In the past year, 41% of over 75,000 surveyed college students reported having major or minor depression, 36% reported having an anxiety disorder, and 14% experienced suicidal ideation.
This key finding from the 2022-2023 Healthy Minds Study by the Healthy Minds Network (HMN), an adolescent and young adult research organization focused on mental health, highlights the need for student mental health support.
In response to this national issue, colleges and universities, leaders, researchers, and organizations are developing innovative ways to reduce mental health stigma, advance conversations, revise institutional policies, and expand programming to better support the campus community.
Recent efforts by two leaders, Dartmouth College and HMN, are doing exactly that. An event hosted at Dartmouth, combined with their new university strategic plan, is bringing national attention to the topic and informing policies and programs across campus. In addition, HMN is creating a digital collaborative resource that showcases data-driven mental health initiatives proven effective in higher education.
Dartmouth College
This past fall, Dartmouth College, Geisel School of Medicine, and the C. Everett Koop Institute at Dartmouth Health Medical Center brought the conversation of student mental health to the forefront by hosting a panel, led by CNN correspondent Sanjay Gupta, MD, that convened eight surgeons general to discuss ways colleges and universities can support their campus communities. The historic moment marked the first time in 25 years that all the living surgeons general gathered in one place for a united purpose.
It raised awareness of the academic pressure and stress college students face, says Lisa McBride, PhD, associate dean for DEI (diversity, equity, and inclusion), professor of medical education in the Geisel School of Medicine at Dartmouth College, and Insight Into Diversity editorial board member.
“I think the [event] actually elevated the need for us as administrators, and particularly college presidents, to focus on the mental health of students. … When I thought of this [panel], I didn’t know the impact that it would have,” McBride says.
Current Surgeon General Vivek Murthy and his predecessors met with Dartmouth student leaders and spoke at the panel on a wide range of topics related to the issue of mental health, including stigma, campus support, early diagnosis, and treatment. They also convened a roundtable event on the Future of Health Care, hosted at the Geisel School of Medicine, where they discussed a variety of topics including health care worker burnout and inequities in the health care system.
“I think that one talk does not solve the issue,” says Antonia Novello, MD, the first woman and first Hispanic person to serve as surgeon general of the U.S. “After that talk, many students will come out about their problems, and then the institution has to be ready to tackle [those issues] at that time of need.”
Since the panel, McBride has continued building momentum with collaborations among students, surgeons general, higher education institutions, and leaders in the field.
Dartmouth worked with The Jed Foundation (JED), a nonprofit that protects emotional health and works to prevent suicide for teens and young adults, to develop Commitment to Care, a strategic plan for new campus initiatives published in October. Focus groups across campus informed the project, which prioritizes improving mental health outcomes.
As a result, Dartmouth made revisions to institutional policies, such as expanding the Time Away for Medical Reasons policy and eliminating overnight fees at the Dartmouth College Health Service Inpatient Department/Infirmary. More than 440 faculty and staff were trained to champion student mental health and well-being last year. Yoga and meditation opportunities are offered across campus to support emotional wellness.
“The most important thing to remember is mental health is equal to physical health. … It’s OK not to be OK. But it’s not OK for you to stay that way.”
– Antonia Novello, MD
Geisel School of Medicine students also have free access to in-person campus counseling services and teletherapy. Digital offerings make it possible to recruit more mental health professionals of color so underrepresented students feel comfortable talking about topics like racial trauma, says McBride.
These policies aim to diminish the particularly low rates of mental health service utilization among students of color across the country. The highest annual rate of past-year treatment for Asian, Black, and Latino students was at or below the lowest rate of White students, according to the report “Trends in College Student Mental Health and Help-Seeking by Race/Ethnicity: Findings From the National Healthy Minds Study, 2013-2021.”
One person utilizing the medical school’s counseling is Macri Gil Diaz, a third-year medical student. Diaz was a campus mental health advocate in her previous role as co-president of the Latino Medical Student Association, and currently serves as co-chair of academics with the Geisel School of Medicine Student Government.
