Depression and suicidal ideation are stubbornly high among college students despite increased efforts by universities to combat the long-growing problem.
While nearly all four-year institutions and the vast majority of community colleges offer mental health services, it hasn't been enough to combat the academic stress, increased screen and social media time, rising isolation and other factors experts say can contribute to the difficulties students face.
A Johns Hopkins University analysis of data collected from more than 560,000 college students by the Healthy Minds Study and released this month found large increases in mental health symptoms from 2007 to 2022.
Suicidal ideation was up 154 percent, restlessness increased by 80 percent and trouble concentrating rose by more than 77 percent. Women, minority students and people experiencing financial difficulty were more likely to experience depressive symptoms.
"We have expanded services in colleges and universities, but we haven't really redesigned the system. We're still treating mental health as a service, instead of making it a campus-wide strategy. We need to invest in prevention and peer support," said Pierluigi Mancini, interim president and CEO of Mental Health America.
A UnitedHealthcare study from last year found consistent levels of eating disorders, suicidal ideation and substance abuse disorder among college students from 2022-24.
The same data set from the Healthy Minds Study seemed to show a decrease in some mental health symptoms from 2022-24, with suicidal thoughts down 3 percent in that period and severe depression dropping 5 percent. The rates dropped from a high during COVID-19 but still outpace the general population.
"If you looked at all these big prevalence studies in 2022, it was approximately, at that time, one-third of university students were reporting clinical anxiety and two-fifths were reporting clinical levels of depression ... Using the exact same kind of mental health survey measures, adult population had prevalence rates of 6 to 7 percent. So, even though we are starting to see that there's a little bit of improvement in this anxiety and depression and loneliness, it's still so much higher in college and university student populations relative to if you were an adult not kind of in that setting," said Leslie Rith-Najarian, a lecturer in clinical psychology at the University of California, Los Angeles (UCLA).
But the trouble is in identifying what exactly is causing the longer-term trends.
In a survey from Inside Higher Ed in 2024, students said the No. 1 factor driving the campus mental health crisis was balancing school with economic, personal and family duties.
Thirty-seven percent of students said academic stress, 33 percent said social media and 29 percent cited loneliness.
"I think it's a huge range of things, unfortunately, and a lot of it comes down to the state of the world today. A lot of stress around what's going to happen when they get out of college. Are they going to be able to find a job? Are they going to be able to afford housing and being able to live on their own?" said Jen Rothman, director youth and young adult initiatives for the National Alliance on Mental Illness.
"The state of the world, and just really having all of those unknowns while on top of working hard in their classes and final exams and passing grades and wanting to be top the class, there's adults who can't even fully handle the stressors, and we typically have more of the skills necessary for handling that," she added.
Schools have not ignored the issue: One study shows 95 percent of four-year institutions and 80 percent of community colleges offer mental health services to students.
Some schools, such as UCLA, are creating screening programs to identify and connect students who need mental health support.
But experts say many colleges have taken a reactionary approach, which is part of the problem.
"I think we need to talk about stabilization and not just resolution. Our health care system in general is a reactive health care system. So, a lot of colleges and universities kind of reacted to all of the increase in mental health issues we experienced after 2020, but we need to go beyond that. If we're truly going to help college students, we need to be able to develop a system that is going to serve the capacity that actually exists," Mancini said.
"Most of the colleges, again, they have the counseling centers," he added. "What's missing is ... prevention. We need to move to the other end. We need to be able to develop those prevention strategies, to be able to intervene when the students first begin to recognize or even if they don't recognize. We need to have people around them that can help them recognize that there is an issue and they have the ability to get ahead of it."