The Persistence of Mental Health Issues

Introduction

Mental health among college students has become a major concern—some call it a “crisis” among young people. Articles about the mental health struggles of college students appear regularly—what kinds of issues they face, where they stem from, and what resources students can turn to.

As a result of the COVID-pandemic, students were driven inside, away from their regular support systems, and the college experience as they once knew it (or knew of it) was stripped of its essence. The impact this had on students’ mental health is significant, but at the same time, it is important to acknowledge that these problems are not new.

Indeed, in our ten-year national study on higher education (published in The Real World of College), which was conducted before the COVID-19 pandemic,  students reported mental health issues (stress, anxiety, depression, etc.) as the most prevalent and important problem  on their college campuses. Other constituencies on campus (faculty & admins) readily agreed. Indeed, it was one of the few, if only, agreements among the eight constituencies that we surveyed.

Interestingly, however, the mental health problems that students described were not what one might have assumed/or predicted—we expected to hear about social dynamics, finances, or pre-existing diagnoses. Instead, we found that students most often discussed academic pressure they feel/experience—the stress they felt surrounding grades, GPAs, the volume of work, and overall academic performance.  

Accordingly, we wanted to investigate further: how do current college students describe mental health problems on campus? Do they discuss issues of isolation, social anxiety, peer relationships, finances, etc.—or something entirely different? 

What did we find? 

Over the last two years (2020-2022), we, a team of four researchers trained in psychology and education, have followed students at four different colleges. We asked them to keep weekly portfolio or journal entries about problems or “dilemmas” they faced, observed, or heard about over the course of an academic year; and we spoke with them one-on-one at least four times over Zoom. We never prompted students to talk about mental health issues but suspected that they would—and we were right.  

Most crucially: The conversation surrounding mental health in college has not changed materially. 

We were somewhat surprised that the pandemic was not the sole topic of stress for students; after all, the kinds of headlines that we were seeing across the news were about the fear and anxiety surrounding COVID. Fewer than 10% of the entries about mental health issues directly stemmed from COVID. Instead, the pandemic was a catalyst that heightened and exacerbated problems that already existed—more specifically, the pressure and rigor of academics. Over a quarter of the portfolio entries about mental health contained ideas related to academic matters. Students felt this stress, which often turned into real anxiety, even more during the pandemic.  

Despite the news about colleges no longer requiring SAT scores on applications, and some professors moving away from strict grading systems, students’ preoccupation and stress surrounding external measures of success continued to grow. Apparently, the pandemic contributed to this—when nearly everything seemed to be spiraling out around students, getting good grades, and maintaining a high GPA was one of the rare indices that remained within their control. But even then, the stress of achievement overtook students' emotional well-being. Consider this testimony: 

I texted my friend in full panic mode, and basically just like vented about how entirely stressed I am. I swear my fight-or-flight mode kicked in, like I’m sweating and my heart is beating faster and my leg won’t stop bouncing. My hands were actually shaking to the point I couldn’t text well. It makes me wonder about all of this stress. I mean, as a college student I’m technically signing up for this. If I want to be a good student and do well, this is what it takes. I have to be on top of my shit all the time… I should take it all in stride and realize that this is what I signed up for, right? Not complain about it because this is the reality of academia. 

Of course, students brought up other topics and ideas that contributed to their mental health—sometimes what helped it, but more often what worsened it. They expressed anxiety about the dynamics they had with roommates, friends, and romantic relationships, as well as their family members. Occasionally, they would express distress over finances, usually related to holding a job (or jobs) while being a student and needing money for day-to-day expenses. And when a large-scale political event happened (such as the presidential election in 2020, the January 6, 2021 insurrection on the capitol, and Russia invading Ukraine in February 2022), students discussed feeling overwhelmed by the current state of the world. However, none of these topics came close in number, or emotional valence, to that of academic stress.  

The pressure of academics and its relationship to mental health issues should be of concern to all who care about the sector. After all, academics are—or arguably should be—at the core of the college experience. If students are not well equipped to handle or cope with this stress, then we cannot expect them to have an experience that is both meaningful and enjoyable.  

