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2 Mental Health, Substance Use, and Wellbeing in Higher Education in the United States
Pages 33-62

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From page 33...
... "Community college" is a term used in the United States to refer primarily to institutions of higher education that confer associate degrees as the terminal degree. This report will reference data related to associate degree–granting institutions, even as some community colleges have begun to offer bachelor's degrees (AACC, 2019)
From page 34...
... Demographic factors such as socioeconomic status, race/ethnicity, and first-generation status can increase the likelihood of academic vulnerabilities that correlate with lower rates of completion, often increasing the need for remedial coursework that community college students require at higher rates than do those at bachelor's degree–granting colleges and universities (Snyder, de Brey, and Dillow, 2019)
From page 35...
... . In postsecondary education, the overall enrollment of female students achieved parity with males in the late 1970s, and the share of female students has continued to increase, reaching 57 percent of overall enrollment by 20182019 (Snyder, de Brey, and Dillow, 2019)
From page 36...
... The inclusion of people of color in BIPOC reflects the ways that individuals from other race and ethnic groups have also been dis criminated against in the United States. Historically Excluded: This term includes individuals who are BIPOC in addition to other identities that have had limited access to higher education and have faced broader discrimination based on gender, race and ethnicity, socioeconomic status, citizenship, sexual and gender minority status, disability, first generation student status, and their status as students with dependents.
From page 37...
... . As will be described later in this chapter, students who are BIPOC are also more likely to be first-generation students and to come from lower socioeconomic status.
From page 38...
... It is negatively impacting students, as it is the entire population, in ways we do not yet fully understand. Some recent studies have identified examples of that impact at specific institutions; in one study, students reported more stress and anxiety due to the COVID-19 outbreak (Son et al., 2020)
From page 39...
... Similarly, screening instruments used in general population surveys, such as the nine-item major depression module of the Patient Health Questionnaire (PHQ-9) , are known to significantly overestimate prevalence rates (Levis et al., 2020)
From page 40...
... Center for Collegiate Mental Health at Pennsylvania State University: CCMH started in 2004, is a Practice-Research-Network dedicated to the field of college student mental health. CCMH brings science and practice together by collecting aggregate, de-identified, standardized mental health data through routine clinical practice from more than 650 college counseling center members.
From page 41...
... The ACHA-NCHA now provides the largest known comprehensive data set on the health of college students, providing the college health and higher education fields with a vast spectrum of information on student health. The sur vey has undergone two revisions, the ACHA-NCHA II from 2008 to 2018 and the ACHA-NCHA III starting in fall 2019.
From page 42...
... In addition to the differences mentioned previously between self-reported data and clinical data, there is also variation in the types of instruments used for screens and diagnostics that can yield significantly different results. For this reason, some of the figures associated with each trend include data points from multiple sources with notations on the instrument used to create a more nuanced understanding of the trend.
From page 43...
... Data from HMS2 show there has been an increase in the percentage of students self-reporting symptoms of generalized anxiety (based on the GAD-7 2 Each participating school provides the Health Minds Study team with a randomly selected sample of currently enrolled students over the age of 18. Large schools typically provide a random sample of 4,000 students, while smaller schools typically provide a sample of all students.
From page 44...
... Schools with graduate students typically include both undergraduates and graduate students in the sample. Undergraduate students include community college students.
From page 45...
... The NCHA is a large, national survey of college health administered each semester. Participating universities recruited random samples of enrolled students to complete either paper or web-based surveys of past-year beliefs and behaviors regarding a variety of health and health-risk variables.
From page 46...
... in self-reported levels of depression among college students seeking counseling, despite increases in the numbers of students in treatment. 5 Using the Patient Health Questionnaire (PHQ)
From page 47...
... c NCHA: Within the last 12 months, have you been diagnosed or 7.5% 17.3% 130.7 treated by a professional for depression? c aCCMH (clinical data)
From page 48...
