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!

App Culture: Set on Mindfulness of Mental Health

Never before have we seen such a surge in apps focused specifically on mental health, mindfulness, and stress reduction.
The popular meditation app Headspace and our Apples App of the Year, Calm, both had major updates this year that expanded their breadth considerably, taking on topics such as mindfulness for children and better sleep. The creators of the new app Lake: Artists’ Coloring Books tackle destressing a bit more actively. It offers an ever-changing selection of drawings, created by burgeoning illustrators and artists, that you can color in—which is perhaps the most accessible meditation of all.
Several apps leverage the latest research on cognitive behavioral therapy to help address larger issues. Although the apps are not a substitute for professional treatment, they do put a host of resources at your fingertips. Pacifica provides a self-help toolkit and access to a support group whenever you need it, while Joyable lets you work with a trained coach via text, email, or phone.


Letter from our Executive Director

2017 has been a dynamic year in mental health. For some, it feels like both a lifetime and a single second has passed since the year started back in January.

Thanks to you, some big steps have been made in bringing mental health care in the United States into the 21st Century.

We couldn’t have made progress happen within Higher Education without your generous support.

We maintained coverage for mental health and substance use benefits thanks to the thousands of you who called, emailed, and sent letters to your legislators telling them to make mental health a priority.

Our high student affairs policy standards let peers show their expertise and experience, which opens new career paths and more opportunities to transform lives and services.

This is all thanks to you – with you, we can change the trajectory of thousands of young lives.

We cannot thank you enough for your support. Griffin Ambitions Ltd and Vital Time will not settle for the answers of the past in mental health care and treatment.

With your help, we can take charge of a brighter future—where there is always hope.

To all those preparing for the celebrations, happy holidays from all of us here at Griffin Ambitions!

Be well,


Jacob M. Griffin


Most Y’all Missed This ’13 Reasons Why’ Detail & It Sheds Insight Into Alex’s Story

If you haven’t finished 13 Reasons Why, exit out of this post right now because I am about to end all debates about the last episode.

Based on the best-selling novel of the same name, 13 Reasons Why is proving to be one of the best and most socially aware young adult series in recent memory. It accurately shows what high school parties are like, using the kind of language high schoolers truly use (yes, F-bombs come out in droves), and not pulling any punches on more sensitive material. From almost everyone who has seen the show (many critics excluded), it is a poignant, incredibly well-done series that hits home pretty hard.

Seeing as it’s been several weeks since the show aired, you’ve probably either finished the series or got most of the way through it, which is what brought you here. It was a compelling show that made you want to get to the end just because of what it was talking about. For the same reasons, you probably had a hard time finishing it. However, if you weren’t paying enough attention while watching, you’ll not have noticed this one moment that changes the show’s entire narrative completely.

'13 Reasons Why' [Credit: Netflix]
’13 Reasons Why’ [Credit: Netflix]

It’s All In The Little Details

Unlike Clay Jensen, I’m not going to drag this out and make you wait 13 hours to know the whole story of what happened to Hannah Baker. During the 13th and final episode of the series, the Baker family finally has their deposition against the school. Several of the students from the tapes are called in and we get to see a few of their recordings as they’re sitting there being interviewed.

If you look to the bottom left corner of the screen, you’ll see the date that the tapes were recorded. Taking into account that the show was released on March 31st, 2017, this date changes everything about the show.

Zach Dempsey's deposition. '13 Reasons Why' [Credit: Netflix]
Zach Dempsey’s deposition. ’13 Reasons Why’ [Credit: Netflix]

November 10th, 2017: None of this has happened yet. OK, well some of it has.

The Story So Far

Hannah went to the park with Justin Foley, sparking that ill-fated picture of her on the slide. Hannah met Jessica Davis and Alex Standall; they started going to Monet’s every day to get hot chocolate and whatever the hell Alex was drinking. The three of them had their falling out due to Alex’s stupid list. Hannah and Courtney Crimson found out that Tyler Down was Hannah’s stalker. Courtney painted Hannah as a lesbian to salvage her own reputation. Hannah went on a pretty crummy date with Marcus Cole, after which Zach tried to make things better, but it ended poorly for both Hannah and him.

The rest of it probably hasn’t happened yet, however. Now, I’m not entirely sure about whether Ryan Shaver’s tape happened, but the rest of it certainly hasn’t.

This means that Bryce Walker hadn’t raped Jessica, Sheri Holland hadn’t knocked over the stop sign that led to Jeff Atkins’s fatal car crash, Clay and Hannah hadn’t hooked up — resulting in Hannah being unable to show her true feelings for him out of past traumas, Bryce hadn’t raped Hannah yet, and Mr. Porter hadn’t told Hannah to just let go of what happened to her and act like it never happened.

Giving life one last chance. '13 Reasons Why' [Credit: Netflix]
Giving life one last chance. ’13 Reasons Why’ [Credit: Netflix]

But the biggest, most important takeaway from knowing this is that Hannah is still here. We still have the chance to help her and prevent this from happening. We can still save Hannah. There is still time.

