College Mental Health Services Research Articles

Enhancing University Students’ Mental Health under Artificial Intelligence: Principles of Behaviour Therapy

The increasing prevalence of mental health issues among university students has become a growing concern globally. This review explores the potential of Artificial Intelligence (AI) integrated with principles of behaviour therapy to address mental health challenges among university students. The paper examines how AI technologies, including chatbots, virtual reality, and machine learning algorithms, can be harnessed to provide accessible, personalized, and effective mental health interventions. Furthermore, it discusses applying behaviour therapy principles within AI-driven mental health interventions, focusing on techniques such as cognitive restructuring, exposure therapy, and reinforcement strategies. The review highlights the promising outcomes and challenges of integrating AI and behaviour therapy principles in university mental health services, emphasizing the need for ethical considerations, privacy protection, and cultural sensitivity. By synthesizing current research findings and theoretical frameworks, this paper provides insights into the potential of AI-driven behaviour therapy interventions to enhance university students’ mental health and well-being.

'You are being categorised as better than you are'.. Male students’ perception of male student mental health

ABSTRACT The mental health of English university students is an increasing concern and is now often described as a ‘crisis’. Most higher education students are at the key age of onset for mental ill-health, and simultaneously face pressures associated with academic attainment, and navigating new social practices. Male students are significantly more likely to take their own lives than females, and yet more research attention has typically been given to female student mental health. We need to better understand the impact of the university environment on male students specifically, and what can be done to better support male students who experience mental ill-health. Through interviews with 16 male UK university students, this paper explores the perceptions of male students about mental ill-health, including potential causes of, and support seeking for male students specifically. Findings centre around three themes: the impacts of the university environment on male mental health, masculinity culture as a potential cause of male student mental ill-health, and barriers to male students seeking and accessing support for mental ill-health. Conclusions have implications for Higher Education Institutes in supporting (male) students with transitions to university, and for university mental health services. Moreover, understanding the specific male student lived experiences may assist in developing effective ‘gender sensitive’ (rather than gender specific), support.

Caught between two worlds: mental health literacy and stigma among bicultural youth

ABSTRACT Purpose Bicultural youths are at higher risk of mental health problems and are less likely to utilize mental health services, yet our knowledge of their mental health literacy and help-seeking behaviours remains limited. Methods To fill this gap, the current study explored bicultural youths’ mental health literacy and stigma by conducting semi-structured interviews with 14 Canadian university students in 2021. Results Our analysis revealed that bicultural youths may be torn between two worlds: intergenerational tensions between participants assimilated into individualistic Canadian culture and their more collectivist parents meant that they had different cultural perceptions of mental health literacy and stigma. While being caught between these two worlds may be detrimental for bicultural youth, our results also suggested that a trans-cultural factor—celebrities’ mental health journeys—may promote help-seeking behaviour across participants. Furthermore, our study speaks to the ways that unprecedented events such as the COVID-19 pandemic impact mental health literacy among bicultural youth. Our findings might be used by university mental health services to encourage help-seeking among bicultural students. Conclusion The acculturation of mental health literacy, stigma, and associated intergenerational differences needs to be considered by university wellness services.

Brief Virtual Reality Mindfulness is More Effective than Audio Mindfulness and Colouring in Reducing Stress in University Students

ObjectivesAlthough various multi-week mindfulness programs have been introduced for stress reduction over the past decades, there is still little evidence on the effectiveness of short, self-applied interventions. This study aims to compare the effectiveness of virtual reality mindfulness and audio mindfulness, as well as a simple colouring session.MethodSixty-seven participants were initially enrolled, with 64 remaining after exclusions. They were randomly allocated to one of three face-to-face stress management interventions: virtual reality (VR) mindfulness, audio mindfulness or colouring. Before and after the 10-min intervention, questionnaires were administered to assess differences in perceived stress, psychological well-being, and engagement. Heart rate was also measured to indicate physiological stress.ResultsVR mindfulness was the only intervention to significantly increase wellbeing. Both VR and colouring significantly reduced stress, with VR producing the largest reduction in heart rate, though this was not statistically significant when compared to baseline. The three conditions were perceived as highly engaging, with the highest scores corresponding to VR mindfulness and the lowest to audio mindfulness.ConclusionsThis study shows that a single brief session of VR mindfulness can produce short-term beneficial effects in people at high risk of stress, greater than those achieved through colouring and audio mindfulness. This suggests promising direct implications for university mental health services, although future research is needed to explore long-term benefits as well as the relative efficacy of longer interventions.PreregistrationThis study is not preregistered.

