College Student Mental Health and Wellness: Coping on Campus

This chapter provides an overview of the current state of college student mental health. It describes the contextual factors affecting college students’ mental health, such as institutional funding devoted to students’ wellbeing; the COVID-19 pandemic and its consequences; and sociopolitical realities such as racism, gun violence and anti-Semitism. The sensationalistic and opportunistic portrayal of college student mental health in popular media is explored, as are the positive and negative effects of social media on students’ wellbeing. Finally, the current scene with regard to college student mental health is placed in a historical context to highlight long-standing concerns and changing trends facing today’s college students.

This chapter begins with a brief overview of various sources of truth, including authority figures, faith, science, reason and experience. Although all sources of truth are recognized as valid, science is particularly valuable because of its relative objectivity. Therefore, the balance of the chapter describes three major sources of empirical information about college student mental health. First, the Center for Collegiate Mental Health (CCMH) is discussed, followed by the Healthy Minds Study (HMS) and then the National College Health Assessment. The latter two are national surveys of college students, whereas CCMH only collects data from students receiving mental health services. The HMS, like CCMH, gathers data specific to college students’ mental health; the National College Health Assessment, which is conducted by the American College Health Association, collects information on college students’ physical and mental health. Taken together, these three sources of data provide the basis for comparisons between college students who are and are not receiving mental health services, allow for determinations of trends in college student mental health and serve as the basis for hundreds of studies on the prevalence, causes, correlates and consequences of college students’ mental health.

This chapter provides an overview of prominent theories about areas in which college students develop and how they do so, as well as factors that hinder students’ growth. Although there are a multitude of theories about college student development, such as those that describe students’ moral or cognitive growth, this chapter will focus on theories that are most closely related to students’ mental health and wellbeing. The seven domains in which college students grow, according to Chickering, are reviewed first, followed by Sanford’s theory that posits that college students need a proper balance of challenge and support to develop. Next, the chapter explores Baxter Magolda’s theory of self-authorship, which proposes that college students are responsible for becoming adults by actively narrating their own beliefs, identities and relationships. The chapter concludes by examining various models of cultural identity development. Although these models are not specific to college students, virtually all students will develop their identities along one or more cultural dimensions before they graduate. Models of ethnic identity development, White racial consciousness and faith development are presented in detail.

This chapter addresses one of the most common and long-standing problems among college students, namely depression, as well as a potential consequence of depression, suicide. A formal definition of depression is presented, and symptoms of depression are discussed. Notably, clinical depression is differentiated from “feeling down” or having “the blues.” Common measures of depression for college students are described, and the current prevalence of depression among college students is explored, along with data pertaining to trends and trajectories. Particular attention is devoted to differences in rates and severity of depression among students of various ethnicities, gender identities, disabilities and sexual orientations. Next, the chapter covers various theories about and studies on the causes and consequences of depression, as well as preventive and remedial efforts that students can engage in to minimize the adverse effects of depression. The chapter concludes with a focus on college student suicide, including its prevalence, predictors of suicidal thoughts and behaviors and prevention and treatment of college student suicide.

This chapter differentiates stress from generalized anxiety, discussing the nature and prevalence of each among college students. The chapter then delves into generalized anxiety in detail, covering instruments that measure generalized anxiety, cultural considerations associated with generalized anxiety and the causes, consequences, prevention and treatment of generalized anxiety among college students. The next section of the chapter focuses on social anxiety among college students, similarly addressing its defining characteristics, prevalence, cultural considerations, causes, consequences, prevention and treatment. The final section of the chapter follows a similar structure in discussing posttraumatic stress disorder (PTSD) among college students. Throughout the chapter, attention is devoted to neurotransmitters and brain structures that are involved in anxiety and its treatment through antianxiety medications. Case examples are used to help bring theoretical concepts and research findings to life.