It’s essential for colleges to consider the learning and work environments of students when tailoring resources, Diaz says. For medical students, it can be hard to manage counseling appointments with barriers like changing clinical schedules and studies.
“I still go to therapy every week … it is the one thing that has helped me succeed not only personally, but also academically,” she says.
Healthy Minds Network
To further aid colleges and universities, HMN and the Mary Christie Institute are developing a digital repository focused on successful preventative interventions, including policies, programs, and services that address student mental health in higher education. HMN researchers are synthesizing available data and evidence to create a resource of best practices.
The project was prompted by a gap in information on population-level approaches to student mental health, says Daniel Eisenberg, PhD, professor of health policy and management at the University of California, Los Angeles, and principal investigator for HMN. In addition, digital products, such as training programs, are new, less regulated, and harder to evaluate.
Interventions that are experiential, or focused on active learning, tend to be the most effective, he says. As a result, HMN also will create an active learning network for experts, peer researchers, and campus leaders to further collaboration and advance effective programming on campuses across the nation.
Eisenberg predicts that the first report, a guide to digital mental health interventions, will be complete in March.
Resources for Students Seeking Help
National:
- Suicide & Crisis Lifeline: Call or text 988.
- Crisis Text Line: Text “COALITION” to 741741.
- TrevorSpace: An affirming, online community for LGBTQ+ students.
On Campus:
- Search for your college’s counseling services, hours, and locations.
- Talk to your dorm’s resident adviser (RA).
- Reach out to trusted friends.
Information courtesy of the Mental Health Coalition.
Overall, world events are drawing attention to the issue of student mental health, Eisenberg says.
“But at the same time … mental health has always been a major concern for students and really, [everyone],” he says. “I think it’s more that there’s this increased awareness and attention to the topic — now more than ever.”
Further Support
Colleges and universities aiming to further their mental health support can start by reviewing general guidelines provided by JED. Among JED’s list of actions are identifying students at risk, providing mental health and substance misuse services, increasing help-seeking behavior, promoting social connectedness, and following crisis management procedures.
While clinical services are important, many students can benefit from other forms of care, like group or peer-based programs and wellness coaching, says Eisenberg. Additionally, clear guidance for accessing mental health resources can be a priority across university communications.
DEI can also be considered alongside student well-being and mental health needs.
“For example, a sense of belonging on a campus can be good for mental health and also it’s important for equity and inclusion concerns. … ideally campuses are thinking about the intersection of these areas,” Eisenberg says.
Beyond institutional support, Novello says it’s essential for friends to check in on each other and watch for signs of distress, such as trouble sleeping, changes in eating habits, or loneliness. Community support encourages those struggling to seek help.
“The most important thing to remember is mental health is equal to physical health … It’s OK not to be OK,” she says. “But it’s not OK for you to stay that way.”
To learn more, visit mentalhealth.dartmouth.edu and healthymindsnetwork.org.
This article was published in our January/February 2024 issue.