Access and efficacy of university mental health services during the COVID-19 pandemic.

This study sought to understand the mental health issues, mental health support and efficacy of that support among university students. All students enrolled in a College of Arts and Sciences at one mid-size university received an email that contained a link to an anonymous, online questionnaire developed and disseminated through PsychData. 162 students completed the questionnaire. Mixed methods: Data was summarized using descriptive analysis, testing for significance, testing for differences, and content analysis. Participants reported high levels of anxiety (76%) and depression (65%). Results indicated that participant demographics were associated with types of mental access, and support. Unexpected results included lack of knowledge or information on cost, and how to access mental health services hindered access for participants, and although telehealth was the most widely used support, in contrast to other studies, participants indicated a preference for face-to-face mental health services. Results highlight the need for improving communication about and access to mental health services in higher education Recommendations and implications for policy and support services are provided.

Mental health, study skills, social support, and barriers to seeking psychological help among university students: a call for mental health support in higher education.

Poor mental health among youths is a complex worldwide issue. Many countries with medium-to-low levels of development, particularly those in Southern Europe, have not introduced appropriate mental health and educational strategies to identify the key factors influencing wellbeing, promote psychological wellbeing, and prevent poor mental health among youths. In response to these trends, we sought to uncover insights for developing interventions for youth mental wellbeing. We assessed mental health, study skills, barriers to seeking psychological help, and perceived social support among Kosovar university students, and investigated their experiences with professional mental health services and their needs and perceptions regarding the importance of professional mental health services on campus. The study used a parallel mixed-methods design. Participants included 234 university students. Quantitative data were gathered through validated questionnaires, including the Depression, Anxiety, and Stress Scale, Multidimensional Scale of Perceived Social Support, Academic Anxiety Scale, Study Skills Assessment Questionnaire, and the Barriers to Seeking Psychological Help Scale. Qualitative data on the students' experiences with mental health services and their perceptions regarding the importance of professional university mental health services were explored through open-ended questions. Most students experienced anxiety and depression, more than half were stressed, and most reported poor or moderate study skills. Lack of trust in mental health professionals was a major barrier to seeking psychological help, followed by difficulties in self-disclosure. Perceived social support and academic anxiety were significant predictors of barriers to seeking psychological help. The participants believed that mental health and academic support from the university would help improve their mental wellbeing, study skills, self-esteem, self-perception, and attitudes toward social support; raise awareness regarding mental health; and help them overcome personal and academic challenges. Our findings highlight the need for more comprehensive and accessible mental health services on campuses. By providing adequate support and resources to address various personal and academic factors that contribute to mental health issues in university students, universities can enhance students' academic success and personal growth.

UndocuCare: Strategies for mental health services that affirm undocumented college students’ psychological needs

AbstractThere are an estimated 427,000 undocumented college students enrolled in higher education. Undocumented college students encounter unique challenges associated with their precarious immigration status that impacts their psychological well‐being. In this article, we contextualize the mental health of undocumented college students and the role of college mental health services and professionals in supporting college students’ psychological well‐being. We end with recommendations and, in some cases, examples for campus mental health services, college counseling professionals, and counseling‐related preparation programs to develop policies and practices that affirm and support the mental health of undocumented college students.Practical Takeaways Undocumented college students face a higher education landscape that is riddled with discriminatory public policies and college environments that largely neglect their specific needs and fail to promote their success. Immigration policies shape the well‐being of immigrant students by way of immigration status. For instance, college students with precarious immigration status (lacking access to permanent legal protections) have been found to have lower psychosocial well‐being compared to groups with more secure or permanent statuses (i.e., naturalized citizens). College mental health services are paramount in developing strategies and efforts that affirm the specific psychological needs of undocumented college students. We provide recommendations for higher education institutions in three areas: campus mental health services, college counseling professionals (developing cultural competency for mental health services with undocumented students, engaging in structural changes to affirm undocumented students’ mental health, holding broader campus initiatives to advocate for immigrant rights), and counseling‐related preparation programs.

