It Takes a Campus

How colleges and universities can better support students with behavioral health issues

Nance Roy, Ed.D.
Clinical Director, The Jed Foundation

The need for campus-based support for students with behavioral health conditions is clear. According to NAMI, nearly 73 percent of students living with a mental health condition experienced a mental health crisis on campus. Yet, 35 percent of those students reported that their college did not know about their crisis. Overall, 40 percent of students with diagnosable mental health conditions did not seek help.

Colleges can best meet students’ needs by enhancing institutional awareness and response to students who are struggling. While most colleges and universities have behavioral health services to support students, often not everyone on campus is aware of the resources. Even the best of programs and services can’t be effective if they remain largely unknown and not well utilized.

Below are five steps—based on JED’s work and research—that colleges and universities can take to better connect students to behavioral health services.

Eyes everywhere
First, educate campus staff and faculty that responsibility for students’ emotional well-being must be shared by all who regularly interact with students, such as residence advisors, professors, academic advisors, and coaches. These people need to understand and recognize the signs of struggle, as well as how to engage students and connect them to appropriate services.

The JED Foundation is working with college campuses to adopt  a multidisciplinary, campus-wide approach to behavioral healthcare. We are not suggesting that every campus constituent serve as a first-line mental health provider; rather, that everyone on campus know the signs of emotional struggle, understand how to engage students in a conversation, and know how and where to refer students for help. By educating and empowering constituents across campus, we will have a far broader reach in identifying and supporting many more students who may otherwise fly under the radar.

Secure support of senior administration
Second, obtain support of senior administration for introducing a campus-wide approach to behavioral health. How? Convey the significant connection between emotional well-being and academic performance: students with mental health issues have higher-than-average drop-out rates. The Healthy Minds Network’s research indicates that each point a student “scores” on the PHQ-9, a depression screening tool, increases his or her risk of dropping out.

Tending to the behavioral health needs of students is intrinsically tied to an academic institution’s mission—that is, helping students succeed and achieve academic success. But there is also a business case for focusing on behavioral health: it helps students stay in school, graduate, and obtain gainful employment. When students don’t graduate or have to drop out for medical reasons, the college or university loses tuition dollars and the prospect of future alumni giving.

Collaboration between behavioral care and primary care
Third, get the primary care providers involved. College counseling centers have difficulty keeping up with demand for services, even though only about 10-12% of students on campus are seen there. However, a vast majority of students on campus go to their college health center for colds, flu, injuries, and other illnesses. If campus health centers routinely screen students for mental health issues, substance abuse, and suicidality, we will catch a large number of students who might otherwise fall through the cracks. Students are best served when campus-based primary care providers practice collaborative care, working in consultation with behavioral health providers to manage and monitor a student’s care.

Reach out early
Fourth, start educating students about campus services and connecting them to local providers even before students arrive on campus. How? Most schools require students to show proof of certain immunizations and present basic medical documentations. We recommend colleges and universities include voluntary questions about the student’s mental health and medication they may be taking. Then the university can proactively share information about available campus resources.

Involve families
Finally, recognize that families play an important role in connecting students to campus-based services. There are a lot of eyes on a campus and there are numerous ways the campus safety net can be activated, but if you notice your student is struggling, pick up the phone and call the campus counseling center. If you think your student is missing classes, or you haven’t heard from him or her in a while, or you see familiar signs of anxiety or depression, don’t wait. If no one on campus is alerted to a potential problem, students might not get the help they need.

Reason to be encouraged, reason to be hopeful
While the challenge of meeting students’ behavioral health needs is great, I see this as a hopeful time. As a society, we are becoming more comfortable talking about mental health and our personal struggles. With more students coming forward with behavioral health concerns—whether they’re confiding in a peer, resident advisor, professor, coach, counselor, or nurse—campuses have an opportunity to provide appropriate support for a greater number of students. By engaging all stakeholders—the entire campus community, healthcare professionals, government, young people, and parents—we will be in a better position to safeguard student mental health.

Your Turn

  • What steps has your college or university taken to address students’ mental health?
  • What has been effective for connecting students to mental health services?
  • What do you think the school should be doing? 

Dr. Roy serves as the Clinical Director of The Jed Foundation and is an Assistant Clinical Professor at the Yale School of Medicine, Dept. of Psychiatry. She has over 20 years of experience as a psychologist working in college mental health. She was Assistant Dean of Health and Wellness as well as Director of the Health and Counseling Center at Sarah Lawrence College, and Associate Dean of Health and Wellness at Rhode Island School of Design. She is a senior advisor for the National College Depression Partnership and her publications have focused on effective strategies for treatment and management of at-risk students on college campuses. She earned a BS degree from the University of Rhode Island, an MS from the University of North Carolina, and an Ed.D. from Harvard University.

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