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Six out of 10 college students live with mental health disorders. And although the American School Counselor Association (ASCA) recommends a 250-to-1 ratio of students to school counselors, the national average was 415-to-1 for the 2020-2021 academic year. Clearly, an imbalance exists that needs to be corrected. And, without a strategy for meeting student demands for care, the impact of long wait times for care is likely to be felt at college and university campuses across the country.
A study using eight years of data from more than 350,000 students at 400 college campuses found that the mental health of college students across the U.S. is on the decline. More than 60% of students surveyed during the 2020-2021 academic year met the criteria for one or more mental health problems – a nearly 50% increase from 2013. So as student-to-counselor ratios and student mental health decrease, repercussions are felt by students as it relates to their ability or willingness to seek care.
The latest Student Voice Survey conducted by Inside Higher Ed and College Pulse and presented by Kaplan, indicates that one year into the pandemic:
- 65% of university students report having fair or poor mental health.
- 63% of those students rate their college’s response to student mental health and wellness services at a C or lower, compared to 43% of all students.
- 47% say they could have used more support from their college for psychiatric disorders.
- Only 15% of respondents engaged in college-offered counseling.
In short, more college students are living with mental health disorders but aren’t getting the professional help they need. While there are many reasons for this, the stigma of mental health problems is among the top barriers to help-seeking, according to the Surgeon General’s Report on Mental Health and the President’s New Freedom Commission on Mental Health.
What is the stigma of seeking care?
How is “stigma” defined? It generally refers to the public stigma of having a mental illness. According to The Psychologist, “Public stigma is society’s rejection of a person due to certain behaviors or physical appearances that are deemed unacceptable, dangerous, or frightening.”
The perceived stigma attached to having a mental illness is not the only type of stigma that inhibits the decision to seek therapy. There’s also a felt public stigma associated with seeking professional services, separate from the public stigma associated with mental illness. With this stigma, what one suffers from is less important than the simple behavior of seeking psychological help, whether that’s for a chronic, diagnosable mental disorder or for processing a tragic event, such as the death of a loved one. Simply seeking professional psychological help has made some feel embarrassed or ashamed.
Psychology experts Dr. David Vogel and Dr. Nathaniel Wade explain that mental health stigma isn’t only what others think. They said that for many people, a separate process exists for individual self-stigma. This can be specifically associated with seeking help. Particularly in the case of the self-stigma associated with a mental illness, an external source applies the label of mental illness, and then the person decides whether or not to accept it.
In comparison, Vogel and Wade said that the often voluntary act of seeking therapy may result in an internally applied label. This can happen when the symptoms of mental illness are not perceived by the individual to be extreme enough to merit counseling:
“In this case, we argue that the role of self-stigma in the decision to seek help might be even more pronounced because it is difficult for many to both acknowledge the need for professional help and not feel a sense of failure or loss as our society portrays needing help as a weakness.”
These nuances of the public- and self-stigmas are important, as they allow mental health professionals to effectively address the stigma of mental illness in a focused manner.
What are help-seeking stigmas for college students?
According to a survey conducted by The Harris Poll, only 30% of college students who received mental health counseling used their university services. For many students, it’s not easy to access support on campus. Seventy-two percent of students don’t even know where to go on campus to receive mental health treatment.
Red tape and restrictions routinely frustrate students and can keep them from getting help. Many colleges also have caps on the number of sessions students can attend and some charge co-pays. And, university-sponsored health plans rarely cover mental health services, limiting cost-effective options for students.
Another barrier to accessing mental health resources is the idea that students feel they may not merit help. Among those not in therapy, half of the students surveyed in The Harris Poll say it’s because they don’t think their problems are serious enough to warrant help. In the survey, 25% say the thought of reaching out for help is too overwhelming.
The full list of results from The Harris Poll highlights the complexity of the problems keeping students from getting the help they need:
The stigma of seeking care in specific student populations
In the fall of 2020, 53% of undergraduates in the U.S. were white, compared with 69% of all undergraduate students in 2011. But, increasing diversity among college students goes beyond race and ethnicity. It includes students from affluent families, those from low-income households, as well as an increasing number of first-generation college students who may need additional support.