Ideação Suicida em Estudantes Universitários: Avaliação com Rorschach

Abstract University students are particularly susceptible to suicidal ideation and behavior due to issues inherent to this vital lives’ moment. The Rorschach test can help to understand these students’ suffering. The objective was to evaluate perception, thinking, stress, and distress in the Rorschach test domains in university students attended at a public university mental health service, comparing students with suicidal ideation with those without it. A total of 36 students aged 18 or over were assessed. The instruments were: Rorschach Performance Assessment System (R-PAS), Columbia Suicide Severity Rating Scale (C-SSRS) and Self Report Questionnaire (SRQ-20). Two analyses were performed using Wilcoxon Mann-Whitney test, according to the presence of suicidal ideation in the last 30 days (SRQ-20) and in the last six months (C-SSRS). Statistically significant differences were found in the two analyses, indicative of greater perceptual distortion in students without suicidal ideation and of stress and distress in students with ideation.

Barriers and Facilitators to Mental Health Help-Seeking and Experiences with Service Use among LGBT+ University Students in Chile

Barriers limiting access to mental health care for lesbian, gay, bisexual, trans, and other sexual and gender minority (LGBT+) university students have not yet been explored in depth. The aim of this study was to explore the barriers and facilitators to mental health help seeking and experiences with service use among LGBT+ university students. Participants were 24 LGBT+ students between 18 and 23 years of age from a university in Chile. Individual semi-structured interviews were conducted and analysed using thematic content analysis. Multiple barriers and facilitators influence mental health help-seeking of LGBT+ students, with some of these barriers being explicitly related to LGBT+ issues (e.g., fear of discrimination or accessing specialised services). Perceived effectiveness of services was closely related to access safe/affirming care. Trans students reported more barriers to help-seeking and negative experiences with professionals than their cisgender peers. Perceptions of university mental health services as safe spaces for LGBT+ students were related to a positive perception of the university regarding LGBT+ issues. Knowing the factors that either hinder or facilitate help-seeking and characterising service use experiences in this population is useful for improving access to mental health services and for the development of policies that promote affirmative care for LGBT+ people.

Sexuality and Gender Identity Inequities in Substance Use Disorder and Its Treatment among American Indian, Alaska Native, and Native Hawaiian College Students

Background The aim of this study was to investigate inequities in substance use disorder (SUD) diagnosis, opioid misuse, marijuana misuse, SUD treatment utilization, and utilization of university mental health services among sexual and gender minority (SGM) American Indian, Alaska Native, and Native Hawaiian (AI/AN/NH) college students. Methods Data consisting of 8,103 AI/AN/NH students’ responses to the American College Health Association’s National College Health Assessment survey from fall 2015 through spring 2019 were utilized for this study. Multivariable logistic regression models were used to compare the odds of SUD diagnosis, opioid misuse, and marijuana misuse in SGM AI/AN/NH students to cisgender, heterosexual peers. Unadjusted odds of SUD treatment utilization and utilization of university mental health services were also evaluated. Results Compared to cisgender females, transgender (aOR = 4.43, 95% CI = 2.67–7.34) and gender diverse (aOR = 2.86, 95% CI = 1.61–5.07) students had significantly higher odds of SUD diagnosis. Similarly, significantly higher odds of SUD diagnosis were observed among sexual minorities, including gay/lesbian (aOR = 2.95, 95% CI = 1.71–5.09) and bisexual (aOR = 1.97, 95% CI = 1.30–2.99) students compared to heterosexual peers. Sexual minority students had significantly higher odds of utilizing university mental health services (uOR = 2.43, 95% CI = 1.22–4.84) than heterosexual peers. Odds of opioid misuse and marijuana misuse were also significantly increased among sexual minority students. Conclusions AI/AN/NH college students who identify as SGM have higher odds of SUD diagnosis, opioid misuse, and marijuana misuse than their cisgender, heterosexual peers. These findings highlight the need to consider tailored programming for SGM AI/AN/NH students in substance use prevention and intervention efforts in U.S. college settings.

Framework and Overview of a State-Wide College Mental Health Program in Kerala, India.

