College administrators are scrambling to address an alarming treatment gap on campuses nationwide: While nearly 40 percent of college students experience a significant mental health issue, only about one-third of this group receives treatment, according to the 2016–17 Healthy Minds Studyopens in new window, which polled more than 200,000 students at 54 schools across the United States.
"College counseling centers across the country are overwhelmed with visitors," says Lisa Adams, PhD, immediate past president of the American College Counseling Association and director of the counseling center at the University of West Georgia.
The increased demand for mental health services can be attributed in part to increasing rates of depression and anxiety among young people, as documented in the 2017 Annual Reportopens in new window from the Center for Collegiate Mental Health, a practice-research network based at Penn State University. But, says Adams, students are also seeking help more than in past years because of reduced stigma around mental health problems among this population. In addition, thanks to more effective medications, people with severe mental health conditions such as schizophrenia and bipolar disorder are attending college in greater numbers and they often require counseling support.
Universities are looking for creative solutions to meet the growing demand. Among them are a variety of initiatives led by student organizations. Students have started mental health awareness and advocacy campaigns and formed peer-to-peer counseling programs.
A new study by the RAND Corporation suggests that their efforts are working. In the largest longitudinal study of student-run mental health efforts to date, RAND surveyed 1,129 students from 12 California campuses during the 2016–17 academic year about their involvement with Active Minds. Founded in 2003 by college student Alison Malmon after her brother’s suicide, Active Minds facilitates peer efforts to raise mental health awareness on campuses. It has established more than 450 chapters at colleges, professional schools and high schools nationwide.
RAND found that increased familiarity and involvement with Active Minds was associated with decreased stigma toward students who received therapy and increased self-assessed knowledge about mental health. Students who became increasingly involved with Active Minds were also more likely to offer emotional support to peers in need and to help peers get connected to professional help ( Journal of the American Academy of Child & Adolescent Psychiatryopens in new window , Vol. 57, No. 7, 2018).
“I think this speaks to the power of social campaigns on campuses,” says Lisa Sontag-Padilla, PhD, lead author of the study and a psychologist at RAND. “Peer-based organizations have the potential to change the overall climate of the campus related to mental health and to make students feel more comfortable seeking treatment when they need it.”
Adams believes that such student-run efforts are effective because they’re developmentally appropriate. “One of the major goals of the young adult period is to form connections with others in the peer group,” she says. “Students will inherently feel more comfortable talking to people their own age.”
Raising awareness
Active Minds is just one of several student-led mental health efforts nationwide. In Nevada, representatives from the American Psychological Association of Graduate Students (APAGS), APA’s graduate student arm, organize statewide mental health awareness days to bring attention to the issue on campuses and to distribute information about resources. “When people see that on their campus three out of 10 students have suffered from mental illness, it really does decrease stigma in the sense that at least one of their friends is probably dealing with this,” says Leiszle Lapping-Carr, a psychology doctoral student at the University of Nevada, Las Vegas, and state coordinator for the APAGS Advocacy Coordinating Team.
Other student organizations are also deploying students to talk to their peers about mental health. Psi Chi, the psychology honor society, has more than 1,100 chapters that offer on-campus activities such as mindfulness training seminars. Faculty advisors from accredited four-year institutions can apply online to start a new chapter. Mental Health First Aid offers a crisis-response training program geared toward higher-education environments that can be scheduled via the organization’s website (www.mentalhealthfirstaid.orgopens in new window).
A handful of schools have also launched peer-support programs, through which student counselors provide therapeutic services to their peers. At Uncle Joe’s Peer Counseling and Resource Center at Washington University in St. Louis, 60 student counselors—each with more than 100 hours of training—hold one-on-one sessions at the program’s office or by phone to help students cope with anxiety, depression and campus-life issues. Founded in 1978, Uncle Joe’s has seen “a very steep upward trend,” in visits according to co-director Emily Rapoza, a college senior who studies cognitive neuroscience. She attributes the increase to the long wait times at the university counseling center. Like Adams, she believes that peer counseling is popular because it offers a type of support that differs from traditional therapy.
“Because we’re all students at the same university, we’re existing in the same space with many of the same challenges,” Rapoza says. “That creates an inherent level of understanding that can be harder to achieve with a professional counselor who’s in a different life stage.”
Not a panacea
Despite the benefits of such programs, psychologists warn that in many cases, students need professional treatment that peer groups can’t provide. “A good peer program understands when they’ve reached the limits of their own ability to help,” says Eddy Ameen, PhD, APA’s associate executive director of early career and graduate student affairs, noting that peer counselors should receive training to recognize inebriation, psychotic episodes and signs of self-harm. Ameen also recommends that peer-support groups consult regularly with psychologists, both before and after their launch.
More work is needed to maximize mental health resources on campuses and to meet the growing demand for services. Sontag-Padilla says community colleges in particular warrant additional observation, given that they often have limited resources and students may require different types of support.
She also recommends that institutions provide adequate training and information about counseling resources to faculty, who are often the first responders during a mental health crisis. Laura Horne, MPH, director of programs at Active Minds, echoes this advice, adding that the program is increasing its work with all adults involved in university life. “Stigma is very low among students, but we don’t know much about faculty, staff, administrators and parents,” she says.