When it comes to suicide, at any age, those closest to the victim wished they had seen the signs and had the time to stop it. This theme is very evident throughout the series, as every character wishes they had only known what could cause Hannah to want to end her life. As the show points out, it can be obvious that someone is depressed and looking to find a way to put an end to their pain (evident from both Hannah and Alex). However, it is difficult to see it in those closest to you, which is why everyone was so blindsided by what had happened.

The biggest message that the show is trying to push is that we don’t know what’s going on in each other’s lives. We just have to be there for each other and support each other not matter what rumors we hear. There’s too much hate in the world, especially in high school. We need to overcome it and learn to appreciate each other for who we are.

Screen Shot 2017-04-15 at 9.52.51 AM
A worthy share for social media! Don’t forget to tag @GriffAmbitions

We often don’t know if someone is depressed, no matter how evident the signs may be. However, if we can be there for each other, we can prevent something like this from happening again. And, in the case of Hannah Baker, we can prevent it from happening altogether.

With this in mind, it’s interesting to note that Jay Asher’s original ending included Hannah Baker actually surviving her suicide attempt. This original ending was actually included in the 10th anniversary edition of the novel released last December. Which was coincidentally released mere months before the Netflix series aired.

Now I’m not saying that’s suspicious or anything, but maybe, just maybe, it was released around the same time as the Netflix series with the intent to continue the series for a second season – or maybe in another format altogether. Assuming the series does well (as most Netflix series do) and with this small little detail snuck in the finale, the creators could easily turn around and say that Hannah never did kill herself and instead give us a sequel following Hannah and company in a plotline in which she’s still alive.

How Digital Hoarding May Be Damaging Your Mental Health



Photo Overload
Is it time to “Marie Kondo” the photos on your phone?

Your closets may look fresher thanks to Marie Kondo, but what about your inbox? Bookmarks? Photo library? Despite your physical tidying up, there’s a good chance that your cyberspace is as crowded as ever.

When we think of hoarding, we visualize a basement packed to the rafters with musty newspapers, worn-out clothing, and old “Frasier” DVDs. But digital hoarding exists too.

According to a survey by Summit Hosting, a provider of managed cloud solutions, the average American has 582 saved cellphone pictures, nearly 83 bookmarked websites, 21 desktop icons, and 13 unused phone apps… plus 645 gigabytes of material on external storage.

True, none of this takes up physical space in your home, but it does usurp valuable space in your mind, aka the original cloud.

The downsides of digital hoarding

Every 90 minutes, another 150,000 terabytes of new data is created. Each of those terabytes is equivalent to 310,000 photos or nearly 86 million pages of Word documents. So where exactly does it go?

We hang on to a lot of it. According to that same Summit survey, 6.6 percent of Americans are saving between 1,001 and 3,000 unread emails. 1.9 percent have more than 20,000.

“The beauty and downside of your digital life is that you can keep pretty much anything you want,” said Robby Macdonell, CEO of RescueTime, a company that helps individuals manage and get rid of digital clutter.

“Storage space is seemingly unlimited, so choosing to keep files is less of a choice.”

Still, “the more you keep, the less you’re likely to go back and use it,” Macdonell noted. “It doesn’t matter how organized you are if you’re drowning in information.”

Consider your photo library, which likely has hundreds — if not thousands — of images. If you don’t select the ones that truly mean something to you, said Jo Ann Oravec, PhD, a professor of information technology and business education at the University of Wisconsin-Whitewater, “then you just have a “mishmash of various angles and shots that mean nothing.”

Oravec recalls how her aunt, who passed away at the age of 100, carefully curated just six photo books. This finite collection contained all the images of her life that she’d deemed important to save.

“My aunt could create a sense of reality,” said Oravec. “What sense of reality will we create?”

Why we squirrel away in cyberspace

Oravec became increasingly interested in digital hoarding after conversations with her students.

Both undergraduates and graduates expressed feeling overwhelmed with the sheer volume of technological detritus: lecture notes, PowerPoint slides, PDFs of research, snapshots of classroom whiteboards — not to mention their own ever-swelling collections of personal and family items (including Facebook friends they didn’t know but were afraid of unfriending).

“Educational and social technologies… were designed to make it easier for students to engage in critical thinking and analysis as well as in interpersonal interaction,” said Oravec.

“Nevertheless, [they’ve] triggered a sense that ‘more is better. ‘”

She sees this, too, when her students struggle to research writing assignments.

“It isn’t that they’re asking, ‘How do I find materials?’” Oravec said. “They’re coming to me with inches of printed materials they’ve accumulated and then asking, ‘How do I find more?’”

Researchers are just beginning to explore the relationship between physical and digital hoarding.

Both involve a reluctance to get rid of things because they may fulfill a future need or elicit an emotional attachment. Both can interfere with how you function in your daily life and add to an already present sense of anxiety.

