Lessons from Campus: College Students and Mental Health
Lessons from Campus: College Students and Mental Health
Associate Vice President and Director of the Counseling & Mental Health Center; The University of Texas at Austin
First published in Psychiatry Weekly, Volume 7, Issue 17, September 3, 2012
Each year over 20 million people—roughly 16% of the US population—enroll in US colleges and universities. In 1990, when that figure was closer to 14 million, Dr. Dave Drum and Dr. Gus Barón started The National Research Consortium of Counseling Centers in Higher Education as a mechanism to conduct research specifically in college students and mental health. Dr. Chris Brownson, from The University of Texas at Austin, is the current director of the consortium, whose latest college mental health survey included partnerships with over 70 institutions of higher education and over 26,000 student responses nationally. Dr. Brownson and colleagues use these data to conduct research of practices in suicide prevention and optimal care models designed specifically for university mental health centers.
The Campus Mental Health Center
College counseling and mental health centers are often multidisciplinary, their makeup varying greatly from one institution to the next. Some centers may have mental health services available through their general health services, while others may have stand-alone units with psychiatrists and other mental health providers dedicated solely to mental health. “These centers do a lot of training and education, as well,” says Dr. Brownson. “Many counseling centers function as internship sites for psychologists entering the final phase of their graduate education, as well as social workers in training and medical residents.
“The care models in many college mental health centers are focused on treatments that are more short-term in nature,” continues Dr. Brownson. “Most centers can’t afford to do long-term counseling interventions for their students, but this approach can fit well for a student population. Students may come in for 4–5 sessions to address a particular issue they’re working on, then you might not see them for another year, after which they may return for another few sessions addressing a related issue.”
The counseling center at UT Austin offers dozens of psychotherapy groups each semester, addressing depression, anxiety, and other diagnostic concerns. Other groups target specific populations, such as graduate students working on their dissertation or first-generation college students. “These are great interventions for college students,” says Dr. Brownson, “and they’re developmentally appropriate. College is a time of life when people are forming their own identity, and these groups can be helpful for that kind of exploration.”
Academics and Mental Illness
According to The National College Health Assessment report from 2010, 30% of college students said they had been so depressed during the past 12 months that it was difficult to function.1 Nearly half reported feeling overwhelming anxiety, 11% had received a diagnosis or treatment for depression, and 7% had seriously considered suicide during the previous 12 months. The same findings report that stress is the number one academic impediment cited by college students. Could academic stress therefore be responsible for an upward blip in the incidence of mental illness during the college years?
“I don’t know of any research indicating that, once college students graduate, psychological impediments tend to diminish because of lessened stressors,” says Dr. Brownson. “If anything, we’re beginning to see that students who are coming to campus from high school are coming with already significant mental health histories. Among respondents in our last survey who reported seriously considering suicide within the past year, over 75% had entered college with a prior suicidal episode. Although a common perception is that the stressful college environment drives students to have these issues, there is evidence to support the idea that many of these students are coming in with psychiatric histories.
“There is also evidence that being in college is actually a protective factor for students,” continues Dr. Brownson. “For example, suicide rates for college students range from 6.3 to 7.5 deaths per 100,000 students. That’s comparable to 15 deaths by suicide per 100,000 for their age-matched peers. Overall, college campuses appear to be environments that protect against suicide.”
Suicide prevention work on college campuses is becoming a best practice. Many campuses have developed programs that focus on educating students, faculty, and staff on recognizing warning signs of distress or suicide. The University of Texas at Austin has developed the “Be That One” suicide prevention program (www.cmhc.utexas.edu/bethatone). “About half of suicidal college students choose not to tell anyone, but of those who do tell someone that they are suicidal, two-thirds are conveying this to a peer,” says Dr. Brownson. “Educating students about how to help friends in distress is an important component of any campus suicide prevention program.”
Disclosure: Dr. Brownson reports no affiliations with, or financial interests in, any organization that may pose a conflict of interest.
American College Health Association. American College Health Association-National College Health Assessment II: Reference Group Executive Summary Spring 2010. Linthicum, MD: American College Health Association; 2010.