Mental Health in College: What Research Tells Us About Supporting Students
Date: 2026-04-21 07:00:00+00:00
Description: An essential, research-driven guide that reimagines what it means to support the well-being of today's college students With concerns about student mental health on the rise, Alexis Redding and contributors draw on expertise across disciplines to offer practical strategies and deep insight for those on the front lines: student affairs professionals, faculty, advisors, counseling center staff, and families. This timely book addresses the most pressing mental health issues facing undergraduates, delivering an actionable blueprint to help colleges build caring, inclusive communities where all stu

Mental Health in College

What Research Tells Us About Supporting Students

Edited by

ALEXIS REDDING

HARVARD EDUCATION PRESS

CAMBRIDGE, MASSACHUSETTS

Copyright © 2026 by the President and Fellows of Harvard College

All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval systems, without permission in writing from the publisher.

Paperback ISBN 9798895570753

The Library of Congress Cataloging-in-Publication Data is on file.

Published by Harvard Education Press, an imprint of the Harvard Education Publishing Group

Harvard Education Press

8 Story Street

Cambridge, MA 02138

Cover design by Alexis Redding, with design support by Pau Vazquez.

The typefaces in this book are Adobe Garamond Pro and Myriad Pro.

For my mother—a devoted educator and tireless advocate for her students.

Her college classroom is a model of the kind of caring community we envision in this book.

Contents

1. INTRODUCTIONCreating a Caring Community: Supporting Student Mental Health in College

2. Alexis Redding

3. PART 1Perspectives on Student Mental Health

4. CHAPTER 1In Their Own Words: Student Mental Health and Well-Being During College

5. Rainesford Stauffer with Lauren Barton, Mira Ugwuadu, and Esha Bajwa

6. CHAPTER 2The Importance of a Comprehensive Approach in Promoting Mental Health and Preventing Suicide in College Students

7. Laura Erickson-Schroth and Janis Whitlock

8. PART 2An Examination of Student Contexts and Experiences

9. CHAPTER 3Reconsidering the Costs of College: Financial Pressure, Competing Demands, and Student Mental Health

10. Allyson Cornett and Bryan Ashton

11. Voices from the Field: Adrian Gonzales, Vice President for Student Services, San Diego Miramar College

12. CHAPTER 4Mental Health for Community College Students

13. Amanda O. Latz

14. Voices from the Field: Julie Lee, Clinical Psychologist and Co-President of Harvard Alumni for Mental Health

15. CHAPTER 5Meeting the Mental Health Needs of Student Veterans

16. Adam Pierson Milano

17. Voices from the Field: Anabella Morabito, Associate Director for Community Engagement, Harvard University

18. PART 3Supporting Students in College and Career Transitions

19. CHAPTER 6Mental Health and Well-Being in the Transition to Postsecondary Education

20. Angel Pérez and Melissa Clinedinst

21. Voices from the Field: Lauren Deutser, Clinical Social Worker and Psychotherapist

22. CHAPTER 7Addressing Anxiety in Planning for Post-Collegiate Life

23. Joseph Catrino and Dustin Liu

24. Voices from the Field: Jordan Friedman, Health Educator and Founder of The Stress Coach

25. Notes
26. Acknowledgments
27. About the Editor
28. About the Contributors
29. Index

INTRODUCTION
Creating a Caring Community: Supporting Student Mental Health in College

ALEXIS REDDING

Harvard Graduate School of Education

Concerns about student mental health at colleges and universities continue to dominate our conversations about higher education. From the national media to professional publications, headlines regularly warn of an epidemic among young adults who are facing unprecedented levels of anxiety, depression, and suicidality. While the statistics vary from publication to publication and not all data point to this upward trend, one thing is clear: College students are struggling—a lot—and institutions are falling short in supporting them.

For students who do reach out for mental health support during college, there are myriad ways in which we fall short of meeting their needs. Overwhelmed campus mental health centers, dealing with a surge in demand for care without a corresponding expansion of bandwidth, often have lengthy wait times.[1] Other logistical barriers can further delay care, such as complicated multistep screening processes before being assigned to a therapist and limited hours that disadvantage commuter and non-residential students seeking appointments.[2] Campus mental health centers continue to work hard to bridge these gaps and to meet the increased demand, including introducing rapid assessment protocols that allow same-day sessions and stepped care models that prioritize appointments based on severity of need.[3] Yet, students who are not in acute distress can still face frustrating delays of weeks or even months before they are able to access the help that they need.[4]

The introduction of alternative modalities, like increasing access to telehealth appointments, has been a popular approach to help relieve the burden on the campus mental health center. At its best, telehealth creates a convenient and accessible option that increases access to care by expanding both the pool of mental health providers and extending the times when appointments are available.[5] However, this approach introduces new wrinkles to the terrain of care, including the fact that students may be seen by practitioners who have no in-depth knowledge of their college context and the supports that are available to them beyond telehealth. Further, the counselors rarely have insight into the cultural norms and mores of the institution that may impact the students’ experience. Students also express a preference for in-person relationships and have concerns about privacy when trying to engage in telehealth appointments conducted from their home or dorm room.[6]

It is not simply a question of access that impedes mental health care. Many students who need clinical help never reach out for support to begin with. Students cite their lack of understanding health insurance options and general concerns about cost as barriers to access.[7] Beyond the financial burden, students express a fear of embarrassment and societal stigmas that they must overcome in order to seek care.[8] There may also be a lack of institutional trust based on past experiences with faculty and staff that causes students to doubt that they will be respected, understood, and supported on campus.[9] Finally, access issues for international students can be even more complicated, due to fears that seeking help may impact their student visa and ability to continue studying in the US.[10]

Representation also matters when encouraging students to seek support on campus. A real or perceived lack of diversity in the clinical counseling staff at many colleges and universities can further impede access to services for BIPOC (Black, Indigenous, and people of color), LGBTQ+ (lesbian, gay, bisexual, transgender, queer or questioning), and international students.[11] Not having shared lived experiences with students can make it difficult to understand their experiences at school and in society as a whole.[12] Students describe concerns about cultural insensitivity, fears of being misunderstood, or encountering discrimination during treatment.[13]

Given the breadth of these challenges—both real and perceived obstacles to care—there is a growing recognition that we must rethink how we approach student mental health on campus.[14] One promising path forward is the use of targeted universalism—embedding resources and support throughout the campus community that are designed to help all students, not simply those with clinical diagnoses. This approach ensures that those in greatest need receive targeted help while also benefiting students who may not seek help or be able to access traditional services.

While clinicians continue to grapple with important questions of access, reach, and impact within campus mental health centers, this book shifts the focus to a broader goal: cultivating a school-wide climate of care where student wellness and thriving are prioritized using a targeted universalist framework. By cultivating a caring campus, we can create a culture that normalizes mental health support for everyone. In the process, we create the conditions for meaningful, lasting impact where students have the scaffolding they need to thrive in college and beyond.

THIS BOOK

This book is a companion volume to a professional development program I designed and launched at the Harvard Graduate School of Education in 2023. Mental Health in Higher Education: A Theory-to-Practice Approach for Student Well-Being brings together a group of sixteen scholars and practitioners from across the field to share their research on how to create a caring community for students navigating the college years. By design, this course offers a strengths-based, theoretically grounded approach to exploring the mental health challenges facing college students today.

In the pages ahead, you will be introduced to members of our faculty who share their research focused on building a community of care on our campuses and offer suggestions for how we can genuinely create the kinds of robust supports that our students need. Each chapter focuses on the authors’ own research and practice in order to unpack a core aspect of student mental health today. The authors consider how their research impacts students from across a range of identities, backgrounds, and institutional contexts without siloing any one identity. This approach allows us to think about students and their intersecting identities in meaningful and robust ways as we build a caring campus for all of our students.

This book is the only publication focused on college student mental health that takes a truly cross-disciplinary approach by examining the range of issues facing students from across the silos of our functional areas and domains in the field and thinking broadly across the student journey from admission to graduation. In part 1, “Perspectives on Student Mental Health,” we examine the scope of the problem from the students’ perspective and offer a framework for thinking systematically about solutions for creating a culture on campus that puts student mental health and well-being at the center.

Chapter 1, “In Their Own Words: Student Mental Health and Well-Being During College,” is written by journalist and author Rainesford Stauffer. Stauffer is joined by college student coauthors Lauren Barton, Mira Ugwuadu, and Esha Bajwa, who share candid, personal stories of burnout, identity formation, and resilience. Together, they examine the impact of achievement pressure and systemic inequities on student mental health. The chapter calls for holistic, accessible, and culturally responsive support systems to foster genuine well-being and belonging. Their insights offer compelling guidance for creating student-centered campus policies and practices.

Chapter 2, “The Importance of a Comprehensive Approach in Promoting Mental Health and Preventing Suicide in College Students,” shifts our attention to the institution and how we create system-level change to support student well-being. In this chapter, coauthors Laura Erickson-Schroth and Janis Whitlock share the work of the Jed Foundation (JED), a nonprofit organization focused on protecting emotional health and preventing suicide among teens and young adults in high school and college. They present a comprehensive, evidence-based framework developed by JED for promoting mental health and preventing suicide among college students. This chapter highlights seven interconnected domains ranging from life skills to crisis management that must be considered when creating a caring campus. This chapter advocates for systemic, campus-wide change—grounded in strategic planning, equitable implementation, and cross-campus collaboration—to proactively support student well-being and reduce risk across diverse populations.

The combination of perspectives—bottom up from the student point of view and top down from the vantage point of institutional structures—offers two complementary ways to think about creating a caring community on campus.

In part 2, “An Examination of Student Contexts and Experiences,” we focus on supporting students holistically by considering three aspects of the student journey in context: the impact of finances and basic need security on mental health and college completion, the role of faculty in creating meaningful supports for college students, and the unique challenges faced by military affiliated students.

Chapter 3, “Reconsidering the Costs of College: Financial Pressure, Competing Demands, and Student Mental Health,” offers research by the Trellis Foundation, a Texas-based philanthropic organization dedicated to advancing equitable postsecondary educational opportunities and improving college access, affordability, and completion for low-income students and students of color. Coauthored by Allyson Cornett and Bryan Ashton, this chapter examines how the rising cost of college creates significant financial stress for students, which in turn negatively impacts their mental health, academic performance, and overall well-being. Drawing on their Student Financial Wellness Survey, the authors reveal how financial insecurity, time poverty, and competing life demands—especially for marginalized and student caregivers—intersect to shape student success and underscore the need for holistic, equity-centered institutional responses.

Chapter 4, “Mental Health for Community College Students,” is written by Amanda O. Latz, who draws from her work as professor of Higher Education and Community College Leadership at Ball State University and as the author of Community College Student Mental Health: Faculty Experiences and Institutional Actions to offer suggestions for how to think about meaningful supports for students at two-year institutions. In this chapter, she explores how trauma impacts college students’ mental health, academic performance, and sense of belonging. She underscores the reality that trauma is both widespread and often invisible in higher education settings. It calls for trauma-informed practices across campus systems that are rooted in empathy, equity, and student voice to foster healing, resilience, and meaningful institutional change. The focus of this chapter is on the role that faculty can play, offering tangible suggestions that can be used across a range of institutional contexts beyond community college settings.

Chapter 5, “Meeting the Mental Health Needs of Student Veterans,” focuses on the mental health needs of military-affiliated students, emphasizing how their experiences with military culture, the reintegration process, and navigating campus life can create unique challenges. Adam Pierson Milano, a clinical instructor at the University of North Carolina at Chapel Hill School of Social Work and US Army veteran, calls on colleges to move beyond deficit-based views and instead build affirming, inclusive environments that recognize veterans’ strengths and support their well-being. This is a deeply researched and nuanced look at the veteran experience, which also offers a model for how we can consider the needs of any group of students and design scaffolding to support them as they navigate college.

While each of the chapters in part 2 is focused on a specific type of student experience, the lessons and insights shared by the authors translate broadly and we can draw from these insights to consider how to meet student basic needs, support our faculty in creating meaningful supports inside the classroom, and help all students in moments of transition.

In part 3, “Supporting Students in College and Career Transitions,” we look at two key pivot points that are too easily overlooked when thinking about student mental health in the college journey: (1) the transition into college and the role of the admissions process and (2) the career search as students transition out of college.

Chapter 6, “Mental Health and Well-Being in the Transition to Postsecondary Education,” examines how the college admissions process affects student mental health, highlighting the pressure, confusion, and inequities built into the system. It calls for a reimagining of admissions practices to better support student well-being, emphasizing transparency, authenticity, and a more holistic understanding of success. This chapter is written by Angel Peréz, CEO of the National Association of College Admission Counseling (NACAC), and Melissa Clinedinst, the director of research initiatives and partnerships at NACAC. Together they share the findings of a national survey of college admissions officers examining the anxiety associated with the college search, the application process, college choice, and the transition to college. They offer actionable suggestions for offering more robust support and humane framing for the admissions process to tamp down the anxiety students bring into college.

Chapter 7, “Addressing Anxiety in Planning for Post-Collegiate Life,” offers a consideration of the role of supports for students during the career exploration and job search process that can positively impact student mental health. Joseph Catrino, executive director of the Dartmouth Center for Career Design, and Dustin Liu, senior associate director for the NYU Stern Initiative on Purpose and Flourishing, draw from their shared work with the Stanford University Life Design Lab. Together, they explore how the Life Design framework can help students manage the anxiety and uncertainty of post-collegiate planning in today’s dynamic and often ambiguous career landscape. Drawing from design thinking, positive psychology, and student development theory, they offer a practical and evidence-based model that supports students’ mental health, resilience, and purpose-driven career exploration, a set of tools that can be used to help students, and an in-depth case study from Trinity College in Connecticut.

In addition to these research-grounded examinations of supporting student mental health and well-being, I interviewed five outstanding practitioners and feature their stories in vignettes that offer a model for how to approach the creation of a caring campus. Together, they bring more than one hundred years of collective experience across diverse roles and institutions and offer unique perspectives on how we consider the needs of all college students. Each of these “Voices from the Field” profiles highlights work being done in a different setting and focuses on a unique issue facing students today. These vignettes offer key insights and practical lessons on how to translate research and theory into practice.

Together, this book offers a new approach to thinking about student mental health and well-being in college. Rather than focusing on the counseling center and clinical interventions, each chapter uses new data and unique research to think about how we change institutional culture to ensure that all students receive meaningful and robust supports as they navigate the path to and through college. By bringing together scholars and practitioners from across our siloed terrain of higher education, we hope to spark a new kind of conversation—one that looks at how we can collaborate across domains and functional areas to create a school culture where every student can truly thrive.

PART 1
Perspectives on Student Mental Health

CHAPTER 1
In Their Own Words: Student Mental Health and Well-Being During College

RAINESFORD STAUFFER WITH LAUREN BARTON, MIRA UGWUADU, AND ESHA BAJWA

When Ria, now nineteen, was in high school, she observed that there wasn’t a single day in the past five or six years where she simply had no responsibilities, where she could just rest or do nothing at all. Between her part-time customer service job, advocacy work, extracurriculars, and high school, every minute was packed, and the pressure was overwhelming. It made her nostalgic for being younger, before she was even old enough to drive a car.

“The pressure consistently feels more and more,” Ria says now as a second-year student at the University of California, Irvine. “I feel like every year of my life, the stress has gotten worse, the pressures have gotten more.”

Now Ria spends an hour on homework every morning, while she also catches up on emails and paying bills. She has class from 9:30 a.m. to 2:00 p.m. straight nearly every day, then works from about 2:00 p.m. to 5:00 or 6:00 p.m. in the fundraising department of her campus. Her club meetings run about 6:00 p.m. to 9:00 p.m.; then she heads home to eat dinner, finish homework, and do it all again the next day. Meanwhile, Ria says, trying to get by in our current digital age, political sphere, climate crisis, and more have all upped the stakes because, as she puts it, “we have to worry about whether the world will even be here in fifty years.” Whatever she’s doing, it feels as if she should be doing more.

When Ria was in high school, she initially spoke with me for a nonfiction book I was writing, All the Gold Stars: Reimagining Ambition and the Ways We Strive. That work focused on ambition and how the United States’ history of ascribing worth to work and valuing accomplishment positions individual achievement as a solution to systemic failures. Throughout that reporting, it became evident that a one-size-fits-all version of ambition, including what one should strive for and how one should pursue those goals, was engulfed in a pressure to achieve that impacted everything from sense of self to mental well-being.

Student mental health has often been referred to as being in “crisis,” with the number of students who felt persistently sad or hopeless sitting at 40 percent in 2023 (down from 42 percent in 2021 and up from 2013), according to data from the US Centers for Disease Control and Prevention.[1] The 2024 Student Voice survey from Inside Higher Ed reported that two in five students say their mental health is impacting their ability to learn or focus “a great deal,” with 41 percent of respondents noting that “the need to balance personal, economic and family duties with schoolwork” was a driver of the “college mental health crisis.”[2]

While pressure to achieve undoubtedly impacts the mental well-being of students, it’s also worth interrogating where that pressure comes from and how much more complicated it can be than it appears. I have interviewed students from different backgrounds, ages, school situations, and circumstances, and what came up most often regarding pressure to achieve wasn’t the inability to tolerate anything less than an A+ or perfectionism that demanded students be the best at everything. Rather, it was a tangle of pressures, all overlapping and exacerbated by deepened inequities and lack of a social safety net, that rendered the stakes of failing or falling short impossibly high.

First-generation Americans, including Ria, spoke about yearning to make their parents’ sacrifices worth it, and some first-generation students emphasized pressure to succeed. Students who are parents discussed navigating work schedules that didn’t fit with their academic schedules and academic schedules that didn’t account for childcare, all while wanting to set a good example for their children. Students spoke about working multiple jobs to put themselves through school while trying to hang onto good enough grades to maintain their financial aid and feeling like they were missing out on “making the most” of college. Others discussed how they felt they’d gotten “off track” when dealing with grief, caregiving, physical or mental health issues, or disruptions to their daily lives that made it impossible for college to be their top priority. A common factor was how they described wanting to be “good enough,” for their professors, their workplaces, their families, their futures, and themselves. Most felt as if, in some way or another, there was something more they could be doing, some way they were falling short.

Meanwhile, students also exist within a broader sociopolitical context. In 2021, a global study of ten thousand young people reported that anxiety about the climate crisis was affecting their daily lives.[3] Legislative attacks on queer and trans young people persist; according to The Trevor Project, 39 percent of LGBTQ+ young people had considered attempting suicide in the past year as of 2024, and while 84 percent reported wanting mental health care, many faced barriers to accessing it.[4] That’s not to mention intersecting housing, childcare, student debt, and workforce crises.

Social, political, and economic climates shape both day-to-day pressures and long-term ones, including what it means to imagine a future amid uncertainty. Right now, students on campuses are under attack for exercising rights to free speech and protest or are being targeted specifically because of their identities.[5] Attacks on students who have participated in pro-Palestine protests, international students, and undocumented students have all escalated with dire consequences, as have federal attacks on colleges and universities.[6] And because so many students come to college specifically to engage in freedom of expression, discover new ideas, and immerse themselves in community, when someone is afraid to do that, it can impact learning, community engagement, and well-being overall.

Relatedly, Ria described campuses hosting events like Wellness Week, where students can get free stress balls, pet a service dog while heading to class, or hear speakers discuss the importance of exercise for a positive mindset. She imagines that the well-intentioned organizers of the events might wonder why turnout is low. “From a student perspective, these events feel superficial against the backdrop of university administration failing to protect our First Amendment rights to protest and to support students facing systemic threats,” she says. She suggests moving beyond wellness initiatives that feel “performative” and toward better understanding how the stress of the world weighs on students.

At the same time, what it means to be considered an “ambitious” student is shaped by how standards of success operate across class, race, gender, institutional expectations, and social scripts of achievement. With stakes this high, flyers stating that “mental health matters” fall short when class policies don’t match; learning through failure sounds supportive in theory, until failing a class spells the end of a scholarship.

And, of course, college students aren’t all young adults; nor are all college students coming to a college or university directly from high school. According to the Lumina Foundation, 34 percent of college students are twenty-five or older, 50 percent are first-generation college students, and 18 percent have children or other dependents. Other data note that as of spring 2024, almost 2.5 million students who were aged thirty or over were enrolled in undergraduate studies. Some students may not reside on campus or may be pursuing higher education part-time.[7]

Across different college experiences, many students described pressure to excel as a student mapping onto various other pressures they’re experiencing, as workers, as parents, as caretakers, and as community members. Centering students in conversations on achievement pressure demands acknowledging that “student” is one part of someone’s identity.

This chapter draws on the voices and original writing of current college students, many of whom are in their late teens or early twenties. Some are working, some have stopped out and returned, and all described pressure to achieve as being a hallmark of their college experience. By capturing their stories in their own words, we have real-time accounts of the intensity of these pressures and solutions students imagine to help combat them, drawing on the depth and honesty of their lived experiences.

STUDENTS SUGGEST CONNECTION, COLLABORATION, AND PEER SUPPORT

University of California, Irvine (UCI), is a public, four-year institution with around 37,350 students, including 29,503 undergraduate students.[8]

While Ria knows her university offers counseling services, she’s never sought them out. If the information isn’t accessible, including where the building is and what health insurance might be required, she believes most students are unlikely to seek out those resources. Rather, the resource that has been most helpful to her is the UCI Basic Needs Center on campus. Broadly, basic needs centers work to ensure students have access to resources that ensure their needs are met, though the scope might vary: Some provide food, clothing, personal care items, and school supplies; others might also offer assistance with housing, transportation, childcare, support in applying for and accessing benefits, or grants to support basic needs. Reporting from Inside Higher Ed notes that growing numbers of institutions are expanding support for basic needs, particularly in light of the fact that 59 percent of students surveyed experience at least one form of basic needs insecurity.[9]

Access to resources that make a tangible difference in students’ lives and well-being is crucial. Through her on-campus job, Ria is eligible for CalFresh, California’s EBT program, and says the UCI Basic Needs Center has a system that other campus resources could learn from: “They’ll schedule an appointment with you where you can do the EBT application with someone who knows how to do it themselves. It’s usually a student, so it’s not an intimidating environment.” Students can have appointments via Zoom, and the person will talk you through the application, cutting through logistical red tape or overcoming procrastination.

Ria has also appreciated opportunities to interact with her professors outside of class time. For one online class, Ria’s professor hosted a “walk with” hour, where students could join her for a walk. “You could pick her brain about professional things and academic related things,” Ria says. “But you could also just get to know her as a person and get to know your peers who are also in that class.” It was a way of “encouraging students to experience something in the world,” Ria says, a point of true connection amid jam-packed Google Calendars.

University of Maryland is a public, four-year institution with around 41,000 students, including 31,000 undergraduate students.

Estephany, a first-generation student at the University of Maryland, mentioned something similar when asked what could help combat pressure. She wishes there were smaller programming events for students to get to know professors. Usually, office hours are packed with students, she says, but she’d love that chance to build connections.

She constantly thinks about the fact that her parents had to leave school to support their families. She thinks of her older sisters, too, who were fourteen and fifteen when the family came to the United States and didn’t have the opportunity to pursue higher education like she did. “In my Hispanic culture, mental health isn’t really touched on, or it’s not really seen as something as such a big deal or very important,” says Estephany. It was difficult to talk to her parents about struggles with anxiety, but it was also nerve-racking to ask for help at school.

Eventually, she joined a Hispanic sorority, where she met people coming from similar backgrounds and found support in shared experiences. Research shows that a sense of belonging supports everything from retention and completion to better well-being and mental health.[10] For many students, participating in affinity groups or affinity spaces can help cultivate a sense of belonging and even reduce stress, with a shared sense of identity and opportunities for meaningful discourse cited as benefits.[11] Estephany was able to talk to professors and resident assistants who guided her toward on-campus resources, too. “It’s like you’re finally seen, and you finally have someone that’s willing to help you,” Estephany says.

She wants that for more students, especially first-generation students. She imagines a required first-year course for all students, one that goes through different mental health resources and explores mental well-being in different cultures. If everyone was learning about mental health, then “everyone can find that sense of belonging and community” and learn how to advocate for themselves, something Estephany says she didn’t learn until well into college. It’s important not just that students have mental health resources but also have a deeper understanding of how mental well-being might intersect with their cultural backgrounds, she says. There’s so much change happening in the country, she continues, so it’s important, especially for students from marginalized communities, to have “safe spaces where they can feel seen and supported.”

Prince George’s Community College is a public, two-year institution with around 11,300 students.[12]

Meanwhile, gathered on Zoom, members of the executive board of the National Alliance on Mental Health (NAMI) club on Prince George’s Community College’s (PGCC) campus discussed their experiences with the importance of peer support with me for this chapter. Most of the students running the club at PGCC experienced the positive impact peer support can have on mental health in their own lives. “I felt like I was alone, like no one really understood me,” says Mary, a twenty-three-year-old psychology student and president of the NAMI On Campus PGCC club. She had lived with mental health struggles for a long time, Mary says, and at points, her family did not understand what she was experiencing due in part to religious and cultural background as well as stigma, she explains. “I felt like I was in a cycle of doom. I felt like I just couldn’t get out. I didn’t know where my life was headed. I didn’t have a sense of purpose.”

Eventually, Mary, who is now a youth mental health activist, speaker, and suicide prevention advocate, found that sense of purpose in advocating for other young people the same way she had to advocate for herself to receive mental health care. She began volunteering at NAMI’s Baltimore chapter and NAMI Maryland, was a NAMI Next Gen advisor, and later founded NAMI On Campus PGCC. Previously, Mary withdrew from school twice after struggling to balance academics with her mental health needs. She worried about having to withdraw again and the fact that it would stay on her academic record. Now, as president of a club, she has to maintain a certain GPA to hold that position. “But I feel like it was better this time,” she says, speaking of this semester. With the support of her fellow NAMI On Campus executives and club advisor, she was able to delegate, saying no when she needed to prioritize self-care. She had open lines of communication with her professors. She found power in sharing her story.

Broadly, in discussions on pressure and mental health, students from different schools or circumstances described a common feeling: isolation, the certainty that you must be the only one struggling, or feeling as if you aren’t doing enough. Creating space for students to talk about burnout, mental health struggles, performance anxiety, or fear of failure in real time can make those feelings less lonely.

“I wanted to know who else was experiencing what I was experiencing,” says Florence, a forty-six-year-old second-year student at PGCC. Florence is the vice president of PGCC’s NAMI On Campus and was the program coordinator for NAMI Prince George’s County. Speaking about her own mental health, Florence said, “It was such a lonely journey and a lonely experience. I just didn’t understand what was going on and why this was happening to me, and if there were other people that were experiencing something similar, I wanted to know, so I could establish a connection with them.”