People who score higher on physical hoarding behaviors are more likely to score higher on those of digital hoarding. Because of that, said Nick Neave, PhD, associate professor of psychology and director of the Hoarding Research Group at Northumbria University in the U.K., “we think the two are very similar and involve the same kind of psychological mechanisms — firstly, a desire to get hold of files, and a strong reluctance to delete them in case they are needed in the future.”

Yet “everyone appears to be at risk of digital hoarding, especially in relation to work,” Neave said.

“Organizations bombard their employees with all manner of information that they don’t know what to do with, and just to be ‘safe,’ they keep it.”

Different generations may also have different motives for hoarding. For instance, Oravec thinks some of her younger students may simply not be aware of the options they have to archive the info they amass.

Older folks, on the other hand, may hoard due to anxiety. Anyone who remembers having to make a special trip to the library, dig through a card catalog, page through stacks of books, andmake copies of relevant research, will realize that information was once “a much more rare and precious commodity,” said Oravec.

Larry D. Rosen, PhD, professor emeritus of psychology at California State University Dominguez Hills and co-author of “The Distracted Mind: Ancient Brains in a High-Tech World,” is currently researching several techniques to see which best helps people avoid becoming obsessed with technology.

But when it comes to a tipping point that prevents us from treating the cloud as a virtual junk drawer, he doesn’t feel we’ve found it yet.

“Just like with societal issues such as smoking or drugs, I feel we’re going to have to observe some strong, real consequences before we’re able to question our own behaviors,” said Rosen.

Oravec agrees. Do nothing and it’s only a matter of time before a virus, cybersecurity breach, or physical damage to your numerous devices cleans everything out for you.


How to ‘Marie Kondo’ your cloud

Still, “the answer isn’t to delete it all and go back to the dark ages, but to find balance and use tech in a way that helps and enriches our lives,” said Macdonell.

To start, here are a few tips:

Take a break

It’s easy to feel like you need to keep contributing to what’s in your cloud just to stay current. “But this can be exhausting,” noted Macdonell. Take a “social media sabbatical” every once in a while.

“Many people feel like they can’t possibly step away from the constant updates, but when they do, they usually find a sense of calm that they’d forgotten was possible,” Macdonell said.

Make your desktop a sacred space

Since your desktop’s the first thing you see when you turn on your computer, “everything you leave on it will pull at your attention,” said Macdonell. His recommendation: Drop files that end up there into a few streamlined folders, like “Planning,” “In Progress,” and “Done.”

Detox your downloads folder

“Your downloads folder fills up fast and can also house lots of files you don’t need, but take up space on your hard drive,” Macdonell said. Go through yours once a week and delete or archive as much as possible.

Keep your inbox clean

Set up filters that allow you to automatically move new emails into specific folders. One hack Macdonell likes: moving any email that contains the word “unsubscribe” into a “Newsletter” folder. “Your inbox should only be for personal messages,” he said.

Audit yourself

Every month, designate time to go through all the photos, files, and so forth you’ve been holding onto. Ask yourself, “Am I ever going to actually use this?” If the answer is no, delete or archive, said Macdonell.

Prepare for feelings to come up

“When you remove things from your life, you’re creating a hole that wasn’t there before, and that can be unsettling,” Macdonell acknowledged.

“It helps to think about the things you’re creating for yourself as you free up space. Digital clutter takes up space in our minds rather than our bookshelves and closets, and by clearing it out, we gain more room for new ideas and activities.”



HealthDay News Report: More College Students Seeking Mental Health Care


THURSDAY, Oct. 25, 2018  — Anxiety, depression and panic attacks are sending U.S. college students to mental health clinics in record numbers, a new study finds.

Between 2009 and 2015, treatment and diagnoses of anxiety increased by nearly 6 percent among these students, followed by depression and panic attacks, which each increased about 3 percent. Anxiety is the most common problem, affecting almost 15 percent of college students across the United States, the researchers reported.

“Mental health is a critical issue for college students, and institutions of higher education need to explore prevention and support strategies that best meet the needs of their campus,” said lead researcher Sara Oswalt. She is chair of the department of kinesiology, health and nutrition at the University of Texas at San Antonio.

It’s not clear if the college environment is causing or even contributing to the increase in these problems. But if mental health problems aren’t addressed, success in school is jeopardized, she said.

Oswalt believes more students are seeking help because more of them are suffering from mental health problems, coupled with a willingness to get help. There is less stigma about mental health issues, and schools may be providing more mental health services.

For the study, Oswalt and her colleagues used data from the American College Health Association to collect information on more than 450,000 undergraduates.

The investigators found a significant increase in the diagnosis and treatment for eight of 12 mental problems they examined, with anxiety, depression and panic attacks accounting for the biggest increases.

The researchers also found that students are more willing to use university mental health services.

By 2015, nearly 20 percent of those surveyed said they used these services, an increase of more than 4 percent since 2009. Moreover, nearly 75 percent said they would consider using university mental health services — an increase of nearly 7 percent.

College students’ need for mental health resources is increasing, Oswalt said, so schools need to do more to safeguard their students’ well-being. They must do it in a way that is effective and use outside services when they cannot handle demand themselves, she suggested.