This chapter begins with a brief history of the ways in which alcohol has been ingrained in American culture since the arrival of European settlers and their enslavement of African people. The chapter then addresses important aspects of alcohol and other drug use among college students. Because of the popularity of alcohol and cannabis among college students, they occupy the primary focus of the chapter, although other psychoactive drugs are briefly discussed as well. The chapter draws from data collected by the Healthy Minds Study, the Center for Collegiate Mental Health (CCMH) and the American College Health Association (ACHA) in describing the prevalence of alcohol and cannabis use among college students, as well as trends in the use of both substances. The reasons college students drink and use cannabis are explored, as are the many consequences, including academic, legal, physical and interpersonal. The chapter examines a number of prevention strategies that colleges have used to minimize the negative consequences of substance use, including large-scale scare tactics, educational efforts and norming campaigns, as well as individually tailored programs; the effectiveness of each is reviewed.

This chapter covers two behaviors that greatly affect college students’ mental health and wellbeing: eating and sleeping. The chapter begins with a definition of eating disorders and distinguishes clinically disordered eating from other forms of problematic eating. The chapter describes common eating disorders among college students: anorexia nervosa, bulimia nervosa, avoidant restrictive food intake disorder (ARFID) and binge eating disorder. The chapter then discusses measures of problematic eating among college students, including the SCOFF, the Eating Disorder Inventory and the Eating Concerns subscale of the Counseling Center Assessment of Psychological Symptoms (CCAPS). Next, the chapter discusses the prevalence of problematic eating among college students. Cultural considerations are described, with particular attention paid to gender, sexual orientation and ethnicity. Causes of problematic eating among college students are discussed, and the consequences of problematic eating are explored, from shame to medical complications to death. Treatment options are detailed, as are barriers to seeking professional help. The chapter follows a similar structure in covering healthy and problematic sleep behaviors among college students. In particular, the chapter explores measures of sleep quality, the prevalence of problematic sleep among college students, their causes and consequences, as well as strategies for correcting poor sleep and interventions for promoting healthy sleep habits.

The chapter explores academic success and academic distress, noting that both high- and low-performing students experience academic distress. The multidimensional nature of academic distress is discussed, including worry about future performance; stress about current performance; low academic self-confidence; frustration; confusion; poor motivation; and excessive expectations, both self-imposed and other-imposed. Popular measures of academic distress among college students are presented. The chapter also presents information related to the prevalence and mental health predictors of academic distress and academic success. Attention is devoted to cultural considerations (e.g., gender and ethnicity) not only in academic distress and success but also in terms of starting salaries for college graduates. The chapter focuses on the prevention and remediation of academic problems by exploring typical campus resources that promote academic success, involvement in extracurricular activity and choosing a major that is suited to a student’s interests, abilities and values. The chapter concludes by focusing on several prominent theories of career development. For example, Super’s lifespan career development theory is covered, as is Holland’s person–environment theory and social-cognitive career theory.

This chapter begins by covering four parenting styles and their effects on college students’ wellbeing. Next, the effects of parents’ divorce and parental death on college students are explored. In addition to relationships with their parents, the chapter also examines college students’ relationships with their friends. Friendships based on utility or pleasure are contrasted with those based on virtue. Next, the chapter explores the effects of college students’ friendships on various aspects of their academic performance (e.g., dropping out of school) and social lives (e.g., drinking behaviors). The role of social media in college students’ relationships is considered as well. The chapter concludes with a focus on college students’ romantic relationships.

Mental health is not simply the absence of psychological problems any more than physical health is the absence of disease. This chapter explores various aspects of optimal mental health and wellbeing among college students. It examines the question of what is required for college students to both feel their best and function at or near their highest levels. It also discusses the characteristics of peak mental health, including its transient nature. Predictive factors such as exercise, diet, sleep and social connection will be explored. Regarding the features of optimal wellbeing, the following variables are described: integrity, values, mindfulness, self-compassion, flow and resilience. These variables are considered in an integrated fashion as components, as well as byproducts, of wellness. Hettler’s multidimensional model of wellness is presented at the outset of the chapter, followed by Keyes’ theory of flourishing.