Prior to her enrollment at Prince George’s Community College, Florence says she was terminated from a long-time federal government job because of her disability, a mental health condition, and for advocating for other employees with disabilities to be treated fairly. For her, part of the pressure to achieve includes feeling as though she has to “work overtime to overcome people’s perceptions” of her on top of maintaining her grades. “This has been a big battle,” she says of her mental health. “I think I’m doing pretty well with overcoming it and being an example of how to lead.”

While the club executives note they are not mental health professionals (though several members hope to pursue mental-health-related careers), they say the organization’s education and outreach go a long way in reaching students. The club’s faculty advisor also serves as the program director of the Wellness and Mental Health Center at PGCC, so the organization can direct members who need professional support there.

The club executives also make it clear that one doesn’t have to have a diagnosis or be seeking professional counseling to participate. “Maybe they just lost a loved one, or they might be experiencing some type of burnout,” says Mary.

Some students say peer support creates safe spaces regardless of what challenges a student is experiencing, especially since they note there are a variety of reasons someone might not seek out professional care. “There’s some real fear of how Black people have been treated in this country in the healthcare system and by our government,” Florence says, adding that many people might not feel comfortable talking to a psychiatrist or therapist right at the start. Factors like stigma, access to and affordability of care, and having the language to describe what one is experiencing could also be barriers.

Above all, students note that centering those directly impacted is key to supporting mental well-being. “You got to talk to the students,” Florence says. “People that have been impacted need to be included in those conversations.”

Dismantling achievement pressure means listening to the students at the intersection of these issues. For this chapter, three students, from three different schools, wrote essays unpacking their own experience with pressure to achieve and mental health. Despite attending different kinds of institutions, pursuing different majors, and coming to the conversation with different personal experiences in their attempts to access support, all three captured common themes in how they feel pressure to achieve has shaped their college experience, highlighting both how widespread these pressures are and how deeply nuanced they feel. Their stories act as guides for not only what pressures feel like but for what supports have been meaningful throughout their college experiences.

STUDENT EXPERIENCES IN THEIR OWN WORDS

THE FREEDOM TO FAIL

Lauren Barton, Walters State Community College

Walters State Community College is a public, two-year institution in Morristown, Tennessee, with total enrollment across all campus sites of 5,834 students.[13]

I’ve dealt with academic pressure and burnout for the majority of my life, but it was so, so much worse when I was a homeschooling high school student stuck inside the house. In the beginning, the primary causes were my family and the constant threat of the unknown—college. It seemed as if my years in middle and high school were spent preparing me for future classes, potential scholarships, and little successes like high ACT scores and letter grades that made me and my family feel like it was all worthwhile. I didn’t even have a long-term plan at the time; I just knew I wanted to go to college and, when I was sixteen, that I would study journalism. Now, as a rising college junior, I realize that those pressures were just a drop in the bucket. The pressure and burnout have tripled since graduating from high school in 2023. However, I have felt significantly more freedom since starting college, specifically the freedom to fail.

My school, Walters State Community College, is a predominantly white university with five campuses scattered throughout the East Tennessee area. Since first enrolling students in 1971, Walters State has grown to include over 159 areas of study for over five thousand students.

I don’t feel the freedom to fail a class, per se, but to fail to meet expectations and to be okay with an occasional “C.” Knowing that I might bomb a test but that my world won’t end because of it—it’s a liberating feeling, just like one might get when riding a motorcycle or hiking the Appalachian Trail. Yet that doesn’t mean the notion of academic failure no longer debilitates me.

I began to develop a love for college classes when I dual enrolled at a local community college during my last two years of high school. However, even a love of learning wasn’t enough to save me from the direct negative impact college has had on my mental health. I made the President’s List last semester, and now I struggle to make it through my BIO 1010 lab with a passing grade. Coming down from the high of being a “good” student has left me feeling disappointed in myself and anxious for next year. Will I be able to keep myself afloat? What seemed clear before was tainted with doubts and lingering expectations, so I am constantly second-guessing myself. The pressure to keep up my grades while I work as a freelance journalist and part-time cashier, plan ahead for when I transfer, and keep my family happy has nearly led me to my breaking point on multiple occasions. If I didn’t already know that I could handle it, then I’d say that it’s almost too much to bear—almost.

I know I’m capable, and I know that I’m smart. I know I can do this again. If I have this piece of paper, which is important to me because it’s proof of my intelligence, then I can make my family proud of me; I can achieve recognition from the alumni at my school; I can slap it on my resume and let my future employers know how smart I am; I can take a picture, post it online, and let the whole world see how well I’m doing. Except that’s not sustainable, and my mental health is paying the price for it. That’s why my approach to success in recent months has shifted away from getting the best grades to utilizing the resources I have on campus.

I spend time interviewing students and faculty for the articles I write and to learn more about the varying perspectives in my rural community. I use the library’s database to read about things that interest me, like hatpins and Thomas Jefferson’s national newspaper, The National Gazette. I hang out with my teammates during debate meets and find comfort in knowing I’m not alone in my experiences.

Regardless of my redefinition of success, I can’t ignore my grades. They spell out life or death when it comes to my education, which is entirely due to my financial aid. It is obvious to me that financial aid and traditional academic success go hand in hand, and I, like thousands of students throughout the country, am in no position to throw any of those opportunities away. The help I receive through programs like The Tennessee Promise and the Help or Proceed Education (HOPE) scholarship has been enough to cover my tuition thus far and has left me feeling more confident in my independence for when I transfer to a four-year school in the fall. It’s been invaluable, despite leading to a lot of stress.

Through conversations I’ve had with other students, I’ve learned that the so-called college experience actually includes an abundance of depression, anxiety, and a concerning lack of sleep, which sounds about right from where I stand. So many of my classmates have expressed doubt, exhaustion, or even a general lack of faith about where their futures are headed. While I love being surrounded by my professors and classmates, I’m left with so many questions about the way things are versus the way I had envisioned them to be. Is college romanticized to fill us with false hopes to make it easier? Will things ever change, or is this just the way it is? Despite its toll on my mental health, college is still more than worth it to me. I will begrudgingly put up with the stress, burnout, and incredibly high expectations, but it’s a shame that I have to do so.

Despite everything, I love college. It’s a wonderful experience that I wouldn’t trade for anything else in the world. What I don’t love is feeling so anxious that I feel physical symptoms of my anxiety or so worn out that I don’t have the energy to do the things I like. This semester, I decided to take a break from pitching new stories or starting new projects. Before last weekend, I hadn’t even had the time to sit down and watch a movie. The accumulation of one terrible feeling after another is what finally led me to decide to visit my school’s mental health counselors next semester. I need the support. I know I can’t continue alone anymore, but the thought of reaching out has been beyond intimidating, as I don’t even know where to begin with that process or what I would say, but I’m hopeful. I have to be. It’s important to me to find a way to continue my education without feeling so exhausted, and I think this is a great first step.

COLLABORATION AND HOLISTIC SUPPORT ARE OVERLOOKED KEYS TO IMPROVED STUDENT WELL-BEING

Mira Ugwuadu, Washington University in St. Louis

Washington University in St. Louis is a private institution in St. Louis, Missouri, that, as of 2024, serves 7,313 undergraduate students in traditional programs.[14]

As the daughter of an immigrant father from Nigeria and second-generation immigrant mother from the Philippines, academic excellence was always the standard—a commonality among many immigrant households. At a young age, I learned to take pride in excelling academically, as nothing less was accepted, and I subconsciously formed a dependence on academic validation through programs like the “gifted program” in elementary school and “AC” (advanced classes) in middle school. I did not realize how this affected me until I was overloading on Advanced Placement courses in my STEM/STEAM magnet program at my high school. The environment of this program was one where my peers were always one-upping each other, competing on everything from how hard their classes were to how little they slept. Academics were the priority over basic necessities like eating and sleeping, and I was consumed by the vicious demands of stress, pressure, and eventually burnout.

Eventually all that was driving me to do well in school was fear of disappointment: fear of disappointing my teachers, my parents, and my future self. I also felt like I was trying to prove that I belonged there, as one of the few Black students in our magnet class. After so many late nights and comparisons, subtly or not so subtly made by my peers or teachers, the self-motivated Mira who was curious and eager to learn was reduced to a burned-out student motivated only by good performance and fear of failure.

I remember dreading every waking moment of high school. The habit of neglecting my needs for academic performance that I’d developed in my first year got worse during the COVID-19 pandemic, where the switch to virtual classes resulted in less differentiation between school and life.

Countless meals were skipped, many nights were restless, and my body suffered through the pains and scars of self-harm. When we returned in person, those feelings intensified until I developed incessant suicidal thoughts. If I did poorly on my schoolwork, I didn’t want to live. If I did well on my schoolwork, the expectation to continue performing well decreased my will to live. If I didn’t have schoolwork, the anticipation of more in the future made me not want to live. The worst part was that many of my friends shared the same sentiments, so I was conditioned to believe that letting school suffocate me to my wits end was a normal experience, and I would have to wait until retirement, if I made it there, to have a happy, fulfilling life.

In high school, counselors were often overworked, unresponsive, or unwilling to do anything other than call my parents, which I don’t blame them for, because of the school counselor shortage across the country. The American School Counselor Association recommends 250 students per school counselor, yet as of 2022, the national average of students to school counselors is 385 to 1.[15] After years of continued effort, I was finally able to receive professional help, but many of my peers were unable to get the help that they needed, an unfortunate reality for many students.

When it came time to make decisions on what colleges I wanted to apply to, I knew that I was looking to avoid schools with cut-throat, competitive environments like my high school. After enduring extreme depression and even witnessing the lives of friends lost to academic pressure and competition, I couldn’t bring myself to apply to schools where it seemed like academic success was prioritized over student well-being. My mental health experiences in high school informed every part of my college decision.

Ultimately, I was looking for a university that had a collaborative, encouraging student body who valued experience and learning rather than being at the top. This led me to my final decision: Washington University in St. Louis (WashU). Not only was this school a great fit for my academic needs, but it provided me with financial support through the John B. Ervin Scholars Program. And through interactions with students and alumni, I could gauge a sense of community and collaboration that none of the other schools seemed to exhibit. Before even stepping foot on campus, I felt like my college experience would be supported academically, financially, and socially—and it has been thus far.

Obviously academic pressure negatively impacts the well-being of students, but it doesn’t stop there. For many, college is known as the “best four years of your life” and allows students to have the freedom to learn more about themselves, to really figure out who they are and how they operate. However, the stress of academic pressure can easily hinder students’ ability to learn about themselves, as well as reach their full potential academically and professionally. As a college student, collaborative environments rather than competitive ones have been crucial in helping me prioritize my mental well-being and thrive in college.

Improving student well-being through alleviating these academic pressures requires a holistic approach, because pressures are interwoven with many aspects of academia, like health-care access, lack of educational access to opportunities, and other systemic inequities.

Students should have access to academic resources like tutoring, mentoring, recorded lectures, and office hours because these opportunities for extra help allow students to feel supported academically, which fosters an environment of collaboration. At WashU, there are resources like Peer-Led Team Learning (PLTL), an evidence-based method where a student who has already taken the class leads small group practice sessions for subjects like calculus, physics, and chemistry.

In my experience, these spaces have not only contributed to my academic success—especially PLTL for chemistry and calculus—but they have created community spaces where we can work through problems as teams and help each other out when we’re struggling academically. Students need to know that they collectively are here to learn and can help one another succeed because, frankly, there is not one spot at the top.

Along these lines, other academic policies should be implemented for flexibility related to deadlines and attendance. College is a busy time, and many unexpected situations occur, like getting sick or dealing with family troubles. However, students are often afraid to miss class during these situations, even when they’re not feeling well physically or mentally, because of their fear of losing points or missing something important in class.

I’ve even been to the emergency room with a peer who was sick and passed out from exhaustion after attending classes and studying for exams despite her illness; she was worried more about her exam and grades than she was about her health. Our bodies’ cues for rest and care are often overridden by the anxieties of academic pressure, which is why we minimize our sicknesses or struggles and sacrifice our health and well-being for good performance. Even at my school, where collaboration is welcomed, I’ve dealt with the struggle of push-and-pull feelings when trying to decide if I should miss class when I’m feeling sick or struggling with my mental health. In some classes, professors have established environments where there are open lines of communication, and it is clear that they genuinely care about student well-being. They would rather grant us an extension on an assignment and leave us feeling happy and healthy than give us bad grades for missing class. Only in those environments have I felt fully comfortable missing a class to rest, recover, and take care of myself during times of need.

Fostering an environment of communication between professors and students, where students don’t lose points for missing class or where professors can grant extensions for some assignments, would only benefit students’ well-being. Given it’s difficult to learn and perform well when you’re not feeling well, the quality of their work for their professors would improve as well. Universities like the University of North Carolina at Chapel Hill have even implemented “Wellness Days” to allow students to have a few days of break during the semester to tend to their well-being and mental health.

Students should also have access to mental health resources, whether that be counselors, psychiatrists, anonymous helplines, or peer-facilitated counseling resources. At WashU, we have student-run resources like Uncle Joe’s Peer Counseling and SARAH (Sexual Assault and Rape Anonymous Hotline), which have confidential helplines and offices open at late hours where trained college peers can help talk through problems and refer students to on- or off-campus resources. When students are struggling with academic pressures or other situations that negatively impact their well-being, knowing about these options can make a huge difference in overall student success.

Additionally, within university messaging toward students, student success should not only be academic. Preaching empty “mental health matters” is not enough. Without implementing proper support systems that showcase that student well-being is at the forefront of a university’s priorities, the relationship between students and the university is already built on mistrust and empty promises. Emphasizing overall student well-being, while providing the necessary actions and support, will improve student satisfaction with the university, foster a happier and healthier community, and improve university productivity and reputation.

As a student, I have learned about the dangers of excess stress and unnecessary pressure, and the importance of collaborative environments and treating mental health as seriously as physical health, through anthropology class discussions, psychology class lectures, psychopathology lab research, and personal experience. I understand the significance of facilitating healthy mindsets surrounding academics and creating healthy, collaborative environments where students feel supported and encouraged.

As someone who is studying to become a mental health professional and intends to dedicate her life and career to advocating for and improving mental health care in her communities, I try my best to actively dismantle stigmas regarding mental health in every way I can. That includes helping my peers academically and continuing to foster environments of collaboration; being a listening ear for friends to show that vulnerability and mental health struggles shouldn’t be seen as signs of weakness; advocating for students and communities who are not often listened to in conversations about mental well-being; and having an open mind to learning more about mental health in different communities so that I can apply this knowledge to my future career. All that students like me ask for is an environment where open communication and collaboration are encouraged and student well-being is prioritized over “measures of success.”

EXEMPLARY HIGH SCHOOL STUDENT TO COLLEGE BURNOUT

Esha Bajwa, University of Louisville

The University of Louisville is a public, four-year institution with a student body total of 24,123 as of 2024–2025. The university serves a total of 17,248 undergraduate students. Enrollment includes 34.3 percent first-generation college students.[16]

In high school, a back-to-back class structure and competitive STEM-based curriculum shaped me into a workaholic and a high achiever. You learn at an early age that “successful” people do everything that they can to get the job done, even to the detriment of their physical and mental well-being. I’ve always tied a lot of my positive emotions and my worth to being perceived by others as a good student, a good worker, and a good friend. If I’m reliable, then everyone around me will be happy with me. I’ve always cared so much about the opinions of my teachers because school was something I had to work hard for.

Four grueling but manageable years later, I thought I was ready for college. In a lot of ways, college and academia are incredibly romanticized: College is supposed to be the best years of your life; you’re only in college once, so make the most of it; I met my best friends/soulmate(s) in college. These are all phrases that highlight how there’s this innate pressure that college is meant to be this extremely important time in your life.

The culmination of my internal drive to meet ambitious expectations of myself, my desire to compensate for the familial sacrifices made for me, and the external pressure to succeed as a woman of color growing up in predominantly white spaces impacted my mental health and, later, provoked burnout. With the assistance of the accommodations and resources that are known to me now, I have improved my potential for academic success and implemented realistic goals to prevent reoccurring burnout. There needs to be a widespread shift within college culture and policies to directly support students experiencing mental health crises and burnout.

Once I got to college, I approached the first few semesters with the same mindset and habits that I had in high school, since I knew it had worked previously. However, I began to experience low-energy days that were more and more frequent, which caused me to lose focus and led to a steep decline in my mental state.

What’s different now? There’s no way that I lost steam. I’ve always been able to do that. That disconnect was incredibly heavy. Over time, my initial enthusiasm had soured and was replaced with dread: How was I going to live up to these expectations when I was already cracking under the pressure?

The disconnect manifested physically, like I was in a “freeze” state. My mind was racing with all the tasks I wanted to accomplish or needed to do, but my body would not budge. I felt embarrassed and ashamed for having trouble with basic tasks like feeding myself, hygiene, and a healthy sleep schedule. I continued to push myself in hopes of one day shaking off this new mental adversity, only to reach a point where there was no full recovery possible. I failed a class for the first time and had to request for a special withdrawal the same semester.

My burnout was reaching a breaking point; I was realizing, okay, I actively will have to let go of my ability to do well in this class or make it to this event. I had to become a little more messy as a person, though I’ve always tried to be super put together. That burnout was when I felt like I was this ball of yarn, and everything just started unraveling. The mess was more visible.

There were also external factors I didn’t consider. During my freshman year, I was a commuter student. I didn’t get my license until the end of the first fall semester, and I was very reliant on my family to get places. I did feel a little disconnected because I was on campus all day, but I had to go home at the end of the day; I remember more-than-twelve-hour days.

Eventually, I decided to move out. I felt like I was in survival mode for a lot of my childhood and early teens. I had to be the best version of myself so that my mother did not have to worry about me not being able to be independent. It was just assumed that we’d be in the house, living at home, until we were married. So moving out took a lot of courage, and I was in shock afterward. That obviously impacted my academics and my ability to handle college.

On top of this, I’ve been in the midst of trying to figure out if I have underlying health issues or chronic illness that exacerbates the mental health challenges. It feels that society, in general, is more accepting of, “Oh, you have a broken leg; of course, you need extra time.” But with mental health, it can still come across as, “Oh, you’re lazy, or you’re just not committed enough.”

It’s a vicious cycle of having this burst of energy and knowing I should make use of it. Then, I push myself to my absolute limit, trying to be as productive as I can so that I can feel good and “redeem” myself; then I have an adverse reaction of intense fatigue that I literally can’t shake off. I decided to try psychiatric medication for the first time last year. That was a big step for me, acknowledging that therapy might need to be supplemented with something else.

Something that’s helped is being involved. In college, I wanted to find my niche groups, because I had always grown up in areas where I was just one of the few minorities. I got involved with leadership roles in the Asian Pacific Islander Student Union (APSU) and the Society of Women Engineers at the University of Louisville. With APSU, I remember the first meeting: I’m in a room of other AAPI (Asian American Pacific Islander) people who aren’t my family. It felt amazing, heartwarming, and comforting. Being involved on campus makes you feel like you’re not only a college student; it brings more humanity. You’re not just a student in a seat.

There are other solutions I think about that could help get students to a place where they don’t feel as if they should drop out or fully give up. I think the biggest thing is having readily available treatment that doesn’t have a long wait list. I’ve seen that with some of my friends, who felt discouraged from going to the counseling centers and being put on hold for more than a month.

Equipping enough staff to see students based on the size of the school is important. So is having a range of options for people to dip their toes in: a short-term or walk-in option for urgent situations and something for people who have never been to therapy before and want to give it a shot.

Something that my school has done recently is add an after-hours hotline, which has been huge for me this semester, because I have to work nine to five for my internship. A crisis line or after-hours line should feel safe for marginalized folks who don’t want cops called on them for trying to reach out. That’s a point of hesitation for a lot of people, because they are worried about their safety if it escalates or that police will not be able to help them and could cause them more harm.

Another solution I think could help the general student body is more awareness of disability resources. Mental health should be highlighted in what accommodations are available. Having mental health days built into university policy or more support in learning how to advocate for yourself could be helpful, so students don’t feel like they have to overshare with their professors and just provide necessary information for transparent communication about succeeding in their course.

My accommodations with the Disability Resource Center greatly improved my ability to recover from burnout and approach my academics with a fresh start and realistic goals so that I still have a chance at success, even when experiencing intense mental health symptoms. I also received extended time on exams and took them in a separate test room from most of my peers, which eased my test anxiety and enabled me to perform better on some exams. I’ve always been a slow processor, and I didn’t realize how powerful it was for me to be given more time.

I thought I needed to fit the mold of a “typical” student, but as it turns out, I needed to acknowledge that needing additional help and resources does not make me less than as a student and does not make me any less capable or smart enough to complete my courses.

A CALL TO ACTION

Throughout student stories, consistent themes emerge around what they would like to see in terms of support.

Accessible Resources

Students highlighted the importance of resource accessibility: In addition to maintaining resources centered on basic needs, belonging and inclusion, and mental well-being, students emphasized a need to reduce barriers in terms of access to or awareness of those resources. This could look like listing resources on syllabi or class websites; emphasizing structures for support at school events, office hours, or in class; or ensuring wider distribution of materials. Many students mentioned needing repeated exposure to resources; some expressed that they didn’t realize what accommodations or resources they had access to and would have utilized them sooner had they known. Sharing those resources openly and proactively could dismantle stigma and ensure all students know what support exists, even before they need it. Students also mentioned increased investment in counselors, partnerships with local mental health organizations to bolster resources, peer counselors, workshops on learning what accommodations exist and how to advocate for yourself, and supports for students who work, attend part-time, take evening classes, or can’t access campus resource centers.

Open Lines of True Communication

In addition, students described the need for policies that center student well-being. Many expressed the desire for more open lines of communication with faculty or staff members. Similarly, some students articulated that while they know classes are a priority, they are also juggling countless roles, responsibilities, and stressors outside of the academic environment that impact performance within it. Ensuring policies and discussions around well-being include the larger context is a crucial means of making those spaces or policies more responsive.

Students as Partners Collaboration

Some articulated a need for students as partners when it comes to dismantling pressure and increasing support for well-being. Acknowledging that taking care of one’s self doesn’t stand in opposition to achieving goals or academic success—rather, it supports those efforts—goes a long way. Positioning mental well-being as a part of the overall student experience is critical, as is asking key questions that center students: Where can support be built in and reinforced through equitable policies that meet students where they are? Are there places for students to express uncertainty, fall short of expectations, or change direction? Are there consistent opportunities to survey students? If so, is there infrastructure to implement student feedback? Prioritizing collaboration with students, some students said, means first building trust with them and showing commitment to an ongoing process of conversation, learning, and action.

CHAPTER 2
The Importance of a Comprehensive Approach in Promoting Mental Health and Preventing Suicide in College Students

LAURA ERICKSON-SCHROTH AND JANIS WHITLOCK

The Jed Foundation

Mental health trends among students in higher education pose significant challenges for student well-being and academic success. Recent research highlights a sharp rise in mental health concerns, including depression, anxiety, and suicidal ideation, among college students.[1] The Healthy Minds Study (2023) revealed that 48 percent of college students experience symptoms of depression and 41 percent report significant anxiety. The American College Health Association’s National College Health Assessment (2023) found that 15 percent of students had seriously considered suicide in the past year. These alarming trends not only affect students’ mental and emotional health but also have detrimental effects on educational outcomes and relationships and, in the most severe cases, can lead to loss of life.[2]

The challenges facing college students are multifaceted, driven by academic pressure, financial burdens, social challenges, and the transitional nature of college life.[3] Increased digital engagement, including with social media, and social isolation have further intensified mental health struggles.[4] Global events, such as the COVID-19 pandemic, magnified these challenges by introducing stressors like uncertainty, loss of loved ones, decreased connection, and disrupted learning environments. The pandemic also exposed and deepened disparities in mental health care access, emphasizing the need for responsive and inclusive institutional strategies to better support students facing systemic barriers to care.[5]

The Jed Foundation’s (JED) framework, known as its Comprehensive Approach to Mental Health Promotion and Suicide Prevention for Colleges and Universities, is a campus-wide framework designed to support systems-level development of holistic mental health efforts in higher education.[6] The underlying premise of the JED Comprehensive Approach is that proactive and comprehensive systems-level approaches are much more effective in reducing student risk than the more common single-intervention care models. The approach emphasizes evidence-based strategies, conceptualized across seven core domains, intended to promote resilience, ensure early intervention, and create a supportive campus culture that helps students thrive academically and personally.

This chapter explores the pressing need for systemic change to address mental health in higher education, integrating insights from existing research and the principles of JED’s Comprehensive Approach. By providing practical strategies, case studies, and implementation guidelines, it is intended to assist institutional leaders, administrators, and mental health professionals with strategies for enhancing student well-being, mitigating risks, and fostering a sustainable support system across campuses.

WHY USE A COMPREHENSIVE APPROACH?

Historically, college mental health services have relied heavily on single-intervention approaches, such as counseling centers addressing crises after they occur.[7] While counseling services are essential, relying solely on treatment neglects the broader systemic factors contributing to mental health challenges.[8] Students experiencing stress or early warning signs may not receive support until they reach a crisis point, leading to worse outcomes.[9] Traditional approaches also fail to address prevention, life skill development, and institutional culture. Fortunately, many schools are working hard to build in additional support through more upstream approaches, though efforts are sometimes piecemeal.