Mental health issues are common among college students, and structured services have been proven to enhance outcomes. Despite increased enrolment for higher education in India, college mental health services remain sparse. JEEVANI is the first structured state-wide college mental health service in India. This paper describes its framework and provides an overview of its functioning during the initial five months. In 2019-2020, the Directorate of Collegiate Education, Government of Kerala, implemented the program in 66 colleges catering to approximately 60,000 students. Qualified counsellors were trained to identify issues and provide interventions and early referrals, using a stepped-care approach. They conducted awareness programs to promote mental health and reduce stigma. The services were accessed by 2,315 students during the assessment period (October 2019 to February 2020). The beneficiaries were predominantly females (54.1%). Over a third (38.8%) belonged to the lower socio-economic strata, and 2.5% had significant vulnerabilities. Although no syndromal diagnoses were made, anxiety and depression were the most common presentations. The counsellors provided 3,758 individual sessions and facilitated support for students who reported academic difficulties or interpersonal issues. Severe mental illness was detected in 54 students, and referrals for specialist mental health input were initiated in 68. Describing the framework, sharing the technical material, and providing an overview of its functioning from a resource-constrained setting in India may encourage higher education institutions in low- and middle-income countries to consider similar projects.

Transitions to campus mental health care in university students: Determinants and predictors

Background: Access to university mental health services is poorly characterized. Our objectives were to (1) assess patterns of access and (2) explore predictability of contact with student mental health services. Participants: Data derived from the U-Flourish study, which includes a survey of successive cohorts of incoming undergraduate students attending Queen’s University, located in Ontario, Canada (Cohort 1: 2018, Cohort 2: 2019). Methods: Survey data sets were deterministically linked to administrative data provided by Student Wellness Services. Analyses included cross-tabulation, logistic and negative binomial regression. Predictive modeling used LASSO regression. Results: Baseline symptoms were robust determinants of access. For example, a PHQ-9 rating in the severe range (≥ 20) was associated with an OR of 9.71 (95% CI: 4.46–21.1). A predictive algorithm did not outperform cut point-based interpretation of PHQ-9 or GAD-7 ratings. Conclusions: Self-reported symptoms are consistently associated with service use, supporting the widespread use of symptom screens.

The mental health information needs of Chinese university students and their use of online resources: a holistic model

PurposeThis research aims to explore the nature of Chinese students' mental health information needs and to identify the online resources they use to meet those needs.Design/methodology/approachData was collected from three Chinese research-oriented universities using semi-structured interviews and a survey. Twenty-five university students with varied backgrounds were selected for semi-structured interviews to explore the triggers and nature of their needs. Then, printed and online questionnaires were distributed to undergraduate and postgraduate students and 541 valid responses were processed for descriptive statistical analysis and variance analysis.FindingsThe following findings were incurred. First, the triggers of university students' mental health information needs mainly are mental health being in the news, personal interest in gaining mental health knowledge, mental health issues, required formal learning and preparation for mental health counselling. Second, eleven types of information are used, with an emphasis on employment pressure, study stress and self-understanding. Third, mental health information needs differ with mental health status and some social-demographic factors (including gender, urban or rural origin and educational stage). Fourth, information needs can be characterized as dynamic; complex and diverse but concentrated on a few types; ambiguous and hard for participants to define; private; stigmatized; self-dependent and substitutable. Fifth, Internet sources used to meet such needs are mainly search engines, Question and Answer platforms, public social media platforms. Finally, a model of mental health information needs was built based on the above findings to map the whole process from what triggers a need, to the content and characteristics of information need, and online resources used to meet those needs.Practical implicationsThe paper provides suggestions for university mental health services in developing more tailored knowledge contents via effective delivery methods to meet diverse needs of student groups.Originality/valueThis research is novel in using empirical data to build a holistic model that captures the context and the nature of mental health information needs of university students.

