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Mental Health in College Populations: A Multidisciplinary Review of What Works, Evidence Gaps, and Paths Forward
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January 2025
... University is a time of transition; greater independence and less oversight mark the social, learning, and emotional worlds of young adults. With freedom to make life choices, have fun, and choose one's friends, there is also more isolation and stress, financial worry, and learning struggles [1][2][3]. Early adulthood's slope is slippery; many young people thrive, but some flounder, and others even suffer. Indeed, mental health is taxed upon university entrance with depression, anxiety, and stress peaking around the age of 25 [4][5][6]. ...
... Indeed, mental health is taxed upon university entrance with depression, anxiety, and stress peaking around the age of 25 [4][5][6]. In the Middle East/North Africa region, depression and Yet, the reality is that being a university student is often marked by loneliness, lack of meaning, and low or negative moods [1][2][3]. For students in international forms of education, there is often a disconnect between student's prior education systems and that which is being offered, such that independent critical thinking, student-led motivation, academic writing, defending one's ideas, and group-based learning conflicts with memorization and rote learning [32][33][34]. ...
... It is often used interchangeably with the umbrella term of "happiness," referring more generally to an affective state of feeling good, while "wellbeing" refers to, and also includes functioning well over time. Further, while research to guide initiatives grows, what is relied upon more often stems from the West (e.g., [1]) and is based on "WEIRD" samples, i.e., Western, Educated, Industrialized, Rich, Democratic [44] that is not always helpful elsewhere. Further, the most recent iteration of positive psychology 3.0 construes wellbeing from a systems perspective, whereby contexts are the unit of intervention and understanding, versus individuals alone [41,45]. ...
How happiness is defined depends on who is asked. In the case of universities, student happiness should prevail, yet their voices are often overlooked. This is also the case in the research literature where non-Western views are less frequently reflected. The United Arab Emirates (UAE), a country whose population is comprised of nearly 90% expatriate residents, is a good study case as campuses are filled with international students and the wellbeing of residents is a national priority. Responses from 80 UAE-based expatriate students reveal they are happiest with friends and in social activities and interactions; they want more opportunities to connect socially in classrooms and campuses, efforts which can be crafted by faculty. They also want joyful, inspiring learning where they can discuss and be exposed to other views, with many driven by the need to feel productive, efficacious and engaged. Solutions included the need for faculty to develop warmer student relationships, the maintenance of online learning to reflect realities of work and relationships, and for students to be treated with more respect as fee-paying adults. As the number of international students rise, research into their happiness and what universities can do to increase it remains a global priority.
... Mental health in higher education is an urgent, growing, and widely researched topic (Abelson et al., 2022;Jayman et al., 2022;Pandya & Lodha, 2022)-yet, until recently, the focus has primarily been on students (Dinu et al., 2021). There is an epidemic of mental health concerns among university staff, demonstrated in part by high levels of burnout and stress (Urbina-Garcia, 2020) with increased support-seeking (Morrish, 2019). ...
Research has reported an epidemic of mental health concerns among staff in higher education. Universities can improve staff mental health by creating work environments that are more psychologically, socially, and organisationally safe and supportive. Yet, qualitative evidence in this area remains limited, and there are calls for further qualitative research to understand how institutional and systemic conditions affect university staff mental health. We accordingly designed a programme of embedded mixed-methods survey research to explore how university climate shapes psychosocial safety, psychosocial risk, and mental health at one Australian institution. In this article, we present findings from the qualitative dimension of our work: an inductive qualitative content analysis of 857 staff responses to one open-ended survey question: ‘How do aspects of the university impact your mental wellbeing?’ Participants spoke to six distinct aspects of university climate: (i) workload; (ii) institutional systems and policies; (iii) institutional culture; (iv) local management; (v) senior management; and (vi) harmful behaviours. Together, these findings reveal great complexity in how systemic, institutional, and relational phenomena all impact university staff. We situate our findings within the context of existing scholarship on staff mental health in higher education; discuss their implications for future research, practice, and policymaking; and conclude with an urgent call to action.
... Higher education has elevated student mental health to an absolute priority, as colleges and universities struggle to address the problems caused by the precipitous increase in students reporting distress and requesting assistance. In order to lend coherence to this extensive corpus of knowledge, Abelson, Lipson, and Eisenberg [13] undertook an exhaustive examination of the policies, practices, programs, and services that influence the mental health of students. ...
This paper aims to investigate the state of mental health of the students at City College of Calamba in the Philippines regardless of their gender. Using a quantitative approach, four hundred eighty-seven (487) college students responded with the validated questionnaire known as the College Adjustment Scale Assessment tool which was acquired by the institution was utilized. With the average mean of 1.9255 which is interpreted as "Low Risk" means that majority of the students in the institution appear to be dealing with typically pleasant mental state. It further implies that the respondents do not have significant or worrisome levels of mental health issues on average regardless of their gender. While individual experiences may vary, this overall low-risk rating suggests that, as a group, these college students are coping rather well with the numerous pressures and challenges that frequently accompany the college experience. Their mental health looks to be stable, and they may not be experiencing severe anxiety, depression, or other mental health conditions at levels that would cause immediate worry.
... 1 Building upon these principles, there are calls for the application of public health and health-promoting approaches to addressing mental health-and mental ill-health-in university settings. 2 Yet, despite the potential to impact populations comprising over one million students and over 100 000 staff, uptake of these approaches in Australian universities has been limited. 3 Although institutional adoption of (mental) health-promoting approaches remains partial in Australian higher education, there has been some growth in relevant epidemiological and interventional research. ...
While comprehensive mental health promotion inherently involves individuals, there is an ongoing need to address large‐scale determinants of people's mental health and wellbeing—particularly policies and environments. To have the best possible chance of creating positive change, mental health promotion must also work throughout key mediating structures such as places of education and work. This includes universities. Yet, in their efforts to address student and staff mental health and wellbeing, Australian universities have demonstrated limited uptake of comprehensive mental health promotion approaches. In this commentary, I discuss a recent review of Australia's higher education system—the Australian Universities Accord—as a catalyst for strengthening institutional action and change through a comprehensive mental health promotion lens. I discuss key findings—and silences—made clear throughout the review process. I then advocate several urgent priorities for university‐level change—across institutional assessment, institutional accountability and performance, and institutional leadership and power—if Australia's universities are genuinely committed to improving mental health and wellbeing among students and staff.
... Ranging from academic accommodations to mental health support, these services are indispensable for catering to the unique needs of each student (Ezarik, 2022;Hyseni Duraku, Davis, & Hamiti, 2023). For students experiencing war trauma, this individualized support may encompass counselling services, extensions on assignments, and alternative examination arrangements (Abelson et al., 2022). Collectively, these measures contribute to the establishment of a supportive learning environment that recognizes and addresses the specific challenges faced by these students, thereby facilitating their academic and personal development within the university setting. ...
People living with disabilities are excluded in various ways, like the infrastructure designs of Nigerian buildings, the school environment, job opportunities, and social services. Demola Adeleke’s Facebook Blind Chronicles is a personal narrative of the collective narratives of people living with disabilities. This study adopts a discourse approach to textual analysis and observes that personal Facebook narratives allow survivors of social and institutional exclusions to bear witness to their subjugation in organic society. Through this mirroring, this study accounts for strategies for combating barriers to social inclusion for people living with disabilities. This study, through the application of an art-based research approach, trauma theory, and the concepts of “gaze” and “proximity,” attempts to analyse dimensions of proximity and gazing as vectors of exclusion for people living with disabilities and the effects of such exclusions. This study concludes that sensitization, implementation of new laws, and enforcement would lead to social inclusion for people living with disabilities.
