The College Mental Health Crisis: at a glance

The history of colleges and universities engaging directly in the mental health care of students spans more than a century. From the start, the services were designed to ensure student success and were inextricably tied to the institutions in which they emerged. They were also closely tied to the prevailing interventions and models, including student body needs, available resources, and sociocultural trends and norms of the time. Interventions have evolved, the student body has become more diverse, resources have expanded, and society has changed, yet mental health services have, for many decades in most institutions, remained bound to the same service model: Professionals on staff provide direct care.
Within the last decade, the traditional model has been strained by the unprecedented increase in demand for collegiate mental health services. While aspects of the increase are well documented—including the most common presenting concerns (anxiety and depression), affected populations of students (most), and institutions impacted (all)—the reasons behind this increase are not well understood. The most common assumptions for this shift include: decreased stigma, more access to mental health treatments prior to college, greater availability of services, rising stress and trauma in various communities, and the changing role of college students and parents as active consumers of services. Whatever the driving force behind the rising demand, the result is the same. More students are seeking mental health care across all types of higher education institutions. It is easy to see how the traditional professional provider-dominant service model is now tested with greater numbers of students seeking help. This model has led to students not readily accessing or even receiving the care they might need and an increasingly negative perception (true or not) of the readiness or capacity of colleges and universities to care for students with mental health concerns. Recent growth in mental health care budgets often have been limited to incremental boosts in staffing or operating budgets. Even those institutions that funded additional counseling staff report that the ongoing demand continues to outpace the availability of providers. In other words, colleges and universities have not been, and likely will not be, able to staff their way out of this problem. If colleges and universities are going to take responsibility for the mental health care of students but are not in positions to drastically expand resources to maintain levels of care, a new model is needed. To be successful, the new model must be consistent with previous models: The goal is student success, and practices must use resources efficiently and be effective, socioculturally relevant, and responsive to the needs of diverse students. In addition, a new model must be relentlessly accessible to all and leverage assets both within and outside institutions. Only then can institutions hope to meet mental health service demand.
Seeking help for mental health concerns is one of the most difficult actions a student can take. They must recognize their distress, identify that the distress is worth addressing, be open to the help of another person (let alone a professional), know where help is located and how to access it, and reach out for help. Given this incredible sequence of steps, it is incumbent upon every higher education institution to make sure that students seeking help for the first time can talk!