The State of Mental Health in Colleges — A Saddening New Normal

9 min readApr 29, 2019

This particular semester was an extremely difficult one for me, with many days filled with feelings of being overwhelmed, and as a result, was often a poor student than I should have and could have been. As someone who has had family members who had struggled with suicidal intent, experienced severe anxiety attacks in University, and had some difficult relationship issues to pull through this semester, I understand that a lack of adequate coping mechanisms can truly exacerbate the stresses of college life. Hence, for the topic of happiness, I wanted to explore a topic that was close to my own state of mind — the state of mental health among college students.

Recently, I had came across an interesting article penned by a Yale NUS student commenting on the state of affairs in her own college. She makes an interesting observation on the current discourse around mental health as constituting a “simplified, pop version of the biomedical model that sees mental disorders as something that is common and “can affect anyone”.”

She acknowledges the truth of these discourses’ technicalities but also notes that it is dangerous to blindside the crucial environmental factors that shape our mental health. In particular, she showed deep concern on the normalisation of the bad state of mental health at Yale-NUS and college campuses in general. Notably, the fixation on solutions like programming and resourcing via counselling units or better self-care notably places the onus on the individual, without much of a perceived change in the improved mental welfare of the college cohort. She attributes this to the lack of ‘solutions’ that have truly addressed the root causes of poor mental health.

As someone who had once headed the Mental Health Student Interest Group on my own residential campus (Cinnamon College), I understand where she is coming from. No amount of free food, time spent with cute kittens and puppies, awareness posters, or notes to spread positivity, can change the reality of the stringent academic workload or the excessive pressures to “succeed” by taking on multiple extracurricular activities. My student interest group had done a survey to compile a mental health resource package for the student community (USP), and had found such a similar stigmatising discourse on mental health that in some ways, disturbingly glorifies holding onto an image of false ‘perfection’ — ie. the 5.0 GPA student with many accolades to his/her belt and simultaneously normalises a culture of overworking, 4am nights and bare emotional survival behind the facade of a smile.

In 2015, an NUS survey revealed that 78% of university students had experienced mental health issues during the last year, with 33% recording suicidal thoughts.

The author from Yale NUS puts it best,

“We don’t have poor mental health because we need to learn more about healthy nutrition and exercise, we have poor mental health because we are a generation suffering from an unprecedented pressure to succeed in an unfavorable labor market and immersed in a culture that values a narrow definition of achievement…
Addressing students’ mental health is a lot harder than just providing some free pizza, and might set us up to face some uncomfortable truths, such as the fact that leading a happy life under late capitalism might involve some degree of being “unsuccessful” — which is not an option for those of us for whom success is a matter of survival. But at least that would be a more honest conversation.”

With the thought of prompting ‘honest conversation’ in mind, I decided to take a look at the available data on the state of mental health of college students. I contextualised my search for data to the United States, as available mental health data on a nation-wide scale (not based on a single tertiary institution) is difficult to access. I was interested in answering three questions — is it a common phenomenon? How does one make a meaningful yet nuanced indicator about the state of mental health among college students? Finally, what are the data’s implications?

The Global State of College Mental Health

Researchers from the World Health Organisation, led by Columbia University Psychology Professor Randy P. Auerbach, surveyed 14,000 freshmen college students from 8 countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain and the U.S.) and found that 35% struggled with a mental illness.The most common mental illness diagnosed amongst these students was major depressive disorder (21.2%), followed by general anxiety disorder (18.6%). This prevalence is similar to the global data set on most common mental illnesses.

Crucially, while schools have made serious investments in mental health resources, the researchers assessed that colleges are poorly equipped to handle the increased mental healthcare needs, where demand far exceeds supply.

The State of College Mental Health in United States

Similarly, colleges in the US are struggling to keep up with increase in requests for mental health counselling. The increase in demand can clearly be seen in U.C. L. A., where in 2005, the university was providing mental health services to less than 10% of its students, and 10 years later, this became more than 20%. Efforts in increasing college resources increase internet-based screenings, “resilience peers” who are not licensed to provide counseling but are undertake a peer-helping role, volunteer-based enrollment of online programmes that teach skills to combat anxiety and depression amongst others.

Besides understanding current efforts by the colleges in supporting the mental welfare of the student (noting that these programmes ameliorate rather solve root causes), I also wanted to understand the prevalence of mental health symptoms amongst college students in the U.S which sparked the increased resourcing of mental health services.

During my research, I came across the Healthy Minds Study which is an annual survey conducted at campuses across U.S.. The goal of this study is to collect the most comprehensive national data on mental health, help-seeking and related factors in college populations. The dataset can then be used to inform the college administration work’s on campus.