... Through a general education curriculum, the university faculty community enacts these values and academic objectives to define the experiences that should occur during a college career by the time of graduation, whether that be the idealized as 4 years/eight semesters of uninterrupted coursework and/or the commonly occurring disrupted studies (Abelson et al., 2022;e.g., stop-outs due to physical or mental health, family responsibilities, financial constraints, academic probation, transfer). A welldesigned general education curriculum equips students with the high-impact experiences that the community of scholars prioritizes most. ...
Faculty at a large public research university designed a required, high-structure, active learning course for all incoming and transfer students to acknowledge and address the challenge of transitioning from high school to college. The course, College Thriving, covers topics on growth mindset, the science of how students learn, selecting academic areas of study, stress management, and wellness. As a one-credit, pass/fail course, with 12 weekly meetings across the course of the semester, the course serves as a warm and welcoming environment for all students to come together with a trusted adult such as an academic advisor, instructor, or student success professional. Students build networks, enhance self-knowledge, and positively engage with other students and campus resources to increase their ability to benefit from their college years at a large public global research university. The course is part of a new general education curriculum at the institution and prioritizes revealing the “hidden curriculum” of college to ensure that all new college students start with common language and the support of peers and professionals. In developing this course, our academic community was committed to creating inclusive, shared learning environments for all incoming students as they progress toward their academic degree and offering support as soon as student need is identified. In this article, we describe the course, key outcomes after the first year, and future directions.
... A growing body of research has recently been accumulated to document mental health concerns among university populations, which has become a priority for academic institutions [31,32]. Recent evidence from 2023 indicates that one-third of the campus community, including faculty, staff, and students, experiences symptoms consistent with depression, anxiety, and/or stress [33]. ...
In recent years, there has been increasing recognition of mental health concerns in academia, with stress, burnout, anxiety, and depression being reported among faculty members. The demanding work environment, the need to balance personal and professional duties, and the constant pressure of productivity while navigating multiple tasks of teaching, research, mentorship, professional development, and service all impact the mental health and overall well-being of faculty. Higher education institutions have structurally changed as has the research landscape. These changes as well as faculty-specific and student-specific factors coupled to the effect of the COVID-19 pandemic have led to profound effects on the mental health of academics. This paper is a narrative review of the pertinent literature describing faculty mental health and well-being. It summarizes the available evidence on factors influencing faculty mental health and shows the prevalence of anxiety, depression, stress, and burnout among faculty from various academic fields and along the whole academic ladder. Using a suggested framework that collates the efforts of leaders and faculty, the paper concludes by exploring strategies that promote work–life balance among academics and suggesting effective interventions to improve their mental health outcomes.
... Administrators of college students' education play a significant role in improving school management. The administrators are responsible for strengthening the mental health of students by changing managing ideas, improving student education management, innovating management techniques and methods, and promoting the development and progress of education management for college students (4). This can be done by providing physical education to students because this education is not only related to fitness and sport but also contributed toward the healthcare of students. ...
Present study has aimed to understand the intervention and prevention of the mental health crisis of college students. For this purpose, this study has checked the effect of trust in wellbeing information on preventive behavior and mental wellbeing. The target population taken for this study is the students of colleges situated in Mainland in China. The data was collected from the 458 students of the college. Smart PLS has been employed on the data to get the results using partial least square structural equation modeling. For this purpose, the data were analyzed in two stages, i.e., measurement model stage and the structural model stage. Results of this study have revealed that trust in wellbeing information plays a significant and positive role in setting preventive behavior and the mental wellbeing of students. Further, it has also been revealed that preventive behavior also plays a significant and positive role in mental wellbeing. Additionally, preventive behavior has been found as an important mediating variable among the relationship of trust in wellbeing information and mental wellbeing. Moreover, family support is crucial by positively moderating the relationship between preventive behavior and mental wellbeing. Many practical implications have been found among which the foremost is that the education institutes must undertake those efforts that aim to ensure the fairness in the information spread regarding the mental wellbeing during seminars, workshops and administration should play a positive role responsible for strengthening the mental health of students by managing ideas, improving student education management, innovating management techniques and methods.
College student mental health has been a critical concern for professional counselors. Anxiety and depressive disorders have become increasingly prevalent over the past decade. Utilizing machine learning, a subset of artificial intelligence (AI), we developed predictive models (i.e., eXtreme Gradient Boosting [XGBoost], Random Forest, Decision Tree, and Logistic Regression) to identify US college students at heightened risk of diagnosable anxiety and depressive disorders. The dataset included 61,619 students from 133 US higher education institutions and was partitioned into a 90:10 ratio for training and testing the models. We employed hyperparameter tuning and cross-validation to optimize model performance and examined multiple measures of predictive performance (e.g., area under the receiver operating characteristic curve [AUC], accuracy, sensitivity). Results revealed strong discriminative power in our machine learning predictive models with AUC of 0.74 and 0.77, indicating current financial situation, sense of belonging on campus, disability status, and age as the top predictors of anxiety and depressive disorders. This study provides a practical tool for professional counselors to proactively identify students for anxiety and depressive disorders before these conditions escalate. Application of machine learning in counseling research provides data-driven insights that help enhance the understanding of mental health determinants, guide prevention and intervention strategies, and promote the well-being of diverse student populations through counseling.
Objective:
Investigate the association between perceived social support and depressive symptoms at different stages of academic progress.
Participants:
Undergraduate students (n = 505) enrolled at a large southeastern university.
Methods:
Students completed a cross-sectional survey about their self-reported physical and mental health. Logistic regression was used to assess the relationship between depressive symptoms, perceived social support, and academic class standing.
Results:
Academic class standing and perceived social support were both significantly associated with depressive symptoms. Compared to freshman, odds of having depressive symptoms were 2.15 times higher for sophomores and 3.94 times higher for seniors. For every one unit increase in perceived social support, the odds of depressive symptoms decreased by 51%.
Conclusions:
A significant association between depressive symptoms and social support was identified for all undergraduates in this sample. The differences identified between social support and depressive symptoms reveal the need to tailor support provided at different academic stages.
Background
A considerable gap in knowledge exists around mental health trends in diverse racial and ethnic adolescent and young adult populations. The purpose of this study is to examine annual trends for mental health and help-seeking by race/ethnicity in a national sample of college students.
Methods
Survey data come from >350,000 students at 373 campuses that participated in the Healthy Minds Study between 2013 and 2021. Analyses are descriptive in nature focusing on year-by-year prevalence and help-seeking rates for each racial/ethnic group.
Results
In 2020–2021, >60% of students met criteria for one or more mental health problems, a nearly 50% increase from 2013. Mental health worsened among all groups over the study period. American Indian/Alaskan Native students experienced the largest increases in depression, anxiety, suicidal ideation, and meeting criteria for one or more mental health problem. Students of color had the lowest rates of mental health service utilization. The highest annual rate of past-year treatment for Asian, Black, and Latinx students was at or below the lowest rate for White students. Although Arab American students experienced a 22% increase in prevalence, there was an 18% decrease in treatment.
