A Third of College Freshmen or More May Have a Disorder

A new study screened students at 19 universities across the world.

Posted Oct 05, 2018

Leigh Trail/Shutterstock
Source: Leigh Trail/Shutterstock

At least one in three first-year college students meets the criteria for a mental health disorder, according to a recently published study. The new prevalence estimates, based on data from an international group of students, demonstrate the need for college counseling centers to continue developing innovative approaches to serve a high volume of students.

“Alarmingly, few actually seek out treatment,” says Randy Auerbach, an associate professor of psychiatry at Columbia University and the lead author of the report, which was published in the Journal of Abnormal Psychology. “We need to figure out ways to reach students in need to help them better navigate their collegiate careers.”

As part of a World Health Organization project to study college mental health from an international perspective, Auerbach and his colleagues sent surveys to incoming first-year students from 19 universities in Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, and the United States. The questionnaires relied on criteria from the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders to screen for six common types of mental illness: major depression, generalized anxiety disorder, panic disorder, mania or hypomania, alcohol use disorder, and substance use disorder.

The team concluded that 31 percent of students met the criteria for a mental health condition in the past year. Similarly, 35 percent of the cohort was classified as having had a mental illness at some point throughout their life. The symptoms of a condition often emerged in early to middle adolescence and persisted into the present.

These rates fall roughly in line with estimates of mental health conditions for American adults, says Daniel Eisenberg, a professor of health management and policy at the University of Michigan, who was not involved with the research. For example, the National Comorbidity Survey Replication, designed to assess mental health across the country, found that 32.4 percent of American adults experienced mental illness in the past year. The National Institute of Mental Health places the number of Americans living with mental illness closer to 20 percent.

Still, the findings may underestimate the true prevalence of disorders among college students, Auerbach says, since the team only screened for six disorders and only enrolled first-year students. For those disorders, 18.5 percent of students had experienced depression in the past year, 16.7 percent had generalized anxiety disorder, 4.5 percent had panic disorder, 3.1 percent had mania or hypomania, 6.3 percent had alcohol use disorder, and 3 percent had substance use disorder. 

Adolescence is a pivotal time, and a laundry list of items can contribute to the onset or worsening of mental illness. They include childhood trauma, biological changes, the transition to college, financial stress, academic pressure, lack of sleep, social isolation, new relationships, exploring sexuality and other aspects of identity, and uncertainty about the future.

Mental health challenges among adolescents, at least in the U.S., seem to be growing in recent years. For instance, one study found that the number of adolescents who reported experiencing a major depressive episode in the last year rose from 8.7 percent to 11.5 percent between 2005 and 2014. Another found that symptoms of depression and rates of suicide have increased among children ages 13 to 18 between 2010 and 2015. At the same time, The demand for mental health services on campus is growing. From 2010 to 2015, students accessed 30 to 40 percent more counseling services, even though college enrollment increased by just 5 percent, according to the Center for Collegiate Mental Health.

Attaining international estimates, as the current study does, will allow researchers to better understand how different factors contribute to mental health. “If we start to see notable similarities and differences across countries, we can start to tease out the potential significance of some of these explanations for why problems are rising in the U.S. or other specific countries,” Eisenberg says. The prevalence of experiencing a mental health disorder in the past year was 43 percent in Australia, 37 percent in Northern Ireland, 36 percent in Germany, 33 percent in Spain, 32 percent in South Africa, 27 percent in the U.S., 24 percent in Mexico, and 19 percent in Belgium. However, the actual numbers may differ due to variation in how many people in each country responded to the survey.

College counseling centers face the challenge of addressing a growing number of students’ needs. One approach is to reach out to students earlier in the development of a disorder, because only 15 to 20 percent of students with mental health conditions seek out services, Auerbach says. Others include decreasing the stigma surrounding mental illness, which could encourage students to seek treatment, and hiring more counselors.

Auerbach is interested in leveraging technology to address mental health in college communities. His team is developing internet-based treatments, such as online cognitive behavioral therapy. There is evidence that such programs are as effective as face-to-face counseling for certain patients, Auerbach says, so the goal is to develop algorithms that determine which treatments will best serve which students.

“Mental health disorders have a ripple effect well beyond students’ college careers,” Auerbach says. “Being able to identify when these problems are occurring is critical, as is trying to find ways to intervene earlier, which ultimately may lead to more effective outcomes.”

Despite these challenges, college counseling centers have a unique opportunity to heal young adults struggling with mental illness. Since college students are relatively young, interventions can benefit a person’s life for a long time to come.

“The college age range is typically when mental health conditions emerge, and college communities offer a lot of different channels by which they can have an impact on mental health, not only linking students to services and providing services, but also more preventative measures,” Eisenberg says. “There are so many opportunities to have a positive impact.”