Because 75 percent of all serious adult psychiatric illnesses start by age 25, universities have an essential role in addressing mental health issues early, Oswalt explained.

According to Stewart Cooper, director of counseling services at Valparaiso University in Indiana, “Oswalt appropriately advocates for a systems approach to respond to these often debilitating disorders among college students.”

Cooper suggested several approaches, starting with ways to avoid emotional problems in healthy students. These include building resilience along with ways to manage stress and get enough sleep.

In addition, programs are needed that focus on detecting mental health problems early — making it possible to prevent them from getting worse — and to minimize complications and limit disabilities before the problem becomes severe. “Mental health screening days and evidence-based materials and interventions that are technology-based fit here,” he said.

Schools also need to offer therapy to students to reduce the negative effect of an already established mental health problem. These programs can help restore function and reduce complications, Cooper said.

The report was published Oct. 24 in the Journal of American College Health.

More information

Visit the National Alliance on Mental Illness for more on mental health among college students.


SOURCES: Sara Oswalt, Ph.D., chair and professor, department of kinesiology, health and nutrition, University of Texas at San Antonio; Stewart Cooper Ph.D., director, counseling services, professor, psychology, Valparaiso University, Ind.; Oct. 24, 2018, Journal of American College Health

WSJ—Failure 101: Colleges Teach Students How to Cope With Setbacks

Schools say students need help understanding that stumbles are inevitable, and even valuable, parts of growing up  – Wall Street Journal Report

Colleges nationwide are trying to instill in students a concept that seems contrary to encouraging excellence: It’s OK to fail sometimes.

Vanderbilt University, Princeton University and other schools have workshops and post online vignettes with students and staff discussing their failures and moments of self-doubt, while University of Montana students post “Best Fail Ever” stories on bulletin boards around campus and Colorado State University has passed out thousands of stickers with inspirational quotes about resilience.

At the University of Central Arkansas, the two-year-old Fail Forward Week encourages faculty to talk about failure and show TED talks on the subject. Students write about their own failures, ranging from academic challenges to relationship woes, on large sheets of paper placed around campus.

“We always painted failing a class or failing a test in a completely negative light, and we didn’t give the space to say if this does happen, it’s a moment in time, and here’s the process by which you learn from it,” said Amy Baldwin, director of the department of student transitions.

The school’s Office of Student Success hands out certificates giving students and others permission to screw up “and still be a totally worthy, utterly excellent human being,” according to the document.

Young adults face an onslaught of curated social-media feeds that show peers’ seemingly perfect lives, school officials say, which can make them feel alone in their failures. Add to that the bubble of parental protection and the high stakes associated with attending a pricey college, and schools say students need help understanding that stumbles are inevitable, and even valuable, parts of growing up.


“Children do not become strong if they are protected from setbacks, teasing, exclusion and conflicts,” said Jonathan Haidt, a professor of ethical leadership at New York University’s Stern School of Business and co-author of “The Coddling of the American Mind: How Good Intentions and Bad Ideas Are Setting Up a Generation for Failure.”

An American College Health Association survey last spring found that 52% of undergraduate respondents said academics had been “traumatic or very difficult to handle” within the prior 12 months, the highest rate since at least 2009.

Florida State University began requiring new students this year to complete an online program addressing stressors both big and small, ranging from witnessing violence as a child to roommate conflicts. Participants choose from an assortment of videos and audio clips, and narratives of students describing their own challenges and coping mechanisms are particularly popular.


FSU sophomore Aaron Ostler says many classmates don’t know how to digest and move on from moments of failure and can benefit from hearing about how classmates bounce back.

“They feel like if they do almost anything wrong, they’ve done everything wrong,” said the 19-year-old biology major.

Mr. Ostler said he experienced “tunnel vision” about a bad grade in chemistry last year and briefly convinced himself he wouldn’t get into medical school as a result.

Officials from many schools say they’re trying to ease a resource crunch at their counseling centers, many of which have seen skyrocketing demand for services to help students with depression and anxiety.

Bentley University, in Waltham, Mass., is planning an event for next spring featuring staff and faculty discussing their own failures, and lessons learned.


Sheila Atiemo, a junior, says she felt unmoored after realizing she didn’t enjoy—and wasn’t performing well in—an accounting class last year. She previously got good grades and planned since high school to major in the field.

“I freaked out,” said Ms. Atiemo, 20. “The thing I feared most was not knowing what comes next.”

She also worried about what her peers would think. “Bentley is a very fast-paced, competitive school. People don’t like to share their downfalls,” said Ms. Atiemo, who is now studying global management.

Peter Forkner, director of Bentley’s counseling center, said the purpose of the spring event will be to help attendees accept and learn from failure.

“The truth is failure sucks,” he said. “Failure feels bad. It’s not something that we necessarily want to celebrate, it’s just not something we need to feel so much shame over.”

New Study Reveals Alarming Trends in College Student Mental Health

A researcher discusses the most concerning — and encouraging — findings from a decade’s worth of data.


