Student mental health worsens

To say that the college years are a time of great change is an understatement; whether you stay at or near home, or move to a four-year college, the post-secondary years are often a time of new experiences, unfamiliar responsibilities, growing pains, and learning curves. They can also be a time when some students have to manage their own physical and mental health for the first time without parental support.

“University is a key period of development; the age of onset of lifetime mental health problems also coincides directly with traditional college years – 75% of lifetime mental health problems will appear by age 24,” says Sarah K Lipson, assistant professor of health law at the Boston University School of Public Health, policy and management. For more than 10 years, she has studied college student mental health with the Healthy Minds Network, a national project she co-directs with researchers from the University of California, Los Angeles, the University of Michigan, and the Wayne State University.

In a new study, Lipson and colleagues reveal how common depression, anxiety, and other mental health issues are, and how these issues unequally affect students of color. The paper examines survey data collected by the Healthy Minds Network between 2013 and 2021 from 350,000 students on more than 300 campuses. This is the first long-term multicampus study of its kind to analyze differences in treatment and prevalence of mental health problems by race and ethnicity. The study was co-authored by Lipson and other members of the Healthy Minds Network team.

“As an aspiring clinician of color, I believe tracking these trends helps support efforts related to stigma reduction and [mental health] an education that can be targeted to certain communities,” says Jasmine Morigney, a doctoral student in clinical psychology at Eastern Michigan University and co-author of the study.

Researchers used screening tools to measure mental health symptoms, levels of flourishing and whether a student received treatment while in college; participants self-identified their race and ethnicity.

They found that the mental health of college students across the United States was in steady decline over the eight years of data analyzed, with an overall increase of 135% in depression and 110% in anxiety from 2013 to 2021; the number of students who met the criteria for one or more mental health conditions in 2021 had doubled compared to 2013.

Need for mental health support exceeding resources

Native/Alaskan Native students were found to have the greatest increases in depression, anxiety, suicidal ideation, and other mental health issues, as well as the greatest decreases in fulfillment. In 2016, about one-third of Alaska Native/Native students tested positive for depression, a level similar to other racial and ethnic groups in the study. But in the 2019 and 2020 semesters, half of those respondents tested positive for depression.

“There hasn’t been enough research on this population,” Lipson says. “I hope these data document the urgency of understanding some of the unique factors shaping the mental health of these students. Native/Alaska Native students need to be part of the conversation for universities to invest in resources that match their preferences.

For white college students, the prevalence of nonsuicidal self-harm and eating disorder symptoms increased more significantly compared to other groups. In all other categories — depression, anxiety, suicidal ideation, and one or more mental health conditions — increases were seen the most among nonwhite students. During the semesters of the COVID-19 pandemic, Native/Alaska Native and Asian/Pacific Islander/Desi American (APIDA) students reported the largest increases in mental health issues, according to data.

Although more students overall are seeking help and accessing mental health services on college campuses than they were in 2013 — which is good news, Lipson says — the prevalence of problems mental health seems to exceed the number of students who find and receive support. And some groups of students are actually less likely to get help than they were a decade ago. For example, Arab-American college students experienced a 22% increase in mental health problems but an 18% decrease in treatment over the eight years of the study, highlighting a critical gap between symptom onset and access to help. During pandemic semesters — when many schools moved away — fewer students of color had access to needed services.

“I find the change in treatment rates among students of color in the context of the COVID-19 pandemic to be quite surprising,” Morigney says. Salary fell the most in 2020 among APIDA and black students. “Given the impact of the pandemic on this community and the concentrated traumatic racism, that makes this finding quite alarming,” she says.

Not just a pandemic issue

Although researchers tracked significant increases in anxiety and depression during the height of the COVID-19 pandemic, Lipson says the numbers show the continuation of a troubling trend rather than a singular spike.

“The mental health crisis exists beyond college and university,” Lipson says. But the potential to step in and reach students at a particularly important time in life is enormous. “It may not be perfect, but many four-year colleges have some of the best resources people will ever have,” Lipson says, since these institutions can use their resources to break down many barriers to care, such as lack of available suppliers, long waiting times and financial constraints.

University policies aimed at addressing and eliminating racial discrimination on campuses and in health care settings can also reduce the mental health risk factors experienced by many students of color.

“I would like to see universities working to improve and promote diversity in their behavioral health workforce,” Morigney says. Students of color may not know if counseling centers on their campus have staff with similar cultural backgrounds and might be reluctant to seek out services, she says. “The majority of mental health professionals are white, and universities are essential not only to provide students with culturally and ethnically diverse care, but also to provide opportunities for clinicians of color to serve these students.” Providing educational opportunities to encourage students of color to enter the mental health field is also a huge opportunity.

“One of the most important aspects of this study is documenting these inequities and communicating them to people who can use this information to implement change,” Lipson says. For colleges across the country concerned about retention rates — many colleges are seeing more and more students drop out before completing their studies — she says the conversations about student retention and mental health need to come together. It is often “the same students who have the lowest retention rate in higher education [who] are the same students who are least likely to access mental health services when they are struggling, and mental health is a predictor of retention,” she says.

“Overall, we need to embed mental health in the classroom so that it doesn’t require a student to take time out or motivate themselves to seek help,” Lipson says. “There is a lot we can do to embed mental health into the lives of students by default.”

– This press release was originally published on the Boston University website

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