Mental Health, Substance Use, and Wellbeing in Higher Education Supporting the Whole Student (2021) / Chapter Skim
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The term mental illness will be used specifically in reference to diagnosed serious mental health disorders, including depression, schizophrenia, bipolar disorder, or anxiety disorder.
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economy, so that finding new funds to provide additional resources for students experiencing mental health problems is proving to be problematic. Nonetheless, a December 2020 survey by the American Council on Education found that 68 percent of university presidents ranked student mental health concerns as among their most pressing issues.
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The committee believes that institutions have a responsibility both to enhance the wellbeing of all students and to provide additional support to a subset of students with more severe emotional distress and mental illness. Over the course of the study, the committee: • Identified and reviewed programs, practices, resources, and policies that institutions of higher education have developed to treat mental health is sues and to support wellbeing on campuses; • Analyzed the challenges institutions face -- including financial, cultural, and human resource obstacles and methods to address these challenges; • Investigated factors related to the funding of and access to mental health services and support for student wellbeing, such as student academic performance and campus climate; • Examined, to the extent possible, the relationship between student mental health, wellbeing, and rates of alcohol and drug use, and recommend ways in which institutions can address substance use and its effects on campus climate; and • Produced a consensus report with recommendations that will be broadly distributed on campuses, at professional society meetings, and in other venues.
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While dealing with stress is a normal part of life, for some students, stress can adversely affect their physical, emotional, and psychological health, particularly given that adolescence and early adulthood are when most mental illnesses are first manifested. In addition to students who may develop mental health challenges during their time in postsecondary education, many students arrive on campus with a mental health problem or having experienced significant trauma in their lives, which can also negatively affect physical, emotional, and psychological wellbeing.
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This institutionalized function can lead college and university leaders to assume that simply bolstering their counseling centers would be a sufficient solution to the mental health and wellbeing problems that today's students face. It is the committee's judgment, however, that counseling centers cannot and should not be expected to solve these problems alone given that the factors and forces affecting student wellbeing go well beyond the purview and resources that counseling centers can bring to bear.
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Institutions should improve their infrastructure to respond to needs that arise, and their efforts must include building an institution-wide culture that values and supports student wellbeing. MOVING FORWARD There are no one-size-fits-all solutions to the challenges institutions of higher education are facing to meet student demand for mental health, substance use, and wellness services.
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At the same time, this kind of culture change, even with the highest levels of support, cannot be implemented solely by administrators, counseling center staff, and an institution's student affairs office. Rather, it requires the entire faculty, staff, and student body working together to establish a culture that recognizes the importance of attending to the demand for services that now exists, proactively addresses student mental health and substance use, supports those students who have issues, and creates an environment that supports the wellbeing of everyone 2 See: https://wellbeing.ubc.ca/okanagan-charter.
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Establishing a campus-wide action commission with representatives from faculty, students, staff, and administrative units, with a clear and effective leader, dedicated resources, and a clear charge to build a culture that supports student wellbeing, would be a strong first step toward promoting culture change and creating such an environment. Aside from campus culture, institutional medical leave and re-enrollment policies can serve as barriers for students whose mental health or substance use problems are severe enough that they lead the student to withdraw from school at least temporarily.
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However, the assumption that bolstering the capabilities of the counseling and psychological services centers and creating other programs aimed at improving student wellbeing will simply create another major financial burden for colleges and universities with no tangible benefits is not necessarily true. Colleges and universities lose revenues when students drop out because of mental health or substance use problems.
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According to the Health Resources and Services Administration, this situation is projected to get worse, not better, in the years ahead. Possible partial solutions include increasing the use of teletherapy, enabling peer-to-peer support initiatives, and turning to the community, including university and local health services, to increase capacity, particularly for students with more serious mental health issues.
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The Equity in Mental Health Framework, for example, is an accessible resource for schools seeking to promote mental health and wellbeing among Black, Indigenous, and people of color, as well as students with other identities, including sexual and gender minorities. DEVELOPING FACULTY, STAFF, AND STUDENT CAPABILITY TO SUPPORT EMOTIONAL WELLBEING AND MENTAL HEALTH It takes everyone on campus to contribute to an environment that fosters student wellbeing, protects students from developing mental health and substance use issues, and helps facilitate access to services that would benefit them.
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The recommendations are as follows: RECOMMENDATION 5-1 Institutional leaders, starting with the president and board of trustees or regents, should articulate the importance of creating a culture of wellbeing on their campus, one that recognizes the range of individual behaviors and community norms that affect wellbeing, acknowledges the magnitude of mental health and substance use issues on campus, addresses the stigma associated with mental illness and substance use disorders, and provides a range of resources to support students with different levels of need. RECOMMENDATION 5-2 Leadership from all segments of the campus community is needed to promote a culture of wellbeing.
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They should also work more directly with state and local governments, where relevant, to help bring this about. • To ensure that mental health and emotional wellness services are priori tized, institutions should consider reallocating existing institutional funds to support counseling centers, support the increased use of online mental health services (when appropriate)
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This assessment should include the extent that students are aware of and know how to access available resources, both on campus and in the local community, to address students' mental health and substance use problems. • At the end of the academic year, institutions should review the many data points collected about their clinical trends and utilization as a way to understand how resources on campus can be used most effectively.
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• If counseling centers rely on community-based resources to meet the mental health needs of their students, they should consider investing in case managers/resource navigators to help students connect with these community-based resources. • Institutions can make wide use of telehealth options for those populations and situations for which it is appropriate.
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16 MENTAL HEALTH, SUBSTANCE USE, AND WELLBEING IN HIGHER EDUCATION RECOMMENDATION 5-10 Institutions of higher education should recognize that there is no single approach to promoting wellbeing and dealing with mental health and substance use problems that will be appropriate for all student populations. • Support services should be tailored to the unique histories, circumstances, and needs of individual student populations.
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