Mental Health: An Epidemic for Universities – I

From 2020-2021, there has been a fundamental change in the way mental health and wellbeing is viewed and approached by universities. ^[3] In a March 2021 survey conducted by Inside Higher Ed, student mental health was the top priority for US university presidents, with 96% expressing concern about students and 94% expressing concern regarding the mental health of employees. ^[13]

 This is reinforced in an Inside Higher Ed survey of student affairs leaders, conducted by Gallup, in which university leaders said the top issues that dominate their time are student mental health (94%), and student well-being (91%). ^[27]

During COVID-19, the majority of college and university leaders placed the emphasis on physical health, with the priority of stopping the spread of COVID-19. “When we saw a physical health crisis, we did not respond to the mental health crisis running parallel”, said Marlene Tromp, President, Boise State University. ^[33]

That perspective has now largely changed with a greater emphasis on both mental health and physical health. Kevin Kruger, President of the Student Affairs Administrators in Higher Education said, “There is a clear understanding on campus that the long-term solutions must include population-level wellness and well-being initiatives in addition to therapeutic interventions.” ^[27]

According to the Association for University and College Counseling Center Directors, students today are mostly dealing with three major psychiatric conditions: anxiety (48%), stress (39%), and depression (34%). ^[39]

Unfortunately, there has been a significant increase in the number of students at university with a mental health condition – even before COVID. In 2017, the Institute for Public Policy Research (IPPR) reported that there had been a fivefold increase in the number of students who disclosed a mental health condition to their college or university over the past decade. IPPR research found that over the past five years, 94% of universities experienced a sharp increase in the number of people trying to access support services. ^[3]

Interestingly, the proportion of students saying their mental health had deteriorated rose in similar fashion across western countries, including 75% in the US, 70% in the UK, and 67% in AU. ^[21] One study found that six times more young people in England have psychological challenges today than a generation ago. ^[47] And in Australia, a survey of over 3,300 students across 40 universities and 30 TAFES undertaken by the National Union of Students in 2016 found that 67% of 16-25 year-olds rated their mental health as poor or fair. ^[22]

Overall, just 34.7% of Australian students reported a sufficient level of wellbeing. ^[20] Similarly in the US, 65% of university students rated their mental health as “fair” or “poor”, according to Inside Higher Ed’s recent Student Voice survey of college students. ^[18]

William Leahy, Deputy Vice-Chancellor for Brunel’s University in London observed the first time many students access any kind of mental health treatment is when they start at university. “We have seen unbelievable underfunding of secondary schools over many years – and not just schools but social services, youth clubs, all those services that used to be preventative, they’ve all gone.” The result of this underfunding places an extra burden on universities to take on the responsibilities of the health or social services. ^[47]

Additionally, diagnosis of mental health conditions can be more challenging for new students, as the university does not know what constitutes a normal mood, disposition, and mental state for each individual. Furthermore, unless volunteered by the student, counselors don’t know if students were previously diagnosed with a condition and the scope of mental health counseling and treatment they’ve received prior to arriving at the university.

Of course, the quality of mental health treatment varies from one university to another. Unfortunately, students with more advanced conditions that require psychiatric services may not be able to access these services. For example, a survey of one the Association for University and College Counseling Center Directors (AUCCCD) found 35% of universities don’t offer psychiatric services on their campus. ^[39]

More than half of students said they would not know where to go if they or someone they knew needed professional mental health services right away, according to an Active Minds survey. ^[8]

Many universities rely on their websites to communicate what resources exist, yet when students were surveyed if their university’s websites included information about mental health, 64% responded “no” or “do not know.” ^[53]

And for those that do know where to go for help, 60% of college students say the pandemic has made it harder to access mental health care, according to a survey on the impact of COVID-19 on student well-being. ^[54]

During COVID, most universities used virtual treatment to bridge students’ lack of direct access to various mental health services.  And while this approach was deemed successful overall, challenges included more difficulty with assessing students’ state of mind and needs and achieving connectedness with students when physically separated. ^[3] According to a study by University College London, many patients experienced serious disruptions to their access to and quality of mental healthcare as a result of shifts in treatment from in-person to virtual support due to the pandemic. ^[38]

And while virtual treatment can scale better, it was not ubiquitous. In fact, some students faced gaps in resources in treatment and resources when transitioning from home to university or vice-versa. An American College Health Association survey in early April found that less than half of colleges and universities were able to virtually treat students regardless of where they were living. ^[8]

In some cases, licensing laws prohibited treatment across state lines in the US. ^[8]

Given the prevalence of mental health challenges faced by universities, it’s understandable university executives are making this their top priority. As we continue to explore mental health, our next article in this series will cover how COVID has exacerbated mental health, the impact mental health challenges have on universities, students, the blind spots universities need to address, and how SafeZone can help you address them. We thank you for your interest in this topic and invite you to share this content with your peers as you prepare to tackle this head-on in the upcoming semester.