Campus Check-In: Mental Health Treatment Expands to Apps

As campuses struggle to meet mental health needs, digital tools are considered.

Posted Feb 20, 2019

A Washington & Lee University freshman who survived his own suicide attempt recently filed a lawsuit for $12 million in damages against the administration and another $12 million against a school counselor for negligence and gross negligence in their advice to him. He reportedly was told to go to class and to football practice, and to check back later.

In Illinois, a lawsuit filed recently alleges that hazing at the sorority Alpha Kappa Alpha was responsible for the suicide of Northwestern University basketball player Jordan Hankins. NU has suspended the sorority from campus.  

While suicides are less common, over the last 10 years, mental health diagnoses have dramatically risen among college students. Mental health stigma has also decreased, as there has been a significant increase in students seeking mental health services, most commonly on their campuses.

College campuses are struggling to keep up with their students' mental health needs. Across the country, the average student-to-counselor ratio is 1,737 to 1, and at schools with student bodies greater than 35,000, the average student-to-counselor ratio is 2,624 to 1. 

At the vast majority of colleges and universities, there are clearly not enough professional staff members to meet the mental health needs of students. And while more students seek assistance, many who need support never seek help.

As a clinical psychologist and college mental health researcher, I have spoken with students who report that they haven’t sought mental health services at times when they could have benefited.

Sandra (not her real name), a college junior, shared with me that she’s struggled with depression and anxiety for years, but couldn’t find the time and motivation to schedule an appointment. She says she was further deterred by hearing reports from friends who were put on waitlists for treatment.

As was the case with the suicides resulting in recent high-profile lawsuits, tragedies on college campuses across the nation reveal reports from family and friends noting that students had inadequate access to mental healthcare.

Certainly, a plethora of barriers to seeking mental health care exist, including students thinking their symptoms are normal or that care won’t be effective, as well as time constraints, continued stigma, cost of treatment, and a desire to handle problems privately.

Digital mental health tools, such as web-based and app-based programs, offer the potential to circumvent many of these barriers and help students build on their own stress management and coping skills. These types of programs have been shown to be effective at improving user’s mental health, and offer the convenience of being accessible 24/7.

Thousands of free and low-cost mental health apps exist, and while there are a growing number of examples of campuses offering online self-help courses there are still relatively few digital mental health programs fully integrated into the resources and care provided within college campuses.

Searching for digital mental health tools can be tremendously overwhelming, and we know that the typical ways people find apps do not necessarily lead them to programs that are effective.

Certainly, some critics may argue against digital mental health tools due to a belief that the typical college student should be spending more time in face-to-face conversation and less time hooked into their digital devices.

There are a few problems with this.

Traditional face-to-face therapy is not available to thousands of students. College counseling centers typically offer free or low-cost treatment to enrolled students and are the main option for mental health care for many students.

However, college counseling centers are frequently under-resourced and operate on waitlists for much of the year. While most counseling centers offer some form of crisis appointments, when students can be immediately seen by a counselor, the capacity for ongoing care is often limited and students are referred to other counseling services in the community.

From what I have observed, many students drop off at this point, citing barriers such as low continued motivation, an inability to pay for sessions, and the inconvenience of traveling off campus for treatment.

As the American College Health Association begins developing priorities for Healthy Campus 2030, campus leaders can consider how they can capitalize upon already available digital tools to meet students digitally and support student mental health.

To support college student mental health and wellness, campus administrators can prioritize identifying and disseminating information about appropriate digital mental health tools to their campus communities. This need not be solely the responsibility of college counseling centers, as many distressed students never make their way to these centers.

Ideally, digital mental health tools can be incorporated into campus-wide programming, including resources handed out in classes, by clubs and student organization, and through other health and wellness initiatives.

The larger university and college community needs to be sensitive to the needs and preferences of students who spend much of their day connected to smartphones. And as more students seek help, demand will continue to outpace supply for traditional face to face mental health treatments. 

Mental health wellness needs to be a top priority for every student and member of the university community. Promoting digital mental health tools as an option for mental health care could guide countless students onto a path of wellness that may otherwise not be taken.