The United States faces an unprecedented mental health crisis, with youth and young adults at the center (U.S. Department of Health and Human Services, Office of the U.S. Surgeon General, 2021; White House, 2022). Even before the coronavirus disease 2019 (COVID-19) pandemic, nearly 50 percent of college students reported at least one mental health concern. Without proper support, college students are at risk for a variety of both immediate consequences (e.g., academic impairment, substance use, suicide) and longer-term ones (e.g., stop-out, drop-out, and lower lifetime earning potential). The COVID-19 pandemic notably exacerbated these issues and underscored the urgency to identify and implement solutions to ameliorate the youth mental health crisis. In 2021, the National Academies of Sciences, Engineering, and Medicine called on the field of higher education to address growing concerns about student mental health by identifying and elevating emerging and promising approaches that offer a more holistic way to support student mental health in higher education (National Academies of Sciences, Engineering, and Medicine, 2021). Serving as the main entry point for more than 40 percent of students seeking a postsecondary education degree, community colleges represent a tremendous, untapped opportunity to better address mental health in the United States, particularly for students who have been traditionally underserved (e.g., students of color, first-generation students, and low-income students). However, there is limited evidence and guidance that colleges can use to inform the implementation of multilevel, holistic approaches to support students with varying mental health needs.
To address this knowledge gap, we examined qualitative data from eight community colleges at the forefront of implementing multilevel approaches (i.e., a combination of prevention, early intervention, and/or treatment services) to support student mental health. Specifically, the study was designed to do the following:
- describe community college efforts to support mental health on a continuum of care from prevention to treatment
- describe how these colleges are addressing student mental health through the broader college environment
- identify challenges and facilitators that these community colleges encountered in addressing student mental health.
Methods
In collaboration with Active Minds and the Jed Foundation, we identified and recruited community colleges that represented a select group that was likely “ahead of the curve” on implementing multilevel and holistic strategies to support student mental health. In addition, we selected colleges that represent geographic diversity across the United States and serve large proportions of students of color or low-income students. Between February and July 2022, we conducted interviews with representatives from each of the eight colleges (15 interviews with 28 individuals, consisting of 19 mental health counselors or implementers of mental health programs and nine administrators). We analyzed the interview data using a combination of deductive approaches (comparing data against findings from the existing research base and insights from mental health experts) and inductive ones (identifying themes and patterns that could not be categorized by a priori knowledge).
Lessons Learned and Implications
Our findings from these eight colleges highlight a set of lessons for community colleges across the country to consider when strategizing how best to support student mental health. Below, we highlight five key lessons and their associated implications for educational institutions, practitioners, and policymakers.
Lesson 1: Community colleges in our study are implementing multilevel mental health supports, though most lack a clear organizing framework. We found that colleges implemented a wide variety of efforts to support student mental health across the spectrum from well-being to illness. These efforts included student-centric programs (e.g., stress reduction seminars or educating students on available resources), faculty/staff focused efforts (e.g., gatekeeper training or educating staff on the link between mental health and academic success), and institution-wide efforts (e.g., forming mental health task forces to drive strategies to support student mental health). Yet most colleges did not have a clear institutional vision or strategic plan for how mental health supports could be coordinated and delivered.
- Implications: Community colleges should consider adopting and formalizing a strategic plan or framework grounded in research evidence to improve coordination and collaboration across efforts, reduce redundancies, and guide decisionmaking on allocating resources. Such a framework also could create a common language among postsecondary institutions, which increases the likelihood that colleges can more easily learn from each other to scale promising practices to support student mental health.
Lesson 2: Community colleges have expanded the reach of their mental health supports through integration in the broader college environment. All participating colleges highlighted the importance of considering the whole college environment and the need to deeply integrate mental health supports and services with other college activities. These efforts included (1) enhancing academic environments, such as integrating information on mental health resources into course syllabi or lessons, (2) staff education on the importance of student mental health and what to do when interacting with a distressed student, (3) colocation of mental health and academic or basic needs and services, (4) the establishment of cross-disciplinary task forces, and (5) more explicit referral and screening processes and supports between instructors, academic counselors, and mental health counseling staff. Participants from those colleges using several of these approaches shared stories of success in supporting a broader base of students and fostering a supportive campus climate.
