have noted an increased number of clients suffering from self-injury issues, and 45.7 percent have reported an increased number of clients struggling with alcohol abuse. However, these percentages are probably even higher as students dealing with substance abuse and eating disorders are less likely to seek treatment at counseling centers than students dealing with depression and anxiety disorders.

Congress recognized the need to take action in addressing this growing mental health crisis on college campuses in 2004 with the passage of the Garrett Lee Smith Memorial Act (GLSMA). GLSMA created three programs to address the mental and behavioral health needs of young people; Campus Suicide Prevention, State/Tribal Youth Suicide Prevention, and the Technical Assistance Center. These three programs have made a significant difference in addressing the issue of suicide, the second leading cause of death among college students and third leading cause of death for young people ages 15-24, across the nation.

APA's members were instrumental in developing the idea for the Campus Suicide Prevention initiative, which is designed to provide education and outreach related to suicide prevention on college campuses. The program has funded a broad range of prevention, education and outreach services, ranging from effective multifaceted and culturally responsive suicide prevention systems to education campaigns to raise awareness about suicide and mental and behavioral health risks.

Yet, despite these significant achievements, the existing programs have only tackled part of the problem that our nation's college counseling centers are facing. The APA continues to advocate for the Campus Suicide Prevention program to have the flexibility to provide mental and behavioral health services for students and hire appropriately trained staff. Such an expansion is essential, since 91 percent of counseling center directors reported that the recent trend toward greater numbers of students with severe psychological problems continues to be true on their campuses. College counseling centers are frequently forced to come up with creative ways to manage their growing caseloads. For example, 76.6 percent of college counseling directors reported reducing the number of visits for non-crisis patients to cope with the increasing number of clients.

Research clearly shows just how much strong mental and behavioral health supports can improve student life. Without the proper psychological services, students with emotional and behavioral problems have the potential to affect many other people on campus, including roommates, classmates, faculty, and staff with disruptive and even dangerous behavior. However, when students receive help for their psychological problems, counseling can have a positive impact on academic success, retention, and personal well-being.  The most recent survey of college counseling center directors found that 59 percent of clients indicated that counseling had helped them remain in school and 60 percent stated that counseling helped improve their academic performance. Moreover, with more than 65 percent of high school students attending postsecondary education institutions, these counseling centers help millions of students.

Encouraged by the strong and ongoing support of APA and other groups, Congress has renewed its commitment to students' growing mental health needs. On April 6, Sen. Jack Reed (D-RI), Sen. Lisa Murkowski (R-AK),  Sen. Richard Durbin (D-IL), and Sen. Tom Udall (D-NM) introduced the Garrett Lee Smith Memorial Act Reauthorization of 2011 (S.740). This legislation acknowledges the progress made since the 2004 passage of the original Garrett Lee Smith Memorial Act as well as the work that remains to be done by modestly increasing the authorization levels for the Campus and Youth/Tribal Suicide Prevention programs. The reauthorization includes changes to the Campus Suicide Prevention program that will allow for more flexibility in the uses of funds to enable grantees to best meet the needs that exist on their campuses. For example, it maintains a strong focus on prevention, outreach, and education while allowing for the provision of mental health services to students and the hiring of appropriately trained staff. You can get involved and join us in these efforts by contacting your Senators to urge them to cosponsor S. 740. For more information, please contact Jennifer Smulson.