Comprehensive frameworks address mental health through multimodal interventions.[10] Rooted in public health models that understand systems change as a product of multiapproach and sector action, comprehensive frameworks focus on engaging a wide swath of the campus community in prevention, early identification, and development of key support systems across campus communities. By engaging students, faculty, and staff, institutions foster a supportive environment that reduces stigma, increases help-seeking, and ensures that students can access the support they need before issues escalate.[11] A growing body of evidence supports the effectiveness of comprehensive mental health strategies in higher education.[12] For example, programs implementing multitiered approaches, such as life skills education for students and staff mental health training, have demonstrated significant improvements in student well-being and academic performance.[13] Campuses adopting comprehensive mental health models have seen reduced suicide rates, increased retention, and enhanced student satisfaction.[14]

Creating a sustainable, comprehensive approach requires institutional commitment and a culture of mental health awareness.[15] Leadership must prioritize mental health at all levels, from policy development to resource allocation.[16] Institutions that integrate mental health into their strategic goals foster environments where students feel supported and encouraged to prioritize their well-being. By building a campus culture that values mental health, colleges and universities empower students to seek help, develop resilience, and achieve academic and personal success.[17]

THE JED FOUNDATION’S COMPREHENSIVE APPROACH

During the 1990s, the US Air Force developed a comprehensive suicide prevention program in response to increasing suicide rates among service members. Led by David Litts, the initiative found that while suicide accounted for 24 percent of service member deaths, fewer than one-third who ended their lives by suicide had accessed care.[18] Formal evaluation of the program showed a 33 percent reduction in suicide rates from the baseline period (1990–1996) to the postimplementation years (1997–2002). The US Air Force saw a reduction not only in suicides but also in homicides, accidental deaths, and intimate partner violence.[19] In 2004, The Jed Foundation, established by Phil and Donna Satow after losing their son Jed to suicide while in college, collaborated with the Suicide Prevention Resource Center to adapt these insights for college settings.[20] The resulting Comprehensive Approach to Mental Health Promotion and Suicide Prevention for Colleges and Universities lays out a road map for community-wide commitment and integrated strategies across multiple domains.[21] As of 2024, the JED Campus program has reached 5.6 million students across 444 institutions, including 243 completed and 201 active institutional participants. The diverse portfolio spans 366 four-year schools, 70 two-year colleges, and 8 graduate institutions. Notably, 80 participating institutions are designated as minority serving, including historically Black colleges and universities (HBCUs), Hispanic-serving institutions (HSIs), Asian American and Native American Pacific Islander institutions (AANAPISIs), Native American–serving nontribal institutions (NASNTIs), and tribal colleges and universities (TCUs).

A recent impact evaluation of the JED Campus program demonstrates significant mental health improvements, with students at participating schools showing, from baseline to program completion, a 10 percent reduction in suicidal thoughts, 13 percent reduction in suicide planning, and 25 percent reduction in suicide attempts. Students also had lower anxiety and depression scores. The program positively impacted academic metrics, with each additional year of participation correlating with increased graduation rates (0.5 percent four-year, 0.6 percent six-year) and retention rates (0.8 percent) compared to national averages.[22]

System-level changes were equally notable, with substantial increases in institutional capacity and commitment. From program start to completion, more schools reported that emotional health was seen as a campus-wide issue (49 percent vs. 74 percent), and an increasing number screened students for depression, anxiety, and suicidal thoughts at primary care visits (55 percent vs. 77 percent). Schools also strengthened their support infrastructure. More schools reported having partnerships with local substance use services (67 percent vs. 89 percent) and having postvention protocols in place (68 percent to 79 percent) to address the aftermath of a student suicide. Mental health stigma campaigns became more prevalent (74 percent of campuses at baseline and 86 percent at program completion), and environmental safety assessments showed marked improvement (46 percent at baseline and 75 percent at program completion), reflecting a comprehensive enhancement of campus mental health services and support systems.[23]

Schools achieving greater strategic plan progress showed stronger improvements, including lower levels of mental health stigma among students, even greater improvements in anxiety and depression scores, and even lower rates of suicidal thoughts, planning, and attempts. While student flourishing rates declined across schools during this period, students at schools that had made more progress in implementing their strategic plans demonstrated greater resilience, with less of a decline in flourishing rates.[24]

The JED Comprehensive Approach

The JED Comprehensive Approach (fig. 2.1) outlines seven key domains that, when integrated, create a proactive and supportive mental health ecosystem:

1. Foster Life Skills
2. Promote Connectedness and Positive Culture
3. Recognize and Respond to Signs of Distress
4. Reduce Barriers to Help-Seeking

5. Ensure Access to Effective Mental Health Care

6. Establish Systems of Crisis Management

7. Reduce Access to Lethal Means

In addition to the seven domains, JED’s Comprehensive Approach includes two guiding principles that steer the course of the work across domains: strategic planning and equitable implementation.

To participate in a robust strategic planning process, each campus forms an interdisciplinary team, with staff, faculty, and student representatives from key departments, including the office of the president, student affairs, counseling, athletics, facilities, and residential life. This team works alongside a JED Campus advisor to integrate data from student participation in the Healthy Minds Study with information from a baseline assessment of systems, policies, and procedures to create a strategic plan that guides the committee’s work.

The team works to ensure that, throughout the process, equitable implementation is a fundamental part of all discussions.[25] This includes considering questions such as the following: Which groups of young people are having the most difficulty finding community? Are there particular categories of students that utilize counseling services more or less frequently than others? Asking these questions helps the team to learn more about the student population. To address them, JED assists each institution in analyzing their data and guides schools on how to work collaboratively with their institutional data team members to extract data points and analyses relevant to their knowledge and tracking goals. A committee might discover, for instance, that student parents are struggling in specific ways.[26] This information then helps to drive the design of resources and programming that create pathways for all students to succeed.

FIGURE 2.1The importance of a comprehensive approach in promoting mental health and preventing suicide in college students

The interconnected domains of the JED Comprehensive Approach create a synergistic approach to student mental health, starting in whatever framework area offers the most traction. When life skills development reduces stress and strong social connections facilitate early identification of struggling students, these elements work together to prevent crises and encourage help-seeking. This comprehensive implementation builds a culture of well-being, with evidence showing reduced student distress levels and increased service utilization.[27]

Success requires institutional commitment through leadership support, strategic planning, and cross-campus collaboration. Schools must align mental health initiatives with broader objectives, provide adequate resources, and maintain continuous assessment to adapt to evolving student needs. The following sections examine each domain’s key elements and practical implementation strategies.

FOSTER LIFE SKILLS

Life skills are a cornerstone of well-being across a variety of domains. More specifically, research suggests that teaching life skills, such as problem-solving, emotional management, and interpersonal communication, can strengthen regulation and social integration, thereby reducing suicide risk. By enhancing individuals’ capacity to navigate challenges, life skills training may buffer against the psychological distress associated with loneliness and other socioemotional factors that contribute to suicide.[28] Decades of research demonstrate the effectiveness of life skills education and social-emotional learning (SEL) interventions in schools.[29] Life-skills-based interventions in adolescence and young adulthood have been shown to improve various outcomes, including but not limited to social-emotional skills, attitudes, behavior, and academic performance.[30] Specifically, SEL programs that focus on life skills development can be particularly beneficial in promoting mental well-being and reducing risk behaviors.[31]

WHAT COUNTS AS LIFE SKILLS?

Life skills education represents a crucial component of comprehensive suicide prevention strategies on college campuses. Research consistently demonstrates that developing practical competencies in areas such as time management, stress reduction, and interpersonal communication can significantly enhance students’ resilience and well-being, ultimately reducing suicide risk factors. However, effectively implementing life skills education requires thoughtful integration into the existing campus ecosystem through multiple complementary pathways rather than standalone initiatives. In terms of content areas, life skills encompass multiple broad domains, but the following are among those that commonly surface as salient across campus contexts:

- Time management and organization: One area of life skills development is effective time management, which can promote a sense of control and reduce feelings of hopelessness that often precede suicidal behavior. Researchers have found that teaching goal setting, organization, and other time management strategies to high school students leads to improved academic performance, self-esteem, and overall mental well-being well into later life,[32] and JED’s work suggests these techniques are likely effective in college settings as well.

- Stress management and emotional regulation: The negative impacts of stress on college students’ mental and physical health are well documented.[33] As such, proactive approaches to stress management are crucial. Teaching stress-reduction strategies, such as mindfulness, relaxation exercises, cognitive-behavioral techniques, and healthy coping mechanisms, can empower students to manage stress effectively and regulate their emotions, thereby decreasing the risk of mental health symptoms and suicide.[34] Education related to stress management should recognize the impact of discrimination and other chronic stressors, integrating stress-reduction techniques specific to these realities.

- Decision-making and problem-solving: Developing critical thinking and decision-making skills enables students to navigate complex situations, solve problems effectively, and make informed choices about their academic, social, and personal lives. By building capacity for rational, ethical decision-making, life skills education can enhance students’ ability to seek help, access resources, and engage in constructive problem-solving when facing suicidal thoughts or other mental health challenges.[35]

- Financial literacy: Financial stress is a significant concern for many college students, and research indicates it can exacerbate mental health issues and suicidal thoughts. Integrating financial literacy education into suicide prevention efforts may help young people develop skills to manage economic challenges and preserve their psychological well-being. About 23 percent of college students experience food or housing insecurity, and financial stress cannot be alleviated through skill development alone, so schools should also establish procedures for identifying students who are struggling to access food, housing, or medical care and connect them to relevant resources.[36]

- Interpersonal and communication skills: Building healthy relationships and communicating effectively are vital, as social support and connection have been consistently identified as protective factors against suicide.[37] Research suggests that programs focused on enhancing empathy, conflict resolution, and other interpersonal competencies may bolster social integration and reduce suicide risk by equipping individuals with the tools to form and maintain meaningful connections.[38] Education on building healthy relationships should also discuss negative relationship patterns and intimate partner violence.

- Physical health and wellness: Promoting healthy lifestyle choices, such as regular exercise, balanced nutrition, and adequate sleep, is essential for overall well-being.[39] Colleges can offer resources and programs that encourage students to prioritize their physical health, including fitness classes, nutrition counseling, and health education workshops. These initiatives may positively impact mental health and reduce vulnerability to suicidal thoughts and behaviors.[40]

Life skills education represents a crucial component of comprehensive suicide prevention strategies on college campuses, but effectively implementing life skills education requires thoughtful integration into the existing campus ecosystem through multiple complementary pathways.[41] The most effective pathways are those that are easily incorporated into the established cadence of campus life:

- Academic curriculum integration: Core life skills can be embedded within existing general education requirements and disciplinary coursework. First-year experience courses can introduce time management and study skills, while subject-specific classes can incorporate relevant competencies—financial literacy in business courses or communication skills in humanities.

- Co-curricular programming: Dedicated workshops and certificate programs provide focused skill development outside traditional coursework. Residence life programs offer effective venues for building interpersonal and decision-making skills, while career centers can address financial literacy alongside job preparation.

- Digital resources: Meeting students where they are through technology enables just-in-time skill development. Mobile apps and online modules can deliver targeted content when students need it most—stress management techniques during exam periods or financial planning at tuition deadlines.

- Peer education models: Training student leaders as peer educators creates sustainable skill-sharing networks. Residential advisors, orientation leaders, and student organization officers can receive specialized training and then facilitate learning among peers through both formal programming and informal interactions.

- Campus service integration: Existing services can expand their focus to include life skills development. Counseling centers might offer preventative workshops on emotional regulation, while academic advisors incorporate time management coaching into registration meetings.

The most effective approach coordinates across these pathways, ensuring consistent messaging while reaching students through diverse touchpoints. This multifaceted implementation strategy creates numerous opportunities for skill development throughout students’ academic journeys, normalizing these competencies as an integral part of the college experience rather than specialized interventions.

PROMOTING PHYSICAL HEALTH AND WELLNESS

Promoting physical health and wellness is an important part of supporting life skills development among college students. At a private college in California with a student body of eight thousand, a strategic initiative was implemented to overhaul the institution’s fee-based fitness services, making them completely free for all enrolled students. The college had previously charged for access to fitness classes and facilities, a model that limited participation due to cost barriers. In response to student feedback and growing concerns over the physical and mental well-being of the campus community, the administration decided to eliminate all fees associated with fitness programs. This shift not only removed financial obstacles but also encouraged a broader segment of the student body to engage in physical activity. As a result, fitness facility usage increased by 92 percent, with more students participating in group fitness classes and using gym facilities regularly. The impact was not just quantitative; the program fostered a healthier, more active campus culture, contributing to improved overall student wellness.

PROMOTE CONNECTEDNESS AND POSITIVE CULTURE

Tightly linked to life skills, social connectedness plays a crucial role in suicide prevention and mental health promotion within higher education. Research consistently demonstrates that strong campus relationships significantly impact student well-being and academic success by reducing isolation, anxiety, and depression while improving academic performance and campus engagement.[42] Studies specifically identify loneliness as a suicide risk factor, while peer connections serve as protective factors.[43]

There are many ways that schools can make changes on a system level to help students find community:

Create Engagement Opportunities

- Diverse student organizations: Offer a wide range of clubs, intramural athletics, and volunteer opportunities that appeal to various interests and identities. These structured activities provide natural entry points for students to find like-minded peers and develop meaningful connections.

- Community service initiatives: Implement service-learning projects that connect students while contributing to the broader community. Shared purpose-driven activities often create stronger bonds than purely social events while simultaneously developing civic engagement.

Train Campus Personnel

- Frontline staff training: Equip resident advisors, academic advisors, and coaches with skills to identify students showing signs of isolation and loneliness. These frequent student contacts can serve as early detection points when properly trained to recognize withdrawal behaviors and declining participation.

- Pilot implementation: Begin with a focused training program in one student-facing department (such as residence life) with clear protocols and specific referral pathways. Starting small allows for refinement of processes before campus-wide implementation and builds evidence for broader adoption.

Create Support Systems

- Connection concern system: Develop a connection concern form similar to academic alert systems for flagging students who may need community engagement support. This formalized process ensures isolated students don’t fall through the cracks and creates accountability for follow-up.

- Regular refresher training: Establish brief quarterly sessions (thirty to forty-five minutes) to maintain awareness and skills among staff members. Consistent reinforcement prevents program drift and allows incorporation of lessons learned from previous interventions.

Use Data-Informed Approaches

- Baseline assessments: Gather initial data through existing evaluation systems using validated instruments that measure social connection and belonging. Integrating questions into already-established surveys improves response rates and reduces survey fatigue.

- Mixed-methods research: Supplement quantitative measures with focus groups and journey mapping exercises to identify specific transition points where disconnection occurs. These qualitative approaches provide context and student voice that numbers alone cannot capture.

Employ Targeted Interventions

- Demographic analysis: Disaggregate connection data by demographics, class year, residential status, and academic program to identify groups needing specific support. This targeted approach ensures resources address actual disparities rather than assuming all students face identical challenges.

- Network mapping: Implement visualization tools that illustrate campus social connections to identify isolated pockets within the community. These visual representations can reveal unexpected patterns and help prioritize intervention areas not obvious through traditional metrics.

Use Physical Environment Design

- Intentional spaces: Create residence halls and common areas specifically designed to facilitate casual interaction and community building. Physical environment significantly influences social behavior through features like community kitchens, comfortable gathering areas, and strategic furniture arrangement.

- Outdoor engagement areas: Develop outdoor spaces that encourage spontaneous gathering and activities accessible to diverse student populations. Weather-appropriate outdoor areas extend the campus social environment beyond buildings and promote physical activity alongside connection.

Garner Institutional Support

- Cross-departmental collaboration: Form working groups that include residence life, student activities, counseling services, and facilities management to coordinate connection initiatives. These collaborative approaches prevent siloed efforts and create comprehensive strategies that address multiple dimensions of student experience.

- Leadership endorsement: Secure visible support from faculty and administrative leadership to elevate the priority of connection initiatives. Executive sponsorship ensures adequate resources, removes bureaucratic barriers, and signals institutional commitment to student belonging.

A focus on inclusivity and belonging is particularly crucial, as marginalized groups often face unique challenges in building social networks and accessing mental health support.[44] Funding for community-building clubs and activities for young people at increased risk of loneliness, such as students of color at primarily white institutions, commuter students, and student parents, can help to provide support for young people who would not otherwise access these types of resources.

In developing initiatives to strengthen connections, it is crucial to understand how social norms influence suicidal behavior. While social connections can serve as protective factors, they may also increase risk depending on the norms of the social group.[45] When people view themselves as failing to meet societal expectations, it can trigger shame and entrapment, heightening suicide vulnerability.[46] Additionally, research shows that students who perceive suicide as common among their peers are more likely to consider it themselves.[47] However, fostering positive norms supporting help-seeking and emotional vulnerability creates protective environments where individuals are more likely to seek support when needed.[48] Schools can work alongside student leaders to incorporate positive mental health messaging into student groups.

Since peers are often the first to be aware of mental health challenges, peer-led programming has emerged as an effective approach to promoting student support.[49] Colleges can implement various strategies to cultivate social connectedness across diverse student populations:[50]

- Peer mentoring programs that match experienced students with those in transition periods (first-year, transfer, or returning students)

- Wellness ambassador initiatives where trained students promote mental health resources and facilitate conversations in residential communities

- Peer-led support groups focused on specific challenges (academic stress, identity exploration, grief) or shared experiences (first-generation students, international students)

- Student-facilitated workshops on recognizing warning signs and referring friends to appropriate resources

Faculty-student engagement through mentorship programs, accessible office hours, and inclusive teaching practices further reinforces a sense of belonging and support. In order to promote faculty involvement in these activities, colleges must invest in supporting well-being and positive culture for faculty as well, paying particular attention to those who themselves might feel less included in campus culture.

The evidence for approaches that emphasize community building is compelling: Strong social ties are associated with lower rates of depression and anxiety, better academic outcomes, and improved overall well-being.[51] Through regular assessment and targeted inclusion programming, institutions can identify and support isolated students, ensuring that social connectedness initiatives create diverse engagement opportunities through student organizations, cultural clubs, athletics, and other activities, ultimately building a more resilient and supportive campus community.

RECOGNIZE AND RESPOND TO SIGNS OF DISTRESS

Early identification of students at risk for mental health challenges requires a multifaceted approach beginning before students arrive on campus. By implementing comprehensive pre-enrollment mental health assessments, institutions can gain valuable insights into the unique needs and vulnerabilities of their incoming student populations, allowing them to tailor support services accordingly.[52] Ongoing monitoring and evaluation of student mental health on college campuses is crucial. Approximately half of all lifetime mental health conditions begin by age eighteen and almost two-thirds by age twenty-five.[53] Mental health conditions are highly prevalent among college students and are on the rise.[54] However, a significant proportion of these issues remain undiagnosed and untreated, in part due to the limitations of traditional assessment methods.

By implementing evidence-based screening tools, colleges can proactively detect struggling students and connect them to support services. Pre-enrollment assessments typically take the form of confidential online questionnaires administered during the admissions process or orientation, covering topics like depression, anxiety, substance use, previous mental health treatment, and coping mechanisms. Many institutions partner with the American College Health Association’s National College Health Assessment (ACHA-NCHA) to implement standardized screening that provides both individual data and comparative benchmarking across institutions. For colleges with limited resources, free validated screening tools like the Patient Health Questionnaire (PHQ-9) for depression or the Generalized Anxiety Disorder scale (GAD-7) can be integrated into existing admissions or orientation platforms. In addition, to ensure effective ongoing monitoring, institutions can consider implementing standardized mental health and substance misuse screenings during primary care visits.[55] If primary care providers are off campus, colleges might ask for confirmation that a screening was conducted so that they might better tailor care once the student arrives on campus. All schools, especially those without health services, should develop strong referral networks with community providers, hospitals, and emergency services to ensure continuity of care.[56]

To create a comprehensive safety net, schools should offer or expand mental health training programs for campus professionals, enabling faculty and staff to better identify, consult, and refer struggling students.[57] Students at risk often exhibit subtle behavioral, academic, or emotional changes, such as prolonged sadness, social withdrawal, missed classes, declining academic performance, and increased irritability.[58] Recognizing these signs is essential for timely interventions. Staff training should be complemented by peer identification programs that teach students to recognize warning signs, check in on their peers, and facilitate connections to support services.[59] Additionally, institutions need to develop or refine clear protocols for reporting students of concern, ensuring that identified risks can be appropriately addressed through established channels.

Key Elements of Effective Early Identification

- Screening and assessment tools: Regular mental health screenings using validated tools like the PHQ-9 for depression and GAD-7 for anxiety help identify students experiencing distress.[60] Digital platforms can also engage students in self-assessment.

- Training for faculty and staff: Mental health training programs, such as QPR-based (Question, Persuade, Refer) programs and Mental Health First Aid, equip nonclinical staff with skills to recognize and address early signs of crisis, providing students with critical connections to support resources.[61]

- Data-driven approaches to identification: Utilizing predictive analytics allows institutions to assess patterns of absenteeism, academic performance, and engagement to identify students needing support.[62] Adhering to Family Educational Rights and Privacy Act (FERPA) and Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulations ensures student data is used responsibly and confidentially. These insights allow institutions to direct resources where they are most needed, while ethical considerations ensure student privacy and confidentiality are protected.[63]

- Proactive outreach to students in high-risk situations: Certain situations are predictably difficult for students, such as facing disciplinary action. Campuses can implement policies that require increased outreach to students who are likely to be facing high levels of stress.

- Coordination of care and referral processes: A streamlined referral system connects students to appropriate resources, including counseling services, peer mentors, or external providers. Case management teams play a crucial role in ensuring follow-up care and support.[64]

MENTAL HEALTH TRAINING

At a college in New York with a student body of 5,000 and over 1,300 full-time and part-time employees, student affairs leadership launched a comprehensive mental health training program aimed at equipping both staff and students with the skills to identify, reach out to, and refer individuals in need of mental health or other support services. Recognizing the significant role that faculty, staff, and peers play in identifying early signs of distress, the college developed this initiative to bridge the gap between students who may be struggling and the vital resources available to them on campus. Over two years, the program successfully trained all full-time and part-time employees, as well as a large percentage of students, fostering a culture of care and support across the campus. Training sessions, now offered each semester, provide participants with tools to recognize warning signs of mental health challenges, respond with empathy, and guide individuals toward appropriate resources. The program has been instrumental in removing barriers to help-seeking behavior, encouraging students to reach out when they need assistance and making it easier for staff and peers to offer support. As a result, the college has seen a noticeable increase in students seeking help and a reduction in stigma surrounding mental health issues. Additionally, the program has contributed to the creation of a more inclusive, compassionate campus environment, where individuals feel empowered to both offer and seek help without fear of judgment.

REDUCE BARRIERS TO HELP-SEEKING

A key component of nearly all comprehensive mental health frameworks is the promotion of help-seeking behaviors and the reduction of barriers to connecting to mental health services. College students frequently encounter obstacles to accessing mental health support, including concerns about confidentiality, a lack of awareness of available resources, and societal stigma.[65] While awareness campaigns have had a positive impact on mental health stigma and helped students become more informed about resources, many young people, especially those from marginalized groups, report additional roadblocks to seeking out help when faced with mental health challenges, including cost and insurance issues as well as fears of being a burden on caregivers or being misunderstood by providers whose identities may not match theirs.[66] These obstacles can impede timely intervention and support, which is why a holistic, multifaceted approach is necessary to foster a campus culture in which seeking help is normalized, encouraged, and supported.

Proactively identifying high-risk populations, a critical part of all comprehensive models, will only be effective if services are easy to access and barriers to help-seeking are addressed. Promoting help-seeking behaviors involves addressing both systemic and individual barriers that students may face when seeking mental health support.

EXAMPLES OF INITIATIVES COLLEGES AND UNIVERSITIES EMPLOY TO DECREASE BARRIERS TO HELP-SEEKING

- Anti-stigma campaigns: Campaigns like those run by the college student group Active Minds, as well as Seize the Awkward, a collaboration between The Jed Foundation, the American Foundation for Suicide Prevention, and the Ad Council, aim to reduce mental health stigma through education and awareness raising, which can encourage more students to seek support.[67] Programs incorporating personal narratives from students with lived experiences of mental health challenges have been particularly effective at fostering empathy and combating stigma on campus.[68]

- Confidential and anonymous services: Providing connections to private and anonymous options for students to access mental health resources, such as telehealth counseling and online support groups, can help address concerns about stigma and lack of confidentiality that often prevent students from seeking in-person help.[69] Digital platforms and mental health apps can offer anonymity and accessibility that may appeal to students.[70]

- Free and low-cost insurance and services: Because many people avoid care due to lack of finances, campuses can play an active role in ensuring access to free or low-cost services, providing assistance enrolling in health insurance plans, and educating students about the availability of affordable insurance and health care.

- Peer-led initiatives: Peer-led initiatives, such as Active Minds, help foster trust and relatability among students, potentially increasing the likelihood that students will reach out to their peers for support during times of distress.[71] These programs can also serve as a gateway to professional mental health services by educating students on the availability and benefits of counseling and other mental health resources, while also working to reduce the stigma associated with seeking help.

- Embedding mental health initiatives into campus life: Providing mental health education during orientation and other campus programs is key to developing self-awareness, coping skills, and resilience in students. This approach normalizes help-seeking behaviors and equips students with the tools to manage the stresses of college life, an integral element of the holistic approach to student well-being.[72]

- Integrating mental health into the curriculum: Incorporating mental health education and wellness topics into the core curriculum can help normalize discussions around mental health and reduce stigma for college students.[73] Colleges should consider implementing mandatory mental health seminars, offering wellness workshops, and integrating mental health themes into relevant courses. This can create a campus environment where seeking help for mental health challenges is seen as a natural and expected part of the college experience.

- Assessment of barriers specific to student groups: Understanding the obstacles that particular groups of students may face in seeking help can assist campuses in identifying approaches that may increase service utilization. Commuter students, for instance, may benefit from extended counseling department hours, or male students may feel more comfortable speaking with male clinicians.

Supporting and enhancing help-seeking for mental health challenges requires a multifaceted approach that respects and integrates cultural perspectives. Comprehensive models emphasize inclusive services, including a representative counseling staff and multilingual support.[74] Colleges should also actively engage students in developing solutions, as students are positioned to offer useful insights into the campus environment and its impact on their peers’ mental health.

Tested technology-based solutions, such as virtual counseling and mobile apps, further enhance accessibility and flexibility for students. Virtual mental health services, including online therapy and support groups, have emerged as an effective way to reach students who may be hesitant to seek in-person care due to stigma or logistical barriers.[75] Moreover, mental health apps can provide personalized support and guidance, often in an anonymous format that may appeal to students wary of traditional treatment.[76] Regardless of the elements campuses include in their approaches, it is critical to incorporate clear, student-centered messaging when promoting mental health resources. Institutions should use multiple communication channels—such as social media, emails, and classroom announcements—to increase the visibility of available services and encourage students to utilize them.[77]

ENSURE ACCESS TO EFFECTIVE MENTAL HEALTH CARE

Providing accessible, high-quality health care services is essential to fostering a supportive campus environment. This requires a multipronged strategy—including on-campus treatment, recovery support services, and community provider partnerships.[78] College counseling centers play a pivotal role in this approach, offering a wide range of evidence-based interventions, such as individual and group psychotherapy, psychiatric medication management, crisis intervention, and referrals to off-campus providers when necessary.[79] To ensure the efficacy of support services, it is vital to maintain adequate staffing, provide extended hours and telehealth options, and integrate counseling services across campus. This is best accomplished when counseling centers work closely with other campus departments, including academic advising, residential life, and student activities, to create a seamless continuum of care.