Limitations
Response rates raise the potential of nonresponse bias. Sample weights adjust along known characteristics, but there may be differences on unobserved characteristics.
Conclusions
Findings have important implications for campus mental health programming and underscore the urgency of reducing mental health inequalities in college student populations through the identification and implementation of best practices both in clinical settings and through system-level change.
Lesbian, gay, bisexual, and transgender (LGBT) youth are at risk for engaging in negative health behaviors and for experiencing at-school victimization. Specific benefits of attending a high school with a gay-straight alliance (GSA), including lower levels of suicidality, have been published; however, it is unclear whether GSAs are related to lower levels of problematic substance use, depressive symptoms, and psychological distress. Using a sample of 145 LGBT youth recruited from college and university organizations for LGBT students, we examined whether attending a high school with a GSA was related to more positive school experiences and mental health outcomes for LGBT youth. The results indicate that youth who attended a high school with a GSA report significantly more favorable outcomes related to school experiences, alcohol use, and psychological distress. The implications of the findings are discussed as they relate to school psychologists. Important limitations of this study are reviewed.
Studied the effectiveness of a set of techniques for increasing the interpersonal skills of 16 nonassertive (Wolpe-Lazarus Assertiveness Questionnaire) male schizophrenic inpatients (average age 29 yrs). Ss participated in 12 sessions of interpersonal skills training. The effectiveness of the procedure was evaluated with both self-report (Subjective Units of Discomfort Scale) and behavioral measures. The behavioral measures involved ratings of S performance during both role-played and spontaneously enacted interpersonal situations. Several of the situations were used in training, and others were used only during the assessment sessions. To promote extrasession generalization of behaviors, dyads were formed and were given homework assignments to complete. Compared to a control group matched on age, length of total hospitalization, and pretreatment level of skills, the interpersonal skills training group significantly improved on measures of loudness, fluency, affect, latency, eye contact, content, and self-reported assertiveness. These improvements were apparent across both role-played and spontaneously enacted situations and across trained and untrained situations.
Hate crimes against Asian American/ Pacific Islanders (AAPIs) have surged in the United States during the COVID-19 pandemic to alarming new levels. We analyzed data from the Healthy Minds Study, and found that COVID-19 related racial/ethnic discrimination was associated with greater odds of having depression, anxiety, non-suicidal self-injury, binge drinking, and suicidal ideation among AAPI university students (N=1697). Findings suggest that the COVID-19 pandemic precipitated discrimination, which has been linked to mental health problems, calling for more preventive interventions to address the AAPI population, especially given their low rates of formal treatment utilization.
Effective mentoring promotes the development and success of graduate students. Yet mentoring, like other relationships, can have negative elements. Little knowledge exists about the problematic mentoring that graduate students experience despite its potentially detrimental impacts. To begin to address this gap, we conducted an exploratory interview study to define and characterize negative mentoring experiences of 40 life science doctoral students. Students attributed their negative mentoring experiences to interacting factors at multiple levels-from interpersonal differences and poor relationship quality to issues at the research group, departmental, organizational, and discipline levels-all of which they perceived as harmful to their development. We found that doctoral students experienced forms of negative mentoring similar to those reported in workplace and undergraduate research settings, but they also experienced negative mentoring that was unique to academic research and their stage of development. Our results are useful to mentors for reflecting on ways their behaviors might be perceived, to mentees for avoiding situations that might be conducive to negative mentoring, and to programs and institutions for improving structures and processes to prevent negative mentoring. Our findings also serve as a foundation for future research on the prevalence and impacts of negative mentoring experiences in graduate education.
While there have long been campus efforts to better support students from diverse backgrounds, these programs, services and interventions have not been systemic. This paper documents student success infrastructure elements which share similar features that enhance their effectiveness, suggesting some basic ways of re-orienting the way higher education is organized that better support student success. The shared features of effectiveness within the student success infrastructure include broad stakeholder engagement, collaboration, learning, clarity & transparency, equity, and alignment.
As the research on mindfulness expands to include school-based interventions, middle school educators across the country have implemented mindfulness in the classroom. However, similar to other social-emotional learning approaches, when implemented in the absence of cultural context and trauma-informed care, mindfulness can be weaponized. In this paper we describe how educators can facilitate mindfulness practice in the classroom in affirming, culturally responsive and trauma-informed ways. In doing so, we propose a new vision for how mindfulness can further equity work in schools.
Background
Due to the increasing concern over student mental health and wellbeing, attention has turned to the matter of creating environments, communities, and institutions which enable students to flourish.
Methods
To explore the role of accommodation environments in first year student mental health and wellbeing, eight focus groups were conducted in two universities in North West England and analysed using thematic analysis.
Results
Three overarching themes were identified: ‘ The betwixt space ’; ‘ Accommodations as vessels to cultivate friendships and communities ’; and ‘ The importance of accommodation-based pastoral staff ’. As attachment to place and relationships with significant others are disrupted by the transition, this leaves young people vulnerable whilst they go through a process to re-attach to new people and a new environment, and loneliness and social isolation were keenly felt during this period. Physical attributes of place that prevent social cohesion further exacerbated feelings of loneliness.
Conclusions
As it is common for students to withdraw physically and psychologically when they do not form friendships within their flat, accommodation-based pastoral staff have an important role to fulfil. Although these findings demonstrate the importance of the human element within accommodation, designing places that facilitate community, a sense of we-ness, and belonging is crucial.
We tested whether a psychoeducational course improved well-being in three cohorts. Study 1 found significantly higher mental well-being in first year undergraduates who took the course compared to a waiting-list control. Study 2 revealed that students taking the course when COVID-19 restrictions began did not experience increases in mental well-being but had significantly higher well-being than a third matched group. In Study 3, an online course increased mental well-being in University students and staff during a COVID-19 lockdown. These findings support the claim that psychoeducational courses are beneficial in both live and online formats and in times of collective uncertainty.
African Americans experience numerous stress-related health outcomes and encounter disproportionate barriers to utilizing health-related services that could reduce poor health. Culturally-responsive mindfulness mHealth approaches provide promising opportunities to increase access to health skills that can reduce stress and improve wellbeing among this population. We employed a within subjects pre-post design over a two-week intervention period to analyze if the use of a culturally-responsive mindfulness mHealth application (app) contributed to pre-post changes in a sample of 39 African Americans. Paired t-tests revealed that, following the intervention, participants used more mindfulness practices, had greater self-efficacy using mindfulness, had lower levels of emotion regulation difficulties, and reported lower levels of stress. Participants also expressed high levels of satisfaction with the app and gave it positive ratings for its usability. These findings support the feasibility of a culturally-responsive mindfulness mHealth app to reduce stress and improve emotion regulation skills among African Americans. Future research directions are proposed.
Nearly 50% of graduate students report experiencing emotional or psychological distress during their enrollment in graduate school. Levels of distress are particularly high for transgender and nonbinary graduate students who experience daily discrimination and marginalization. Universities and colleges have yet to address and accommodate the needs and experiences of transgender and nonbinary graduate students. Given the multitude of challenges these students may face, educational settings should not present additional barriers to educational success and well-being. In an effort to improve graduate education for transgender and nonbinary students, we add to the existing scholarship on affirming work with transgender undergraduate students by addressing the unique concerns of graduate students. We use a social-ecological model to identify sources of discrimination in post-secondary education and to provide transgender- and nonbinary-affirming recommendations at structural, interpersonal, and individual levels. For practitioners who wish to do personal work, we provide guidance for multicultural identity exploration. A table of recommendations and discussion of ways to implement our recommendations are provided.