“I became interested in college student mental health about 10 years ago when I was doing my master’s at Harvard and serving as a first-year residential proctor. As a live-in advisor to a group of 30 freshmen at Harvard, I saw first-hand how pervasive mental health problems were on campus, and the degree to which mental health affected so many other facets of my students’ lives. Inspired by this lived experience at Harvard, I then went on to do a joint Ph.D. in public health and higher education at University of Michigan, where I focused on understanding and addressing mental health needs in college populations, and opportunities for prevention and intervention. Now as a faculty member at Boston University, my work continues to focus on campus mental health and data from the Healthy Minds Study, which I lead with my colleague, Daniel Eisenberg, at University of Michigan.”

The Healthy Minds Study is an annual survey study, conducted each semester at campuses across the country. The motivation behind the study is to collect the most comprehensive national data on mental health, help-seeking, and related factors in college populations — and to disseminate this research in a way that can inform practice and policy for adolescent and young adult mental health. Many campuses that participate in the Healthy Minds Study do so as a needs assessment in order to understand the prevalence of mental health symptoms among their students, rates of help-seeking, and risk factors for mental health. They then use these data to inform their work on campus.

Our most recent study provides empirical evidence to support a trend that many, particularly mental health practitioners on campus, have been observing anecdotally for years: that more and more college students are seeking help for their mental health. My research team and I have been collecting annual, population-level survey data through our Healthy Minds Study, and this paper is the first time that we have combined all years of data (2007-2017) to examine patterns in college students’ use of mental health counseling/therapy, psychotropic mediation, and lifetime diagnoses. Our data are drawn from nearly 200 campuses and include over 150,000 students. We’ve found the following:

  • Past-year treatment increased from 19 percent of all students in 2007 to 34 percent in 2017, with similar patterns for counseling/therapy and medication use.
  • Most students are seeking help on their campus.
  • Diagnoses rose from 22 percent to 36 percent over the past decade.

As a mental health services researcher, I have two reactions to this, one is a (mostly) celebratory tale and one is a cautionary tale: The singular problem that I have been dedicated to addressing through my research and dissemination is the “mental health treatment gap,” the proportion of adolescents and young adults with clinically significant symptoms who are not receiving mental health services. The celebratory tale is that the treatment gap is narrowing (though it is still wide, especially for young people of color and others from traditionally marginalized groups); much of my work these days is around understanding and addressing the mental health needs of college students of color, in fact, and issues around belonging, identity, and inclusivity.

The cautionary tale, at a system-level, is that much of the “burden” of students seeking help is falling to college counseling centers. In our national study, counseling centers were the most common place for students to receive services, and it is important to recognize that many counseling centers across the country (like the mental healthcare system in this country writ large), are under-resourced and operate at full capacity with waitlists for much of the year. In the paper, my colleagues and I discuss opportunities to alleviate this strain through digital mental health programs, which offer the possibility of expanded treatment accessibility while circumventing barriers to traditional treatment, such as time and convenience.

We also explored changes in symptoms of depression and suicidal ideation as well as levels of stigma as potential explanatory factors for increased service use. The findings indicate that mental health continues to be a growing concern on campuses across the country, with higher rates of symptoms year-to-year. We also find, however, that stigma has decreased and that attitudes towards mental health and services are improving, which is a reflection of a broader social shift regarding mental health and the way we talk about this important topic. The state of mental health on campus is complicated and multifaceted, particularly when we think about disparities by race, gender identity, sexual orientation, and other student identities; simply put, an increasing number of students are experiencing depression, anxiety, eating disorders, and reporting suicidal ideation, but more and more students in need are seeking help.

College campuses need to think critically about how they are investing in student mental health and well-being and how this compares to other investments. In previous publications, our Healthy Minds team has documented a strong relationship between mental health and academic performance. For example, we have found that college students with depression are more than twice as likely to drop out of college. I also think mental health needs to be part of broader conversations around student retention, particularly given that marginalized students are faring worse in both mental health and graduation rates. And college presidents have an important role to play in guiding this conversation.

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More on Mental Health on Campus:

What Campus Mental Health Centers Are Doing to Keep Up With Student Need

If You’re a Student Who’s Struggling With Mental Health, These 7 Tips Will Help

The Hidden Stress of RAs in the Student Mental Health Crisis

Is Penn State University working to address student mental health needs?


UNIVERSITY PARK, Pa. — Mental health treatment in higher education is a complex practice that has been rapidly evolving in response to a growing demand for services. For example, between fall 2009 and spring 2015, student utilization of university and college counseling centers increased by an average of 30-40 percent (CCMH 2015 Annual Report). While treatment provided by counseling centers has been found to be effective in decreasing student distress (CCMH 2017 Annual Report), many years of escalating demand have led to treatment limits and prioritization of rapid-access services, which may be impacting the ability of centers to provide ongoing treatment (CCMH 2016 Annual Report).

2018 CCMH report cover page

The 2018 Center for Collegiate Mental Health (CCMH) Annual Report, found that college students seeking treatment (and the professionals who treat them) continue to identify anxiety and depression as the most common concerns for seeking treatment, among dozens of other concerns. For the first time in five years, anxiety did not increase in prevalence whereas depression increased slightly again. Most other areas of self-reported distress remain flat or are even decreasing.