A comprehensive leave policy should establish a centralized office to coordinate voluntary and involuntary medical leaves while prioritizing accommodations that might allow students to remain enrolled. The policy should ensure parity between physical and mental health leaves, provide clear documentation requirements and return processes, and include provisions for student support both during leave and upon return. For involuntary leaves, which should be rare and used only as a last resort, the policy must require individualized assessment and clear appeals processes, with the recognition that suicidal ideation alone does not justify mandatory leave.

Targeted outreach and interventions for student populations at increased risk—such as LGBTQ+ students, student-athletes, and international students—can help reduce disparities in access to mental health services. Hiring staff who reflect the student body and providing training in trauma-informed care ensures that all students feel safe, supported, and understood when seeking help.[80] Counseling centers should also communicate regularly with campus learning centers to ensure that neurodivergent students and those with learning disabilities receive appropriate support.

ESTABLISH SYSTEMS OF CRISIS MANAGEMENT

Developing and implementing comprehensive crisis management procedures is essential to addressing mental health emergencies and ensuring student safety and well-being on college campuses.[81] A structured approach includes clear protocols for identification, assessment, and intervention. Guidelines for faculty, staff, and resident advisors help them recognize warning signs and initiate appropriate actions. Continuous access to trained mental health professionals is facilitated through 24/7 crisis hotlines or online crisis chat services.[82]

A detailed and widely disseminated crisis response plan addresses various situations, such as mental health emergencies, suicidal ideation, violence, and self-harm. This plan delineates roles and responsibilities for key campus stakeholders, including counseling services, campus security, residential life, and local emergency services. Regular reviews and updates of these procedures ensure alignment with best practices and evolving student needs, with periodic drills and simulations testing effectiveness and identifying areas for improvement.[83] Collaboration with local mental health providers and emergency services establishes clear communication channels and coordinated care.[84] Crisis response plans must include protocols for addressing substance misuse. Provision of amnesty programs for substance misuse is linked to greater likelihood of accessing needed medical services and fewer emergencies requiring advanced care. This is particularly important for students who may have concerns about first responder actions and attitudes.[85] Campuses with amnesty policies should advertise these widely to ensure that students are aware of them. It is also recommended that campuses make naloxone available in dorms and other campus gathering places in the event of a student opiate overdose.

WHAT GOES INTO A CRISIS MANAGEMENT PLAN?

- Comprehensive crisis response plan: Creating and disseminating a detailed plan for addressing various crisis situations, such as mental health emergencies, suicidal ideation, violence, and self-harm, is essential. This plan should establish guidelines for faculty, staff, and resident advisors to recognize warning signs and initiate appropriate interventions.[86] It should also delineate roles and responsibilities for key campus stakeholders, including counseling services, campus security, residential life, and local emergency services.

- Regular review and updates: Equally as important as establishing crisis protocols is conducting periodic reviews and updates to align with best practices and evolving student needs. This includes drills and simulations to test effectiveness and identify areas for improvement.[87]

- 24/7 crisis support: Providing continuous access to trained mental health professionals through campus crisis hotlines provides a clear point of entry for students in crisis and others concerned about their well-being.

- Collaboration with external resources: Establishing partnerships with local mental health care providers and emergency services ensures clear communication channels and coordinated care.[88]

- Creation of behavioral intervention teams: At-risk and behavioral intervention teams serve as centralized campus resources that receive, assess, and coordinate responses to reports of concerning student behavior. These teams maintain regular meetings to review cases, develop intervention strategies for identified students of concern, and assure clear communication channels that engage parents, faculty, staff, and other stakeholders.

- Specific postvention plan: In addition to having clear procedures for addressing students in crisis, every campus should have a postvention plan in place outlining the approach the school will take in the case of a student death by suicide. This plan should include information on how to facilitate rapid support for the student body, best practices for communicating with the campus community and with students’ caregivers, and a clear approach for how to memorialize the deceased.

An effective crisis response system in higher education incorporates foundational elements to ensure timely and structured intervention. Clear communication plans facilitate efficient information flow during crises. Designated response teams provide expertise and structure, while the rapid deployment of mental health resources leads to effective intervention. Maintaining well-documented emergency response procedures enables rapid responses to various crises, including mental health emergencies, natural disasters, or incidents of violence.

The aftermath of a crisis requires structured support and continuous evaluation to improve future responses. Postintervention support includes ongoing care for affected students and staff, such as debriefing sessions and peer support groups, to facilitate long-term recovery. Regular drills, workshops, and training sessions prepare the campus community for effective crisis response. Comprehensive documentation and review processes identify gaps, evaluate response effectiveness, and inform updates to protocols.

REDUCE ACCESS TO LETHAL MEANS

A critical component of a comprehensive approach for protecting mental health and preventing suicide on college campuses is the implementation of policies and environmental strategies to reduce access to potentially lethal means, such as firearms, rooftops, and certain medications. These strategies aim to reduce the risk of suicide and self-harm by limiting the availability of methods that are likely to be fatal. This involves a multifaceted approach encompassing environmental safety measures, policy development, and community partnerships.

Policies that promote safe firearm storage, such as encouraging the use of gun locks and safes, can significantly reduce the risk of impulsive firearm-related suicides. Securing rooftops, restricting access to hazardous areas, and installing barriers are critical environmental safety measures.[89] Collaborating closely with facilities management staff is essential for implementing and maintaining these physical safety measures, ensuring that campus environments remain secure and minimize potential risks. Environmental scans should be conducted regularly, as new hazards can arise.

It is important to note that the effectiveness of means reduction strategies can vary depending on the specific context and the means being targeted. A comprehensive approach to means reduction should be tailored to the needs of the campus community and should be implemented in conjunction with other prevention and intervention strategies. Limiting access to lethal means, such as firearms, medications, or high-risk campus areas, is a proven strategy for reducing suicide risk.

HOPE SIGNAGE

A university of approximately four thousand students worked to prioritize means safety as a broader strategy to reduce suicide risk and promote help-seeking behaviors. Their initiative was to install hope signage across campus. They were able to install over two hundred signs on building and garage rooftops with visible and accessible messages of support for students in crisis. This initiative demonstrates to the campus the role of environmental interventions in mental health promotion and suicide prevention in a higher education setting.

IMPLEMENTATION AND INTEGRATION

The promotion of mental health is a shared responsibility across the entire campus community, requiring collaboration among students, faculty, staff, and administrators.[90] A comprehensive approach aims to create a safety net that supports students throughout their college experience, from pre-enrollment through graduation. Effective mental health approaches adopt a strategic, collaborative, and evidence-based approach that aligns the different elements of the approach and ensures continuous evaluation of their impact. Institutional leadership and a shared commitment to mental health are crucial for the successful implementation of a comprehensive approach. College administrators, faculty, and staff must work in tandem to embed mental health support within the fabric of the institution, allocating necessary resources, providing ongoing training, and championing a culture of care and support.

Continuous assessment and data-driven decision-making are also essential for the continuous refinement and enhancement of the comprehensive approach. Colleges should leverage data from various sources, such as student surveys, clinical records, and program evaluations, to gain a deeper understanding of the evolving mental health needs of their student population, assess the effectiveness of their interventions, and make informed adjustments to their comprehensive approach.[91]

Integration of the comprehensive approach within the broader institutional ecosystem, including academic affairs, student services, and campus safety, is crucial for ensuring a coordinated and holistic approach to student well-being.[92] By aligning the comprehensive approach with other campus initiatives and leveraging cross-departmental collaboration, colleges can create a seamless network of support that empowers students to thrive both academically and personally.

Implementation challenges are inevitable, and colleges must be prepared to address them through ongoing stakeholder engagement, flexible planning, and a commitment to continuous learning and improvement. Continuous quality improvement, sustained commitment, and a willingness to adapt to emerging challenges are key to the long-term success and impact of a comprehensive approach to student mental health on college campuses.[93] Use of specific continuous quality improvement (CQI) strategies, such as plan-do-study-act (PDSA) cycles, can help institutions systematically test, evaluate, and refine their implementation efforts over time.

Common challenges, such as limited financial and human resources, siloed organizational structures, and cultural resistance to change, can be navigated by fostering cross-functional collaboration, strategically prioritizing initiatives, and effectively communicating the importance of mental health support to the entire campus community. Successful integration often involves specific structural elements that facilitate cross-departmental collaboration. For example, some institutions have established dedicated mental health task forces with diverse representation from counseling services, academic affairs, student life, and campus safety that meet regularly to coordinate initiatives and address emerging concerns. Some campuses have implemented care teams that hold weekly case management meetings to identify and support students showing signs of distress, creating formal pathways for information sharing while maintaining appropriate confidentiality. The University of Michigan’s embedded-counselor model places mental health professionals directly within academic departments and residence halls, reducing barriers to access while fostering natural collaboration between clinical staff and faculty. Similarly, campus wellness-coaching programs train staff from various departments to provide basic support and appropriate referrals, extending the reach of mental health resources beyond traditional counseling centers. These structural approaches establish clear responsibilities, communication channels, and accountability measures that transform theoretical integration into practical, sustainable systems of care.

IDENTIFYING RESOURCES TO SUPPORT FRAMEWORK IMPLEMENTATION

Implementing a comprehensive mental health framework like JED Campus requires thoughtful resource allocation, especially for institutions facing budgetary constraints. Rather than viewing this as an all-or-nothing proposition, colleges can adopt a phased implementation approach, beginning with high-impact, low-cost elements while seeking sustainable funding for more resource-intensive components. Many institutions have successfully leveraged multiple funding streams to support mental health initiatives, including student health fees, grants from private foundations, alumni donations earmarked for student wellbeing, and partnerships with local health care systems. Some colleges have found success with wellness fees specifically designated for mental health services, while others have reallocated existing resources by integrating mental health support into existing student success initiatives to demonstrate return on investment through improved retention rates.

For institutions with limited resources, prioritization becomes essential. Begin by conducting a comprehensive needs assessment to identify the most pressing gaps. Consider realigning existing staff responsibilities rather than creating new positions—for example, training residence life staff in mental health first aid or incorporating wellness components into existing first-year experience courses. Regional partnerships with neighboring institutions can create economies of scale, potentially sharing costs for specialized services, after-hours crisis support, or staff training programs. Many campuses have also successfully engaged academic departments (psychology, social work, counseling) to develop supervised practicum opportunities that simultaneously provide additional service capacity and valuable training experiences. Remember that even modest investments in preventative approaches often yield significant returns through reduced crisis intervention needs and improved student retention—data points that can help make the case for increased institutional commitment to comprehensive mental health frameworks.

LEVERAGING DATA AND TECHNOLOGY

Effective implementation of a comprehensive mental health approach requires the strategic integration of data, technology, and evidence-based practices.[94] Colleges can leverage data to gain valuable insights into the mental health needs and trends within their student population, identify high-risk groups, and evaluate the effectiveness of their mental health interventions.

Adopting comprehensive data collection and analysis systems can help institutions track key metrics, such as utilization of counseling services, rates of suicide and self-harm, and students’ self-reported experiences of mental health and well-being. In practice, these data systems often include regular campus-wide surveys using validated instruments like the Healthy Minds Study or Patient Health Questionnaire, appointment tracking systems that monitor wait times and service utilization patterns, and electronic health records that capture presenting concerns and treatment outcomes. Some institutions have implemented early alert systems that integrate academic performance data (missed classes, declining grades) with counseling center utilization to identify at-risk students before crises emerge. For example, Georgia State University uses predictive analytics combining multiple data sources to identify students who may need additional support, while Northeastern University employs a comprehensive dashboard tracking key wellness indicators across different student populations. Advanced implementations may include secure data-sharing agreements between campus departments that maintain appropriate privacy protections while allowing coordinated care planning. This information can be used to tailor outreach efforts, design targeted interventions, and continuously refine the institution’s mental health support services to better address the evolving needs of the student population.

Furthermore, the integration of tested technology-based solutions, such as online mental health screenings, self-help resources, and telehealth services, can help expand the reach and accessibility of mental health support, particularly for students who may be reluctant to seek in-person care or face geographical or logistical barriers.

Digital interventions can also provide valuable data on student engagement and outcomes, allowing colleges to monitor the effectiveness of these tools and make data-driven decisions about their integration within the comprehensive mental health approach. Digital interventions include mobile applications that teach mindfulness skills, online cognitive behavioral therapy platforms, virtual reality environments for exposure therapy, text-message-based support systems that deliver coping strategies or check-ins, and AI-powered chatbots that provide immediate support and appropriate referrals. Many institutions also utilize telehealth platforms for remote counseling sessions and self-guided online courses addressing specific concerns like stress management or sleep hygiene. These digital tools typically include analytics dashboards that track usage patterns, completion rates, and self-reported symptom changes, providing administrators with actionable data for program evaluation and resource allocation.

Ultimately, the strategic use of data and technology can enhance the overall impact and sustainability of a comprehensive approach to student mental health, ensuring that institutions are equipped to proactively identify, support, and empower students throughout their academic journey.

FUTURE DIRECTIONS AND EMERGING TRENDS

The implementation of comprehensive mental health approaches represents a critical shift from reactive to proactive approaches in college mental health. Future development should focus on strengthening these frameworks through enhanced data collection and outcomes research, particularly examining their effectiveness across diverse student populations and institutional types. Key priorities include developing standardized metrics for evaluating framework implementation, identifying essential components that drive positive outcomes, and establishing best practices for adaptation across different campus contexts. Additionally, research should examine how comprehensive frameworks can better integrate emerging technologies and innovative service delivery models while maintaining their core focus on prevention and early intervention. As comprehensive approaches evolve, particular attention should be paid to strengthening cross-campus collaboration, enhancing the accessibility of mental health services, and developing more sophisticated strategies for identifying and supporting at-risk students. This includes examining how these approaches can more effectively meet the needs of students who encounter barriers to care, enhance crisis response capabilities, and foster sustainable institutional change in mental health promotion and suicide prevention efforts.

CONCLUSION

Comprehensive, evidence-based approaches to addressing college mental health challenges require institutional commitment, continuous assessment, and adaptation to emerging student needs. As mental health concerns continue to rise among college students, integrated approaches are essential for creating supportive campus environments that promote well-being and academic success while reducing risk factors for suicide and other adverse outcomes.

PART 2
An Examination of Student Contexts and Experiences

CHAPTER 3
Reconsidering the Costs of College: Financial Pressure, Competing Demands, and Student Mental Health

ALLYSON CORNETT AND BRYAN ASHTON

Trellis Strategies

THE EVOLUTION IN COLLEGE COST AND FINANCING

Increasingly, public conversations are centering on the value of postsecondary education with a focus on return on investment for various credentials.[1] This conversation is often anchored in discussions about the high cost of postsecondary education: In fact, the Education Data Initiative reports that the average cost of four-year tuition and fees has risen over 179 percent during the past two decades.[2] The reality of tuition costs may feel a bit different to students, as the sticker price and net price are often not the same, as was highlighted by a 2024 McKinsey study indicating that the average net price has only increased around 4 percent over the past decade.[3] However, sticker price is still a key metric of college cost as the most visible price point to the consumer, and it is undeniably a significant source of stress for college students.

While the tuition and fees portion of college cost has risen, students are also subject to the same cost of living increases that have occurred across the United States. These indirect costs of college—including food, housing, and transportation—have become an increasingly important part of the equation for college students, especially the growing demographic of students at later life stages who are caring for their children, parents, and other dependents.[4] Research from the State of Student Aid shows that for full-time undergraduates living off campus, indirect costs made up 58 percent of the total cost of attendance for two semesters at four-year public institutions and 71 percent at two-year public institutions nationwide.[5]

As the direct and indirect costs of education have risen, there have also been significant changes in the methods students use to pay for college. Today’s students are borrowing more to attend school and, in turn, accumulating higher levels of debt compared to previous generations. The proportion of undergraduate students taking out loans rose from 34 percent in 1992 to 46 percent in the 2019–20 academic year.[6] The average federal college loan debt upon graduation has increased by approximately 48 percent (adjusted for inflation) between the 1995–96 and 2023–24 academic years.[7] In the 2022–23 academic year, half of all bachelor’s degree recipients from public and private nonprofit four-year colleges graduated with student loan debt, with an average amount borrowed of $29,300 among those who took out loans.[8]

Understandably, these changes in college financing have created very real financial pressure for students as they consider how to pay for each tuition bill and their daily needs. Institutions across the country recognize this and have engaged in the development of new initiatives to help support students’ essential needs, including the development of over eight hundred food pantries on college campuses since 2012.[9]

However, aid resources have not kept up with the increase in direct and indirect college costs. The Pell Grant, supported by the federal government, has historically served as the primary need-based aid source for students across the country. However, we have seen the per student funding for the Pell Grant stay relatively stagnant, resulting in a 40–50 percent drop in purchasing power of a maximum grant since the late 1970s.[10] As students are forced to diversify the sources that they use to pay for college, there is increased fragility in the ability to stay enrolled; if just one loan, grant, or scholarship falls through, it can leave them short and disrupt their education. As a result, students are often unsure about the best way to finance their education while enrolled.[11]

This increase in expenses, without an increase in associated aid, has put additional financial strain on students. This strain can create financial stress and anxiety for students—in fact, 31 percent of students reported that finances were the reason they stopped out of postsecondary education.[12] It is important to note that these financial barriers are interrelated with other challenges. For example, a student facing low financial security may take on additional employment while enrolled, resulting in limited time to complete assignments. Lack of academic progress as a result of time poverty can then lead to a loss of financial aid, further compounding students’ financial insecurity. Despite all of this, students who are currently enrolled still believe that college is a good investment in their financial future, with 72 percent indicating that they agree or strongly agree with that sentiment.[13]

Amid this evolving landscape of college financing, students are also juggling multiple demands on their time, dealing with financial stressors that impact their ability to meet their basic needs and navigate mental health challenges. This chapter draws on multiple national studies of student well-being to understand how these difficult realities of learners’ daily lives intersect to create a challenging environment for student success—and how institutions can approach these interconnected issues. In particular, Trellis Strategies’ Student Financial Wellness Survey (SFWS) serves as a robust dataset and foundation for this chapter. The SFWS is a no-cost, self-reported, web-based survey that documents the financial well-being, mental health, and success indicators of postsecondary students across the nation. The Fall 2023 implementation drew responses from 62,367 students at 142 colleges and universities—93 public two-year institutions, 1 private two-year institution, 36 public four-year universities, and 12 private not-for-profit four-year institutions.

COMPETING DEMANDS AND PRIORITIES

For years, the traditional image of a college student was that of a relatively recent high school graduate starting their college journey for the first time, marking their transition into adulthood as they balance new responsibilities with academics and campus life. However, this characterization no longer captures the diverse range of individuals enrolling in postsecondary education.[14] Today, a significant and growing segment of the college-going population includes first-generation students, financially independent students, those over the age of twenty-five, students with children or other dependents, and those who work part-time or full-time while enrolled.[15] These students often face substantial obligations and competing demands outside of school, which can influence their mental health, academic performance, and overall well-being.

Parenting students, who now make up more than one in five college students in the US, often struggle to balance their caregiving responsibilities with their educational goals.[16] This challenge is highlighted in the results from the 2023 Student Financial Wellness Survey (SFWS), which found that 41 percent of student parents spent over forty hours a week caregiving for their dependents, and 23 percent had missed at least one day of class due to lack of childcare.[17] When faced with a hypothetical loss of childcare, nearly a third (32 percent) predicted they would take fewer classes or drop classes. Respondents also wrote in responses further explaining the importance of childcare to their academic persistence. For example, one student described how their ten-year-old son attended a before- and after-school program to accommodate their college class schedule. “If this wasn’t available, I would not be able to attend college at all,” the student reported. Other respondents were looking to the future when their childcare was uncertain, for example, when anticipating the shift from online classes to in person as part of a longer degree trajectory. “[Next semester] I plan to be in the nursing program, which is in person,” one student explained. “I have five children and cannot be in person unless I have childcare.”

These students’ stories exemplify the fragile state of many parents’ support systems. The combined demands of parenthood, employment, and academics can lead to time poverty, which prevents student parents from engaging in adequate self-care, socializing, and studying. Ultimately, this can affect their academic success and ability to fully participate in their education, leading to over half of student parents leaving school without their desired degree or credential.[18]

Many undergraduate students now hold part- or full-time jobs while enrolled in school. In 2020, 40 percent of full-time students and 74 percent of part-time students were employed.[19] In the 2023 SFWS, 68 percent of undergraduate respondents worked for pay while in college, with 41 percent of those students working forty hours or more a week.[20] Among these students, 38 percent viewed themselves as “workers who go to school” rather than “students who work.” Generally, working while in college has been found to adversely affect student performance, with a strong negative relationship observed between grade point average (GPA) and each additional hour worked while in college.[21] Indeed, 25 percent of employed respondents to the SFWS missed at least one day of class in the prior semester due to conflicts with their job, with 11 percent missing three or more days.[22] Working long hours, absenteeism, and deprioritizing the student persona can have significant impacts on students’ academic journeys and personal development.

As the student persona evolves on campuses across the country, their lives become increasingly complex. This complexity extends to their financial situations, as students face more intricate financial landscapes as they age. These include evolving housing and transportation needs that accommodate employment opportunities and dependent care for children and aging family members. Engaging in academic pursuits incurs monetary costs, as previously outlined, but there is also an opportunity cost for many students. The hours dedicated to learning are not available for employment, caregiving, or other activities. This time poverty can lead to potential income loss and increased expenses, such as those from eating out instead of cooking at home, paying for additional childcare hours, or using rideshares instead of public transportation.

FINANCIAL STRAIN

While the increased burden of student debt has been widely discussed in the national media, less attention has been paid to how college students experience their daily financial lives. Increased debt loads have long-term implications for students, but debt accumulation is often ultimately evaluated in terms of students’ increased earning potential. Unfortunately, however, many students report that student debt has caused them to delay life events like purchasing a home, having children, and saving for retirement.[23] These outcomes are all realities associated with the dramatic shift in the cost of postsecondary education and how students pay for it. In addition to the academic stress and responsibilities associated with college, students must also budget, pay bills, and manage their credit responsibly, often with uncertain incomes. Unstable personal finances, high tuition costs, and limited familial support can further complicate their ability to make ends meet.[24]

To better understand the daily financial strain that students experience, we can draw insights from the 62,367 student responses to the 2023 Student Financial Wellness Survey (SFWS).[25] In it, students self-report that they are facing daily financial difficulties, which can lead to increased stress and impact academic performance. Nearly three-quarters of SFWS respondents (71 percent) experienced financial difficulties while in college, and of these students, 47 percent had difficulty concentrating on their schoolwork because of their financial situation.[26]

The SFWS reveals that students are financially fragile, with 56 percent reporting they would have trouble getting $500 in cash or credit to meet an unexpected need within the next month.[27] This lack of financial safety among students shows the value of having reactive financial aid programs, like emergency aid, that students can utilize to meet unexpected expenses, which might range from a broken laptop to a blown tire that impacts their transportation security. Nine percent of students reported that they had borrowed either a payday loan or auto title loan in the past twelve months to help make ends meet.[28] Notably, consumer debt incurred during an emergency is often considered the worst kind of debt due to the terms and conditions and collection practices associated with these types of loans.

Respondents to the SFWS were also asked about how their institutions supported them as they navigated these challenges. Only 39 percent indicated that their institution was aware of the financial challenges they faced.[29] A feeling of institutional awareness and support is key to establishing a sense of belonging and connection within the institution but is often an underappreciated portion of institutional messaging and support services. While students can work with student affairs and financial aid professionals who have expert knowledge about college financing, they also often engage with faculty and academic advisors who may not have the same training. These student-facing personnel can benefit from increased awareness of and training around student financial challenges to help create a sense of campus-wide support for these issues.

As discussed above, student financing has become more complex as the cost of college has risen. Just four percent of respondents to the SFWS were able to “pay their way” through college using just their savings or current income.[30] Ninety-six percent used other sources, such as grants, scholarships, and student loans.[31] Of those with student loans, 58 percent had more student loan debt than expected at the time of survey, and 70 percent were less than confident they could repay the debt they’ve acquired during their education.[32] Only 10 percent of students, at the time of the survey, were very confident they could repay their loans.[33] Research shows that student loan debt, especially high levels of debt, is linked to negative emotional and mental health outcomes, including increased rates of stress, anxiety, depression, and suicidal ideation.[34]

To help make ends meet, students are turning to alternative sources of support. Public assistance has historically had many barriers to student access, but 30 percent of students reported using some form of public assistance (food, housing, or medical) in the prior twelve months.[35] Additionally, recent efforts have been undertaken to streamline the enrollment and eligibility process for some public assistance programs, and institutions have announced new initiatives to screen students for eligibility based on financial aid data. These promising practices can help students receive the financial support they are entitled to and that can decrease their burden of indirect costs.

These SFWS statistics offer a broad overview of the financial instability many students face in pursuit of higher education, while Studying on Empty, a qualitative research study by Trellis, brings those numbers to life with vivid, poignant, personal accounts. In this study, Trellis followed students throughout the course of the academic year and explored the manifestations and consequences of basic needs insecurity.[36] For example, researchers interviewed Veronica, a full-time student who struggled to manage her college and living expenses on the inconsistent paycheck from her retail job. Veronica worried about making rent at the off-campus apartment she shared with roommates, and she reported skipping meals to ensure she could pay for housing. The financial stress caused sleep disruptions, which in turn impacted her ability to focus on school. “I would be lying in bed trying to sleep, and I couldn’t because I was stressing out about money,” she told researchers. The study further showed that financial wellness, in particular, basic needs security, is rarely a static state. Rather, individuals experience different levels of financial strain throughout the academic year. One full-time, premed student, Molly, began the study with a high/marginal level of food security and had a restrictive but attainable budget. In month 2 of the study, she left her part-time work-study job to focus on her academics in preparation for the MCAT. Molly was able to access free food by eating at her parents’ house and volunteering at the Veterans Administration, but ultimately a combination of recurring vet expenses and pricy medical school applications left her in a state of very low food security by month 6; at the time of the final interview, she had fifty dollars in her bank account. This mirrors the precarious financial reality for many Americans.