... , and schizophrenia all appear on the ACHA's annual National College Health Survey.7 • Anorexia nervosa: "People with anorexia nervosa may see themselves as overweight, even when they are dangerously underweight. People with anorexia nervosa typically weigh themselves repeatedly, severely restrict the amount of food they eat, often exercise excessively, and/or may force themselves to vomit or use laxatives to lose weight.
From page 49...
... Over time, more individuals who received diagnoses of ADHD and began treatment at a young age have graduated from secondary education, and many have entered postsecondary education. Increased awareness of and treatment for ADHD have raised the number of students with mental illness who may not have been able to complete a postsecondary education previously;
From page 50...
... According to data from HMS, the proportion of students reporting having a plan of suicide within the past year also increased from 1.5 percent in 2007 to 6.3 percent in 2019, while attempts to die by suicide rose from 0.6 percent in 2007 to 1.5 percent in 2019. Women reported a slightly higher rate of suicidal ideation (10.7 percent)
From page 51...
... a CCMH: Serious suicidal ideation (lifetime) b 30.9 36.7 18.8 CCMH: Suicide attempts (lifetime)
From page 52...
... The similarity of these data points for such different populations across such different time periods highlights the challenges associated with accurately measuring prevalence rates for difficultto-assess concerns such as suicidal ideation. Further underscoring this challenge, clinical data provided by CCMH in 2018 indicated that 39.6 percent of students seeking treatment reported "thoughts of ending my life" (in the last two weeks)
From page 53...
... There is no national database, registry, or single study that collects data on death by suicide. In addition, student deaths by suicide that occur during breaks, in off-campus housing, or when a student has taken medical leave to address health concerns may not be counted consistently.
From page 54...
... The Big Ten Counseling Centers does not include any community colleges or minority serving institutions. Despite this caution, this study is actually quite consistent with other studies in the past two decades examining available data to determine rates of suicide for college students; these studies have consistently found that rates of suicide for college students are much lower than the general population -- suggesting that being a college student is very likely a protective factor for suicide risk.
From page 55...
... In other words, the overall average suicide rate at Big Ten college campuses was 39.4 percent of the U.S. population national average.
From page 56...
... In a survey of the nation's college students and adults from ages 19 through 60, the authors found that prevalence of past-month alcohol consumption has declined modestly since 1980, when men had slightly higher use; the gender gap disappeared by 2000. Among college students, binge drinking has traditionally shown a significant gender difference, but a gradual long-term decline in binge drinking among college men since 1985 and little change among college women has narrowed the gap (in 2018, 32 percent of male college students binge drank compared to 27 percent of females)
From page 57...
... . Regarding "dry" campuses, one study found that students had lower rates of alcohol use and binge drinking at schools that prohibited the use of alcohol on campus compared to schools that allowed alcohol use (Wechsler et al., 2001)
From page 58...
... . Trends in Prescription Medication Misuse In 2018, 4 percent of full-time college students misused a prescription medication in the past month, a decrease from 5 percent in 2017, with stimulants being TABLE 2-5  Comparison of Measures of Marijuana Use in Higher Education Students from Multiple Sources in 2013 and 2018 Year Fall 2013 Fall 2018 % Change Measures of Marijuana Use (%)
From page 59...
... . Impact of Substance Use on College Students In 2004, the last year for which estimates are available, 599,000 college students were injured because of their alcohol use, 696,000 were hit or assaulted by another drinking college student, and 97,000 experienced a sexual assault or date rape perpetrated by another college student who had been drinking (Hingson, Zha, and Weitzman, 2009)
From page 60...
... . Factors that increased risk for sexual assault included non-heterosexual identity, membership in a Greek organization, and binge drinking, among others.
From page 61...
... There are other types of comorbidity in addition to mental illness and substance use. Different mental health disorders can occur together -- comorbid anxiety and depression, for example -- and they can co-occur with physical health disorders -- depression and diabetes, for instance (OPA, 2020)


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