“As institutions confront the cumulative impact from years of rising demand for mental health services, it is critical to remember that we have spent more than 15 years actively working to prevent suicide, increase help-seeking, and train our communities by identifying and referring students at risk to treatment. As a result, institutions must be creative and wholistic in their response to a new level of demand that will not go away; but must not forget that we actively worked to create the very demand we are seeing, and our first job is to grow service capacity quickly in order to effectively support, and treat, students who are identified and referred,” said Ben Locke, senior director of Penn State Counseling and Psychological Services, and executive director of CCMH, on increased demand and importance of an array of services.

As with past years, the 2018 report found that self-reported lifetime prevalence rates of “threat-to-self” characteristics (self-injury, suicidal ideation, suicide attempts) increased for the eighth year in a row, highlighting the important service that counseling centers serve in supporting students at risk and our broader national success in identifying and referring students who need help. Students reporting life-time threat-to-self characteristics, when seeking treatment, use an average of 20 to 30 percent more services than students who do not (CCMH 2015), which further increases the strain on counseling centers as they seek to balance being responsive to new students in distress while also providing effective treatment for those who need it.

The 2018 report specifically examined the impact of two high-level center policies on treatment outcomes for the purpose of informing higher education policy-makers: (1) how counseling center’s systems for handling new clients impact treatment outcomes, and (2) whether access to counseling center electronic medical records, by health care staff, impact treatment outcomes. Regarding systems for handling new clients, also known as “clinical models,” the report found that counseling centers that assign new clients to counselors with a dedicated appointment time demonstrated significantly greater symptom reduction, significantly more appointments per student, and significantly shorter wait times between appointments than counseling centers that require counselors to absorb new clients regardless of their existing caseload. In addition, the 2018 report found that policies governing access to electronic medical records, by health center staff, were not associated with significant differences in treatment outcomes, suggesting that treatment outcomes are determined by other aspects of counseling center operations.

“In addition to eight-year trends and a national population-level perspective on college students seeking mental health care, the 2018 CCMH report provides specific and actionable findings that should be used by administrators to inform policy decisions related to mental health care in higher education. In particular, the take-home message from the last four reports is that counseling centers are doing everything they can to accommodate the growing demand for service, such as prioritizing rapid access to care. However, this report highlights the negative impact associated with enacting these adjustments to services, such as providing a decreased dosage of treatment, and consequently less effective services. While it is critically important that counseling centers are responsive to the growing number of students who are identified and referred, it is equally important for institutions to recognize the value of policies that support effective treatment of students in distress,” said Locke.

These are some of the findings in the 2018 CCMH Annual Report:

  • Anxiety and depression (as reported by students and their counselors) continue to be the most common presenting concerns for college students, as identified by counseling center staff. Anxiety did not increase in prevalence for the first time in four years, whereas depression continued to increase in 2017-18.
  • Student’s average rates of self-reported anxiety and depression continue to increase while other areas of self-reported distress remain flat or decreasing.
  • The average rate of self-reported “threat-to-self ” characteristics increased for the eighth year in a row among students seeking treatment. Nearly 36 percent of students seeking treatment endorsed having experienced serious suicidal ideation in their lifetime but only 8.2 percent of students seeking treatment report serious suicidality in the last month. Clinicians identified suicidality as a current concern for just under 10 percent of students.
  • The prevalence rate of students who have received prior mental health treatment continue to remain largely flat over eight years. However, the rate of students who have received prior counseling has trended up over the last three years, with 54.4 percent of students seeking treatment indicating they have been in counseling before.

The 2018 Annual Report describes 179,964 unique college students seeking mental health treatment; 3,723 clinicians; and more than 1,384,712 appointments from the 2017-18 academic year. This is the 10th year the report has been produced.

The Center for Collegiate Mental Health at Penn State is an international practice-research network of nearly 550 colleges and universities focused on understanding and describing college student mental health. CCMH collects and analyses de-identified data on college students seeking mental health treatment at colleges and universities in the U.S. and internationally.

The full report can be found online at

Technology is creating alternatives for inaccessible mental health care

“We know that mental health can be difficult to protect if you are from a lower income background,” one expert told us. “The cost of therapy can make it inaccessible to a lot of people.”

It’s estimated that this year alone, over 10 million Americans will be affected by seasonal depression, which is also known as Seasonal Affective Disorder or S.A.D for short,” Liam Hackett, Founder & CEO at Ditch the Label, an anti-bullying non-profit organizations, told Yahoo Finance.

“We know that mental health can be difficult to protect if you are from a lower income background,” he added. “The cost of therapy can make it inaccessible to a lot of people.”

S.A.D. is most common in the colder months, with symptoms including fatigue, feelings of worthlessness, suicidal thoughts, sleepiness, guilt, and anxiety. David Guggenheim, Chief Behavioral Health Officer at Callen-Lorde Community Health Center, suggests seeing a mental health professional if you are experiencing these symptoms.