It is important to note that these financial circumstances present differently based on students’ identities and personal circumstances. Students who identify as caregivers may find themselves needing to adjust their academic commitments following the loss of childcare. Similarly, students who primarily identify as workers may prioritize commuting to their site of employment rather than campus when faced with transportation challenges. A learner’s persona as a student, worker, or parent can interact with their financial realities to complicate their academic journey. Moreover, an individual’s experience of financial strain can have negative impacts on their physical and mental health, further complicating the decisions they must make when prioritizing academic, work, and personal responsibilities.[37]

Positive mental health is integral to academic performance and overall student satisfaction. Despite the critical role of mental well-being in persistence, completion, and attainment of credentials of value, today’s college students experience an alarming prevalence of anxiety, depression, suicidality, and related issues.[38] Comprehensive data from the 2023–24 Healthy Minds Study (HMS), which surveyed 104,729 students at 196 colleges and universities, indicates that 47 percent reported symptoms of depression or anxiety, and 50 percent had been diagnosed with a mental health disorder at some point in their lives.[39] The 2023–24 HMS also found that only 38 percent of these students had positive mental health as measured by the Flourishing Scale, an eight-item questionnaire assessing self-perceived success in such domains as relationships, self-esteem, purpose, and optimism.[40]

In addition to facing relatively high rates of mental health concerns, college students frequently struggle to meet other basic needs essential to thrive, such as food, housing, insurance, and childcare. Mental well-being, along with access to targeted supports and services, is often deeply intertwined with students’ capacity to meet their needs, which can significantly influence student success.[41] Mounting concerns related to basic needs insecurity among college students led the Department of Education to include measures on food insecurity and homelessness for the first time in the 2019–20 National Postsecondary Student Aid Study (NPSAS:20).[42] The nationally representative study confirmed that students attending colleges and universities of all types contend with basic needs insecurity, with 23 percent of undergraduates suffering food insecurity and 8 percent reporting homelessness.[43]

Unsurprisingly, experiencing financial difficulties has been a substantial and consistent predictor of poor mental health in college students.[44] Financially stressed students often struggle to maintain high GPAs and may reduce their credit hours per semester. This can lead to longer degree completion times, increased dropout rates, higher debt burdens, and a negative perception of their overall quality of life.[45] Students’ finances can also significantly hinder their access to mental health treatment, especially for those without insurance or access to a primary care provider. The financial burden of managing their overall health, mental health, and other basic needs can force students to make difficult decisions about whether they can afford to continue their education.

To better understand the prevalence and relationship of these factors, the Student Financial Wellness Survey (SFWS) utilizes validated scales to assess the prevalence of food insecurity, major depressive disorder (PHQ-2), and generalized anxiety disorder (GAD-2), in addition to a comprehensive set of questions related to financial security, housing insecurity, and homelessness.[46] Analysis of these data reveals that 32 percent of 2023 SFWS respondents faced symptoms of major depressive disorder (fig. 3.1), and 43 percent exhibited symptoms of generalized anxiety disorder (fig. 3.2).[47]

The compounding nature of mental health concerns, financial stressors, and academic challenges was apparent in the collected SFWS data. For students navigating one or more mental health concerns, 58 percent agreed or strongly agreed that they had difficulty concentrating on their schoolwork due to their finances, compared to 35 percent of respondents without poor mental health indicators.[48] Furthermore, students who were experiencing basic needs insecurity (food insecurity, housing insecurity, or homelessness) were more likely to experience poor mental health, including symptoms of major depressive disorder (42 percent) and generalized anxiety disorder (53 percent). Prior research suggests students facing multiple basic needs insecurities have an increased risk of experiencing poor health outcomes, lower academic performance, and higher levels of stress, anxiety, and depression.[49]

FIGURE 3.1PHQ-2: Self-reported frequency of depression indicators in prior fourteen days

FIGURE 3.2GAD-2: Self-reported frequency of anxiety indicators in prior fourteen days

In the 2023 SFWS, students with symptoms of generalized anxiety disorder and major depressive disorder indicated financial anxieties and difficulties at higher rates on every relevant measure (table 3.1). More than four in five of those with a positive screen in the GAD-2 (82 percent) and PHQ-2 (83 percent) had encountered financial difficulties while in college. Additionally, 30 percent of students likely experiencing major depressive disorder and 28 percent of those reporting anxiety had run out of money eight or more times from January 1, 2023, to the time of the survey (October–November 2023).

TABLE 3.1Select experiences of students with positive GAD-2 and PHQ-2 screens

All students (n = 62,844)

Positive screen—GAD-2 (n = 22,647)

Positive screen—PHQ-2 (n = 17,021)

Financial Security

Experienced financial challenges or difficulties while enrolled

71%

82%

83%

Would have difficulty getting $500 in cash or credit

56%

67%

69%

Worried about having enough money to pay for school

61%

71%

72%

Worried about paying current monthly expenses

53%

66%

68%

Borrowed a payday loan in 2023

5%

6%

6%

Borrowed an auto title loan in 2023

5%

6%

6%

Ran out of money eight or more times

20%

28%

30%

Basic Needs Security

Food insecure

45%

58%

62%

Housing insecure

42%

53%

55%

Homeless

14%

19%

21%

Experiencing one or more forms of basic needs insecurity

58%

71%

74%

BARRIERS TO SUCCESS: CHALLENGES FACED BY VULNERABLE STUDENT COMMUNITIES

While many students experience the intersection of financial insecurity and poor mental health, these difficulties can be especially acute for students from marginalized backgrounds. Their circumstances are often exacerbated by social inequities and factors beyond their control, such as discrimination, structural racism, low family incomes, and other unique stressors. The chronic stress resulting from these adverse social conditions can lead to significant mental health disparities. This includes LGBTQ+ and gender nonconforming students, first-generation students, students of color, former foster youth, and others with marginalized social identities.[50]

TABLE 3.2Select demographics of students with positive GAD-2 and PHQ-2 screens

Two-year students

Four-year students

Positive screen—GAD-2 (n = 27,600)

Positive screen—PHQ-2 (n = 27,640)

Positive screen—GAD-2 (n = 24,885)

Positive screen—PHQ-2 (n = 24,901)

Race/Ethnicity

American Indian or Alaska Native

46%

32%

40%

36%

Asian, Hawaiian, or other Pacific Islander

35%

31%

37%

32%

Black or African American

39%

34%

39%

34%

Hispanic or Latino

43%

35%

45%

35%

International

45%

34%

35%

33%

Two or more races

47%

34%

45%

33%

White

46%

32%

44%

29%

Gender

Female

49%

35%

49%

34%

Male

36%

31%

33%

28%

Age

Traditional age (18–24)

46%

35%

44%

32%

Adult learner (25+)

40%

30%

38%

29%

Special Populations

First-generation

46%

35%

47%

37%

Parent

39%

29%

36%

26%

Working for pay

45%

34%

44%

32%

Former foster youth

51%

40%

57%

46%

LGBTQ+

65%

52%

63%

49%

Overall basic needs insecure

53%

42%

53%

42%

The 2023 SFWS highlights significant disparities among vulnerable student communities, including LGBTQ+ students, former foster youth, and first-generation students (table 3.2). These students experienced elevated rates of poor mental health, basic needs insecurity, and financial insecurity compared to their peers.

Notable differences exist within these populations, underscoring the intersectional nature of these challenges. Of all student groups measured, LGBTQ+ students reported the highest prevalence of anxiety and depression symptoms, with 63–65 percent indicating generalized anxiety disorder and 49–52 percent experiencing major depressive disorder. Conversely, parenting students (with at least one dependent child) were less likely to report mental health concerns than their non-parenting peers but were simultaneously more likely to experience financial and basic needs insecurities. This phenomenon does vary by age; the responses to the GAD-2 and PHQ-2 by “younger” parenting students (under the age of twenty-five) were more in line with the non-parenting population than their parenting peers over the age of twenty-five.[51] Differences in mental health indicators by age were relatively common throughout the 2023 SFWS dataset. Generally, students over the age of twenty-five indicated anxiety and depression at lower rates than their peers aged eighteen to twenty-four yet reported increased financial insecurity, basic needs insecurity, and lower levels of familial support.[52]

SFWS respondents who worked for pay while enrolled, particularly those enrolled at two-year institutions, also encountered elevated rates of anxiety (45 percent) and depression (34 percent) symptoms. Students who work long hours are more likely to experience poor sleep and sleep disturbance, which can exacerbate symptoms of depression, especially among those experiencing financial strain.[53]

A CALL TO ACTION

Conversations on campuses have increasingly focused on student mental health and its critical role in student success. Data from the 2023 SFWS reinforces the urgency of expanding support for students, particularly by addressing the contributing factors to mental health challenges, not just clinical symptoms. The authors offer the following implications for campus practitioners:

1. Use data to drive strategy.

Institutions should regularly collect data to better understand student mental health. This can include expanding information collected at the point of intervention for mental health services to include a better understanding of students’ financial lives and stressors. Additionally, campuses should collect prevalence data at the campus level through initiatives like the SFWS, the National College Health Assessment, and the Healthy Minds Study to better understand the evolving needs of their student populations and the connectivity of various contributing factors. These insights can inform targeted interventions and help campuses prioritize resources where they are most needed.

2. Recognize financial support as mental health support.

Institutional leadership should view efforts to close gaps in unmet financial need, including direct and indirect costs, as a form of proactive mental health support. This requires a shift in mind-set from viewing financial aid as an enrollment management tool to recognizing it as a strategic lever for student success and well-being. Holistic mental health initiatives might include reevaluating financial aid packaging and connecting students with social safety net programs for which they qualify.

3. Honor students’ multiple identities.

Campuses are well served by acknowledging that the student identity is often not a learner’s primary persona; recognizing and supporting learners’ multifaceted identities can play a powerful role in fostering their sense of belonging. Policies, procedures, and practices should be reviewed and, where necessary, reimagined to reflect the complexity of students’ lives beyond the classroom.

4. Address time poverty with intentional design.

Reducing time poverty among students is essential. Institutions can support students by designing course schedules and campus experiences that are more flexible and intentional, helping learners better balance their academic, work, and personal responsibilities.

CONCLUSION

As the cost of college and living continues to rise across the country, finances have become an instrumental part of the student success conversation. Students face daily financial pressure that intersects with their ability to attend class, dedicate appropriate time to learning, and fully engage in the college experience. Individuals are increasingly presenting on campus with additional personas, including caregivers or primary wage earners, that contribute to significant time poverty. As a result, they often prioritize work or caregiving responsibilities over academic commitments, not by choice but out of necessity. These financial pressures and chronic stressors can contribute to the increased mental well-being concerns that we see on campuses across the country. This balancing act between survival and success can lead to elevated levels of stress, anxiety, and depression. As practitioners, we have a responsibility to recognize the unique role that finances play in students’ lives as they manage competing demands and attempt to resource their educational journey. By adopting a holistic approach that considers essential needs like food, housing, and transportation, we can better support students in managing their mental health and achieving their educational goals.

VOICES FROM THE FIELD

Adrian GonzalesVice President for Student Services San Diego Miramar College

Adrian Gonzales has served in a range of leadership roles across the California Community College system since 1998. This includes as both a vice president of student affairs and dean at the College of the Desert, as well as the vice president of student services at Palomar College. He also served as acting president at San Diego Miramar College (SDMC) and interim president at Palomar College. Across these roles, his work has been grounded in a deep respect for students’ diverse journeys and a steadfast commitment to building a campus culture that supports their success both in and out of the classroom. For nearly three decades, this focus has driven his efforts to advance equity and expand access to higher education.

Today, Gonzales is the vice president of student services at SDMC, a two-year institution in San Diego, California, where he oversees the success and well-being of approximately 13,500 students, most of whom attend part-time.[1] His current team includes three licensed mental health professionals who operate under a triage-and-referral model in which students receive short-term counseling (up to five sessions) before being referred to longer-term community-based resources. This approach is supplemented by a campus-wide stress-reduction campaign, peer workshops, and integrated mental health and student health programming across campus.

Gonzales approaches mental health as both a clinical priority and a community responsibility. His efforts center on destigmatizing mental health conversations, supporting the whole student, and fostering a sense of belonging for all. Below, he shares key lessons learned for building a campus culture of care rooted in these three guiding principles.

DESTIGMATIZING MENTAL HEALTH CONVERSATIONS

While the counseling team meets with students who reach out for mental health support, Gonzales knows that many students do not ask for help because of the perceived stigma.[2] To meet this broader need in the community, his office works to normalize the stress of the college experience and offers campus-wide programming with embedded conversations about mental health supports. Through lunchtime social activities and workshops, they make it easy for students who don’t engage with the counseling center directly to be part of these important conversations and to learn about the supports available to them. Hosting fun events with free food, live music, and animals draws students to these gatherings where the staff can build connections with the students and share resources that are available on campus.

These activities are also strategically timed to coincide with periods of high stress during the academic year when Gonzales knows students may be feeling especially isolated and overwhelmed. For example, social gatherings during finals combine free food and a relaxed atmosphere with information about stress-reduction techniques. These interactions both offer immediate help to students by way of advice and guidance during high stress moments and help to broaden access to formal supports that are available on campus by increasing awareness and encouraging future outreach. Removing the stigma around the struggle that students experience and making resources readily available, Gonzales and his team can demystify and normalize the process of seeking help more broadly and ensure that students do not feel alone in their struggles.

SUPPORTING THE WHOLE STUDENT

The student affairs team at SDMC focuses on ensuring that students’ basic needs are met, understanding that this kind of help can make the difference in students being able to complete their college courses and in their overall state of well-being in the process.[3] Their Jet Fuel Resource Center initiatives include services that are free to students, including a professional clothing closet, emergency housing partnerships with local hotels, and a free farmers market.[4] The Jet Fuel Food Pantry is a vibrant space that offers fresh food, shelf stable items, snacks, and frozen products to take home.[5] There is also a Pantry Pickup Program for students to order and access food, hygiene kits, period supplies, baby care products, and household items that can be picked up at any time, including after hours for students on campus in the evenings, further expanding their ability to support all students on campus.[6]

Gonzales and his colleagues have worked hard to centralize these resources on campus to help normalize and destigmatize help-seeking behaviors. These offerings used to be more limited, relegated to small closets, and in out-of-the-way locations on campus, so advocating for central locations on campus further reduces perceptions of stigma around basic needs support. Meeting student need is both about the tangible delivery of goods and services and empowering them to know that they can ask for help without shame.

Using Physical Space to Foster Community and Belonging

Since students are only on campus part-time, creating physical spaces for gathering and community building is also key to creating a caring campus at SDMC. This both helps to encourage a sense of belonging for students and builds connections to the available supports in the community. Gonzales emphasizes that dignity, accessibility, and community connection must be centered in service delivery, even when the space or budget isn’t ideal.

Gonzales’s office created a central hub, the Kaleidoscope, bringing together the LEAD (Leading Equity, Anti-Racism, and Diversity) Center, the Pride Center for LGBTQ+ students, and giving dedicated spaces to both a Latinx and Native American Resource/Success Center, the Black/African American & AANHPI Resource/Success Center, and a mindfulness room. They recently opened an expansive new Veteran’s Resource Center (VRC) to serve the more than 2,500 veterans, active-duty military, and their dependents on campus with admissions support, peer mentoring, access to VA benefits, and their first full-time counselor dedicated to supporting veterans.[7] A student wellness center is slated for a full renovation through newly approved funding as well.

CHAPTER 4
Mental Health for Community College Students

AMANDA O. LATZ

Ball State University

Community college students constitute almost 40 percent of all college students in the United States.[1] This is a significant proportion of the student population, and, therefore, community college students are an important subgroup upon which to apply theory to practice in support of college students’ mental health. While the research on this subgroup continues to grow and gain traction, much more is currently known about student mental health within traditional four-year colleges and universities. Even though the research focused on community college student mental health is still developing, we know, for example, that a larger proportion of community college students aged eighteen to twenty-two manage mental health concerns than collegians at four-year institutions.[2] Furthermore, those concerns are typically more severe.[3] In fact, approximately half or more of community college students are experiencing some kind of mental health concern or illness.[4] The most common of these include anxiety and depression.[5] We also know that community college students face more barriers to resources and care than students at four-year colleges and universities and that they are less likely to seek out and access services related to mental health.[6] Moreover, the COVID-19 pandemic further exacerbated these issues.[7] While this information may paint a bleak picture, community college students are frequently seen as resilient by their faculty, and institutional leaders are paying more attention than ever to community college student mental health.[8]

Although causality is hard to determine, there is a relationship between mental health concerns and college student success outcomes.[9] That said, among community college leaders, addressing student mental health is no longer a maybe; it is an imperative. More and more community colleges are putting thought and resources into prevention, intervention, and treatment options for students. Thinking along the wide spectrum between mental well-being and illness is necessary for a comprehensive institutional approach to the issue. Prevention includes a focus on maintaining student wellness and thriving in terms of mental health. Intervention includes action steps meant to support a student with a mental health challenge in getting access to the help and resources they need, such as an initial counseling appointment, health insurance options, and connections to broader community services. Finally, treatment options include ongoing access to a campus counseling center, community-based mental health services provider, and/or mental health apps with robust service menus.

Within this chapter, a brief overview of the community college sector will be provided. I explain why supporting community college student mental health is important by focusing on student persistence and institutional retention. Penultimately, I translate research and theory into practice for four audiences: leaders and administrators, staff, faculty, and students. Finally, I encourage readers to engage in dreaming about equitable community college futures in which students are able to engage the learning process and the community college experience with full and relevant support and without the presence of insurmountable barriers.

UNDERSTANDING THE COMMUNITY COLLEGE CONTEXT

The community college is a unique sector of US higher education. While robust in size and scope, the community college is a relatively new postsecondary education innovation, with the nation’s first community college, Joliet Junior College in Illinois, opening in 1901. At present, there are 1,026 community colleges in the United States serving, in total, approximately 10.2 million students.[10] While their structures vary widely, there are community colleges in all fifty states. These institutions offer students myriad educational opportunities, including transfer education, career education, developmental education, and community education, and this is not an exhaustive list.

Because these institutions are accessible in terms of location, price, and open-admissions policies, community college students represent the most diverse array of learners in United States higher education.[11] Put another way, community colleges support “the most diverse classroom[s] of students ever to sit side by side in American higher education.”[12] In terms of price, during the 2023–24 academic year, the average annual tuition and fees for public, in-district community colleges was $3,990 as compared to $11,260 for in-state, public four-year institutions.[13] In addition, 66 percent of community college students attend part-time, 58 percent are women, 32 percent are first-generation college students, 13 percent are single parents, and 23 percent are students with disabilities.[14] In terms of race, 43 percent of students enrolled in credit-bearing courses are white, 28 percent are Hispanic, 12 percent are Black, 6 percent are Asian / Pacific Islander, and 1 percent are Native American.[15]

As noted above, in recent years community college student mental health has become a top issue among leaders. Most of the extant research on college student mental health is focused on students enrolled at four-year institutions. Most research shows, however, that a larger proportion of community college students face mental health concerns than their counterparts at four-year institutions. To compound this, the concerns are more severe among community college students, and these students have fewer institutional resources on which to rely and more barriers to resources and treatment to overcome. The situation is tenuous and complex. As community college student mental health awareness grows, however, many institutions are using the growing body of research on this topic to inform and shape institutional actions in support of student wellness and success. At the same time, recent research shows those efforts are largely surface level.[16]

THE IMPORTANCE OF SUPPORTING COMMUNITY COLLEGE STUDENT MENTAL HEALTH

While supporting community college student mental health is important in and of itself, there are other reasons why this work is being framed as more and more important within the community college sector. Student attrition is one such major reason. Severe and unaddressed or untreated mental health issues can make going to and being successful in college untenable. Yet community college student persistence and institutional retention are critical for several reasons. If students leave the institution, they lose access to all the community college has to offer. Persisting to completion has at least four significant student benefits, categorized here into four areas: learning, relationships, resources, and access. Holistic support of students’ ongoing access to these benefits through effective and scaffolded mental health support is worth the time, effort, and money.

Generally, community college students graduate at lower rates than their counterparts at four-year institutions. For example, the National Center for Educational Statistics Trend Generator indicated that among the 2017 student cohort, 61 percent of students at four-year institutions graduated within 150 percent of normal time, or six years. By contrast and among the 2020 cohort of students at two-year institutions, only 39.4 percent of students graduated within 150 percent of normal time, or three years.[17] To be sure, these measures are imperfect and contestable.[18] Yet they signal a long-standing area of improvement for community colleges under neoliberal forces impacting higher education within the United States, such as performance-based funding.[19] In fact, “few community colleges have escaped pressure to improve graduation rates, especially among marginalized populations.”[20] And, therefore, student persistence and institutional retention require attention from college personnel, boards, and policy makers. College is challenging, and mental health struggles make staying in college and performing well while there more challenging. Conversations about supporting student persistence and institutional retention must address student mental health. More and more, those conversations must also address the mental health of college personnel who do the work of supporting students.

Learning

In terms of learning, attending a community college gives students the opportunity to understand concepts, build skills, and have new and novel experiences. For example, students taking an introductory anthropology course will learn about enculturation, symbolism, kinship networks, and rituals. Understanding these concepts can help students interpret the world around them and make new meaning of their experiences. Furthermore, students in a welding program will take a series of courses focused on learning different types of welding techniques, such as shielded metal arc welding or stick welding, gas metal arc welding, and gas tungsten arc welding. Building these skills is valuable as students seek employment and career advancement opportunities. Lastly, community college students learn through having new and novel experiences connected to their coursework. For example, students may engage in study abroad, service learning, internships, and clinical experiences. These new and novel activities provide students with a wealth of growth and development opportunities.

Relationships

Community college students are afforded the opportunity to build meaningful relationships through enrollment. The student-faculty relationship is important, as it is related to student success outcomes.[21] Through in- and out-of-classroom, broadly defined, interactions with faculty, student learning is ripe for deepening. Furthermore, faculty play a key role in referring students to other faculty, campus personnel, and even potential employers. Students also have the chance to build relationships with campus staff, such as academic advisors, career educators, librarians, tutors, and student success coaches. These relationships, too, provide access and connection to information, resources, and other people. Student-to-student relationships within the community college can also be important and valuable.[22] Relationships with other students can help validate feelings and experiences, be a source of valuable information, and provide encouragement and accountability. While many community college students have busy lives outside their student role, academic camaraderie and peer support through study groups and student organizations, for example, are nonetheless valuable. Finally, through opportunities such as internships, clinical experiences, field trips, and career fairs, students have the chance to build relationships with potential employers. These relationships are key to future career opportunities and advancement. They are also paramount for upward social mobility.

Resources

Community college students also have access to all manner of analog and digital resources, including learning contexts, materials, and people; student services; campus affordances and entities; and experiential learning. Learning contexts include learning management systems (LMSs), physical classrooms replete with learning technologies, and laboratories, which can include high-powered microscopes, field-specific software, medical simulators, advanced manufacturing equipment, greenhouses and campus gardens, and restaurant-quality kitchen equipment. Students also have access to various learning materials curated by faculty and other curriculum specialists. These materials include books, articles, film, software programs, digital and sonic assets, models, and prototypes. Finally, students have access to people who provide information, teach concepts, mentor and advise, and offer feedback, such as faculty, student success coaches, and tutors.

A vast array of student services is available to community college students. Campus units housing these entities may include academic advising, disability services, housing and residence life, recreation services, athletics, veteran services, financial aid, counseling centers, cultural centers, career centers, international student services, collegiate recovery, community resource hubs, and health centers. Access to these vital services is critical for student success. For example, campus health centers may provide vaccines at no charge. Disability services may connect students with physical disabilities with note takers, screen-reading software, or course materials in braille. Athletics may provide students and their families access to exciting sporting events at no charge. Career services may provide students with internship information, resume reviews, and access to a clothing closet to prepare for job interviews. Yet if students stop or drop out, they lose access to all these key resources.

Community colleges also offer a variety of affordances and other entities to their students. These include physical library spaces as well as electronic databases, e-book rentals, and other services provided by the library. Physical library spaces can include quiet study areas, group study rooms, computer labs, and physical books and other items, such as electronics available for loan. Libraries often hold vast online journal and magazine subscriptions and access to the catalogs of other libraries, which facilitates interlibrary loan options. Campuses also typically offer Wi-Fi to students—and sometimes campus visitors—at no charge. Quiet study spaces with electrical outlets and cords, student lounges, on-campus childcare centers, food pantries, and campus cafeterias also are key resources from which enrolled students benefit.

Being a community college student provides opportunities for experiential learning. Examples include field trips, study abroad, service learning, clinical experiences, practicums, and internships. Field-based learning is much different than learning inside a classroom, laboratory, or online course. For example, learning anatomy and physiology through reading the course text and making flash cards is one approach. However, visiting a human cadaver laboratory while on a course field trip and interacting with the cadavers under the guidance of the course instructor can bring greater understanding dimension and texture to the learning process. Similarly, visiting preschools and engaging very young children in learning activities as part of a practicum is very different from reading about how to do so. In one final example, working as an information technology (IT) intern for an insurance company during the summer can be an incredibly meaningful learning experience, helping students understand what IT specialists do and whether that career path is one they want to pursue.

Access

College credentials of all kinds (diplomas, certificates, degrees) open doors to gainful employment and social mobility for community college students and their families. Sometimes students leave college, having learned enough to become marketable in the job search or to advance in their current career. This is a good outcome for the student, and, conceivably, the money and time involved have not been wasted. When a student departs before earning a credential and has no viable gainful employment prospects, however, this is not always a good outcome for the student. Again, the credentials students earn at the community college—alongside all the learning that happened on the journey—can give students access to all sorts of opportunities related to careers, career advancement, ongoing postsecondary education, and social mobility.

Persistence and Retention

It is important to emphasize here that students persist, and institutions retain. Retaining students toward eventual completion is also important to institutions’ financial health. Healthy enrollments support the institution’s functionality, and, often, rates of retention and credential completions are factored into performance-based funding metrics. There is evidence to suggest that supporting students’ mental health is good institutional financial practice, as students with mental health concerns are twice as likely to leave college without graduating as students without such concerns.[23] Simply put, supporting community college student mental health is good for students, and it is good for business. These investments can yield higher rates of retention, which positively affect the institution’s bottom line.

Supporting community college students’ mental health is supporting students’ ability to achieve student success. And one of the most important student success outcomes is completing the credential the student intended to complete. This is important to the student’s bottom line; harboring student loans without a credential is a precarious financial situation. Student persistence to completion can be impeded by mental health issues, and while important strides have been made, it is incumbent upon community colleges to give even more targeted and intense time, resources, and effort into supporting community college student mental health.[24] Persistence and retention are different sides of the same coin. Institutional retention efforts support students’ ability to persist.

VIGNETTE: BLAIN’S STORY

While the information above may seem self-evident or obvious, breaking down the importance of supporting community college student mental health into its foundational components is valuable. It lays the foundation for starting action and subsequent inertia around this topic. Advocates for college student mental health support cannot take for granted that others understand the depth, complexity, and gravity of the issue. These foundational components enhance understanding. In what follows in this section, I provide a vignette with the aim of bringing to life connections between community college student mental health and the components elucidated above.