Background
Mental health issues are increasing in higher education and finding ways for students to get help when needed is important.
Objective
We tested if the tone of a short syllabus and the presence of a special statement addressing mental health would increase intentions to approach instructors for help.
Method
We used a 2 (Tone: warm vs. cold) × 2(Statement: present vs. absent) experimental design. Participants (N = 257) read one of four, two-page syllabi, and rated intentions to reach out for help and the instructor.
Results
We found a main effect for tone on three Reach Out statements and ratings of the instructor. Presence of the statement influenced likelihood to reach out for help with personal problems.
Conclusions
Both the tone of a short syllabus and the presence of statements normalizing reaching out for help can influence student intentions to contact instructors for help.
Teaching Implications
Writing a warm toned syllabus and addressing stress and mental health with a university statement may increase student’s intentions to ask for help.
About a third of college students struggle with anxiety, depression, or an eating disorder, and only 20-40% of college students with mental disorders receive treatment. Inadequacies in mental health care delivery result in prolonged illness, disease progression, poorer prognosis, and greater likelihood of relapse, highlighting the need for a new approach to detect mental health problems and engage college students in services. We have developed a transdiagnostic, low-cost mobile mental health targeted prevention and intervention platform that uses population-level screening to engage college students in tailored services that address common mental health problems. We will test the impact of this mobile mental health platform for service delivery in a large-scale trial across 20+ colleges. Students who screen positive or at high-risk for clinical anxiety, depression, or an eating disorder and who are not currently engaged in mental health services (N=7,884) will be randomly assigned to: 1) intervention via the mobile mental health platform; or 2) referral to usual care (i.e., campus health or counseling center). We will test whether the mobile mental health platform, compared to referral, is associated with improved uptake, reduced clinical cases and disorder-specific symptoms, and improved quality of life and functioning. We will also test mediators, predictors, and moderators of improved mental health outcomes, as well as stakeholder-relevant outcomes, including cost-effectiveness and academic performance. This population-level approach to service engagement has the potential to improve mental health outcomes for the millions of students enrolled in U.S. colleges and universities.
Objective
Graduate students report high levels of distress, levels that professionals are calling a mental health crisis. Researchers have identified several factors that may exacerbate student distress, but our objective was to assess positive aspects that may attenuate distress. Methods: Over 3600 graduate students from 10 campuses responded to questionnaires assessing depressive symptoms as well as both positive and negative aspects of their current lives. Results: Both negative factors (financial concerns, poor mentorship, and perceived institutional discrimination) and positive factors (social support, departmental social climate, and optimism about their career prospects) are related to depressive symptoms in the expected directions, although the positive factors have stronger effects. Further, positive factors buffer the effects of the negative aspects on depressive symptoms. Conclusion: Although findings are correlational and do not imply causation, results suggest potentially modifiable factors that universities should consider when considering graduate student well-being.
This study explored trends in health and wellness peer educator training using five years of data from a multi-institutional study. Findings indicated training increased among 17 health and wellness topics over five years, and peer educators utilized the knowledge gained in their training to facilitate programs and engage in educational conversations. Peer educators without training though are also engaged in these outreach activities. Implications for student affairs practice are included.
Substance use and mental health problems are associated with academic difficulties among high school and undergraduate students, but little research has been conducted on these relationships among graduate students. The sample consisted of 2683 graduate students attending two large, public universities. Standard measures were used to collect data on demographic and program characteristics, mental health, substance use, advisor satisfaction, and burnout (i.e., exhaustion, cynicism, and inefficacy). Linear regression models evaluated the relationships between each mental health and substance use variable with burnout, as well as the moderating role of advisor satisfaction. Students with a greater number of substance use and mental health problems had higher levels of exhaustion, cynicism, and inefficacy. No statistically significant relationships between substance use and burnout were found. High levels of stress, moderate or severe anxiety symptoms, and moderate or severe depressive symptoms were associated with increased levels of burnout. Advisor support moderated the relationships between stress and both cynicism and inefficacy such that the effects of stress on these dimensions of burnout were lower among those who were satisfied with their advisor. Graduate students with mental health problems might be at increased risk for burnout; however, having a supportive advisor might buffer this association.
It is well established that graduate students face large amounts of stress during their education. Despite this, little research has focused on factors that can help this high stress population maintain well-being in the face of numerous challenges. One potentially important but neglected probable wellness determinant is the advisor-student relationship. This study explored to what extent advisor and department characteristics related to advisor selection are associated with student well-being and examined whether a positive advisor-advisee relationship can reduce the negative effects of stress on student well-being. Four hundred and forty-six graduate students from Ph.D. programs across the United States completed an online survey asking advising-related questions as well as assessments of stress, physical health, psychological well-being, and demographics. Results indicated that higher faculty advisor satisfaction was associated with reports of higher positive affect, lower negative affect, and better sleep efficiency, but slightly worse health compared to a year prior to survey. Additionally, high quality advisor-student relationships and greater control over switching advisors were associated with less affective disruption under high stress indicating possible stress buffering effects. Together, these results indicate that advisor-advisee relationships in graduate training may be an important future area of intervention and focus for campus well-being.
The COVID-19 pandemic has already produced profound impacts on college students, with unprecedented directives for student relocation from their college campuses and dormitories mid-semester and coursework that took place through virtual learning. The current disruptions and anticipated potential long-term changes call for immediate prioritization regarding next steps for addressing college mental health and well-being. This viewpoint article highlights two urgent priorities for addressing current college mental health needs: the development of strategies for ensuring mental health service access, and intentional outreach to college students with special circumstances. The current crisis also represents an opportunity for campus administrators, mental health professionals, researchers, and policymakers to leverage innovative models of care as well as identity-related student assets, strengths, and resilience-promoting factors to support students’ eventual return to campus and to respond more effectively to future massive disruptions.
Sexual violence is a prevalent public health issue among college students and associated with adverse mental health outcomes. Modern social movements that bring awareness to sexual violence, such as #MeToo, have facilitated institutional coverage of the issue. A cross-sectional survey, the American College Health Association National College Health Assessment IIc was administered in Spring 2017 (n = 54,497) and Spring 2018 (n = 50,770) across universities (n = 83) in the United States. Data analyses utilized descriptive, bivariate, and multivariate methods. Relationships between sexual violence and seven mental outcomes, anorexia, anxiety, bulimia, depression, insomnia, stress level, and suicide, were assessed and compared across time periods. Logistic regression indicated that sexual violence was significantly associated with all mental health outcomes and that the measures of association for anxiety and suicide ideation decreased significantly from the year 2017 to 2018. Results confirm the adverse effect of sexual violence on mental health among college students. Possible implications of these findings include the role of social movements in dismantling stigma and mitigating the mental health impact of sexual violence.
Background:
In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries.
Methods:
GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution.
Findings:
Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990-2010 time period, with the greatest annualised rate of decline occurring in the 0-9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10-24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10-24 years were also in the top ten in the 25-49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50-74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI.
Interpretation:
As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve.
Funding:
Bill & Melinda Gates Foundation.