Visualising the Data

I had manually extracted the year-on-year data for three variables:

% of respondents who reported past-year therapy
% of respondents who reported knowledge of mental health services on their college campus
% of respondents who reported past-year perceived stigma

I had chosen these three specific variables for the following reasons respectively:

Respondents who reported past-year therapy was a meaningful indicator to me about the prevalence of mental health symptoms amongst college students as it showed (1) that formal diagnosis of students, (2) implicitly hinted at greater awareness of mental health services and (3) also demonstrated a possible reduced stigma to help-seeking. Hence given the implicit factors, i felt that this was a significant enough ‘Mount Fuji’ metric of sorts.
Give the hypothesis above, I sought to see if there was a rise in the awareness and knowledge of mental health services on campus.
Finally, I chose past-year perceived stigma as I felt that another potential reason why past-year therapy rates would rise could be reduced perceived stigma and I wanted to see if my hypothesis was true.

Data Analysis

I highlight the following trends:

Past-year treatment on campus increased by 8 percent from 19 percent of all students in 2007 to 27 percent in 2018.
There has also been an increased (although it has fluctuated greatly) of roughly 59% of all students in 2007 to 76% of all students in 2018 having knowledge about mental health services on campus, suggesting that attitudes towards mental healt and services are improving. .
Perceived stigma also appears to have reduced significantly from 2007, remaining at stable 47% felt by all students in 2018.

Implications of the Analysis

First, there is a tale of hope.

It appears that the “mental health treatment gap”, the proportion of adolescents and young adults with clinically significant symptoms but are not receiving mental health services, is narrowing. The good news is that we are getting people to come in sooner. While I nuance that this is different and still wide across people of colour and other traditionally marginalised groups, it is a step-up. There then appears to be a broader improved shift in discourse around mental health services in seeking mental health alongside greater knowledge and access to do so.

But also, a tale of caution.

As mentioned earlier in this article, there is an issue in an over-taxed college mental health service system. In another article, the report had found that an increasing number of college students are seeking help for mental health issues, at a rate that outpaces the growth in enrollment by five fold. This had led to routine complaints by students on the long wait time to get appointments at counseling centres.

Another cautionary tale would be the tendency to attribute the increased prevalence of students seeking mental health services and treatments as a consequence of a ‘sicker student body.’

As Locke, a Penn State University researcher expresses,

“You don’t see a 38 percent relative increase because of a sudden disappearance of resilience at the national level,” To criticize students for seeking out help for their mental health concerns, he added, would be “blaming the victim.” “We need to avoid judging students as lacking a characteristic,” Locke said.

Conclusion

Studies have presented strong findings backed with large sample sizes that college student mental health crisis is a reality in America and globally. This ‘crisis’ has been defined by the indicator of a substantial increase in treatment-seeking in college students. Whereas perhaps 10% were self-identified and seeking treatment in the 1980s, now approximately 33% are. This significant increase has been shown to be influenced by both more accepting attitudes about reporting distress and seeking and receiving treatment, and actual increases in stress, anxiety, and depression and other related problems.

Saddeningly, this state of affairs appears to be the new normal for college students.

Recommendations

While we may not be able to immediately change the structural conditions that enable the poor mental health of college students, the findings have suggested several ways to move forward in the short-term.

Given the prevalence, campus centres can be better staffed and resourced to reflect the increased demand rather than basing their budgets on historical calculations of the number of students enrolled and previous rates of students requesting appointments. Campus mental health resources play a crucial role in early intervention which is needful given the context of mental health as a number one reason why students take formal leave from the university. Encouraging an environment of help-seeking is one-way to improve the adoption of healthy coping mechanisms among students.

Notably, as we have earlier noted, honest conversations should also be sought regarding the issue of overwork as stress, as not a factor of the individual, but also with regards to the many attendant environmental factors that shape the college student’s mental welfare. Only then can students and administrators move forward in a way that accurately and realistically changes the current paradigm of the state of poor mental health in colleges.

Perhaps, even in Singapore, we could also undertake such a large-scale survey across the tertiary institutions in Singapore to better craft ways forward in navigating this new normal.

** Sidenote; if by chance you read this article and would like to know more about mental health resources in Singapore (which is my own context), my student interest group had collated a Mental Health Resource Package for students! In it, you can find some basic information on the different mental disorders, dispelled common myths, and a compiled list of resources for students, unique to the context of our residential college :) The resources include on-campus help, organisation websites, hotlines in Singapore, and other informal web resources on mental health projects/initiatives. There is also a 7-day interactive journal at the back, if you simply need to destress or take your mind off things. Access it here at tinyurl.com/LoveUSPMHRP :)

All the best for finals!

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