In addition to students’ comments about academic pressure, we identified two other important themes. 

A significant change: There has been an exponential increase in self-reporting mental health issues. 

Consistent with data from the National Institute of Mental Health, more young people, especially college students, are reporting feelings of stress, anxiety, and depression. When we spoke with students for The Real World of College (RWC), approximately 20% of students described personally dealing with mental health issues. It’s possible that this number is lower than the actual number of students who were struggling with mental health in our sample, but we can only rely on what students told us.  

During the past two years of tracking portfolios, out of the near 150 students we spoke with, 95% of them self-reported struggling with stress and anxiety at any point over the academic year. This is striking not only because of how much higher this number is compared to our previous study, but also because of what it represents: that this issue has become a universal problem across college students from a range of  schools and backgrounds. 

It is possible that the specific features of our approach may have led students to feel more comfortable opening up to us about their stress and anxiety. However, it is hard to ignore that almost every student in our sample reports these issues, and the number of entries about mental health do not change from one semester to the next. Therefore, we feel comfortable saying that this accurately reflects the landscape of mental health issues in higher education more broadly—or at least on the four campuses that we surveyed. 

A problem worth solving: There are not enough resources to help students with mental health issues, but we may have hit upon a helpful approach.  

During the original RWC study, students talked consistently about the lack of resources on their campus to support students who were struggling with mental health issues, particularly long wait times at counseling services due to low numbers of staff. This remains an issue today—oftentimes, students did not know to whom to turn or where to go when confronted with overwhelming anxiety, stress, or more serious problems. And again, the pandemic made receiving counseling even harder for students. As we read students’ portfolio entries, particularly those that were very emotional or charged, we sometimes wondered if they were crying out to us for help.  

Here's our surprising discovery: when we spoke with students over Zoom, they would describe in detail how the process of journaling was therapeutic to them. This testimony came up as a theme across all four schools. We never intended to provide a therapeutic space for students (and we are not mental health practitioners); but students spoke positively about how writing for themselves weekly allowed them to slow down, process, and examine their thoughts more deeply. Journaling has long been recommended by therapists, but it is difficult to maintain without motivation or accountability. For our students, we provided both—the promise of compensation for completing the study, consistent check-ins to remind them to submit entries, and communicating that we were reading them carefully.  

As students go through college, keeping a portfolio or journal may provide potential benefits for students’ mental health. To be clear, it cannot replace formal counseling, therapy, or medication—many students will continue to need those interventions. But in conjunction with other practices, we believe that well-structured and monitored weekly journaling can provide students with an outlet to express and dissect their feelings of stress, anxiety, depression, and more. Colleges may be able to intertwine journaling into the student experience as a broad, first step towards tackling mental health issues on their campus.  Of course, it will be important for students to know that their entries are being read and taken seriously. 

Takeaways

In many ways, our findings about mental health among the students in the portfolio project are not surprising—we have been hearing for years about its prevalence in young people, particularly college students. From our large-scale study of American colleges, we were aware that academic rigor and pressure constitute the primary driver of these issues for students today. However, we are disheartened and concerned by the sheer magnitude of mental health issues in our current work—especially since there are no clear solutions.  

Colleges are tasked with the tall order of providing mental health support to more students than ever before; there will never be enough counselors or practitioners. From our past and current work with students, our beliefs about the relationship between mental health and the college experience have been challenged—and perhaps colleges can learn from our process.  

The benefits of introducing a practice such as journaling or keeping a portfolio into the college experience are two-fold: it helps both students and colleges. Specifically, this intervention could become a space where students feel free to express and dissect their feelings of stress and anxiety without judgment to adults (who are, importantly, not their family); and colleges can better understand what students are actually going through and provide them with the right support to help them process these emotions in a way that will last beyond the college experience. If purposefully and thoughtfully implemented, a powerful collaboration could emerge.  

We are grateful to the Kern Family Foundation for their generous support of this work.