No abstract

Mental health problems represent a potentially important but relatively unexplored factor in explaining human capital accumulation during college. We conduct the first study, to our knowledge, of how mental health predicts academic success during college in a random longitudinal sample of students. We find that depression is a significant predictor of lower GPA and higher probability of dropping out, particularly among students who also have a positive screen for an anxiety disorder. In within-person estimates using our longitudinal sample, we find again that co-occurring depression and anxiety are associated with lower GPA, and we find that symptoms of eating disorders are also associated with lower GPA. This descriptive study suggests potentially large economic returns from programs to prevent and treat mental health problems among college students, and highlights the policy relevance of evaluating the impact of such programs on academic outcomes using randomized trials.

We aimed to provide the most comprehensive picture, to date, of service utilization and help-seeking behavior for mental health problems among college students in the United States. We conducted online surveys in 2007 and 2009 of random samples of students in 26 campuses nationwide. Among students with an apparent mental health problem (32% of the weighted sample), 36% received any treatment in the previous year. The prevalence of psychotherapy and medication use was approximately equal. Treatment prevalence varied widely across campuses, with some campuses having prevalence 2 to 3 times higher than those of others. Apparent barriers to help-seeking included skepticism on treatment effectiveness and a general lack of perceived urgency. Overall, the findings indicate that help-seeking for mental health varies substantially across student characteristics and across campuses. Strategies to address the low prevalence of treatment will need to be responsive to this diversity.

This article reviews what is known about help-seeking behavior for mental health problems in college populations and offers suggestions for the next steps that could be undertaken to improve knowledge and practice in this area. Our review suggests that traditional barriers, such as stigma, can only partially explain the high prevalence of untreated disorders. We discuss the conclusions and limitations of research on campus-based intervention strategies, including anti-stigma campaigns, screening programs, and gatekeeper trainings. In proposing new directions for research and practice, we consider insights from research on other health behaviors (e.g., diet and exercise) as well as innovative ideas from behavioral economics and cognitive psychology regarding behavior change.