College student using hand sanitizer, wearing a face mask, and walking on a college campus, photo by Nemer-T/Getty Images

commentary

(The RAND Blog)

College Students Need Mental Health Support

Photo by Nemer-T/Getty Images

by Lisa Sontag-Padilla

October 12, 2020

Even before the COVID-19 pandemic began, rising mental health problems in the United States had health advocates and providers worried about the need for additional support for struggling college students—and the ability of schools to provide it. The pandemic has only exacerbated this worry. COVID-19 risk mitigation measures, such as continued physical isolation, put students at greater risk of facing mental health impacts from the pandemic. Without proper support and resources for students with mental health needs, there are a range of potentially serious and lasting consequences, including more students dropping out of school, higher rates of substance abuse, and lower lifetime earning potential.

According to a recent nationwide survey of 502 college students enrolled at two- and four-year institutions, an overwhelming majority (85 percent) of students said they have experienced increased stress and/or anxiety as a result of COVID-19. In a recent survey measuring psychological distress among adults in the United States, researchers from Johns Hopkins University found that 24 percent of young adults aged 18 to 29 reported serious psychological distress, compared to 4 percent in April 2018.

Health advocates and providers have long been worried about the need for additional support for struggling college students. The pandemic has only exacerbated this worry.

Share on Twitter

This increased need to support students' mental health is confronting a system that was already taxed before the pandemic materialized. Prior to the pandemic, colleges, particularly community colleges, had insufficient resources to meet students' mental health needs. And students need help. For instance, a 2016 RAND study of nearly 40,000 students on California's public college campuses found nearly 1 in 5 students reported serious mental health issues, and only 20 percent of those students were engaging in mental health services either on or off campus. A 2018 study (PDF) by the American College Health Foundation found that at any time within the last 12 months, 41 percent of students felt so depressed that it was difficult to function and 62 percent felt overwhelming anxiety.

To be sure, the pandemic has worsened circumstances. So, what can colleges do to help students during this extremely challenging period?

Enhance and Expand Telemental Health Service
In response to the pandemic, many colleges remain virtual and have moved toward telemental health services as a way to provide ongoing support for students in need. Prior to the pandemic, a 2018 RAND study found over 60 percent of college students with mental health needs were open to using online mental health services. Given the shift to almost exclusive telehealth care during the pandemic, this number is likely even higher. However, challenges remain around informing students about, and then engaging in, these services in a way that is consistent with safety guidelines.
Establish Partnerships with Community-Based Providers (and Foster Coordination/Collaboration Between Institutes and the Community)
This approach has the potential to fill gaps in service provider capacity, particularly for campuses that lack an infrastructure for a student health center. Helping students get connected to these services, either through a warm handoff or through distribution of information about available telehealth supports through a central hub for students, may reduce some barriers to students accessing care.
Promote and Support Peer-Based Organizations That Focus on Reducing Stigma and Increasing Peer-to-Peer Helping Behavior
A 2018 RAND study on a peer-based mental health organization found that merely being familiar with the organization was associated with a significant improvement in knowledge of mental health issues and a decrease in stigma. Such changes can improve campus climate around mental health, in turn, increasing the likelihood of students seeking help. Given the skill of these organizations to remain engaged with students both on and off campus, campuses should engage these types of organizations around solutions to best support students during the pandemic and beyond.
Engage with Local and National Crisis Centers (Both Financially and Through Capacity Building)
Crisis centers provide mental health services and emotional support for their state or local communities and have crucial roles to play at a time of prolonged social isolation and stress. Most crisis centers are nonprofit, and many utilize trained volunteers as well as mental health professionals. Establishing partnerships at the campus level and providing financial support to these organizations ensures an ongoing resource for students at times of greatest need.

The pandemic has highlighted a system that was already struggling to meet the needs of young adults in this country and has brought new interest to the issues surrounding mental health. Mental health advocates could seize this moment in time to raise awareness of the ongoing mental health needs of college students and also give serious consideration to investments in long-term solutions that will continue to support students well beyond the pandemic.


Lisa Sontag-Padilla is behavioral and social scientist with expertise in student mental health in K–12 and higher education at the nonprofit, nonpartisan RAND Corporation.

Commentary gives RAND researchers a platform to convey insights based on their professional expertise and often on their peer-reviewed research and analysis.