Here’s how stigma correlates with various student demographics:
Sixty-two percent of Latinx people in the U.S. are of Mexican background, followed by 9.5% Puerto Rican, 3.9% Salvadoran, 3.9% Cuban, 3.5% Dominican, and 2.5% Guatemalan. According to a study from the University of California (U.C.), Riverside, 65% of this group of students have mental health issues that go untreated, in part because of the prevalence of the stigma against mental illness. Mental Health America says that mental health and mental illness are often stigmatized topics in the Latinx community, resulting in prolonged suffering in silence. This silence compounds the range of experiences that leads to mental health conditions, including immigration, acculturation, trauma, and generational conflicts with family members. And when Latinxs do seek help for mental illness and suicide prevention, they regularly face hurdles such as cost, a lack of culturally competent mental health providers, and insurance barriers.
Black and African American students
Many Black students don’t get the mental health care and help they need. One study found that 63% of African Americans believe that a mental health condition is a personal sign of weakness. As a result, only 1 in 3 Black adults who need mental health care receive it. According to the American Psychiatric Association, African Americans are more likely to use public health services like emergency rooms or primary care as opposed to mental health specialists. Not only are there beliefs and stigmas that may discourage Black and African American students from talking openly about mental health, but the lack of representation in campus mental health providers that represent this student population also suggests even more additional hurdles for this group.
Asian American Pacific Islander (AAPI) students
Since 2000, Asian American Pacific Islander (AAPI) college student enrollment has increased by 36%. Today, AAPI students comprise nearly 20% of college students at four-year institutions and 14% of students at two-year institutions. While the AAPI population continues to grow, research shows they have the lowest help-seeking rate of any ethnicity — only 2 out of 10 with mental illness receive treatment. According to a Substance Abuse and Mental Health Data Archive (SAMHDA) survey, AAPIs resist getting mental health treatment because they don’t want others to find out, have confidentiality concerns, and fear negative opinions from their peers.
The total number of international students enrolled in U.S. colleges and universities in 2019 was just over 1 million, making up 5.5% of the total student population. Unfortunately, this group of students is less likely than domestic students to address mental health problems or be aware of the availability of services. The American College Health Association found that only 12% of international students who reported suffering from significant anxiety or depression went to counseling. A study published in the Journal of American College Health found that while international graduate students were as likely as domestic graduate students to report stressors affecting their well-being or academic performance, they were less likely than their American peers to be aware of available counseling services or demonstrate help-seeking behavior. The statistics suggest 61% of international students versus 79% of domestic students.
Fifty-six percent of U.S. undergraduates are first-generation college students. Among U.S. first-generation undergraduate students, 41% are Black and 61% are Latinx, compared with 25% of white and Asian-American students. A common feeling among first-generation students is embarrassment, because feeling as though they are imposters on campus. Without long family traditions of going to college, it’s harder for them to feel like they fit in with their peers. According to the National Center for Education Statistics and the National Association of Student Personnel Administrators (NASPA), the six-year graduation rate for first-generation students is 2.5 times lower than continuing generation students.
Combat the stigma of seeking mental health care
How virtual care can reduce the stigma of seeking care
A telehealth or virtual care platform can play a vital role in how higher education supports the mental health of young adults. Offering telehealth services as an extension of on-campus resources can help reduce the stigma of seeking help.
Telehealth reduces access barriers for students who may not otherwise seek care.. Offering virtual support options helps meet students where they are, providing care when and where they need it.
Beyond providing immediate and accessible medical, psychiatric services, and mental healthcare of the highest quality, TimelyMD is committed to providing diversity in mental health and medical providers that students are able to connect with for care. Additionally, TimelyMD’s telehealth services remove the barrier of wait times and access to care that is restricted to regular business hours for in-person care.
The 24/7 access to mental health resources provided by TimelyMD means that students can still access a qualified provider even when the campus counseling center is closed. And TimelyMD’s psychiatry services enable schools with scarce resources to provide advanced mental health support where it may be limited. Enhancing access to mental health care creates more onramps to care for students who may be trying to overcome stigmas and take the first step in seeking care.
Contact TimelyMD to discover how adding a virtual health and well-being platform can remove barriers to mental health and improve college students’ mental health.