Peer-Presented Versus Mental Health Service Provider–Presented Mental Health Outreach Programs for University Students: Randomized Controlled Trial

BackgroundUniversity students are reporting concerning levels of mental health distress and challenges. University mental health service provider initiatives have been shown to be effective in supporting students’ mental health, but these services are often resource-intensive. Consequently, new approaches to service delivery, such as web-based and peer support initiatives, have emerged as cost-effective and efficient approaches to support university students. However, these approaches have not been sufficiently evaluated for effectiveness or acceptability in university student populations.ObjectiveThus, the overarching goal of this study was to evaluate a mental health service provider–presented versus peer-presented web-based mental health resilience–building video outreach program against a wait-list comparison group.MethodsParticipants were 217 undergraduate students (mean age 20.44, SD 1.98 years; 171/217, 78.8% women) who were randomly assigned to one of the intervention groups (mental health service provider–presented: 69/217, 31.8%; peer-presented: 73/217, 33.6%) or the wait-list comparison group (75/217, 34.6%). Participants in the intervention groups were asked to watch 3 brief skill-building videos addressing strategies for building mental health resilience, whereas the comparison group was wait-listed. The mental health service provider–presented and peer-presented video series were identical in content, with presenters using a script to ensure consistency across delivery methods, but the videos differed in that they were either presented by mental health service providers or university students (peers). All participants were asked to complete web-based self-report measures of stress, coping self-efficacy, social support, social connectedness, mindfulness, and quality of life at baseline (time 1), 6 weeks later (time 2, after the intervention), and 1-month follow-up (time 3).ResultsResults from a series of 2-way ANOVAs found no significant differences in outcomes among any of the 3 groups. Surprisingly, a main effect of time revealed that all students improved on several well-being outcomes. In addition, results for program satisfaction revealed that both the mental health service provider–presented and peer-presented programs were rated very highly and at comparable levels.ConclusionsThus, findings suggest that a web-based mental health resilience–building video outreach program may be acceptable for university students regardless of it being mental health service provider–presented or peer-presented. Furthermore, the overall increases in well-being across groups, which coincided with the onset and early weeks of the COVID-19 pandemic, suggest an unexpected pattern of response among university students to the early period of the pandemic. Limitations and barriers as well as research implications are discussed.Trial RegistrationClinicalTrials.gov NCT05454592; https://clinicaltrials.gov/ct2/show/NCT05454592

Barriers to Seeking Mental Help and Interventions to Remove Them in Medical School during the COVID-19 Pandemic: Perspectives of Students.

Medical students are at increased risk for psychological morbidity but the majority of those with mental health problems do not seek professional care. We aimed to uncover the viewpoints of medical students regarding barriers and facilitators to using university mental health services and their attitudes and preferences towards online counselling. Four semi-structured focus groups were conducted (n = 26, mean age = 21.8, ±1.88, 73% males). After reaching data saturation, interviews were audio-recorded, transcribed and content-analysed by two independent coders. Intrapersonal barriers emerged to be perceived low risk, excessive self-reliance, lack of belief in the effectiveness of service, lack of openness. Interpersonal factors were the following: assumed long waiting list, insufficient provision of service information, fear of exposure, and not being familiar with the counsellor and the process. Extrapersonal barriers such as insurance problems, the number of available sessions, adverse sociocultural attitudes, fear of stigmatisation were identified. Students suggested that the university should provide psychoeducation and routine screening, apply social marketing and stigma reduction campaigns, improve information flow, and offer not only personal but also online video counselling to target removing these barriers. The results provide a reference for the redesign of mental health services to facilitate their access by students. Implications and limitations are discussed.

Gender Differences in Mental Health of International Graduate Students

The study investigated the mental health concerns, mental health states, and help-seeking behaviors of international graduate students by gender. Ninety-two respondents accomplished an online survey. The males’ main concerns were academics and finances while it was academics and other relationships for females. There is no significant gender difference in mental health states although, there are more males with 3-5 depression symptoms and moderate-severe anxiety. Both males and females were willing to seek help for their mental health concerns. Both males and females suggested the provision of university mental health services. Further, males added the need for better teacher/adviser-student relations while females added having social events. The depression and anxiety symptoms were higher for male master’s students and for female students who resided off-campus and have a family member/friend diagnosed with a mental health problem. Provision of appropriate university services to attend to the mental health needs of international students is necessary.