But care can be pricey, especially if you don’t have health insurance. A copayment to see a therapist for someone with health insurance is approximately $10-$20/hr, whereas without insurance a 1-hour visit can be anywhere between $50 to $250. And the U.S. Substance Abuse and Mental Health Services Administration states that the most common reason for why people did not get mental health care when they needed it was because they could not afford the cost.

Fortunately, with the growth of technology and communities nationwide, there are some cheaper and even free options for receiving some mental health care.

“There’s programs like Talkspace, or other online platforms, that allow you to text or video chat with a therapist, when they’re needed,” Guggenheim said. “Those cost, typically about $100.00 to $200.00 a month. If you’re looking for no cost, and you’re uninsured, there’s a network of community health centers throughout the country, that can see people without payment at all, or meet you where you are, and do it on the sliding scale.”

Prince William Reveals ‘Not One Celebrity’ Was Willing to Join His Mental Health Campaign

Stephanie Petit

The stigma surrounding mental health issues was enough to make stars turn down a campaign started by Prince William, Kate Middleton and Prince Harry.

During a panel on the subject at the World Economic Forum in Davos, Switzerland, on Wednesday, William shared that working with veterans, disadvantaged children and other groups of people led him to realize that many problems fell under the umbrella of mental well-being.

Together with his brother and wife, he launched the Heads Together initiative to focus on mental health three years ago – but even the royal trio had trouble getting famous faces to join their cause.

“What was interesting when we set up the campaign, not one celebrity wanted to join us,” William, 36, said. “Not one person wanted to be involved in the mental health campaign Heads Together.

The royal dad of three added that they went out to “a lot of people” and “nobody” was interested.

Heads Together still moved forward, and Prince William has noticed that many more people are willing to speak about the issues now.

“That was three years ago, and that was a big deal,” he shared. “Obviously, once we started getting the ball rolling and once we started showing people a lot more of what we’re going to do, people realized that Catherine, Harry and I put our necks on the line here. That actually maybe it was okay, we could join. Then some very brave people came forward from celebrities and from normal people who decided this was really important and they bravely took on the task of speaking about mental health.”

William let out a small laugh when the moderator asked if anyone who was initially hesitant to join had changed their minds.

He answered, “It’s now become a lot easier to talk about, which is fantastic news. And that was the whole point of the campaign – to allow people to feel the freedom and the space to talk about it and not feel there was a stigma.”

In April 2017, William and Lady Gaga had a memorable chat — thanks to FaceTime — about their mental health campaigns.

“We have to make the strongest, most relentless attempt we can to normalize mental health issues, so that people feel like they can come forward,” Lady Gaga told William after he suggested they meet up when she comes to the U.K.

William understands the hesitation, sharing that his work as an air ambulance pilot has left him with experiences he “still [finds] very difficult to talk about.”

The royal explained that many workers in the medical community are haunted by tragedies that they experience on a regular basis.

“I get very emotional about it because it relates very closely to my children and so it is very hard to talk about it,” he said.

In his case, William felt that “the most important thing was understanding and realizing it was there.”

“I think if I hadn’t been doing what I was doing, I might have gone into my shell a bit and gone, ‘I can deal with this myself.’ Then potentially, down the line, it manifests itself in a much worse situation,” he said

William added, “I know that if I hadn’t taken the action that I did then, I would have definitely gone down a slippery slope and I would have been dealing with mental illness on a different level.”

A candid reflection of Anxiety

This week, we hear from Mariela Montanez, a 35-year-old woman who was born in Puerto Rico and grew up in Chicago.

My history with anxiety

My anxiety began when I was young. I would say when I was 12 years old, which was when I moved from one neighborhood to another after my parents separated. There, I encountered a new school and people I didn’t know. It was hard to wake up and go to school. I didn’t know I had anxiety until I was 30 years old and suffered a panic attack. I knew nothing about what I was going through.

How anxiety presents itself physically

My anxiety starts the moment I wake up. My heart beats fast and I can hear it as it feels like its coming out of my chest. I have this feeling as if I am on a roller coaster. My stomach drops and my anxiety has made its presence. My hands tremble at times. I clench my jaw. I’m not sure why but I catch myself doing it. I get headaches that can feel like my head is about to pop like a balloon. I’m so tired by the middle of the day and feel exhausted, as if I have been running all day.

How anxiety presents itself mentally

I think about everything. I keep thinking that things will not get better and then my thoughts amplify. The brain can be your enemy when you have anxiety. I run moments in my life over and over again like a movie and try to find where I could have done better. It’s like a light bulb that turns on but doesn’t turn off. You can’t find the switch.

What a day when my anxiety is at my worst looks like

When my anxiety is at its worst I tend to stay home. I stay in my room and can’t seem to get out of bed. I feel like I can’t catch my breath and constantly take deep breaths. My heart beats fast, my hands shake and I’m very sensitive to others. I cry for no reason, my head hurts and I can’t even eat. If I get a trigger strong enough, I start to hyperventilate. My body goes numb, my face has no feeling and it’s hard to talk. My whole nervous system is on steroids. It’s like I am always scared and have nowhere to go. My chest hurts and my stomach has a large knot.