- Implications: Considering major strides in supporting student mental health, community colleges should continue to integrate mental health supports into the broader college environment (i.e., classrooms, academic advising, basic needs support, financial assistance). In addition, colleges may benefit from identifying and publicly promoting student mental health as a campus-wide priority. Together, these efforts have the potential to demonstrate to students, faculty, and staff the institution's commitment to student mental health and, in turn, to help foster a supportive campus environment for all.
Lesson 3: Strong leadership support and broad buy-in from staff to prioritize student mental health is important. Support from leadership (e.g., presidents, vice presidents, deans) and broad buy-in from faculty and staff to prioritize and support student mental health were key facilitators for establishing a robust set of mental health supports for colleges in this study. Having the president, deans, and other leadership roles prioritize and elevate the importance of student mental health was reported as key to increased financial support for programs, institutionalization of mental health counselor positions, and enhanced participation from faculty and staff in education seminars, gatekeeper trainings, and integration of mental health supports into the classroom environment. However, many participants noted that faculty and staff outside fields related to mental health (e.g., psychology, social work, nursing) have not widely adopted the idea that supporting mental health is part of their role in educating students.
- Implications: Institutional leaders (e.g., presidents, deans, department chairs) may need to do more to elevate institutional priorities around mental health. For instance, institutional leaders from all segments of the college (e.g., president, board of trustees or regents, deans) should consider communicating publicly the importance of creating a culture of well-being on campus. Additionally, institutions could establish and/or maintain a team that involves all sectors of the college that coordinates, reviews, and addresses mental health, substance use, and well-being concerns and efforts. Those colleges that received support from leadership or established similar cross-discipline task forces said that these factors were central to their success in effectively addressing student mental health.
Lesson 4: Community colleges struggle to meet students' mental health needs because of limited resources. At most of the participating colleges, mental health counselors wore many hats, juggling delivery of counseling services, support groups for students, staff education, and orientation week sessions on mental health. Though a variety of factors are at play (e.g., leadership support, limited financial resources), limited staff capacity to “do it all” emerged as a primary challenge to meeting the increasing demand for mental health services and programs designed to bolster a foundation of mental well-being. Additionally, despite the use of a variety of approaches to expand access to mental health services (e.g., use of telehealth, grant funding to hire more counselors, community-based partnerships), many participants expressed challenges in reaching traditionally marginalized and minoritized populations who may need additional support.
- Implications: To address these challenges, community colleges should consider reallocating existing financial resources or seeking opportunities for additional financial resources to increase capacity to deliver sufficient student mental health supports and services. In addition to institutional funding, counseling centers and student success staff should continue to think creatively about how to reach students who need them most and root decisions about programs and engagement in data on their target populations. To help streamline processes and alleviate some of the burdens encountered by mental health counselors, community colleges should consider conducting an audit or needs assessment of current efforts to reduce redundancy across programs while simultaneously improving integration of supports, elevate efforts that have been most successful at reaching students, and identify key areas for opportunity to better engage and support students most at risk (e.g., students of color, queer students, first-generation students, and low-income students).
Lesson 5: Financial support for student mental health should extend beyond the postsecondary institutions. Community colleges struggle to find financial resources to support their efforts (even among a sample of community colleges likely ahead of the curve on addressing student mental health). Participants from a few colleges shared successes in obtaining grant funding from local, state, and federal agencies that have earmarked dollars to support mental health and postsecondary student success efforts. Although these resources are helpful, they did not appear sufficient to meet the capacity and financial needs of the colleges to adequately support their students' mental health; as a result, this responsibility to maintain a constant flow of grant dollars places a tremendous burden on counseling and student success staff.
- Implications: Recognizing that the U.S. higher education enterprise is under tremendous financial stress, finding new funds to provide additional resources for students experiencing mental health problems may prove to be challenging. Nonetheless, establishing consistent, long-term funding sources to support community colleges may be necessary to create sustainable, comprehensive mental health supports for students. Government agencies and philanthropic entities should consider increasing the priority given to funding mental health supports and services on community college campuses. Additionally, national, state, and local funders of higher education should consider incentivizing community colleges to provide support for students' mental health across the continuum of care (prevention through treatment). Finally, states should consider modifying insurance laws or regulations to enable institutions to use general funds and/or designated health fees for expenses that are not covered by students' personal insurance.