Increases in symptoms associated with obsessive-compulsive disorder among university students during the COVID-19 pandemic

Objective The long-term consequences of the COVID-19 pandemic on college students’ mental health remains unknown. The current study explored self-reported Obsessive-Compulsive symptomatology among college student cohorts from pre-, peak-, and later-pandemic time points. Participants Undergraduate college students (N = 524) who volunteered for course credit. Methods Self-report responses on the Dimensional Obsessive-Compulsive Scale (DOCS), which includes subscales for contamination, unacceptable thoughts, harm responsibility, and symmetry, were collected from November 29, 2016 through April 27, 2021 and assessed for differences between the pre-, peak-, and later-pandemic cohorts. Results Peak-pandemic responders reported higher symptomatology for contamination and unacceptable thoughts compared to pre-pandemic responders (and for pre- vs. later-pandemic for contamination), with no significant effects for symmetry or harm responsibility. Conclusions Although the longer-term consequences of the COVID-19 pandemic on students remains unknown, a greater shift in college mental health services from prevention to assessing and addressing more immediate challenges may be necessary.

Prevalence of depression among Libyan medical students

Introduction: Psychological stress is a common psychiatric disorder in medical students and sometimes is associated with depression. Students at university usually met a great pressure that they face in their study life and to the hard circumstances in the everyday life. The aim of this study is to estimate the prevalence of depression and stress among university medical students in Libya. Materials and methods: Data was collected by three different questionnaires: the first questionnaire is 6-ITEM Kutcher Adolescent Depression Scale (KADS), the second questionnaire is Patient Health Questionnaire-9 (PHQ-9) which are used to diagnose and to assess the severity of depression. The third questionnaire is a simplified self-scoring test for evaluating stress and tension levels. The three questionnaires have all been distributed to the medical sciences students at University of Tripoli in March and May, 2019. According to the registered students in the academic year, 2018/2019, the sample size was composed of 170 students. Results: The major finding of screening revealed that 45% of the total students suffering from depression during their study. This high prevalence composed of mild and moderate type of depression among the students (45% and 25%, respectively). On the other hand, about 40% and 50% of the students have identified as mild and moderate stress, respectively. About 10% of the students have detected as severe stress. Conclusions: This study indicates a high prevalence of mild and moderate depression among medical university students in Libya. Results suggest that university mental health services and programs addressing the students are highly recommended.

Mental Health and the Self-Tracking Student

This article examines universities’ adoption of WellTrack—a self-tracking mobile phone application modeled on cognitive behavioral therapy techniques—as a solution to reported increases in the prevalence and severity of student mental health conditions. Drawing from a feminist materialist perspective that understands discourse and the material word as co-produced, this article argues that the app’s design, marketing, and reception are deeply intertwined with the political rationality of neoliberalism, which centers self-responsibility and the market economy. The article first situates the development of the WellTrack app within larger institutional and political shifts towards digital education governance. It then contextualizes the app’s use within the history of college mental health services in the United States, revealing how longstanding socio-medical discourses concerning student wellness individualize structural and systemic factors of ill health. Through close reading and immanent critique of the marketing and media reception of the WellTrack app’s introduction into universities, the article provides an account of how universities are socializing students to relinquish data to private firms in exchange for health services. Students are encouraged to engage in constant self-examination and strive towards a vision of student wellness that precludes an analysis of the structural conditions and intersecting oppressions contributing to poor student mental health. These conditions are social and pervasive, requiring institutional analysis and critique of the university itself.

Addressing Depression and Suicidality in the College Population

Background: The need for mental health care among college students has grown exponentially over the last decades; not only is the number of students needing care greater, but there is a higher acuity as well. 19.9 million students are estimated to attend college in fall 2019. Relatively few consensus guidelines exist on college mental health treatment and services. Objective: The aim of this study is to review the current understanding of depression and suicidality in the college population, current treatment methods, and campus-wide systems considerations for addressing these issues. Method: Review of current literature. Results: The increasing rates of depression and suicidality in the college student population have resulted in increased morbidity and mortality, affecting college students and campuses across the country. A comprehensive approach to address these issues includes treatment at an individual levelincluding psychopharmacological treatment and various therapies, knowledge of campus and local community resources, engaging students’ support systems including parents when appropriate, and campus-wide systems approaches and interventions for reducing depression and increasing ease of access to mental health services. Conclusion: A comprehensive and systems approach is necessary for addressing the increased rates of depression and suicidality among college students.