Young Americans are facing a mental health crisis—and many aren’t getting the support they need.
About three-quarters of college students rated their mental health as “well” prior to the COVID-19 outbreak in March 2020, but nearly half (48%) say their overall mental health has worsened since the pandemic, according to an exclusive Fortune survey of 1,000 college students conducted by The Harris Poll in June.
“Nobody can argue that COVID has made life more difficult for everybody, especially for youth and young adults. I’m not sure we’ve given young adults enough credit for what they’ve had to go through with COVID,” says Alison Malmonexecutive director and founder of the campus mental health advocacy group Active Minds.
In these challenging times, many of the nation’s 16 million college students are turning to their campus counseling services for help—only to encounter limited staff, red tape, restrictions on the length of services, and long wait times. While more than half of college students report they’ve been in therapy at some point, less than a third report utilizing any mental health resources on campus, according to Fortune’s survey.
But despite the obstacles colleges and universities face in providing comprehensive mental health resources, there are actions schools can take now to offer more immediate relief and help mitigate the ongoing crisis on campuses nationwide.
Overall, most experts say it will likely take a multi-pronged approach to address the crisis: long-term training and educating a new generation of therapists, more clinical and non-clinical resources, and a more holistic approach to mental wellness. Students and parents may also need to adjust their expectations.
“Colleges and universities are obviously really interested in academic rigor and people graduating. But the world is not the same [post-pandemic], and so they will have to shift their perception of what is a successful student,” says Dr. Tia Dole, the executive director of The Steve Funda nonprofit focused on the mental health of young people of color.
Why is there a lack of quality services?
Most colleges and universities have little incentive on the surface to provide robust mental health resources. Colleges are fundamentally businesses with many competing priorities. Ostensibly schools only need to provide an education in exchange for the high tuition. But there’s an implicit (and sometimes explicit) promise that these institutions will provide a safe and supportive environment for students to matriculate.
It’s also arguably in the college and university’s best interest to support its student body. Students are more likely to drop out and transfer schools when they experience mental health struggles. The latest data from Sallie Mae found that 14% of students say mental health was the primary reason they did not graduate. Other studies put that figure at closer to a quarter of students.
Yet for all that mental health issues could endanger students’ academic success and overall health, there are few federal or state requirements that schools provide a minimum level of mental health resources.
While almost three-quarters of all college presidents identified student mental health as a pressing issue last year, taking substantive action has been slow-going.
“Everyone recognizes it’s a major issue, and I think every campus is struggling a bit with what are the best approaches to addressing it,” says Paula Johnson, president of Wellesley College in Massachusetts.
In many cases, it’s a matter of resources. There simply aren’t enough. About 35% of colleges report putting limits on individual counseling sessions, according to the 2021 Center for Collegiate Mental Health (CCMH) annual report. And nearly half of college counseling centers use a version of the “stepped care” model, which initially provides students with the least resource-intensive treatment and only boosts the level of care if required. That means many times, students need to try out self-guided solutions, workshops, and peer support groups before they’re given the opportunity to receive individual therapy sessions.
Stepped care attempts to ensure students are getting the support they need, while managing a college’s limited counseling resources. Most colleges only have a few full-time counselors and therapists on staff. About 65% do not have any dedicated staff that provides psychiatric services, according to CCMH findings.
But the current offerings at most colleges often fall short. This kind of crisis needs a national strategy to find workable solutions and set clear parameters, Johnson says. “There’s no agency that owns this issue—and that’s a problem,” she says. As a result, schools have very different standards and protocols, making it even more confusing for students (and their families) to navigate.
Campus counseling centers are also grappling with the nationwide talent shortage of clinicians. “We need more and more clinicians than we ever needed before. And we need to start getting people excited about entering a career in mental health when they’re young,” says Brett Donnelly, vice president of college health business development at Mindpath Healthwhich provides in-person and virtual therapy and psychiatry for college students at seven locations in California and one in Minneapolis.
What can colleges do right now to alleviate the crisis?
Building that talent pipeline is going to take time. Instead, many experts see peer-to-peer mental health resources and even telehealth as more immediate solutions to help ease the crisis on campus.
There needs to be a bit of “de-clinicalization” of the mental health space, argues Malmon. “It can’t be just the clinical mental health workforce that addresses this issue,” she says, adding that many times, peer-to-peer programs like Active Minds can help provide support, as well as encourage students to be more actively engaged in the campus community or student groups. And that sense of belonging can go a long way towards helping sustain students’ mental health.
Many new mental health tech startups are also eyeing this space. Spring Health, founded in 2016, works with a number of higher ed institutions. Most of the schools opt for unlimited access to the company’s digital or self-guided tools—which includes help navigating the best care options and crisis counselors—as well as between six and 12 free sessions with a therapist or medication provider.
“I received my PhD at Yale University and saw first-hand how hard it is for students to get access to mental health care,” Adam Chekroud, co-founder and president of Spring Health, tells Fortune. “Most universities are simply not set up to adequately meet the volume of demand for mental health services. And so, instead, there are incredibly long wait times when people do raise their hand and ask for care, and many students simply don’t bother.”
These services can be expensive for colleges and universities, says Dr. Doug Hankes, licensed psychologist and executive director of student counseling and psychological services at Auburn University in Auburn, Ala. And they’re not always worth the investment.
“A lot of counseling centers and universities…have spent tens of thousands, if not hundreds of thousands, of dollars on these third-party vendors, and students have not utilized them,” Hankes says. But even so, he says he’s been evaluating options for the upcoming school year to provide increased access, as well as a diversity of options for students.
Auburn, a winner of the 2022 Healthy Campus Award from Active Minds, has embraced a multidisciplinary approach to mental well-being that goes beyond just the clinical services offered. At Auburn, that includes student mental health clubs and peer-to-peer support, a “Zen Den” offering a variety of stress management resources for students like a nap room and light therapy for Seasonal Affective Disorder, as well as a therapy dog program that includes Dr. Moose, Dr. Nessie, and Dr. Rooster. Students are also eligible for up to 10 free individual therapy sessions per academic year.
Mental health intervention and prevention may need to come earlier as well—perhaps even in the classroom. Some high schools and colleges require students to take a health class, but rarely is mental health a focus. But if young adults are given tools to help them overcome adversity and manage their stress earlier, it could help alleviate the pressure on college resources. Even in college, it could be a preventive step. Wellesley College includes mental health curriculum in one of its first-year writing courses.
Beyond the direct support from colleges, Hankes says parents and students should come to campus with realistic expectations. Families often expect there will be the same level of resources they received through private care, Hankes says. That’s not always the case—and families may need to make alternative arrangements in advance.
“People are talking about mental health in a way that never existed,” Malmon says. But that means it’s now incumbent for the “adults in the room” to take action and provide this generation with the tools needed to get mental health right.
“We all have mental health. We may not all have mental illness, but we all have mental health,” Malmon says. “And so what are we going to do to support each other and ourselves to improve our mental health and ensure those who need something…can access it? ”