The vignette below paints a picture of a fictional community college student, Blain, who struggles with anxiety and occasional bouts of depression. I present this fictional character to illustrate how mental health struggles can impede students from pursuing learning, building relationships, leveraging resources, and gaining access to increased agency and social mobility by persisting through college to eventual completion, which I outlined above. While this student is fictional, Blain’s experiences are not unique or isolated. They represent pieces of the students who are enrolled at community colleges across the country right now. Let us meet Blain.

Although they were academically successful in high school, Blain never went to college or earned any college credit. Instead, after high school they moved in and out of low-wage jobs quickly, as their family caretaking responsibilities—looking after their niece, nephew, and grandfather—often clashed with a regular work schedule. They are a quick learner and have been good at every job they have ever had, from food service to retail to manufacturing. Being on time, and sometimes not showing up to work at all, was the problem. But sick children and health emergencies led to truancy and missed shifts. Staying employed was hard.

Once their grandfather passed, they were sad and experienced grief but also felt a deep sense of relief. His verbal abuse escalated over time as he became sicker. Shortly after his death, Blain’s niece entered kindergarten, and their nephew became eligible for an early childhood education program during the day. Suddenly, Blain had more time on their hands. So they decided it was time to go to college—or at least try. Blain applied to the local community college. Not only were they accepted but they ended up realizing they could attend very affordably after receiving a grant and qualifying for several scholarships. Soon it was time to start the upcoming term.

Blain completed an online orientation program, which included some mandatory modules and a Zoom meeting with an academic advisor, all of which they completed on the smartphone. One of the modules included a virtual campus tour and encouraged students to review the various clubs and organizations available, which were listed on the student life website. The support group for students with caretaking responsibilities caught their eye. While Blain was unsure about a major, upon reviewing the academic programs available, which included data about the starting salaries in each of the areas, Blain became interested in learning more about the physical therapy assistant (PTA) program. Upon meeting with their academic advisor, Blain learned the PTA program is competitive. It seemed easy to get accepted to community college, but this program was another story altogether. Blain resolved to try, which meant taking a series of prerequisite courses and doing very well in those courses, before applying to the program.

At the start of the term, Blain was so riddled with anxiety; they could not stop shaking upon pulling into their local community college’s parking lot for their first-ever college class. While they wanted to go to college and have the academic ability to learn the material, the fear they experienced in that moment was almost paralyzing. They felt waves of painful heat rush through their chest and radiate out through their arms. Their field of vision changed shape slightly. Breathe. They parked their car and sat staring straight ahead at the building where their classroom resided. What if I am not dressed right? What if I get called on to answer a question? What if I am the oldest person in the room? What if I cannot keep up? What if I look stupid? They remembered to breathe. Somehow, they made their way into the building and their classroom. They found a seat and eyed the instructor, who seemed distant and cold. Class began. The syllabus was reviewed. The language was blunt and terse. Reading it gave Blain the sense they had done something wrong already. But the only thing Blain could really focus on was the in-class presentation the instructor said each student would have to give at the end of the term. The terror bubbled back up. I cannot do this. Blain repeated that statement to themselves a hundred times over. Why would the students be the ones giving a presentation, especially in an introductory psychology class? I know nothing about this stuff!

Once the class was finally over, Blain got back into their car, drove home, and decided not to go back. The next day, however, they received an email from their instructor, who planned to offer some in-class workshops and office hours to help students prepare and practice for their presentations. All that stuff about the brain did seem sort of interesting. Well, maybe I will go back. They then continued reading their email and saw a message about that support group for students with caretaking responsibilities. A callout meeting was happening in two days. Maybe I should go back. They also saw an email from their advisor regarding an information session on the PTA program, being given by the program coordinator. Some program alumni would be there, too. Blain felt a glimmer of excitement break through the anxiety. Okay, I will go back. I will go back one more time.

Vignette Debrief

Through this vignette, we see Blain’s community college journey begin to unfold. Their full and complex life changed significantly with their grandfather’s death and niece and nephew starting school. Having had a series of low-wage jobs, Blain has built some tangible skills and workplace confidence but is not fulfilled. They know they can do more and want to make a difference in the world somehow. With more unscheduled time, Blain decides to pursue college rather than work more hours. Community college seems the way to go. Blain has never talked with anyone about their mental health concerns. They have never received any kind of formal diagnosis. Yet they struggle with what they know is anxiety and occasional periods of depression. Through the vignette, we see their experiences of anxiety manifest. Yet community college is a pathway for changing their life—and their family’s life—but Blain knows this pathway will be especially challenging considering the obstacles they face each day.

If Blain persists, is accepted into the PTA program, and completes it, they will encounter and experience tremendous learning opportunities, new relationships, valuable resources, and access to new life options. Yet their mental health struggles can create friction and blockages difficult to overcome. And a community college not prepared to support Blain could make the friction and obstacles metastasize. For example, synthesizing information and presenting it through aural and visual modes is an important skill, which can be learned within college courses. Blain’s anxiety around giving an in-class presentation may prevent them from persisting in the course. This was evident in their initial reaction to the opening class session. How might the instructor build in flexibility into this assignment? Students might be offered the chance to create a video instead. There are many ways to assess learning. Furthermore, the cold tone of the course syllabus gave Blain pause, yet the instructor’s warm follow-up email overrode their initial pause.[25] A warmer syllabus tone could have made a difference. In terms of new relationships, the support group could give Blain the chance to build community with others in their situation. That such a group even existed helped Blain realize other students might be experiencing similar situations, feelings, and circumstances; this was a comfort, a sense of being understood and welcomed. In addition, the information session featuring program alumni indicated initial college-based connections could last beyond college. This, too, was a positive signal to Blain.

Finally, upon researching the PTA field through the college’s website, Blain realized a starting salary for such a position was around $55,000 to $62,000 in their area. That income would change their life in demonstrative ways. The academic work alone was not the obstacle, not at all. Blain knew how to study and learn. But would their instructor really work with them to grow confident in front of the class? Would their instructor scoff at their anxiety or be understanding and suggest some ways to manage it? Would the support group provide a space for Blain to belong, become part of a community, and learn strategies to better manage their caregiving responsibilities? Could Blain see themselves in the PTA alumni at the information session? Did those professionals who made it ever deal with anxiety or depression?

Through this vignette and subsequent debrief, we see the interplay between community college student mental health and learning, relationships, resources, and access. Community colleges must intentionally build student support structures, ease friction points, and remove blockages such that more students, particularly those who struggle with mental health, can experience learning, relationships, resources, and access. These retention efforts will improve students’ ability to persist. In what follows, I provide targeted suggestions to specific community college audiences.

BRIDGING THEORY AND PRACTICE: LEADERS AND ADMINISTRATORS

Building Contextual Competency

Among other skills and knowledge sets, and as argued by Pamela L. Eddy and Kim E. VanDerLinden, community college leaders ought to cultivate contextual competency.[26] While other competency-based frameworks for community college personnel exist, understanding the various contexts in which community colleges exist and operate is crucial among leaders.[27] According to Eddy and VanDerLinden, “the essence of contextual competency is the recognition of the interrelated aspects of the community college by attending to people, places (or spaces on campus), events (both internal and external to the college), and the many systems embedded in and pressing upon the community college.”[28] When translating this into supporting student mental health, taking an ecological perspective can be helpful. For example, it is important for leaders to understand the local, state, national, and global contexts in which they are leading their institution in relation to student mental health; each context matters.

Considering these contexts individually, the local context includes current students and their mental health and wellness, all mental health resources available at the college and local community, and the institutional and local culture around student mental health. The state context includes the policy and legal landscape, shared resources among institutions, and the state legislature, especially regarding funding allocations. Recent examples related to state legal landscapes include anti-DEI (diversity, equity, and inclusion) legislation and limited or banned access to gender-affirming health care, which can have bearing on student mental health.[29] Nationally, leaders must be aware of general mental health trends as well as trends among the national community college student population. On a global level, the climate crisis can impact students in myriad ways, such as inducing eco-anxiety, which is characterized by distress and worry related to climate change and environmental degradation.[30] Understanding the contexts in which community college leaders and administrators lead is step one in building a foundation of student mental health support.

Catalyzing a Shared Vision

Community college leaders and administrators must catalyze and provide a vision for supporting students’ mental health as a total campus effort. One way to do this effectively is to create and mobilize a strategic plan focused on this work. Upon studying eight community colleges that were providing multiple layers of student mental health support—prevention, early intervention, and treatment—Lisa Sontag-Padilla and colleagues found that despite these comprehensive efforts, a guiding framework was lacking.[31] Without a guiding framework, campus initiatives may be redundant, conflict with one another, and convey mixed messages generating confusion. Some institutions have built plans related to student mental health into their overall institutional strategic plan, while others have built stand-alone plans. Both can work. The key is cultivating a shared vision across the campus community.

Collecting Data

Community college leaders and administrators must have a nuanced understanding of their campus’s student body. While national-level data and trends are important to be aware of, the most important students are those with whom campus personnel are actively working during any given term. Furthermore, keeping tabs on the most recent research on community college students is also important, but studies were conducted with a student sample that may or may not be like the student body with whom campus personnel are interacting. Again, it is helpful and important to understand the community college student research globally. However, the most important information necessary for informing campus-level practice is local-level student data.

As I have written about in the book Community College Student Mental Health: Faculty Experiences and Institutional Actions, there are at least three ways to collect community college student mental health data.[32] These include (1) working with a national organization, or entity, dedicated to this type of assessment; (2) working with (local) university-based researchers; and (3) working with internal institutional researchers. Mental health screening tools are imperative to understand what kinds of mental health concerns students might be experiencing. Example screeners include the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Screener (GAD-7).[33]

It should be noted that mental health screeners are not diagnostic tools. Although many disability services offices may require a formal diagnosis from a trained professional before providing any sort of mental health–based accommodation, community college students can face many barriers to accessing a diagnosis connected to mental illness. These barriers can be financial constraints, limited transportation, limited time, or negative stigmas surrounding help-seeking. There also may be cultural barriers. For example, in some cultures, mental health concerns are to be kept within and dealt with by the family or faith community. If a student does not have a diagnosis for whatever reason, that does not mean they are not struggling with their mental health. Anyone can experience periods of poor mental health—even in the absence of a professional diagnosis.

In addition to collecting student mental health data, those data should be connected to other student data such that disaggregation is possible. While having a total picture of the student body’s mental health is important, the ability to sort the mental data based on one or more variables is critical. Disaggregating the data honors the reality that the student body is not a monolithic group. Upon disaggregating the data based on major/field, race and/or ethnicity, gender, and sexuality, for example, can show patterns and reveal new insights important for effective practice. Studies have shown that, for example, women community college students were more likely to list a mental health issue than men, veteran community college students were more likely to screen positive for depression and post-traumatic stress disorder (PTSD) than civilians, and many Asian community college students come from cultural backgrounds where mental illness is extremely negatively stigmatized, which hinders help-seeking.[34]

Raising Funds

With campus-level data in hand, it becomes easier to cultivate the funding necessary to support students’ mental health. Having data is one thing; using data is quite another. Compelling and digestible numeric data in the form of an infographic (i.e., information graphic) can be one component of the information necessary to share on this topic with those entrusted with making funding allocations to the college, such as state legislators. In addition, the data must be transformed into gripping narratives that go beyond infographics to compel audiences. Complementing student screeners with qualitative approaches to gathering information on this topic can be useful to this end. For example, individual interviews with faculty, staff, and students can produce important insights and key data critical to making the numbers come to life.

It is incumbent upon community college campus leaders to identify or cultivate sources of funding for student mental health support. Ideally, all community college campuses would be home to on-campus and fully staffed counseling centers, complete with robust and expansive services easily accessible to all students. Yet that is not a reality for most campuses. Further, many students may find it inconvenient, embarrassing, or culturally inappropriate to access a campus counseling center. For some, as mentioned above, speaking with a non-family member about personal concerns is not culturally permissible.

Investing in Students Where They Are

There is evidence to suggest mental health apps are a critical mental health intervention on many college campuses—including community college campuses.[35] Mental health apps are a relevant way to connect students with mental health resources, such as therapy, support groups, educational material, and a variety of exercises, such as deep breathing, journaling, and meditation. Plus, there is no need for students to arrange transportation, time off work, or childcare for them to access an app. For example, Holmes Community College, in Mississippi, has offered students free access to Mindyra’s MindHealth Navigator.[36] This app is a way to support students and collect deidentified data from student users. Most students have smartphones, and these apps can be used discreetly. These apps may also have functionality that on-campus counseling centers simply do not have. One example may include connecting students with therapists who specialize, for example, in working with veterans, women, and queer and/or trans students.

Supporting Faculty and Staff

Supporting community college student mental health is a whole-campus effort. Faculty and staff must be trained and supported in thoughtful and systematic ways. For example, data must be interpreted and shared so faculty and staff better understand their students. Data should be disaggregated to the extent possible. Getting curious and asking questions of the data are generative acts that can help faculty and staff provide appropriate support to various student groups. Some example questions to ask of the data include:

- What is the relationship, if any, between mental health and Pell eligibility?

- What is the relationship, if any, between mental health and gender?

- What is the relationship, if any, between mental health and developmental course enrollment?

- What is the relationship, if any, between mental health and academic program?

If students in allied health program areas, for example, screen high for anxiety symptomatology, that is an indicator of a need for specific kinds of interventions, actions, and resource sharing. Because the community college student population is so diverse—even at the individual campus level—the more detailed the information available, the better. Broad actions to support student mental health, such as passive information like a poster campaign or a universal syllabus statement, are a starting point. Yet targeted and specific actions based on disaggregated data have the potential for more significant positive change. The more faculty and staff know about the specific student populations with whom they are working, the better.

In addition, personnel must be trained on noticing the signs of mental health concerns among students; what to do in the presence of a student in some kind of distress or active crisis; how to use campus protocols, policies, and systems designed to support students; and how to care for themselves in the context of rising student mental health concerns. Leaders must realize that supporting students can take a mental and emotional toll on faculty and staff. Faculty and staff may experience their own mental health concerns, not to mention secondary trauma, compassion fatigue, and general feelings of overwhelm. Leaders can support personnel by making caseloads and course enrollment numbers manageable, making tacit emotional labor visible and valid, offering professional development and training, and ensuring access to a plethora of resources.

BRIDGING THEORY AND PRACTICE: STAFF

Community college staff members, such as those working in admissions, financial aid, disability services, library services, and so on, should be provided with opportunities to meaningfully engage with student data related to mental health. Building educational programming, cultivating resources, and delivering services informed by those data are key. For example, career educators will certainly provide students with career-related assessments, résumé reviews, and mock interviewing opportunities, and they may also want to provide students with information about managing the stressors and anxiety of an interview or navigating a career fair.

Staff should also be versed in all mental health–related on-campus resources available to students, such as the counseling center on-campus social workers. Internal policies, practices, and procedures related to student mental health should be a part of onboarding and ongoing professional development for staff. There are many ways to train staff on student mental health.

One place to start is the REDFLAGS model:

Recurrent class absences that are sudden or uncharacteristic of the student

Extreme and unusual emotional reactions

Difficulty concentrating

Frequent display of anxiety or worry about course assignments

Late or incomplete assignments turned in abruptly and with increasing frequency

Apathy toward personal appearance and hygiene

Gut feeling that something does not feel right

Sudden deterioration in quality of work or content of work becomes negative or dark[37]

This model helps campus personnel identify a student who may be struggling with their mental health. Mental Health First Aid (MHFA) is another option for more in-depth training.[38] Certified instructors trained in MHFA take an in-depth and evidence-based approach to helping people understand mental health and substance use challenges. MHFA courses can be taken in person, partially online, or completely online; the associated fee varies. Another valuable and free resource is the Be There Certificate.[39] This self-paced online training experience, full of engaging videos and useful content, is completed online in less than two hours. Lastly, Question. Persuade. Refer. (QPR) is another useful training meant for suicide prevention.[40] QPR is like MHFA in terms of delivery and associated costs but with a direct focus on suicide.

BRIDGING THEORY AND PRACTICE: FACULTY

I have written elsewhere extensively on the topic of community college faculty and student mental health.[41] For example, I have written at length about community college faculty deployment of trauma-informed pedagogies and use of counseling micro-skills.[42] Yet here I will emphasize a few key points. As is now likely a redundant yet critical point, faculty must be students of students to serve them best. Computer science faculty do not teach computer science; they teach students about computer science. That is a key distinction, which often requires a mind-set shift among faculty. Imagine what could be possible if faculty knew their students as well as they knew their field of expertise. Further, imagine what could be possible if faculty knew as much about teaching and learning as they knew about their field of expertise.

Helping faculty support community college student mental health requires faculty to reflect on their role as teachers, educators, or pedagogues and interrogate their beliefs and assumptions about what being a teacher/educator/pedagogue means to them. For example, all college teachers—whether espoused or not—operate from a belief system about teaching and learning. Do faculty think of themselves as the keepers of knowledge, which they then must transmit to students? Or do they see themselves as facilitators of knowledge or information, in which they must create the conditions for students to learn, both individually (e.g., completing course readings and making notes outside class) and socially (e.g., discussing course concepts with classmates in small groups during class)? It is much easier for faculty who see themselves as learning facilitators, rather than information transmitters, to understand the importance of supporting student mental health because they see themselves as having a hand in creating learning conditions and contexts. One important part of creating a context optimal for student learning is the creation of a course syllabus that sets a specific tone for a course.

Learning new things and engaging with academic challenges can be inherently stressful. Yet faculty need not exacerbate the stressors that come with learning. New things students are learning should be appropriately scaffolded, so students are learning bit by bit. Furthermore, when academic challenges are posed to students, concomitant levels of academic support should be available. Under these sorts of conditions, students develop and learn best.

The design, content, and tone of a syllabus matters. While many community colleges and academic units may have required syllabus formats or content, customization can go a long way in intentionally crafting a learning context. Consider, for example, the difference between a warm and a cold syllabus. Cold syllabus language is stern, inflexible, and punitive, while warm syllabus language is compassionate, flexible, and inspiring. An example of a cold syllabus’s attendance policy might read as follows: Students may miss one class session without penalty. For every absence thereafter, students’ grades will be reduced by half a letter grade. An example of a warm syllabus’s attendance policy might read as follows:

Your presence in class is important. It is important for your learning and for us as a class as we work together as a community of learners. If you must miss class for any reason, please reach out to me in advance if possible. Connect with a classmate to check in about what you may have missed. If you miss more than two class sessions, I will reach out to you to schedule a meeting to discuss your situation and offer some potential pathways to get you back on track.

The first example is curt and harsh. It is two sentences in length and written in third person. Students may be so intimidated by the potential consequences of missing more than one class that they drop the course altogether. On the other hand, the warm syllabus example is explanatory and warm. It is written in second person and contains four sentences. The subtext is an expression of understanding and support on the behalf of the instructor. The instructor seems willing to listen to and help students be successful in the course. In fact, one study showed that a warm syllabus coupled with institutional information about mental health may increase help-seeking among students.[43]

It is one thing to draft a warm syllabus. It is quite another to embody that same warmth as a pedagogue. To best support community college students’ mental health, faculty ought to reflect on who they are as teachers as well as their orientation to their students. Being a student of students, understanding available student data, engaging in such professional development as becoming certified in Mental Health First Aid, deploying trauma-informed pedagogies, using counseling micro-skills, and crafting a warm learning environment—beginning with the course syllabus—can go a long way in terms of student mental health.

BRIDGING THEORY AND PRACTICE: COMMUNITY COLLEGE STUDENTS

Many community college students may not realize that community colleges offer more than just classes. Early on, it is important to encourage students to take advantage of all the college has to offer. Knowledge is power. During orientation—with reinforcing messaging throughout the student’s coursework—it may be helpful to break down tuition and fee structures, showing how students are paying, at least in part, for all the resources available at the college. On the one hand, explaining to students that accessing these resources can help them get their money’s worth is emblematic of framing students as consumers. It may be compelling enough of an argument to spur on resource use, however. On the other hand, explaining to students that accessing these resources can help them grow and develop holistically is emblematic of framing students as human beings. This may also be a compelling argument.

Students can be encouraged to be students of the resources available at their institution. For example, the curriculum for most first-year seminar courses includes content focused on campus resources. In courses like these, students literally are students of the resources available at their institution. Yet the encouragement should not stop there. Mandatory syllabus statements linking students to resources and active social media, email, and text messaging campaigns can be helpful in building a culture of resource use among students. Furthermore, embedding campus resources into course curricula and pedagogy can be efficacious.

Students may also benefit from learning about coping skills related to various mental health concerns. Some methods of coping are more effective than others. The literature generally bifurcates coping into adaptive and maladaptive. Often maladaptive coping exacerbates the issue it is meant to address. There may be temporary relief or distraction, but it does not last. Alcohol use and abuse is one example of a maladaptive coping strategy. Some students may not know about the mental health benefits of simple breathing exercises, light and brief physical activity, or managing exposure to social media. Information about healthy coping skills can be shared with students in many ways—both actively through coursework and events and passively through posters, LMS modules, and text messages.

Through intentional, meaningful, and helpful interactions with personnel across campus, students should have the sense they belong and are welcome. Community colleges are resource-rich environments that pride themselves on catalyzing significant life changes among students. Students should be assured they are part of the campus community—one that is focused on their success at every step.

A CALL TO ACTION: DREAMING ABOUT EQUITABLE COMMUNITY COLLEGE FUTURES

In the above sections, I have delineated ways to bridge theory and practice in service of student mental health for a variety of audiences connected to the community college. How can community colleges get this process underway? Dreaming about ideal futures can be a generative way to plan for—or reverse engineer—how to get to one or more of those ideal futures. Supporting community college student mental health is an equity issue, which collecting, examining, and disaggregating data can help illuminate. Students managing mental health concerns need to be understood and supported by the community college environment in which they are attempting to learn. Just as support must be provided, barriers to learning must be taken away.

What does a community college that understands and supports students’ mental health look like? A prompt like this is a starting point that could generate many insights and ideas valuable to the strategic planning process. Consider what actionable steps can be taken today, this month, and this year to break this arduous work into manageable bits. Dreaming helps us imagine what does not yet exist; engaging the imagination is key for progress and innovation. Community college leaders need not dream alone. Intentionally and thoughtfully bringing key members of the campus community together to dream about supporting student mental health in equitable and efficacious ways is critical to making this issue central moving forward. In closing, I want to note that, while this chapter is specifically focused on the community college sector, many of the ideas presented here will have relevance to a variety of institution types within higher education.

VOICES FROM THE FIELD

Julie LeeClinical Psychologist and Co-President of Harvard Alumni for Mental Health

Dr. Julie Lee has been focused on supporting college students and their well-being since 2007. A psychologist who specializes in Gen Z mental health, her tenure has included roles as a staff psychologist at the Bureau of Study Counsel at Harvard University, as an associate dean at Brown University, and as a faculty member at both the Massachusetts General Hospital and New York University. She currently has a private practice in Boston and serves as the Co-president for the Harvard Alumni for Mental Health initiative. Across these myriad roles, she has become a leader in the conversation about mental well-being for today’s college students.

Additionally, she thinks deeply about the needs of international students on US college campuses and writes about the connection between digital technologies and mental health supports for Gen Z. She believes that improving student mental health isn’t just about offering more services. For Lee, improving mental health is about changing the culture as a whole. She calls on colleges to create space for candid, supportive dialogue that is culturally responsive to student needs. In her view, everyone—from administrators to faculty to peer leaders—has a role to play in normalizing the conversation about struggling in college. Her insights help us think about designing programs and practices on campus that meet all students where they are by considering both who they are and the identities they bring to campus.

CONSIDERING THE MENTAL HEALTH NEEDS OF INTERNATIONAL STUDENTS IN US INSTITUTIONS

Lee identifies a unique challenge for international students studying on US campuses. In addition to the typical struggles with the transition to college, international students often face the disorientation that comes with acculturation to a new country and the stress of adapting to a new educational system that may have different norms and expectations. This transition takes place far from home and their existing support system and, often, requires navigating life in a new cultural and linguistic context, for the majority of international students. It is not surprising that metanalyses have shown higher levels of stress among international students when compared to their domestic counterparts and higher rates of both depressive symptoms and suicidality.[1]

Despite these data and the correlated need for mental health support, international students seek and receive lower levels of support from colleges and universities.[2] Many international students come from cultures where seeking help for mental health is heavily stigmatized, making it harder for them to share their distress and ask for help.[3] They may also experience hesitation around finding someone to help who understands their cultural background and values in order to receive help that is sensitive to their lived experiences.[4]

Lee encourages us to ensure that non-US students have access to the support and resources they need and that they feel empowered to use those resources. Meeting this goal starts from asking meaningful questions and listening deeply to our international students as they talk about their experiences on campus. Lee emphasizes the importance of culturally informed outreach, greater transparency about what therapy entails, and compassionate engagement from staff who understand the unique stressors these students face. She believes that the most effective way to promote help-seeking is to challenge the narrative that needing support is a weakness. To do this, she encourages more honest, public conversations about struggle as part of the college experience to normalize the reality of significant emotional, academic, and personal transitions during the undergraduate years.

At Brown University, Lee worked to support students in getting help by offering workshops on how to talk to faculty, including simple peer-led role-play activities to empower them to reach out and build meaningful connections on campus. She also created a peer mentoring initiative to encourage students to help their classmates develop the kind of social and cultural capital they need to succeed on campus. She found this peer
model to be especially effective because the power dynamic of working with a faculty or staff member was removed and students were able to relate to each other meaningfully and immediately.

In our current sociopolitical moment, the intensity of the emotional stress that international students are grappling with cannot be underestimated. The uncertainty about their ability to travel to the US, questions about changing visa status, and increased scrutiny around their beliefs and even their social media posts have led to an intensification of both the emotional import of their experience and a decrease is trust around help-seeking.[5] In creating a caring campus, international students should feel empowered to seek and receive appropriate and timely help that is culturally sensitive and responsive to their unique needs.