Coronavirus disease 2019 (COVID-19) realities have demanded that educators move swiftly to adopt new ways of teaching, advising, and mentoring. We suggest the centering of a trauma-informed approach to education and academic administration during the COVID-19 pandemic using the Substance Abuse and Mental Health Services Administration’s (SAMHSA) guidance on trauma-informed approaches to care. In our model for trauma-informed education and administration (M-TIEA), SAMHSA’s four key organizational assumptions are foundational, including a realization about trauma and its wide-ranging effects; a recognition of the basic signs and symptoms of trauma; a response that involves fully integrating knowledge into programs, policies, and practices; and an active process for resisting retraumatization. Since educators during the pandemic must follow new restrictions regarding how they teach, we have expanded the practice of teaching in M-TIEA to include both academic administrators’ decision making about teaching, and educators’ planning and implementation of teaching. In M-TIEA, SAMHSA’s six guiding principles for a trauma-informed approach are infused into these two interrelated teaching processes, and include the following: safety; trustworthiness and transparency; peer support; collaboration and mutuality; empowerment, voice, and choice; and cultural, historical, and gender issues. M-TIEA’s organizational assumptions, processes, and principles are situated within an outer context that acknowledges the potential influences of four types of intersectional traumas and stressors that may occur at multiple socioecological levels: pandemic-related trauma and stressors; other forms of individual, group, community, or mass trauma and stressors; historical trauma; and current general life stressors. This acknowledges that all trauma-informed work is dynamic and may be influenced by contextual factors.
Importance:
The coronavirus disease 2019 (COVID-19) pandemic and the policies to contain it have been a near ubiquitous exposure in the US with unknown effects on depression symptoms.
Objective:
To estimate the prevalence of and risk factors associated with depression symptoms among US adults during vs before the COVID-19 pandemic.
Design, setting, and participants:
This nationally representative survey study used 2 population-based surveys of US adults aged 18 or older. During COVID-19, estimates were derived from the COVID-19 and Life Stressors Impact on Mental Health and Well-being study, conducted from March 31, 2020, to April 13, 2020. Before COVID-19 estimates were derived from the National Health and Nutrition Examination Survey, conducted from 2017 to 2018. Data were analyzed from April 15 to 20, 2020.
Exposures:
The COVID-19 pandemic and outcomes associated with the measures to mitigate it.
Main outcomes and measures:
Depression symptoms, defined using the Patient Health Questionnaire-9 cutoff of 10 or higher. Categories of depression symptoms were defined as none (score, 0-4), mild (score, 5-9), moderate (score, 10-14), moderately severe (score, 15-19), and severe (score, ≥20).
Results:
A total of 1470 participants completed the COVID-19 and Life Stressors Impact on Mental Health and Well-being survey (completion rate, 64.3%), and after removing those with missing data, the final during-COVID-19 sample included 1441 participants (619 participants [43.0%] aged 18-39 years; 723 [50.2%] men; 933 [64.7%] non-Hispanic White). The pre-COVID-19 sample included 5065 participants (1704 participants [37.8%] aged 18-39 years; 2588 [51.4%] women; 1790 [62.9%] non-Hispanic White). Depression symptom prevalence was higher in every category during COVID-19 compared with before (mild: 24.6% [95% CI, 21.8%-27.7%] vs 16.2% [95% CI, 15.1%-17.4%]; moderate: 14.8% [95% CI, 12.6%-17.4%] vs 5.7% [95% CI, 4.8%-6.9%]; moderately severe: 7.9% [95% CI, 6.3%-9.8%] vs 2.1% [95% CI, 1.6%-2.8%]; severe: 5.1% [95% CI, 3.8%-6.9%] vs 0.7% [95% CI, 0.5%-0.9%]). Higher risk of depression symptoms during COVID-19 was associated with having lower income (odds ratio, 2.37 [95% CI, 1.26-4.43]), having less than $5000 in savings (odds ratio, 1.52 [95% CI, 1.02-2.26]), and exposure to more stressors (odds ratio, 3.05 [95% CI, 1.95-4.77]).
Conclusions and relevance:
These findings suggest that prevalence of depression symptoms in the US was more than 3-fold higher during COVID-19 compared with before the COVID-19 pandemic. Individuals with lower social resources, lower economic resources, and greater exposure to stressors (eg, job loss) reported a greater burden of depression symptoms. Post-COVID-19 plans should account for the probable increase in mental illness to come, particularly among at-risk populations.
Background:
Data from studies with undergraduate and postgraduate taught students suggest that they are at an increased risk of having mental health problems, compared to the general population. By contrast, the literature on doctoral researchers (DRs) is far more disparate and unclear. There is a need to bring together current findings and identify what questions still need to be answered.
Methods:
We conducted a mixed methods systematic review to summarise the research on doctoral researchers' (DRs) mental health. Our search revealed 52 articles that were included in this review.
Results:
The results of our meta-analysis found that DRs reported significantly higher stress levels compared with population norm data. Using meta-analyses and meta-synthesis techniques, we found the risk factors with the strongest evidence base were isolation and identifying as female. Social support, viewing the PhD as a process, a positive student-supervisor relationship and engaging in self-care were the most well-established protective factors.
Conclusions:
We have identified a critical need for researchers to better coordinate data collection to aid future reviews and allow for clinically meaningful conclusions to be drawn.
Systematic review registration:
PROSPERO registration CRD42018092867.
Background:
Millions of people worldwide are underserved by the mental health care system. Indeed, most mental health problems go untreated, often because of resource constraints (eg, limited provider availability and cost) or lack of interest or faith in professional help. Furthermore, subclinical symptoms and chronic stress in the absence of a mental illness diagnosis often go unaddressed, despite their substantial health impact. Innovative and scalable treatment delivery methods are needed to supplement traditional therapies to fill these gaps in the mental health care system.
Objective:
This study aims to investigate whether a self-guided web-based course can teach pairs of nonprofessional peers to deliver psychological support to each other.
Methods:
In this experimental study, a community sample of 30 dyads (60 participants, mostly friends), many of whom presented with mild to moderate psychological distress, were recruited to complete a web-based counseling skills course. Dyads were randomized to either immediate or delayed access to training. Before and after training, dyads were recorded taking turns discussing stressors. Participants' skills in the helper role were assessed before and after taking the course: the first author and a team of trained research assistants coded recordings for the presence of specific counseling behaviors. When in the client role, participants rated the session on helpfulness in resolving their stressors and supportiveness of their peers. We hypothesized that participants would increase the use of skills taught by the course and decrease the use of skills discouraged by the course, would increase their overall adherence to the guidelines taught in the course, and would perceive posttraining counseling sessions as more helpful and their peers as more supportive.
Results:
The course had large effects on most helper-role speech behaviors: helpers decreased total speaking time, used more restatements, made fewer efforts to influence the speaker, and decreased self-focused and off-topic utterances (ds=0.8-1.6). When rating the portion of the session in which they served as clients, participants indicated that they made more progress in addressing their stressors during posttraining counseling sessions compared with pretraining sessions (d=1.1), but they did not report substantive changes in feelings of closeness and supportiveness of their peers (d=0.3).
Conclusions:
The results provide proof of concept that nonprofessionals can learn basic counseling skills from a scalable web-based course. The course serves as a promising model for the development of web-based counseling skills training, which could provide accessible mental health support to some of those underserved by traditional psychotherapy.