My go-to coping mechanism

I drive a lot. It helps me process the feelings. Driving allows the air to hit my face while I am listening to music that makes me happy and I am in control of where I am going at that moment. The one thing that brings me back before I feel anxiety is cartoons. Not the new shows, but the old ones. I love comedy that makes me laugh. If I do have the feeling of a panic attack coming, I sit and look around. I focus on the here and now and sing the ABCs, which for some reason calms me and helps ground me.

What I wish people knew about anxiety

Anxiety can be so debilitating and exhausting. It’s not easy living like you are scared all the time. I am not the only person who suffers through the feelings. My family does too because they don’t know how to help me. Just being able to explain this now is hard. Sometimes you can’t put feelings into words. The only thing you can do is support and go through the feelings with your loved one. Educating yourself for you or a loved one is very important. Life is what you make it and how you decide to live it.

Increased Need for Counseling Services

JAN 21, 2019

According to the American Counseling Association, “Counseling is a professional relationship that empowers diverse individuals, families and groups to accomplish mental health, wellness, education and career goals.” Over the years, the use of university/college counseling centers has significantly increased. The Center for Collegiate Mental Health (2017) annual report stated that over the past six years (until 2016) there was a 28 percent increase in the services used by students at counseling centers and there has been 7.6 percent lesser hour devoted to providing ongoing counseling services. However, according to the Steve Fund (2015), students of color do not seek counseling services at the same rate at White students. As counselors we need to advocate for an increased number of counselors in the college and university setting to increase their ability to provide counseling services to all students.

University/college counseling centers engage in both crisis and ongoing counseling sessions with students for a variety of reasons. The annual report provided by the Center for Collegiate Mental Health (2017) brought the following facts to light:

  1. A number of students engage in two to five counseling sessions, which decreases after six sessions. Additionally, the data collection also provided information that a large group of students received more than 20 appointments.
  2. After four years of data collection, the two most common presenting problems for students were anxiety (#1) and depression (#2). Other presenting problems were relationship problems (#3), stress (#4), family (#5), interpersonal functioning (#6), academic problems (#7), grief/loss (#8), mood instability (#9), adjustment to the new environment (#10), self-esteem/confidence (#11), and alcohol (#12).
  3. There is a relationship between the average length of treatment and the presenting problem. For example, students with presenting problems such as anxiety and depression generally attend the average number of counseling sessions, even though these issues are highest on the list. Students with less common presenting problems, like gender identity exploration or self-injury, generally attend sessions for a longer period of time.

The data provided by the Center for Collegiate Mental Health (2017) provides us with additional information about the counseling needs of students. Counselors working in college counseling centers must often face conflict between their responsibility to the students and to the institution. While providing individual counseling sessions is one of the requirements of counselors, some of the other responsibilities can include outreach activities such as sexual assault awareness, depression awareness, and classroom awareness, amongst others.

A few counseling centers at universities/colleges report having one or two counselors serving a large student population, which may be less than the International Association of Counseling Services, Inc.’s (IACS; 2016) recommendation of one full-time practitioner (excluding trainees) for every 1,000 to 1,500 students. The Association of University and College Counseling Center Directors (AUCCCD, 2017) report stated that there is an average of 1.70 full- and part-time practitioners for universities that have under 1,501 students. In universities/colleges (91) that have 2,501 to 5,000 enrolled students, the average full- and part-time practitioners are 3.01 (AUCCCD, 2017). Especially for counseling centers with a staff to student ratio below IACS’ recommendation, these counselors may have difficulty figuring out how to balance the workload

of meeting the needs of all students and the institution. With a high workload, and conflict between institutional and student responsibility, there are times when the waitlists for counseling services are high and students have to wait longer to be seen by a counselor.

The AUCCCD (2017) reported waitlists for student services at counseling centers can range anywhere from 1 to 5 weeks to over 35 weeks depending on the number of students at the Universities. Additionally, the average wait days for waitlisted students at counseling centers is about 17.3 days for first appointments.

As the number of students of color increase on college campuses, there is an increased need for outreach and counselors who are trained and experienced with working with these students. In addition, there continues to be an increased need for certain types of expertise in counseling diverse student populations such as international students or student-athletes.

The above numbers indicate that there are a lower number of counselors serving a higher number of students whose needs to seek counseling services has been increasing over time. In 2016, universities/colleges increased the number of mental health professionals to meet the needs of their students. For instance, the University of Iowa hired 8 additional counselors, Skidmore College in New York hired additional counselors and added a 24-hour crisis line, Willamette University added a 24-hour hotline service, and Amherst College added a hotline service (News, 2017).

Even though these changes have been made and are helpful in providing more counseling services to students, there is still a long way to go. As counselors, we, support efforts to increase staffing in college counseling centers with policy makers, and for legislators to provide additional funding for counseling services to meet the needs of today’s college students.

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