CHAPTER 5
Meeting the Mental Health Needs of Student Veterans

ADAM PIERSON MILANO

The University of North Carolina at Chapel Hill

Meeting the mental health needs of student veterans involves a combination of proactive and reactive mitigation strategies designed around a multidimensional understanding of veteran identity.[*] Considerations for student veteran mental health live at the intersection of several topics central to national discourse. Veteran mental health remains an issue of public importance with an elusive solution landscape.[1] Concomitantly, the often difficult transition out of military service endures as the subject of academic research, nonprofit missions, and widespread innovation.[2] Choosing to transition from the military directly to higher education, becoming a student veteran, adds additional dimensions of adjustment to include a new set of social norms alongside the co-occurring adoption of both the veteran identity and student identity.[3] These transitions, left without scaffolded support, may result in increased isolation, which can have direct ramifications on mental health.[4] Moreover, student veterans may face mental health challenges, both specific to their military experience and shared with their not-military-affiliated (NMA) student peers, calling for culturally informed but not overgeneralized health care intervention.[5] This combination of factors means that meeting the overall mental health needs of student veterans requires beneficiary-centered community support structures supplemented by culturally attuned mental health care.

In order to lead effective mental health interventions, higher education leaders (HELs) first need to accurately understand who the veterans are within their specific campus communities that may bear the historical memories of student veterans in higher education.[6] Until recently, national student veteran success rates demonstrated that student veterans struggled to complete their degrees, resulting in a perceived conclusion that veterans were underequipped to succeed in academia. The data did not account for common interruptions in education, such as deployment and military training requirements; nor did they account for service members who deferred their service-entitled funding to their dependents or continued pursuing education after exhausting veteran benefit funding.[7] The Millions Record Project and Student Veterans of America, in collaboration with the Veterans Administration (VA), determined that student veterans actually outperformed their NMA peers in grade point average (GPA), yet perceptions of student veteran ability and the resulting bidirectional stigma continue to have an impact.[8]

The relationship between higher education and the military is complicated in its history, conjuring images of the Kent State massacre and other Vietnam War protests.[9] In Ellen Moore’s Grateful Nation, she quotes a US Marine recruiter from the Vietnam era: “I would rather go back to Vietnam than recruit on a liberal arts campus.”[10] Campus communities have certainly become more welcoming than the Vietnam era, though the lasting effect of the perceived antimilitary sentiment of that era persists, as recent studies are definitive in the message that veterans do not perceive a sense of belonging and stigma colors multiple aspects of the student veteran experience.[11] Several instances of overlapping stigma and perceived stigma loom large: campus culture toward the military, military-affiliated students toward their NMA peers, veterans toward mental health, mental health providers toward veterans, and, likely, a series of other multidimensional instances of stigma specific to school region, type of school, and, most importantly, the incredibly diverse veteran population.[12]

Meeting the mental health needs of student veterans means moving away from deficit-based perceptions and instead capitalizing on and enabling the strengths of each specific campus’s student veteran population through direct clinical mental health intervention and community structures that empower belonging. Effective student veteran mental health intervention takes the shape of community efforts to facilitate connection in concert with culturally informed clinical treatment. The university can then establish structures that mitigate isolation and loneliness while campus-based mental health professionals provide quality, culturally informed care to achieve positive treatment outcomes and mitigate stigma. Common foundational themes, such as strength-based approaches and avoidance of the hero/victim mentality, can act as a through line, but effective solutions must originate and adapt to the unique ethos of each campus.[13] These interventions have the greatest impact when conducted within an environment intentionally designed by higher education leaders to address the needs specific to each university environment to create not only a veteran friendly campus but what the Columbia Center for Veteran Transition and Integration calls a veteran-empowering campus.

STUDENT VETERAN IDENTITIES IN A CAMPUS CONTEXT

While the veteran experience, and the term veteran itself, may be unifying in its shared distinction of military service, there are multitudinous factors that can define a military career, a veteran identity, and the aspects of identity that inform the transition to and interaction with higher education institutions. Just like any term used for a group of people who share an identity, there is a fine line between unification and generalization. It is important to note that the veteran identity, and its influence on transition to a student identity, exists within a constellation of identities, impacted by the experience in the military, the social norms of the environment, and the historical frameworks of the military’s relationship to higher education.[14] The internal and external influences of both the military and the university environment play a role in the student veteran’s definition of their own identity and the meaning they place on their multidimensional identities in different contexts.[15]

Inherent in understanding the military identity is the inevitable shift from the deeply idiosyncratic culture of the active-duty military to a new veteran identity, outside the military culture yet normatively separated from civilians. Timothy Black, Marvin J. Westwood, and Michael N. Sorsdal state it best: “Transition from the military to civilian life is inevitable for the majority of service members, successful transition is not.”[16] Student veterans present a distinct version of this challenge as they encounter overlapping transitions: warrior identity to scholar identity, military cultural norms to academia cultural norms, collectivist expectations to individualistic expectations, and intensive structure to increased autonomy.

The identity of a soldier, marine, airman, coastie, seaman, or guardian goes beyond a traditional occupational identity.[17] These labels are an indoctrinated, formative component of an individual’s military life and self-identification. All branches, despite their differences, have a through line of war fighting and strict adherence to a set of values.[18] There are six branches of the military: army, navy, air force, marine corps, coast guard, and space force, each with a distinct ethos, policies, regulations, and norms that dictate how service members move, communicate, think, and act.[19] Regardless of a service member’s role in the military, experiences of real-world significance remain with veterans as they pursue their post-active-duty goals.

Components of occupational aspects of veteran identity must be factored alongside how intersectional and multidimensional identity may change experience, perception, and mental health impact.[20] Any national data should be used solely as a baseline, and HELs must understand who the veterans are on their respective campuses, the needs of those veterans, and the structures in place to support them.[21] The veteran population is too diverse and the higher education landscape is too vast for any national trend to fully predict the need for each specific student body.[22] What may be true of the national sample of veterans may not be true of veterans on each specific campus, including academic ability, mental trends, and obstacles for belonging.

Until recently, national student veteran success rates demonstrated that they struggled to complete their degrees, resulting in a perceived false conclusion that veterans were underequipped to succeed in academia. Early GI Bill data did not account for what happened after the student stopped using their VA financial benefits, such as a student exhausting their entitlements but completing their degree, decisions to defer GI Bill funding to a dependent, or incorrectly processed claims that delayed the student’s ability to fund the semester. The Millions Record Project and Student Veterans of America, in collaboration with the VA, took on the task of obtaining accurate data for the purpose of improving support for student veterans and accurately representing student veteran success.[23] Student Veterans of America determined that student veterans actually outperformed their NMA peers in GPA.[24] Yet the lasting stigma can color the student veteran experience.

There is an inherent contradiction in the student veteran experience. The strengths veterans self-perceive seem also to be the challenges they cite most.[25] Student veteran studies name the abilities to communicate, form teams, lead peers, connect across diverse cultures, and adjust to the stress of constantly changing environments as some of the most commonly occurring self-perceived strengths.[26] Similar studies that focus on challenges identify inhibition to seek support from peers, lack of belonging, cultural transition, or the normative differences between cultures.[27] Belonging is an essential target as it has implications not only on mental health but also academic success.[28] In a study conducted by Katie Sullivan and Kay Yoon, student veterans identified communication skills as a strength related to their military experience.[29] They also found that student veterans recognized that the communication style (active and passive) they honed during their military experience differentiated them from their peers.[30] Studies of military social isolation specifically indicate that the service members’ sense of belonging relies heavily on their place in their platoon-sized element.[31] Student veteran research identifies a yearning for camaraderie and continuation of the collectivist ideals of military culture.[32] Yet other studies report that student veterans opt out of residential life structures built to provide aspects of camaraderie and experience low connection with NMA peers.[33] Perhaps some of the self-perceived strengths serve as differentiators, inhibiting student veterans from integration.

Mental health interventions that address this dichotomy include both direct and indirect mitigation strategies addressing both explicit and implicit mental health concerns. In practice, this involves direct clinical mental health treatments, such as culturally informed evaluations, inclusive intake structures, and adapted trauma treatment, as well as the structures that indirectly benefit mental health by targeting belonging, such as veteran centers, military culture training for campus leaders, and structured mentorship networks, all of which work on elements of veterans’ ongoing transition processes.[34] Meeting the mental health needs of student veterans begins with inclusion in the campus community, supplemented by culturally informed clinical health care, all structured through a beneficiary-centered lens.

A PROBLEM AND SOLUTION LANDSCAPE

When utilizing an intersectional, multidimensional, and strength-based student veteran approach, the diversity that student veterans bring is viewed as a benefit to campus. Veterans are deeply aware their presence may be polarizing on campus, and such perceptions may present obstacles to their ability to belong.[35] This stems from overlapping variables, such as a lack of cultural awareness and presence of stigma from the university community toward veterans, as well as the difficulty in transitions from military culture to higher education, all resulting in potential isolation.[36] Additionally, clinical mental health treatment must include military-specific factors alongside multidimensional, biopsychosocial considerations. This can be addressed through university-wide efforts to decrease stigma and increase opportunities for connection, working in harmony with culturally informed mental health treatment.

Community and Connection

Student veteran mental health intervention first relies on an inclusive community and opportunities for connection across the university. Cornerstone targets of support include aspects of identity formation, transition, belonging, and meaning making, all considered within the context of their unique campus environments.[37] Barriers to engagement with a campus community, compounded by maladaptive aspects associated with military identity trends, could lead to isolation, resulting in serious ramifications to both physical and mental health.[38] The conversation of veteran identity as related to belonging was different in conscription eras due not only to equity issues within the draft and public opinion of warfare but also to the sheer numbers of veterans.[39] Among men under thirty-five, 50 percent were veterans after World War II, a stark contrast to the just 12 percent of the US male demographic in 2014, which may look even scarcer on certain university campuses, suggesting that contemporary veterans’ experiences may be even more isolating than in past generations.[40]

Isolation is perhaps the most consistent through line for student veteran mental health, and when left unmitigated, it can cause an evolutionary-threat response sparked by a feeling that one is not part of a community.[41] Just like with any threat response or survival reaction, one may turn inward to self-assess, to heal, to rest, which could lead to further isolation.[42] This reactionary self-preoccupation may inadvertently prolong the student veteran’s isolation, thus prolonging the state of fight-or-flight response, which is not meant to be sustained, causing decline in physical health, neural pathways learning trauma, and susceptibility to physical and mental illness.[43] The presence of illness could again lead to further isolation, creating a vicious cycle, making it increasingly more difficult to remove oneself. If there is already a presence of trauma, where the internal alarm system stays activated, isolation may enhance perceived safety, compounding cyclical causation.[44]

At first, isolation may seem unlikely. Student veterans are in classes, surrounded by peers, assigned mentors, and come from the military community, often labeled as a proverbial band of brothers. Social isolation may not rely on the number of connections but more so the nature of them.[45] Interaction with others is not the same as meaningful relationships, underscoring the difference between physical isolation and perceived isolation, homing in on the quality of connection versus the quantity of connections.[46] While related, issues of social isolation, loneliness, and perceived isolation are distinct challenges, each with pernicious ramifications. Similarly, solitude is separate from loneliness, the difference between the restorative nature of alone time compared to the pain of disconnection.

Loneliness, while just one aspect of isolation, is perhaps the most central and pestiferous. Loneliness, as a result of social isolation, can begin a trajectory toward mood disorders and, in more extreme cases, correlates with suicide.[47] Émile Durkheim suggests that adoption of a groups’ values, norms, goals, and traditions results in individuals less likely to die by suicide.[48] Data on student veterans demonstrate a push against assimilation to higher education norms and suggests that student veterans are resistant to peer support.[49] The challenge of social isolation is not limited to the military, but those who serve may experience greater exposure to isolation and are at higher risk for negative impact.[50] Targeting loneliness, perceived isolation, and lack of connection is especially relevant for student veterans, who may face additional barriers to belonging than their NMA counterparts.[51]

Addressing isolation and loneliness involves genuine connection with a community, but before attempting to facilitate connection with others, it is essential to begin with an authentic connection with oneself. Travis Martin relates this idea to veterans in his book War and Homecoming as he quotes Charles Cooley, “I am what I think you think I am.”[52] Student veterans are largely not the stereotypes portrayed in the media, and they yearn to be seen outside of archetypal portrayals, yet student veterans may adopt stereotypical behavior. Chris Basel, director of the University of North Carolina at Charlotte’s military-affiliated student center, identifies an adoption of a “Vet Bro” comportment.[53] In veterans, dichotomous identity may relate to the normalization of masculinity within warrior culture, which can be enhanced when the associated invincibility is threatened, such as injury, emotion, or transition out of the service.[54]

Historically, masculine traits are heightened in the military, creating a military masculinization that is effective in combat but encompasses several behaviors counter to fostering effective relationships and developing self-awareness.[55] The impact of this intentional culturalization is exacerbated by the focus on mental fortitude, long-term pain tolerance, and coping with constant discomfort.[56] This process may be complicit in the formation of maladaptive coping strategies and ill-informed interpersonal developmental guideposts.[57] In the military, the mission always comes first, despite individual difficulty or personal obstacles.[58] The values and mind-sets that may work well in an austere, dangerous environment may not naturally translate to a warrior’s personal relationships, both during service and after the individual takes off the uniform.[59] With proper support and guidance, such as mental health intervention or mentorship, aspects of these traits can be translated to dealing with adverse circumstances in life.[60]

Creating connection and providing scaffolded mentorship supports the developing student veteran and invites opportunities for belonging in a campus community.[61] On active duty, connection to a platoon-size element is a key contributor to feelings of belonging.[62] Student veteran studies overwhelmingly communicate a desire for camaraderie and opportunities for collectivism.[63] Student veteran studies also recommend facilitating spaces in which veterans have the opportunity to interact with one another.[64] In higher education, this may translate to establishing small, accountability groups within classes, residential spaces, clubs, or social groups. This recommendation exists alongside the nuanced but essential distinction that identifying military-affiliated faculty, staff, or students for support should not impede opportunities to build relationships, create community, and find connection with NMA students.[65] Lenaya Crandall Hezel, chief programs officer of Warrior-Scholar Projects and scholar of the student veteran experience, emphasizes that veteran centers and military-affiliated programming should serve to foster communication, not sequester veterans from the rest of the community.[66]

While creating connections may prevent isolation and thus mitigate negative mental health impact, the context of that connection is also essential. Involvement in the community and community service are key aspects to diminishing isolation.[67] Community service interrupts the pattern of an inward focus, relieves the stress response, and increases a sense of worth by providing purpose, meaning, and accountability.[68] In this regard, veteran support can be self-sustaining in that beneficiaries can derive purpose through supporting and serving their new campus community.

The presence of such structures as veteran centers, student groups, and designated veteran support personnel can contribute to abating student veteran mental health challenges by increasing a sense of belonging, inclusion, and safety. Mental health needs can be addressed through a lens of community structure and support, specifically within the context of belonging, strength-based leadership, and cultural inclusion. A focus on strength-based interventions addresses a broader sense of potential bias throughout the university, establishing fertile soil from which positive mental health intervention can grow.

Mental Health Trends, Treatment, and Stigma

Strength-based perspectives beyond stereotypical perceptions are the basis not only for veteran incorporation into the campus community but also direct clinical mental health interventions. Campus mental health practitioners must consider and prepare for the distinct clinical presentations, diagnostic trends, and treatment factors common among student veterans, to include culturally impacted attitudes toward mental health and mental health treatment.[69] These differences are held as important considerations alongside the understanding that student veterans will also share mental health symptoms and treatment factors that mirror their NMA peers. The presence of a veteran identity and the variables impacting mental health presentation more common among service members should serve as an additional factor to a biopsychosocial evaluation and case formulation, not as a complete differentiator of case conceptualization and treatment methodology.

Studies suggest that veterans may carry unique diagnostic trends. The veteran population experiences PTSD at a rate between two and four times more than NMA students, and close to a third of student veterans report symptoms that can be associated with PTSD, depression, and excessive alcohol use.[70] The general veteran population also experiences sleep-related disorders at a rate higher than civilians, with one study finding that veterans experienced short sleep disorder at 41.8 percent compared to 9.3 percent of the civilian population.[71] Suicidal ideation remains a central issue when discussing the veteran population, and student veterans are no exception. David M. Rudd, Jeffrey Goulding, and Craig J. Bryan found that 46 percent of student veterans (and student service members) have experienced suicidal ideation.[72]

Military service may result in involvement in or witnessing of potentially traumatic events. The prolonged biopsychosocial-spiritual ramification of direct involvement with an action or act that is dichotomous with value can often result in a lack of trust in a community, other people, or oneself.[73] Most commonly referred to as a moral injury, this injury to someone’s soul or conception of the world can reduce their sense of trust in themselves, others, and the universe.[74] Josephine G. Pryce, David H. Pryce, and Kimberly K. Shackelford use the term “soul wounds” to describe a parallel concept of potentially traumatic experiences that cause service members to question their character, identity, spirituality, and place in the universe.[75] Moral injury, soul wounds, and PTSD comorbidity are common, but one diagnosis does not guarantee the other.

In Operation Enduring Freedom / Operation Iraqi Freedom (OEF/OIF), the casualty-to-death ratio was 7.5 to 1 due to increased evacuation techniques, modern medical care, and the nature of counterinsurgency operations.[76] Just under a third of post-9/11 veterans have experienced PTSD at some point in their life.[77] Generalized anxiety, experiencing depressive symptoms, traumatic brain injury (TBI), and the presence of PTSD symptoms have been found to have a direct negative effect on the academic adjustment of military-affiliated college students.[78] The symptoms of all aforementioned mental health trends relate directly to the conversation about community and connection as many of these diagnoses not only lead to isolation in symptomatology but are also compounded by the stigma of mental health diagnoses further correlated to isolation.[79]

Conversations regarding veteran mental health often focus exclusively on combat exposure, with specific emphasis on PTSD. PTSD is important to address in this chapter, not because it is universal in the veteran experience but because the perception of its pervasiveness can have an impact on veteran treatment and belonging, and those that do have combat-related PTSD require informed care.[80] This is an important competency for counseling centers, as it is likely the most profound difference in clinical presentation between student veterans and NMA students. It is equally, if not more, important to note that not all veterans have seen combat and not all veterans who have seen combat carry a PTSD diagnosis. The Center for Collegiate Mental Health found that nearly two-thirds of student veterans in their study did not experience a “criterion A” event, such as combat, during their military service.[81] As the United States has pulled out from Afghanistan and significantly reduced presence in other combat zones, the number of student veterans with combat exposure is likely to decrease. However, those student veterans that did serve when the United States was still involved in frequent combat deployments and those currently serving in units that continue to see combat require specific considerations, such as the recently termed “operator syndrome” related to allostatic load.[82]

Moral injury, TBI, PTSD, and operator syndrome all contribute to increased rates of social isolation and have correlation with suicidal thinking, posing critical and high-risk concerns for higher educational mental health professionals.[83] Just as it is important to note that the presence of military service does not automatically indicate the presence of PTSD, it is also important to utilize evidence-based, culturally informed practices in the treatment of PTSD. Further, PTSD is not necessarily a lifelong diagnosis, and there are increasing numbers of interventions, such as stellate ganglion blocks, which are becoming ever more available to military personnel.[84] Similarly, multiple studies for student veterans recommend that opportunities for growth, such as meaning making out of their military experience, can contribute to positive outcomes.[85] Currently, the military focuses on the importance of post-traumatic growth in reaction to potentially traumatic events, asserting that the path out of trauma is not always negative and not permanently a downward trajectory.[86]

Creating meaning from military service and processing the experience are central to clinical mental health treatment. This begins with cultural humility as civilian clinicians must strive to expand their skills to formulate treatments and therapeutic relationships with veteran clients within the framework of military cultural values.[87] Many mental health professionals do not have a strong working knowledge of military culture nor the training to address their specific mental health needs.[88] This may include but is certainly not limited to learning the idiosyncrasies of branch culture, considering acculturated language around violence, understanding the relationship between trauma and connection, factoring in societal or campus perceptions of veterans, and addressing stigma through education and quality health care.

The stigma against mental health has decreased among student veterans, though it remains higher than that of NMA students.[89] Active duty soldiers identify stigma as a main barrier to mental health treatment, citing impact to career progression, decreased respect from their unit, and lack of confidentiality due to operational requirements.[90] Active service members report that seeking mental or physical health resources, with the exception of reactive treatment due to extreme events, is associated with being a burden or jeopardizing their belonging.[91] This stigma results in lower rates of help-seeking behavior among veterans as compared to that of the civilian population.[92] Studies suggest roughly two-thirds of service members who experience mental health problems do not receive treatment, and only 43 percent of active-duty service members perceive the military cared for their health and well-being.[93] Cultural expectations of behavioral health treatment and provider interaction in the military may be formative to the student veteran perception of mental health and have ramifications on treatment compliance following their period of service.[94]

It is essential for active-duty military leaders, student veteran leaders, and veteran organizations to continue to address and push against stigma through education and cultural norms. While part of this resistance may be correlated with aspects of social norms and military masculinization, the greatest factor may be the lasting impact of the military’s exceptions to limits of confidentiality.[95] The military functions on regulations and policy that dictate a warrior’s readiness and suitability based on certain physical and mental health diagnoses and treatments.[96] This requires medical providers, including behavioral health providers, to, in some cases, communicate diagnosis, symptomology, and prognosis to a service member’s command team. This may create hesitation or, in some cases, refusal to engage in mental health care. Among service members with unmet mental health needs, 80 percent perceive that their peers are often or always unsure of the reporting requirements to leadership.[97] The therapeutic relationship relies on trust and, therefore, must consider student veteran doubts to the limits of confidentiality, preventing student veterans from perhaps wondering if at any point their dean or professors would be informed of their care as it was with their military commanders.

Student veteran mental health care would be well served to include questions about military experience in their intake forms, which can trigger the use of biopsychosocial evaluation models that are specifically adapted to military culture and ultimately contribute to trend analysis.[98] For example, a biopsychosocial evaluation that asks generally about a history of thoughts regarding harm to others may be inappropriate for a veteran. A provider trained to work with student veterans or utilizing an adapted evaluation model would be mindful that all service members have been placed in scenarios, through training or real-world experience, that considers harm to others. Intake questions about veteran status must exist in concert with whole-person considerations of the patient.[99]

Ultimately, the utilization of mental health services benefits from increased confidence that the service member will be viewed beyond an archetypal veteran and assurance of ethical confidentiality.[100] This is especially true for underrepresented identities, such as LGBTQ+ identifying veterans and female-identifying veterans who face compounded instances of stigmatization.[101] It is also important for campus mental health clinics to not inadvertently advance stigmatization through nonculturally informed or unequipped care. Reducing stigma means being prepared to help veterans process the realities of war, the consequences of combat, the aftermath of taking another life, losing a friend, and, most importantly, translating these experiences to student life.[102] This can occur by directly addressing military needs by having trained clinicians on staff, having a strong referral system to military mental health providers, or utilizing a consultant. Student veterans are receptive to outreach, communication, intervention, and treatment that acknowledge their multidimensional identities in addition to or even separate from the archetype associated with today’s service member.[103]

SUMMARY OF STRATEGIES AND A CALL TO ACTION

Each campus community must develop its own strategies, based on beneficiary involvement, to address issues of inclusion and mental health care. The topic of student veteran mental health is complicated, multifaceted, and may appear differently across higher education environments. This journey may start with asking questions about the campus community:

- Who are the military-affiliated students on my campus?

- How does my institution define military-affiliated students?

- How do we continue to equip our mental health clinicians with current, evidenced-based, and culturally informed practices specific to student veterans?

- What are the experiences of othering that can occur for veterans on our campus?

- What intentional commitments have we made to ensure that veterans are welcomed in our campus community?

- Are we as a campus community aware of the internal resources and knowledge we have for our military-affiliated students?

- Do we consider cultural considerations in military mental health treatment?

The potential questions that campuses can consider must shift over time. The actions required to meet the mental needs of student veterans involve everyone within the socioecological framework of the veteran experience: the higher education community, the mental health clinics, the veterans, and the military itself.

For the Higher Education Community

Veterans are individuals who are committed to and experienced in service. Service to the campus community can be a part of that commitment, benefiting both the service members and their institution.[104] Student veterans bring a set of shared strengths with the potential to be substantial contributors to the campus community, adding their distinct perspective and unique experience to classroom discussion and university culture.[105] This can only occur when HELs use an intersectional lens to provide student veterans with culturally informed support and an opportunity for belonging while viewing each veteran as an individual.[106] This requires HELs to lead with a culturally informed, strength-based perspective that challenges biased social cues and norms they may inadvertently demonstrate.[107] HELs include all those who have the capacity to provide positive change and influence on a campus culture and the mental health of student veterans at the individual, programmatic, structural, or policy level.

One way to facilitate involvement is through mentorship. Mentorship is instrumental in helping student veterans process their military experience, find meaning in their service, and navigate the seemingly competing social norms of their military service, home environments, and new university communities.[108] Even if a student veteran does not choose to openly demonstrate their veteran identity, their first interaction with a campus will be through a VA certifying official, and this interaction can serve as a decision point and early indicator of how the veteran believes they will fare with the university.[109] Just as student veterans should not be held responsible for foreign policy decision, nor should changes in VA policy, delays in funding, or shifts in requirements be laid at the feet of the student veteran, explicitly or implicitly.[110] The kindness, mentorship, knowledgeability, and inclusion of both formal and informal mentorship may factor into a student veteran’s self-selection into a university campus, the world of higher education, and their decisions to remain enrolled.

Effective solutions must originate and adapt to each campus and view their student veterans outside of the hero/victim binary.[111] This charge should not solely fall on student veterans but, instead, include committed HELs in consultation with military mental health experts and student veteran beneficiaries.[112] Campuses can utilize such framework’s as Shane Hammond’s combat veteran conceptual identity model, Aynsley Diamond’s adaptive military transition theory, and D. Vacchi’s model for student veteran support as starting points from which to approach the work.[113] These frameworks support the idea that the incorporation of a veteran identity is an ongoing process, and support must be designed through a beneficiary-centered and intersectional lens that is aware of stigma in its creation and leads with strengths in its execution. There are countless factors that can contribute to a service member’s career experience in addition to their preexisting occupational identities. This complexity underscores the reality that veterans are not well served by one-size-fits-all approaches to address this transition.[114]

Creating opportunities for belonging and scaffolding the formation of avenues for connection may fulfill student veterans’ desire for collectivism.[115] This can exist in spaces for which student veterans can interact with each other, as well as opportunities to interact with or serve the larger student community.[116] As R. J. Jenkins, director of education for the Columbia Center for Veteran Transition and Integration, concludes: “Transition is the responsibility of the veteran, integration is the responsibility of the University.”

