Campus Mental Health Services: Recommendations for Change

My NIMH-funded, mixed methods dissertation study at the University of Michigan was a large study of mental health and mental health service delivery to college students. It started by asking college students in introductory psychology three simple questions:

1) Have you ever experienced psychological distress and symptoms lasting at least two weeks?

2) Have you ever taken medications to treat mental health symptoms?

3) Have you ever seen a therapist for help with mental health symptoms?

I say the study was colossal, because I personally interviewed almost 400 students at the University of Michigan and Michigan State for at least an hour, sometimes up to three, about how their mental health and academics were going. The research participants also completed five different questionnaires that looked at symptom severity, social support, demographic/background, etc.

Finally, I contacted them all a year later to see how they were doing mentally and academically. In the end, I had volumes of both quantitative and qualitative data to analyze, and questions to answer. Which students were doing poorly in terms of their mental health? How much did poor mental health predict failure in college? Were students able to access mental health services when they need them? If not, why not?

It took a team of master’s graduate students to help with data entry. Only the 100 most compelling interviews were transcribed for analysis. Through reporting the findings of three interview-based studies, this dissertation provided a profile of students with mental illness, defined as moderate-to-severe psychiatric symptoms that have typically lasted several years.

The first study described a sample of college students with mental illness based on their demographics, mental health history, mental health service utilization, college-related variables including the impact of symptoms on academic and social life, and their patterns of disclosure about the mental illness. The second study provided a qualitative analysis of help-seeking attitudes, mental health service use, and the intersection of mental health and college. Finally, the third study compared students with and without mental illnesses on a number of college variables, and then tested a college integration model adapted to include mental health and mental health service variables.

Results showed that college students with mental illness are capable of academic performance equivalent to that of students without mental health problems. However, the academic and social aspects of college are taxing for these students, particularly if they are not receiving effective mental health services.

Students with mental illness are motivated to participate in mental health services, especially if services will help maintain educational goals, but many barriers to service use were described. Participants identified numerous problems accessing and maintaining mental health care. Results indicated the need for better processes for assisting students experiencing serious symptoms on campus. Suggestions included improved coordination between higher education mental health resources and the community-based mental health system.

One of the articles generated from the dissertation is, “Campus Mental Health Services: Recommendations for Change,” by my late mentor Carol Mowbray, myself, and several of our colleagues. This paper can be read here. Even though the journal article is over a decade old, and they were based on research from the 1990s, the recommendations still need to be implemented in most locations. It is my sincere hope a Clinton-Kaine ticket would be able to address the inpatient and community mental health services crisis we have.