Universities must prepare students for a complex world, but current mental health levels impair student outcomes. Increased concern over student wellbeing has fostered the demand for positive education interventions – a relatively new topic requiring more research. We tested a positive psychology wellbeing intervention imbedded in undergraduate psychology classes with three studies and 469 participants. Intervention outcomes across three years indicate improvements in wellbeing, positive affect, negative affect and clinical wellbeing categories. Comparisons with an active control indicated the intervention buffered against semester stress. Practice frequency had little effect on wellbeing, however wellbeing gains were higher for students with low baseline wellbeing and those who valued happiness more – suggesting positive education interventions have greater value for some students. This research has important implications for student wellbeing, indicating that imbedded wellbeing programs can improve student wellbeing with minimal resources and low stigma.
The present study explored the impact of publicized incidents of police violence on racially underrepresented college students in the U.S. Approximately 134 college students at various colleges and universities in the U.S. completed a questionnaire that examined their engagement with police brutality videos, reactions about police killings of unarmed Black men (and boys), their encounters with police, and perceptions toward the issue of police violence. The majority of participants were students of color, from the middle to high socioeconomic backgrounds and attended private and public institutions of higher education. The main findings included: (1) social media as a medium to learn about incidents of police violence; (2) students displayed symptoms consistent with post-traumatic stress disorder (i.e., anger, sadness, and fear) after viewing the videos; and (3) student’s race affected how they viewed police violence in social media. These findings reflect that witnessing publicized police killings of unarmed Black men (and boys) is traumatic for college students and contributes to anxiety and fear for future police encounters.
Conventional definitions of mental health, manhood, and social support create barriers to accessing behavioral health care for Black men ages 18 to 30. Targeted behavioral health interventions sensitive to culture, social norms, and gender that circumvent these barriers are desperately needed to improve access and integrated care for this group. This article reports mixed methods findings from the 2017 iteration of the Young Black Men, Masculinities, and Mental Health (YBMen) project, a social media–based, psychoeducational program that promotes mental health, progressive definitions of manhood, and sustainable social support for Black men. Young Black men ( n = 350) across two universities in the Midwest completed baseline surveys on their mental health, definitions of manhood, and social support. Forty of the men participated in the YBMen intervention and at postintervention reported experiencing fewer depressive symptoms on the Patient Health Questionnaire (PHQ-9, Z = −2.05, p < .01) and the Gotland Male Depression Scale (GMDS; Z = −1.76, p < .05). There were also changes on the Conformity to Masculine Norms Inventory (CMNI) for Self-Reliance ( Z = −0.34, p = .26) and Heterosexual Self-Presentation ( Z = −0.18, p = .59), though these changes were not statistically significant. A qualitative review of postintervention interviews revealed participants’ appreciation of the YBMen project and its influence on their mental health, manhood, and social support. Programmatic efforts that support the behavioral health, positive development, and social relationships of Black men translate into positive families, communities, and experiences as they live, learn, love, and work over the life course.
Shunned presents clearly for a wide readership information about the nature and severity of discrimination against people with mental illness, what can be done to reduce this, and after showing, both from personal accounts and from a thorough review of the literature, the nature of discrimination, sets out a clear manifesto for change.
The deaths of Michael Brown, Eric Garner, Freddie Gray, Rekia Boyd, and Walter Scott reflect a pattern of routinized state violence against black people in the United States. While police violence is not new, it has become newly visible over the past year as protesters in Ferguson, Baltimore, and hundreds of other cities have made the issue difficult for the public to ignore. As citizens of this society, each of us has a responsibility to work toward the structural changes necessary to end racially discriminatory policing practices that affect our communities. However, as public health professionals, our role in this movement is unique. Simply put, policing practices harm the public’s health and deepen racial health inequities. Since our existing public health infrastructure continuously collects data on injuries and deaths, public health agencies can play a critical role in preventing police violence by monitoring and systematically investigating its impact on communities. Additionally, while U.S. policymakers have decided that police departments should be one of the primary institutions tasked with addressing drug use, problem drinking, homelessness, sex work, and mental illness, these are all fundamentally public health issues requiring attention from public health researchers and professionals alike.
This book explores the practical strategies outlined by national thought leaders to improve access to mental health care in the practice of college psychiatry. It addresses the escalating need for mental health services on college and university campuses.
Concise yet comprehensive, the book considers the college experience for the increasingly diverse student body, including non-traditional college students, first-generation college students, and students with a history of mental illness. Beginning with a discussion on the current national health trends in college mental health, chapter one explores the current epidemiology of student mental health problems, the systemic challenges in recruitment, and funding psychiatric services. Subsequent chapters then delve into the various systems and models of psychiatric care for college students, including differing parental involvement levels and the importance of collaborative care to short term management and referral of students at risk. Chapters five and six examine mental health considerations for LGBTQ, Black, Indigenous, and People of Color students. Further chapters analyze the critical nature of successfully navigating a leave of absence, as well as the consideration of threat assessment on college campuses. The book closes with a highly relevant evaluation of telemental health and telepsychiatry in the College Setting as it pertains to the ongoing barriers to care caused by COVID-19.
Socially conscious and timely, College Psychiatry is an indispensable text for all mental health professionals.
There are times when taking a leave of absence from college for mental health reasons may be in a student’s best interest. This is particularly relevant when a student is experiencing symptoms which, despite access to treatment and appropriate accommodations at college, endanger their welfare and safety, pose a threat to others, or significantly adversely affect their academic functioning. It behooves colleges and universities to have clear and consistently applied policies and procedures in place which allow students to freely choose this option when appropriate, while protecting them against discrimination based on disability. Colleges can support students and families in this process by minimizing barriers to taking a leave of absence, assisting them with planning for treatment needs and other aspects of their time away, as well as offering guidance and help around their reentry to school. It is optimal if students, families or other allies, mental health providers, and university support systems all work together to agree upon an individualized plan that best addresses the needs and concerns of the student. College psychiatrists often play an integral role in this process.
Parent involvement in their college student’s mental health has increased, perhaps in light of the growing number and complexity of mental health problems on campuses. Parents are more aware of mental health problems in the college population and expect campuses to provide services for their students. College psychiatrists and other psychiatric providers may find themselves collaborating with parents, after obtaining consent from the student, in a variety of situations: the student is experiencing suicidal thoughts; has been psychiatrically hospitalized; or has a serious substance use disorder that puts their life at risk. Even in non-emergent situations, parents can provide valuable information to the psychiatric provider regarding developmental and family history, and also serve as a source of support for the student. This chapter provides examples of how best to work with parents to promote safety and obtain the right level of treatment for the student. It also covers studies regarding parent involvement in college mental health, and reviews the changing laws and policies regarding communicating with parents with and without a student’s consent. Psychiatrists and other psychiatric providers should consider parent collaboration as part of the treatment plan when it will be clinically beneficial to student.
Student wellbeing is foundational to academic success. One recent survey of postsecondary educators found that nearly 80 percent believed emotional wellbeing is a "very" or "extremely" important factor in student success. Studies have found the dropout rates for students with a diagnosed mental health problem range from 43 percent to as high as 86 percent. While dealing with stress is a normal part of life, for some students, stress can adversely affect their physical, emotional, and psychological health, particularly given that adolescence and early adulthood are when most mental illnesses are first manifested. In addition to students who may develop mental health challenges during their time in postsecondary education, many students arrive on campus with a mental health problem or having experienced significant trauma in their lives, which can also negatively affect physical, emotional, and psychological wellbeing.
