A number of authoritative reports, including those from Canada and the United Kingdom, have called attention to an increased demand for mental health services among students that puts a strain on university resources. Several reports have also pointed out that campus mental healthcare services and initiatives are fragmented and insufficient to meet the increasing breadth and depth of student mental health needs.

The tension between the need for effective mental health care that is accessible, engaging, and affordable and the current status quo of resources has reached an inflection point. As recent tragedies on different campuses across the world have shown, this state of affairs is a threat to student success and well-being. It also has implications for universities. The relative lack of data that can be used to develop a comprehensive and coordinated system for student mental health has been the main obstacle in bringing about change.

We are conducting a longitudinal study in collaboration with Queen’s University and Oxford University to determine the extent of mental health needs among undergraduate students.

We are a group of clinicians and academics who have experience in developing mental health services, evaluating them, and studying mental disorders. As such, we understand the importance for the University to take the lead in the development and implementation of a student mental health care system.

As enrolment has increased and the thresholds for entering graduate and professional schools have risen, competition in universities has also increased. (Shutterstock)

Critical period for transition

Higher education is one of the major contributors to healthy growth for individuals and social development. Success is dependent on health, which includes mental health. Transitioning to University coincides with a period of rapid biological, psychological, and social development and the peak risk of serious and persisting mental illness. The brain is growing rapidly and is more sensitive to the dangers that university students are exposed to, such as alcohol, stress, recreational drugs, and sleep disorders.

Students at University are also faced with a variety of stressors, including financial strains and difficulties in making new friends. In Canada, research shows that younger (under 22 years old) students are responsible for the growth of undergraduates. In addition to the growing number of international students and domestic students, both are away from their homes and support networks.

The competition has risen in Canada, and the Western world as the enrolment rate and threshold grade for entry into professional and graduate school has increased.

There is evidence that being a minority at the University and constant social media use may be psychosocial risk factors for mental health issues. Students are often overwhelmed by distress.

Mental illness that is serious and persistent usually begins in childhood or adolescence. Research has shown that 75% of mental disorders start by the mid-twenties. There is usually a significant delay between the onset of illness and the first contact with it. This delay is linked to progressing into more complex disorders, dropping out of school, addiction, and self-harm.

Recent research shows that screening and effective treatment of students are still needed. In a large international study based on World Health Organization surveys, it was found that 1/5 of college students had a mental disorder for 12 months. Treatment rates are low, and mental disorders are associated with higher dropout rates.

Absence of evidence-based model

The public has limited information on the effectiveness of student mental health care in Canada and the U.K. We, as a collective of researchers, have found that most campus mental healthcare services lack validated quality or outcomes indicators in their routine care. This makes it difficult to evaluate the effectiveness of current services.

The organization, integration, and resources of student mental health services differ significantly between institutions. The lack of a universal benchmark for determining standards of care and the absence of an evidence-based model are two factors contributing to these variations.

It is difficult to monitor and determine the mental fitness level of students who have taken medical leave due to mental health issues.

Unique student needs

The majority of university mental health services are derived from short-term counseling services that are not well organized or resourced enough to assess and respond to all the mental health needs of students. Student mental health care should be proactive, rapid, and preventive compared to community-based services.

Students who move from University to home are at a disadvantage when it comes to receiving timely and appropriate health care. (Shutterstock)

Students at University are particularly vulnerable to a lack of timely and appropriate services, as they are between the ages of children and adults. Students are often plagued by distressing and impairing symptoms, which do not meet the inclusion criteria for community-based specialized services.

Effective reform is likely to include not only the reorganization and strengthening of existing services but also new campus-based programs and partnerships with community-based specialty programs based on clinical needs.

Key principles for development

Our research group has developed a set of key principles that will guide the development and implementation of an integrated student mental health system moving forward. Mental health services at universities should be integrated.