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Mental health service use, treatment up among college students

Sarah Ketchen Lipson

A study measuring population-level trends in a nationwide cohort of U.S. college students found that mental health service utilization and treatment increased substantially between 2007 and 2017 among college students in the United States.

Rates of diagnosed mental health conditions also increased by about two-thirds over this decade, study findings published in Psychiatric Services showed.

“This study provides empirical evidence to support a trend that many, particularly mental health practitioners on campus, have been observing anecdotally for years: that more and more college students are seeking help for their mental health,” Sarah Ketchen Lipson, PhD, of Boston University School of Public Health, told Healio Psychiatry.

To determine the population-level trends in mental health service use among college students, researchers collected 10 years of data (from 2007 to 2017) from the internet-based survey, Healthy Minds Study, of a sample of 155,026 students from 196 campuses across the U.S.

Analyses focused on past-year therapy or counseling, psychotropic medication use and treatment (therapy or counseling and medication use) as well as lifetime mental disorder diagnosis. The investigators examined changes in symptoms of depression over the previous 2 weeks and past-year suicidal ideation. They also examined levels of perceived stigma and personal stigma.

Between 2007 and 2017, analysis revealed increases across all measures of mental health care service utilization in the full sample and among the 41,299 students with depression. Analysis showed that rates of past-year treatment rose from 18.7% in 2007 to 33.8% in 2016-2017, with increases observed for both therapy/counseling and medication use. College campuses were the most common location to receive mental health services in the sample.

Lipson and colleagues also found that the number of students with a diagnosed mental illness grew from 21.9% in 2007 to 35.5% in 2016-2017, with the rates of both treatment and diagnosis at or above 30% each year from 2014 to 2017. The rates of past-year treatment rose from 42.4% in 2009 to 53.3% in 2016-2017 and diagnosis from 43.3% to 55.8% among students with depression.

In addition, rates of both perceived and personal stigma dropped over time, from 64.2% to 46% and from 11.4% to 5.7% between 2007 and 2017. Although there was no change in levels of perceived stigma over time among students with depression, personal stigma waned from 8.2% to 5.1%.

Lipson told Healio Psychiatry that as mental health services researcher, she had two reactions to the increases in mental health diagnoses and treatment: a celebratory and a cautionary tale.

“The singular problem that I have been dedicated to addressing through my research and dissemination is the ‘mental health treatment gap,’ the proportion of adolescents and young adults with clinically significant symptoms who are not receiving mental health services,” she said.

“The celebratory tale is that the treatment gap is narrowing, though it is still wide, especially for young people of color and others from traditionally marginalized groups. Much of my work these days is around understanding and addressing the mental health needs of college students of color, in fact, and issues around belonging, identity and inclusivity,” Lipson continued. “The cautionary tale, at a system-level, is that much of the ‘burden’ of students seeking help is falling to college counseling centers.”

In their study, Lipson and colleagues found that counseling centers were the most common place students received mental health care services; however, many counseling centers across the U.S. are under-resourced and have long waitlists for much of the year, she explained.

“In the paper, my colleagues and I discuss opportunities to alleviate this strain through digital mental health programs, which offer the possibility of expanded treatment accessibility while circumventing barriers to traditional treatment, such as time and convenience,” Lipson said. – by Savannah Demko

Disclosure: Lipson reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.