Purpose
Rising rates of anxiety and depression and the varied costs of these conditions indicate a clear need to create learning environments in which graduate and professional students can more readily thrive. However, the absence of multi-institutional, multi-disciplinary evidence about mental health in graduate education has obscured a clear picture of which populations, contexts and social dynamics merit focused attention and resources. The purpose of this study is therefore to analyze prevalence and risk factors associated with anxiety and depression among a large sample of graduate students, with special attention to how graduate education environments and interactions may be associated with mental health.
Design/methodology/approach
This paper offers the first multi-institutional, multi-disciplinary analysis of depression and anxiety among US graduate and professional students. Using a sample of 20,888 students randomly sampled within 69 universities, the author compares depression and anxiety prevalence among fields of study with hierarchical cluster modeling. Then, using a conceptual framework that links social support, role strain and self-determination theories, the author estimates fixed effects multivariate logistic regressions to measure how depression and anxiety are associated with experiencing racial discrimination, support from friends and family, perceived competitiveness in one’s classes, and comfort speaking with one’s professors about mental health.
Findings
Graduate students who endure frequent racial discrimination have odds of screening positive for depression and anxiety that are 2.3 and 3.0 times higher, respectively, than those who never experience discrimination. Support from family and friends moderates these relationships and perceived competitiveness exacerbates them. LGBTQ students and students who self-report that finances are a struggle or tight also have higher odds of depression and anxiety. Students in the humanities, arts and architecture have significantly higher prevalence of depression and anxiety than the sample as a whole.
Originality/value
The paper offers broadest base of evidence to date about patterns that are usually experienced at the individual level or analyzed institution-by-institution and field-by-field. Specifically, the author identified social dynamics, fields of study and populations where attention to wellbeing may be especially warranted. The conceptual framework and multivariate results clarify how organizational and individual factors in graduate students’ mental health may be intertwined through competitive, discriminatory, or supportive interactions with peers, faculty, family and friends. Findings clarify a need for awareness of the contexts and interactions that graduate students experience as well as individual factors that are associated with student wellbeing.
The transition to college involves a number of
novel stressors for young adults and represents a period of
heightened risk for the onset or worsening of diverse mental
health problems. The presence of natural mentors may be
one factor which alleviates risk for mental health problems in
college first-year students. Using a diverse sample of 275
first-year college students, the present study examined the
effects of different types of natural mentors within students’
support networks on internalizing symptoms during the first
semester of college. In addition, analyses explored whether
different student approaches to emotion regulation were one
mechanism by which natural mentors influence internalizing
symptoms. Path analyses indicated that students with a
greater number of close family member/family friend
mentors reported less emotion suppression, which in turn
accounted for the associations between these mentoring
relationships and reduced depressive symptoms and worry at
follow-up. In contrast, less emotionally close mentors, such
as teachers or coworkers, did not significantly shape emotion
regulation strategies or internalizing symptom outcomes.
Results have implications for the design of more targeted
interventions that promote emotional well-being in college
first-year students.
Background and objectives
An increasing number of college students in the U.S. report elevations in stress and anxiety. One approach to addressing this need is to offer skills training programs.
Design
This study used a stepped-wedge design to test the effects of a mindfulness-based coping-enhancement program on college students’ stress-management, emotion regulation, coping, and well-being. The 6-week program includes didactics and practices for mindfulness, coping with challenging situations, regulating emotions, and compassion for oneself and others.
Methods
Participants (N = 208) were predominantly first-year college students living in residence halls on campus, where the program was delivered.
Results
Students who received the program were compared to those who had not yet received the program and reported improved mindfulness, executive control, active coping, self-compassion, social connectedness, resilience, and flourishing. The majority of these changes were maintained at a three-month follow-up.
Conclusions
The results of this study suggest that the program shows promise for supporting well-being in college students.
There is a dearth of psychological intervention research to guide clinicians in supporting individuals who are impacted by systemic racism. Internalized racial oppression, adopting the negative beliefs about one’s group, is one pathway through which racism affects mental health. Techniques from Acceptance Commitment Therapy have been found to decrease internalized self-stigma and to mitigate negative mental health symptoms. The current pilot study examined the feasibility of a group-based intervention for Black women targeting internalized racial oppression. We found pre-post decreases in internalized racial oppression and shame, and psychological distress.
Objective:
This study estimated the prevalence of self-reported symptoms of mental health problems and treatment utilization in a U.S. national sample of community college students and made comparisons with data from a sample of students at 4-year educational institutions.
Methods:
The study used data for 2016-2019 from the Healthy Minds Study, an annual cross-sectional survey. The sample included 10,089 students from 23 community colleges and 95,711 students from 133 4-year institutions. Outcomes were mental health symptom prevalence based on validated screening tools and rates of service utilization, such as use of therapy and psychotropic medication. Analyses were weighted by using survey nonresponse weights.
Results:
Prevalence rates were comparably high in the sample of community college and 4-year students, with just more than 50% of each group meeting criteria for one or more mental health problems. Analyses by age group revealed significantly higher prevalence for community college students ages 18-22 years, relative to their same-age peers at 4-year institutions. Community college students, particularly those from traditionally marginalized backgrounds, were significantly less likely to have used services, compared with students on 4-year campuses. Financial stress was a strong predictor of mental health outcomes, and cost was the most salient treatment barrier in the community college sample.
Conclusions:
This is the largest known study to report on the mental health needs of community college students in the United States. Findings have important implications for campus policies and programs and for future research to advance equity in mental health and other key outcomes, such as college persistence and retention.
Objective
This study examined whether program climate factors, stressors, demographic, and institutional variables were associated with doctoral students’ clinically significant generalized anxiety disorder and major depressive disorder symptoms. Participants: This study examined doctoral students’ responses from the gradSERU survey, which was administered at five U.S. public research universities in 2017–2018 (n = 2,582). Methods: This study utilized confirmatory factor analysis and binary logistic regression. Results: Sense of belonging reduced doctoral students’ odds of clinically significant anxiety and depression symptoms, while academic stressors, relationships stressors, and financial stressors increased such odds. There were no differences in the odds of clinically significant symptoms based on students’ academic program. Students identifying as heterosexual or straight had significantly reduced odds of clinically significant symptoms for both disorders than lesbian, gay, bisexual, or questioning students. Conclusions: The results can aid institutional stakeholders in developing interventions that may be associated with the wellness of their students.
Prevalence studies indicate that higher degree research (Master's and Doctoral) students experience high rates of psychological distress. As a result, universities are seeking evidence-based interventions to better support the mental wellbeing of this student cohort. The present study contributes to that evidence base by asking higher degree research students (HDRs) from a large Australian research-intensive university what they think should be done to improve their wellbeing. After inductively analysing 595 open-ended survey responses, nine themes emerged. The four most prominent themes were culture and community, support services, supervisors and supervision practices, and peer engagement and networking. These themes are interpreted by drawing on the Job Demands-Resources theory of occupational stress. We also compare our findings with typologies of 'doctoral challenges' developed in prior research to extend and refine the 'roadmap' for policy, action and research to better understand and address the high levels of psychological distress that HDRs experience. Overall, the findings of this study suggest that HDRs are likely to benefit from a whole-of-university approach to supporting their wellbeing, and from an academic research culture that values the wellbeing of all its members.