Above: Dartmouth College medical students chat with Antonia Novello, MD, the first woman and first Latina to become surgeon general of the U.S. (Photo courtesy of Rob Strong)
![One day after the mass shooting incident at Michigan State University in February, a University of Florida (UF) student called the UF Police Department (UFPD) concerned about a classmate who was researching guns and ammunition. Instead of just police responding to the call, a trained behavioral health specialist was also dispatched. “Our clinicians and officers spent three hours with that person to really flesh out why he was searching what he was searching,” says Meggen Sixbey, PhD, assistant director of the Behavioral Services Division of UFPD and a co-responder. “Do we have evidence to be concerned? In those three hours with him, they learned that he was in fear of his own safety [due to] things that were going on in his own life.” Without UF’s co-responder approach, Sixbey says, the situation could have escalated quickly or ended differently, and the student may not have received appropriate help. Due to widespread concern around mental health and fears of escalation caused by law enforcement response, partnerships between police and behavioral health specialists are growing across higher education campuses. Experts see this collaboration as a way to aid the most vulnerable by connecting them with needed resources and support. Collaborations differ campus to campus based on institutional needs. While some new programs, like the one at UF, dispatch counselors directly to the scene with police officers, others do not involve immediate on-site clinician response to dispatch situations. The University of Colorado Anschutz Medical Campus, for example, works with both municipal and campus police to provide mental health support services to students, all of whom live off campus. University case managers help officers on the scene when there is no perceived imminent danger. Additional support is provided by the Campus Assessment, Response & Evaluation (CARE) Team, which is a common type of program at colleges and universities. The goal is to reach students before their situation becomes critical. The CARE Team reviews referrals for urgent mental health support among students and connects them to campus resources such as case management and additional counseling services. When assessing a threat, each situation is evaluated based on the NABITA Risk Rubric, a tool used in triaging mental health concerns with an interdisciplinary team approach, says Jan Gascoigne, PhD, associate vice chancellor for student affairs, and associate clinical professor. “Often the situation is determined not to be a threat but really just someone who is struggling and needs help,” she says. “We’d rather try to work with that person, figure out what’s going on, and get them the help they need without having to escalate to a police intervention. Our campus police have the same philosophy.” New programs expand mental health services in dispatch situations, with projects being introduced at Johns Hopkins University, The University of Texas at Austin, the University of Oregon, Colorado State University, and California State University, Long Beach. During a six-month trial in the city of Denver, in which mental health specialists were paired with police to respond to calls involving trespassing and other nonviolent events, a 34 percent drop in crimes was reported, or approximately 1,400 fewer criminal offenses, according to the Stanford University report “A Community Response Approach to Mental Health and Substance Abuse Crises Reduced Crime,” published last year. UF’s program launched in July and is the first in the nation led by a campus police department, Sixbey says. Calls are answered by UFPD, which contacts clinicians when there is a mental health component. Situations might include, for example, a student who threatens suicide, someone who was just fired from their job, or an individual whose property was stolen. It’s essential to decriminalize mental health, or mitigate criminal offenses in such calls, Sixbey says. It’s also important to de-escalate situations with clinically trained professionals to help reduce hospitalizations, which are often traumatic, she says. The UF team is looking for more effective ways to enhance efforts to assist underrepresented individuals because the relationship between these communities and law enforcement has historically been strained, a circumstance highlighted by recent social justice activism and political attention paid to policing. In addition to a campus climate survey, UF is conducting focus groups to see how underrepresented communities on campus view the program. Preliminary feedback points to possible changes in police uniforms, where officers would wear a pin or patch to identify themselves as Crisis Intervention Team trained, which means they have received mental health instruction to guide interactions. Individuals surveyed also showed interest in making the clinician the lead responder instead of an officer. This model was used successfully a couple of months ago, Sixbey says. A faculty member of color called regarding a Black student who made a concerning statement about suicide and left the classroom abruptly. The caller didn’t want police to go to the student’s home because they were aware he had experienced past interactions with law enforcement, but the caller still felt a wellness check was warranted. Based on the information provided, the clinician was able to strategize and lead the interaction. They found that the fears the instructor had regarding the student’s mental health were not present and that he was thankful for the tailored response. “Why a program like this is so beneficial, especially to underrepresented populations, is simply because it provides an additional resource which is an alternative to law enforcement response,” Sixbey says. “Even the best law enforcement officer with an abundance of mental health and crisis intervention team training is still an officer. When you can bring a mental health worker to the scene, it can shift the dynamic and allow for a noncriminal approach to a noncriminal matter.”](https://www.insightintodiversity.com/wp-content/uploads/2023/03/Crisis-Response-1-218x150.png "Counselor-Police Response Partnerships Benefit Students in Crisis")
