Government Relations Update

Since the mid-1990s, there has been an alarming trend on college campuses nationwide: an increase in the number of students seeking help for serious mental health problems at campus counseling centers. In the past decade this shift has not only solidified, but it also has reached increasingly higher levels.

The 2010 National Survey of Counseling Center Directors (NSCCD) found that 44 percent of counseling center clients had severe psychological problems, a sharp increase from 16 percent in 2000. The most common of these disorders were depression, anxiety, suicidal ideation, alcohol abuse, eating disorders and self-injury. A 2010 survey of students by the American College Health Association found that 45.6 percent of students surveyed reported feeling 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. The NSCCD study found that 24.3 percent of college counseling center directors have noticed more 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.

As grim as these statistics are, however, these percentages are probably even higher since students with substance abuse and eating disorders are less likely to seek treatment at counseling centers than students 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. The law 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 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 Americans ages 15 to 24.

APA's members were instrumental in developing the idea for the Campus Suicide Prevention initiative, which provides 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, these programs have only tackled part of the problem facing college counseling centers. APA continues to advocate for the Campus Suicide Prevention program to have the flexibility to provide mental and behavioral health services for students and to hire appropriately trained staff, particularly in light of students' growing need for services. College counseling centers are frequently forced to devise creative ways to manage their growing caseloads. For example, 76.6 percent of college counseling directors reported that they had to reduce the number of visits for non-crisis patients to cope with the increasing overall 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 NSCCD survey found that 59 percent of clients indicated that counseling had helped them remain in school, and 60 percent stated that counseling had 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 young people.

Encouraged by the strong and ongoing support of APA and other groups, members of Congress have renewed their commitment to students' growing mental health needs. On April 6, Sens. Jack Reed (D-R.I.), Lisa Murkowski (R-Alaska), Richard Durbin (D-Ill.) and Tom Udall (D-N.M.) 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 APA's requested changes to the Campus Suicide Prevention program that will allow for more flexibility in the authorized uses of funds to enable grantees to best meet the mental health 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.

We encourage you to get involved and join us in these efforts by contacting your senators to urge them to cosponsor S. 740. For more information, see our "Action Alert" or contact Jennifer Smulson, senior legislative and federal affairs officer, in the APA Education Directorate's Government Relations Office.