Objective: To understand how the college environment might influence mental health help-seeking in Asian American undergraduates. Participants: Participants were 19 Asian American undergraduates recruited through Facebook. Methods: Participants were interviewed about attitudes toward mental health and mental health help-seeking, and thematic analysis with both inductive and deductive codes was used to analyze interview transcripts. Results: Several factors specific to the college environment encourage students to seek help: social support provided by peers and by campuses, psychological distance from home, and physical distance from home. However, other Asian American-specific factors discourage students from seeking help, such as cultural factors and stigma surrounding mental health issues. Conclusions: The college environment may encourage help-seeking, while Asian American-specific factors may discourage it. Potential interventions based on these findings may increase help-seeking rates by focusing on these encouraging factors in a culturally-sensitive way.
Background
Alcohol consumption on college and university campuses is a public health concern. Some universities have instituted medical amnesty policies (MAPs) to encourage calling first responders to the scene of an alcohol-related emergency. This study describes perceptions of a university MAP and the perceived risks of calling first responders among a sample of undergraduate students at a mid-sized, private, residential university. Methods: This is an exploratory, peer-led study, in which student-researchers worked under faculty supervision to devise the aims of the study, recruit and conduct qualitative interviews with participants, analyze data, and organize major findings. Results: Participants in this convenience sample (N = 42) were majority female (n = 33, 78.67%) and white (n = 35, 83.3%). White students often reported risking disciplinary consequences (i.e. suspension) if found in violation of university alcohol policy. White students who were familiar with the MAP praised it as beneficial in improving student safety. Students of color (especially Black students) reported concerns for their safety in the presence of first responders (especially police officers). Awareness of the MAP among students of color was very low, and many reported low levels of institutional trust, suggesting the protections conferred by the MAP should be taken “with a grain of salt.” Conclusions: MAPs may alleviate concern about some perceived risks of calling first responders, but that benefit may not be experienced equitably among students of color. More research is needed to understand the complex relationship between alcohol policies, alcohol-related injuries, policing, and race on college and university campuses.
The mental health of students at U.S. colleges and universities is rapidly deteriorating, and our counseling infrastructure struggles to meet rising demand. Given this reality, colleges must supplement reactive counseling services with preventive, campus-wide initiatives targeting root causes of distress, including loneliness and lack of social support. One promising innovation would be to provide basic training on listening and helping skills to all students so they can take turns reciprocally supporting each other. Self-disclosure and providing support both have strong mental health benefits. This would also increase social connection, which is likely to improve academics and retention. This paper reviews the benefits and limitations of teaching peer support skills to a large volume of students, which may enable colleges to deliver the social and emotional aspects of education that are critical to health and academics, yet often sorely missing.
Mental health disparities in the aftermath of national disasters and the protective role of socioeconomic status are both well documented. We assessed the prevalence of depression and anxiety symptoms among underresourced public university students during the COVID-19 pandemic in New York City. Between April 8, 2020, and May 2, 2020, adult students (N = 1,821) across the CUNY system completed an online survey examining COVID-19-related stressors and mental health and sociodemographic factors. Using multivariable logistical regression to assess the association between COVID-19-related stressors and depression and anxiety symptoms, we found a high prevalence and severity of depression and anxiety symptoms. We also observed that more exposure to COVID-19-related stressors was associated with increased depressive (27.0%, 41.4%, and 63.1% for low-, medium-, and high-level stressors, respectively) and anxiety symptoms (19.3%, 34.6%, 52.2%). In addition, the degree of exposure to COVID-19-related stressors served as an important predictor of depression and anxiety symptoms. Compared to high levels of stressors, the odds of depression were 0.2, 95% CI [0.2, 0.3] for low-and 0.4, 95% CI [0.3, 0.5] for medium-level stressors; for anxiety, the odds were 0.2, 95% CI [0.2, 0.3] for low and 0.05, 95% CI [0.4, 0.6] for medium stressors. Finally, household savings of less than $5,000 increased the risk of anxiety but not depression symptoms, OR = 1.3, 95% CI [1.0,1.6]. Together, these findings tell a devastating story of psychological distress among students from lower socioeconomic groups living in the COVID-19 epicenter of the U.S. pandemic.
Background
Graduate school environments are recognized for contributing to elevated stress levels among student populations. Purpose: The objective was to test whether a behavioral intervention, delivered through an online course on behavior change, is effective in preventing declining mental health. Methods: Data were collected via a quasi-experimental longitudinal study to observe the effect of self-directed behavioral interventions on mental health. Participants included students enrolled in a course on Health Behavior Change at the Yale School of Public Health (n = 45) and a control group (n = 33) of students in the same graduate program. Analyses were conducted to evaluate differences at post-intervention and at a 12-week follow-up assessment in indicators of mental and general health. Results: Enrolled students reported significantly improved mental health outcomes as compared to the control students. At follow-up, multiple differences persisted, with participants who had completed the course reporting sustained improvements in general and mental health. Discussion: Self-directed behavior change interventions are effective in promoting mental and physical health among graduate student populations. Translation to Health Education Practice: This curriculum-based intervention can support student wellbeing in a variety of academic programs.
In diverse classrooms, stereotypes are often “in the air,” which can interfere with learning and performance among stigmatized students. Two studies designed to foster equity in college science classrooms ( Ns = 1,215 and 607) tested an intervention to establish social norms that make stereotypes irrelevant in the classroom. At the beginning of the term, classrooms assigned to an ecological-belonging intervention engaged in discussion with peers around the message that social and academic adversity is normative and that students generally overcome such adversity. Compared with business-as-usual controls, intervention students had higher attendance, course grades, and 1-year college persistence. The intervention was especially impactful among historically underperforming students, as it improved course grades for ethnic minorities in introductory biology and for women in introductory physics. Regardless of demographics, attendance in the intervention classroom predicted higher cumulative grade point averages 2 to 4 years later. The results illustrate the viability of an ecological approach to fostering equity and unlocking student potential.
Introduction
The introduction and passing of restrictive and protective transgender-specific state policies have increased during the past decade. These policies are critical for the health of transgender and other gender diverse people; however, little is known about the relationship between these policies and healthcare use, and the role that race/ethnicity plays in this relationship.
Methods
Analysis was conducted in 2018–2019 using multilevel modeling and data from the 2015 U.S. Trans Survey (conducted by the National Center for Transgender Equality among nearly 28,000 transgender and other gender diverse people across the U.S.) to explore associations between transgender-specific state policies and healthcare avoidance because of fear of mistreatment. State policies included those related to experiences of discrimination, health insurance coverage, and changing legal documents. Restrictive and protective policies were measured individually and as a composite index. The relationship between race/ethnicity and healthcare use was also examined to determine whether there were differences in the association between race/ethnicity and healthcare avoidance by state.
Results
None of the individual policies were associated with healthcare use, but the composite index was significant, such that living in states with more protective policies was associated with reduced odds of avoiding health care because of fear of mistreatment. The relationship between race/ethnicity and health care also varied across states.
Conclusions
Findings suggest the importance of advocating for more protective transgender-specific policies to improve healthcare access for transgender and other gender diverse people in the U.S., particularly for transgender and other gender diverse people of color.