As the coordinator for military student experience, one of the most impactful forms of support I’ve been able to provide veteran students is creating both a welcoming space and meaningful relationships. This goes beyond establishing a physical location. It’s about cultivating an atmosphere that honors their service while acknowledging the unique challenges and sacrifices they face when transitioning into the traditional college environment. I believe it’s essential to build relationships with students that are supportive, student centered, and student led. These relationships form the foundation for trust, empowerment, and community. Hosting social events in the Military and Veteran Student Succes Center at UNC Chapel Hill has been a powerful way to foster these connections. These gatherings offer students a chance to slow down, relax, and engage with others who share similar experiences. They also help bridge connections between veteran students, support staff, and the broader university community. In my experience, these efforts not only support academic success but also promote a sense of belonging, something I believe is especially meaningful for those who have served.

Community building is one of the most effective and essential strategies for supporting student veterans in higher education. Creating dedicated spaces—such as a student center specifically for veteran and military-affiliated students—is a best practice that encourages them to actively engage with both their veteran identity and their emerging identity as college students. In addition, higher education leaders should identify and highlight veteran and military-affiliated staff within the institution who can serve as liaisons. These individuals play a key role in supporting student veterans during their transition and in promoting help-seeking behaviors. Most importantly, institutional leaders must remember that student veterans not only benefit from a holistic college experience; they often deeply value and seek it.

—Saywonza Cuevas, a licensed clinical social worker with over fifteen years of experience in clinical social work, serves as the coordinator for the military student experience at the University of North Carolina at Chapel Hill.

For the Clinic

Veterans represent a microcosm of society, demonstrating overlapping mental health needs and, therefore, interventions with the NMA student population.[117] Additionally, student veterans have specific cultural considerations and instances of unique case presentation that require culturally informed care. Applying any of these skills or considerations first relies on clinics to have a mechanism for identifying student veterans, calling for the incorporation of military affiliation in the intake questionnaire or even during appointment making, which could then trigger a specific biopsychosocial evaluation attuned to military-affiliated clients and providers equipped to work with military veterans.

Providing culturally attuned treatment for military personnel is essential not only to treatment outcomes but also to avoid inadvertently increasing stigma. Culturally informed care requires an appropriate number of staff who are experts or trained in acculturated language around violence, combat trauma treatment, stressors specific to the military environment, and military culture. Cultural knowledge must include the existing stigma that comes as a result of exceptions to limits of confidentiality in the military. Organizations such as PsychArmor, Star Behavioral Health Providers, and the Center of Deployment Psychology fill critical knowledge gaps by providing training in military behavioral health.[118]

LEARNING OPPORTUNITIES

PSYCHARMOR
https://psycharmor.org/

“We believe education and training equates to transformation. This transformation starts with humility, runs on awareness and results in genuine connection. That’s why we’re committed to powering your learning journey. Powered by PsychArmor, learners and organizations can collectively create impact and change for military-connected communities.”

STAR BEHAVIORAL HEALTH PROVIDERS
https://starproviders.org/

“SBHP connects with and trains civilian behavioral health providers on military culture and evidence-based treatments that focus on the unique needs of service members, veterans and their families.”

THE CENTER FOR DEPLOYMENT PSYCHOLOGY
https://deploymentpsych.org/

“The Center for Deployment Psychology (CDP) trains military and civilian behavioral health professionals to provide high-quality, military-culturally sensitive, evidence-based behavioral health services to military personnel, veterans and their families.”

Additionally, clinics must have a working knowledge and a current list of local veteran resources like VA hospitals and VetCenters, as well as nonprofit organizations that provide military mental health care, such as Cohen’s Veterans Network and SOFNetwork.[119] Absent of expert staff, clinics can utilize a consultant who specializes in military behavioral health as a useful and accessible first step in ensuring clinics are prepared for the cultural and diagnostic needs of the student veteran population.

For the Veteran

Higher education is a common enticement for enlistment—the belief in the power of higher education to provide upward mobility. However, student veterans consistently report feeling isolated or removed from the ability to assimilate with the student body. As discussed in this chapter, this is the product of a deep history between higher education and the armed forces, idiosyncrasies of military culture, misperceptions of veteran academic ability, and the transition from military to civilian identity. Utilizing a strength-based perspective allows student veterans to play an essential role in pursuing belonging either alongside positive intervention strategies or despite barriers to belonging. Special Forces Master Sergeant (Retired) Jonathan Lu, the current director of the Center of Health Professions at Wright State University, urges student veterans to think beyond the idea that people will never understand their experiences and to instead use the skills taught in the military about relating to other cultures to increase military cultural knowledge in their new communities. This concept of translating the strengths and skills of military service is a means by which student veterans can find a place in a new higher education community.[120]

For Active-Duty Service Members

Meeting the needs of student veterans on campus begins in the active-duty community. Military leaders can decrease barriers toward behavioral health treatment by challenging existing norms, informing their formations about limits of confidentiality, and addressing policies that weigh the balance between readiness and inadvertent stigmatization. On the programmatic and mentorship levels, military leaders can work with service members to apply existing strengths across professional and personal challenges. This is the aim of such programs as Uniformed Services University’s Special Operations Cognitive Agility Training, which helps service members transpose the adaptability they exhibit in deployed environments to their daily lives.[121] Additionally, military units and local universities can create effective and lasting partnerships that work to increase access and create mutually beneficial collaborations in the areas of research, intervention, and capacity building.

In Closing

When considering mental health for student veterans, it is important to not only factor in the multidimensional identities that exist in conversation with a veteran identity but also how these identities impact the design and implementation of both the preventative and reactive measures that work to mitigate the implicit and explicit presentations and ramifications of mental health. Student veterans’ mental health certainly includes the oft-discussed PTSD, moral injury, or TBI that is pervasive in literature. It also includes young people who have never been exposed to combat and are trying to adjust to a new phase of their lives. With such a diversity of experience, what is definitive is that each veteran is a complex, multidimensional person, with identities that coexist with their former occupational identity as service members. The unifying center for this population is that they raised their right hand to serve in uniform for the country. Some did this out of patriotism, a commitment to challenge, or a desire to serve; others, for a steady paycheck, a roof over their head, access to the GI Bill, and likely a host of reasons specific to each service member.

Aspects associated with military identity, the shift to a veteran identity, and the transition to the norms of higher education place the service member in a moment of challenge and transition.[122] Veterans who make the transition to higher education carry distinct, intersecting identities apart from their varied history of service. This transition marks an important opportunity to target belonging in higher education communities. Contributing factors include the adjustment from a warrior identity to a student identity, the cultural differences between military social norms and those of higher education, and translating their military experience to their educational context.[123] Student veterans must grapple with a reconceptualization of their roles in society and how they fit into their new environment of the civilian college campus.[124] The challenge of transitioning out of the military must be met with culturally informed support structures in higher education and culturally humble mental health treatment.

The word veteran is unifying, signaling a community of those who have served in the military; the word veteran is also alienating, as it separates those in the military from the rest of society. The term veteran defines the student by an occupational identity that they used to hold. They have morphed from civilian to service member to veteran, defined by a past decision, honored by and yet distinguished from society, and asked to transition back into that society while battling the perceived stigma associated with the veteran identity. HELs can shepherd that change to meet the mental health needs of student veterans. Their experiences while in the military, in combination with the inherent challenges of a transition to higher education, call for culturally informed, strength-based approaches to address their mental health.[125]

1. * For this chapter, the term student veteran is used to describe those who left the armed forces after serving in a uniformed capacity regardless of time in service, nature of discharge, or exposure to combat and then entered higher education. Each institution also enrolls other types of military-affiliated students who are not veterans but require their own degree of culturally competent support. This chapter does not explicitly address these military-affiliated students who are not veterans, though many of the challenges, solutions, and recommendations for veterans may very well support all types of military-affiliated students. To differentiate student veterans from the general student body, but not necessarily from nonveteran military-affiliated students, this chapter utilizes the term not-military-affiliated students (NMA students) to describe those with no military affiliation.

VOICES FROM THE FIELD

Anabella MorabitoAssociate Director for Community Engagement Harvard University

Anabella Morabito is the associate director for community engagement in the Office of the President at Harvard University in Cambridge, Massachusetts. At Harvard, she leads strategic initiatives to strengthen belonging across the institution, including at the undergraduate college, twelve graduate and professional schools, and the Radcliffe Institute for Advanced Study. In this role, she founded the Presidential Inclusion and Belonging Student Leadership Council to empower students from across the university to work together to build a caring campus community.

Before coming to Harvard, she was the assistant dean of student Affairs at Regis College, a private Catholic university in Weston, Massachusetts, with approximately 1,100 undergraduate students. She previously served as the associate director at the Regis Center for Ministry and Service.

Morabito approaches her work with a deep respect for students’ dignity and whole selves. Her background in campus ministry informs her commitment to care, connection, and seeing each student as worthy of love and inclusion. These values shape both her policy decisions and daily interactions and inform the insights she shared about creating a community of care on campus by thinking about holistic supports for students and the importance of belonging.

MOVING FROM SILOED SERVICES TO HOLISTIC SUPPORTS

Morabito encourages us to think about how students are experiencing the campus and the impact of departmental silos. Students experience their academic, emotional, financial, and social lives as an integrated whole—not as separate domains managed by different offices. When institutional support is fragmented, it creates friction and confusion, forcing students to navigate multiple bureaucracies while already under stress. This mismatch between how students live and how universities operate can unintentionally deepen harm or delay meaningful help. A more effective approach centers on cross-functional collaboration, ensuring that we respond to students as whole people with complex challenges.

Morabito describes her work at Harvard University as a convener—bringing together disparate offices and stakeholders to respond more cohesively to student needs. Initiatives like the Community and Campus Life Network exemplify this integrative approach. To build this team, Morabito and her colleagues asked the question “If someone is facing a crisis, then who are the people that need to be at that table?” In response to this query, the team built a cross-functional group of counselors, chaplains, deans of students, and emergency services professionals. Morabito notes, “We created a space where people who normally wouldn’t connect are now part of the same conversation. It’s rare to have the person handling emergency alerts in the same room as someone responding to a mental health incident—but now they’re learning from each other and building real partnerships across campus.” Together, the group reads past cases to ask how they could have responded differently and then to think strategically about how to prepare for crises that may arise in the future. This holistic approach to creating support services offers a powerful illustration for approaching student supports differently and responding to the complexity of campus life.

BELONGING AS A STRUCTURAL IMPERATIVE

Morabito believes deeply in the importance of student belonging as a core tenet to on-campus thriving and well-being. For her, belonging is not a luxury but a necessity for all students. She explains that when students can’t fully express or reveal core aspects of their identity, the emotional burden they experience directly impacts their mental health and academic success. These students, she explains, are constantly doing emotional labor by masking their status, concealing financial hardship, or avoiding disclosure of a stigmatized identity. She explains, “They’re constantly thinking about how to mask those parts of who they are, and the amount of pressure that adds to their life impacts their ability to do daily tasks, to move through life.” This invisibility is more than just uncomfortable. It’s mentally exhausting, and it can quietly undermine a student’s success. For Morabito, this burden is directly tied to mental health—and it’s one that institutions have a responsibility to address.

To create a truly caring campus where students belong, Morabito believes that we have to think carefully about how we create structures. She explains, “It is about embedding inclusion into the everyday fabric of campus life and creating a culture where inclusion is not an afterthought but a standard way to operate.” At Harvard, the creation of the Inclusive Event Planning Guide stands as a model of this approach, shifting from a reactive to a proactive approach of planning for what students might need. This practical resource prompts organizers of campus events to consider dietary restrictions, prayer spaces, gender-neutral bathrooms, and religious or cultural holidays in their planning. “Once you do it for one event, you realize it’s not hard. And then you begin to build a practice where those intentional choices are just part of how you approach things,” she concludes. In Morabito’s view, belonging is not just a feeling—it’s a structural, cultural, and ethical imperative. And when done right, it has the power to lighten the burden students carry and ensure that they experience care on campus in all aspects of their experience.

PART 3
Supporting Students in College and Career Transitions

CHAPTER 6
Mental Health and Well-Being in the Transition to Postsecondary Education

ANGEL PÉREZ AND MELISSA CLINEDINST

The National Association for College Admission Counseling (NACAC)

The mental health of students in college begins in high school. The journey to higher education, marked by the college admissions process, is often lauded as a time of possibility and growth. However, for many students, it is a period laden with immense pressure, anxiety, and uncertainty. As a former admissions officer with over twenty-five years of experience and an education researcher who has studied the college admissions process for twenty years, we have witnessed firsthand the toll this process takes on students. The mental health challenges they face during this transition have become increasingly apparent, exacerbated by societal expectations, financial pressures, a lack of access to college advising, media coverage about college admissions, and the complexity of the college admissions and financial aid process. For most students, the process of getting into college is opaque. Students want desperately to be admitted, but they don’t have a clear and transparent understanding of how to achieve that goal.

The increase in stress and anxiety for young people trying to get into college is a global phenomenon, not just an American one. In fact, in 2022 in India, more than one thousand people under age eighteen died by suicides that were attributed to exam failure, and some parts of India have seen a substantial reduction in suicide rates in young people by introducing supplemental exams.[1] In America, multiple student surveys have shown that the college admissions, financial aid, and enrollment process is a common and considerable source of stress.[2] For many students, the educational and social disruptions caused by the COVID-19 pandemic exacerbated what was already a stressful time, and the results were staggering. College enrollment rates for the high school class of 2020 fell by an unprecedented amount, and declines were most pronounced at high-poverty or low-income high schools.[3] It wasn’t until Fall 2024 that total college enrollment rebounded to pre-pandemic levels.[4] The complex systems students must navigate to get into college today are extraordinary. On average, students apply to six to seven colleges, but students applying to highly selective colleges may submit fifteen or more applications.[5] Students must navigate a plethora of different requirements, deadlines, essay prompts, and recommendation letters for each institution, in addition to submitting their materials through multiple application platforms. Although more than one thousand colleges participate in the Common App, which allows students to apply to multiple colleges with one application, many institutions have their own application platforms.[6] For example, the University of California and California State University systems each use their own application portals.

In addition, the majority of students who apply to college need financial aid to afford the cost of attendance.[7] It is important to note that it is not just the college application process that’s riddled with complexity. Financial aid applications also create extraordinary stress and anxiety—especially for the lowest-income and most-marginalized students. While the Free Application for Federal Student Aid (FAFSA) form has been simplified in recent years, the Department of Education’s implementation of the 2024–25 form was disastrous.[8] Many students were unable to complete the FAFSA or had significant challenges in submitting, resulting in a substantial decrease in FAFSA completion rates.[9] Many institutions of higher education also require additional financial aid forms, such as the College Board’s CSS Profile, to award nonfederal institutional aid.[10] Although the College Board has recently introduced a shortened version of the CSS Profile, it remains yet another administrative hurdle for students and families seeking affordable access to higher education.[11]

Although the surge in test-optional policies in the wake of COVID-19 restrictions brought increased opportunities for some students, it also created confusion for both prospective students and their college advisors. Those who apply to test-optional institutions are confused by the multiplicity of options and requirements and often wonder if not submitting testing is going to hurt their chances of being admitted. In fact, in 2020, the National Association for College Admission Counseling (NACAC) created a campaign allowing colleges to commit to the “test-optional means test-optional” promise to take some of the pressure off students who felt colleges were not being transparent about their testing policies. While the majority of colleges have maintained test-optional policies, the return to required testing by a few highly selective institutions has created extraordinary anxiety and confusion for young people. Post-pandemic challenges with test site availability forced many students to travel far from home to take standardized tests, and students whose religious observances conflict with available test dates face additional administrative hurdles to requesting alternatives.[12]

These challenges are compounded when access to quality college advising is limited, exacerbating the difficulties of navigating this process for many students. Students are not alone in bearing this burden. School counselors, frequently under-resourced and responsible for large caseloads, struggle to provide the individualized support students need. It is often the students who need the most support in navigating the process who have the least access to school counselors, due to exceedingly high student-to-counselor ratios. Across the nation, the average number of students per counselor is 376, and in some states, including Arizona, Michigan, and Minnesota, counselors are asked to serve more than 500 students, on average.[13] Although counselor-to-student ratios have been decreasing over the past decade, the average nationally (and in almost all states) remains above the 250 to 1 recommended by the American School Counselor Association (ASCA), indicating further progress is needed.[14] Many school counselors also are called upon to take on non-counseling-related tasks, as well as serving a variety of student needs outside of direct college counseling.[15] The obstacles counselors face are extraordinary, and the impact is often felt by students. It’s no wonder that students feel a tremendous amount of anxiety as they face this process, often with very little guidance.

Experts agree that the college application process does not merely test academic qualifications but also a student’s emotional resilience. The efforts that students put into the college application process must be managed while continuing to maintain their secondary school academic load, activities, and other personal and family responsibilities. As leaders in the field, we have personally experienced students who enter college burned out, exhausted, and disillusioned by the process they encountered in order to get into college. Instead of arriving at college excited, enthusiastic, and energized, they often arrive depleted because of the extraordinary time, energy, effort, and mental fortitude that it took to get into college. This does not set them up for success.

We all know that college brings its own pressures for students, and much has been written about the growing mental health crisis in higher education. This is why it is critical that mental health in high school, particularly during the college admissions process, be addressed by the college access community. It was with this sense of urgency that members of NACAC—a professional association of more than 28,000 admission and college counseling professionals—decided to create an ad hoc committee on mental health and equity in the transition to postsecondary education.

The committee, made up of higher education, secondary, and mental health professionals, was tasked with identifying systemic challenges faced by college admissions counseling professionals and students and recommending ways in which NACAC is best positioned to address these challenges.

In this chapter, we present the challenges identified by the NACAC ad hoc committee, based on their collective professional experience and the results of a national survey of college admissions and counseling professionals. We also share the committee’s recommendations and issue a call to action for secondary and postsecondary leaders. In addition, we highlight efforts currently taking place in the field that aim to reduce the burden on students by simplifying the admissions and financial aid process.

SURVEY RESULTS OF COLLEGE ADMISSIONS AND COUNSELING PROFESSIONALS

The purpose of the survey research was to gather practitioner perspectives about the impact of various aspects of the college admissions and enrollment process on students’ mental well-being, the strategies they use to mitigate these impacts, and their professional opinions on what changes to the process would have the most positive impact for students. Ultimately, the goal of the research was to inform the education community of the ways in which the admissions process can contribute to student mental health concerns and to encourage college admissions and counseling professionals to reflect on and assess their own practices

TABLE 6.1Characteristics of secondary survey respondents

Total number of respondents

1,721

Respondent type

Percent

Public secondary school counselors

55.7

Private secondary school counselors

35.6

Community-based organization counselors

1.3

Independent counselors

4.7

Counselors at international schools

2.7

Methodology

Two surveys were administered by NACAC in April–May 2023. Survey questions were developed by NACAC staff in consultation with the NACAC ad hoc committee members. The secondary survey was emailed to professionals who work with secondary school students: school-based counselors, independent educational consultants (IECs), and counselors at community-based organizations (CBOs). The survey was emailed to 57,799 of these professionals, including both NACAC members and nonmembers, and 1,721 responded. Characteristics of the secondary survey respondents are included in table 6.1.

The postsecondary survey was emailed to 14,416 NACAC-member college and university admissions professionals, and 444 responded. Characteristics of the secondary survey respondents are included in table 6.2.

The secondary surveys sought input from counseling professionals on four distinct phases of the college admissions process (search, application, choice, and transition), recognizing that the challenges faced by students may differ at various points on the path to college enrollment. Admissions professionals at colleges and universities were only asked about the transition phase, given their role in the process. The four phases were defined as follows for survey respondents:

TABLE 6.2Characteristics of postsecondary survey respondents

Total number of respondents

444

Respondent type

Percent

Public postsecondary

43.5

Private postsecondary

53.6

International postsecondary

2.9

- The college search process comprises the period in which students explore and identify colleges to which they intend to apply. It does not include the actual application process, but any and all research and planning that occurs prior, including meeting with school counselors, visiting colleges, consulting college search resources and websites, etc.

- The college application process is defined as the period that begins after a student decides the colleges to which to apply and ends with the application being sent. This period in the process includes determining how to apply (website, Common App, etc.), completing the application, writing essays, proofreading, requesting official school documents including transcripts and teacher recommendations, and submitting the application to the university.

- The college choice process is defined as the experience of a student deciding which college they will commit to attending. This includes analyzing acceptances and waitlist offers, interpreting financial aid award letters, and submitting an enrollment deposit.

- The college transition process is defined as the transition from high school to college once the student has finalized their college choice. This includes students finding support systems, navigating academic, social, and financial challenges, and managing new levels of independence.

Overview of Survey Findings

Although students face unique challenges during each phase of the college admissions process, there were some commonalities worth noting. For example, family pressure and expectations were cited as having substantial impact on students during the search, application, and choice phases. Specifically, the pressure to prioritize the prestige of college choices rather than a good fit for the student was reported to have significant impact during both the search and application phases. Difficulties managing time and tasks to stay on track with deadlines were most prominent during the search and application phases.

Common strategies that counselors use to help mitigate the effects of stressors related to the college admissions process include individual advising. Counselors also cite the importance of starting college advising early in high school rather than waiting until eleventh or twelfth grade. Counselors highlighted that an important part of individual and group advising is explaining the importance of fit rather than prestige in choosing a college to attend. During the application stage, many counselors encourage students to communicate directly with admissions offices, in support of growing independence and self-advocacy. College admissions officers can provide important support for students during the application stage.

The collective wisdom of surveyed counseling practitioners points toward important changes in the admissions process that would benefit the well-being of students. The changes that counselors indicated being most important related to increasing simplification and consistency in such areas as application requirements, deadlines, financial aid processes, and financial aid award letters. They also highlighted the need for more college counseling professionals to support students through the process.

Not surprisingly, the transition phase presents unique challenges compared to the first three phases. Once a student has been admitted and decided where to enroll, challenges become more related to separating from existing support systems, finding new community, and navigating the increased independence and self-advocacy required for life as a college student. For this phase, both counselors and admissions professionals highlight the importance of transition programming provided by either secondary schools or colleges, as well as the importance of helping to destigmatize seeking out mental health support. Common strategies that colleges use to support students include organizing campus visits, establishing cohorts of incoming students, and connecting new students with current college students. Most admissions offices also stay involved with the transition process by continuing to communicate with the students they have recruited.

Detailed Results: Secondary Survey

College Search Stage Complete results for counselors’ responses to the college search portion of the survey are shown in tables 6.3 through table 6.5, including the following:

- More than 40 percent of counselors reported that each of the following had a high impact on student mental health and well-being during the college search process (table 6.3):

- parent and family pressure and expectations

- focus on prestige in their college application lists

- concern about financial resources

- challenges with time management

- Schools and counselors use a variety of strategies to support students during the college search process and mitigate any potential negative impacts (table 6.4).

- More than 90 percent report providing individualized advising and emphasizing fit rather than prestige in their approach.

- More than 70 percent encourage family involvement, provide a college planning calendar, and start the process early.

- When asked to rank order what changes would have the most positive impact on students, the largest proportion of counselors chose focusing on fit rather than prestige (41 percent) as the most important, followed by hiring more school and college counselors (21 percent) (table 6.5).

College Application Stage Complete results for counselors’ responses to the college application portion of the survey are shown in tables 6.6 through 6.8, including the following:

- More than 40 percent of counselors reported that each of the following had a high impact on student mental health and well-being during the college application process (table 6.6):

- parent and family pressure and expectations

- challenges with time management

TABLE 6.3Degree of impact on student mental health and well-being during the college search process

High impact (4)

Moderate impact (3)

Little impact (2)

No impact (1)

Average rating

Focus on prestige in college application list

46.3

33.6

17.4

2.7

3.2

Lack of familiarity with the process

36.7

44.2

18.5

0.6

3.2

Challenges with time management

40.5

48.9

10.1

0.5

3.3

Confronting feelings of inadequacy

32.6

48.5

17.9

1.0

3.1

Parent and family pressure and expectations

55.3

34.5

9.9

0.4

3.4

Concern about financial resources

46.2

36.6

15.9

1.3

3.3

Lack of support from knowledgeable adults

12.9

27.5

49.0

10.7

2.4

Volume of information

34.7

43.2

20.3

1.9

3.1

Inability to visit colleges

14.6

31.9

46.1

7.3

2.5

Fear of leaving the familiar and dealing with different climates and cultures

16.8

36.0

41.5

5.7

2.6

- Schools and counselors use a variety of strategies to support students during the college application process and mitigate any potential negative impacts (table 6.7).

- More than 80 percent reported providing individualized advising and application assistance, encouraging students to communicate with admissions offices, and providing education about financial aid.

- Nearly 40 percent of counselors indicated that simplifying the process with consistent deadlines and application requirements would have the most positive impact on students (table 6.8).

TABLE 6.4Strategies used to support students during the college search process

Percent

Emphasizing fit rather than prestige in counseling activities and materials

91.8

Starting the process and education earlier

77.9

Individualized advising

92.8

College planning calendar that breaks down the process

71.8

Allowing time for the process during the school day

58.3

Providing stress-relieving activities during the school year

34.6

Encouraging parent involvement

75.8

Providing opportunities for college visits

61.3

Providing college information in different languages

16.8

TABLE 6.5Changes that would have the most positive impact on student health and well-being during the college search process

Percent ranked #1

Percent ranked #2

Percent ranked #3

Focus on fit rather than prestige

41.1

15.3

10.9

Resources for counselors

3.9

7.9

10.3

Starting the process and education earlier

8.3

17.1

14.4

Individualized advising

14.0

21.5

0.0

College planning calendar that breaks down the process

2.3

5.5

9.8

Schools allowing time for the process during the day

4.6

10.6

12.6

Hiring more school and college counselors to reduce student caseloads

21.4

12.9

10.7

More parent involvement

2.6

3.8

5.2

More opportunities for college visits

1.4

4.7

5.5

More college information in different languages

0.4

0.8

1.2

TABLE 6.6Degree of impact on student mental health and well-being during the college application process

High impact (4)

Moderate impact (3)

Little impact (2)

No impact (1)

Average rating

Lack of consistency across colleges in application materials and deadlines

35.4

41.4

21.7

1.5

3.1

Lack of understanding of how applications are evaluated

31.3

46.4

21.4

1.0

3.1

Parental and family pressure, including high expectations and focus on prestige

52.3

30.4

15.2

2.0

3.3

Challenges with time management

41.6

48.6

9.6

0.2

3.3

Feelings of inadequacy

24.1

43.5

21.4

0.9

3.0

Pressure to apply to unmanageable number of colleges

24.4

32.7

35.3

7.6

2.7

Lack of financial resources

35.6

34.2

26.7

3.5

3.0

Lack of support from knowledgeable adults

11.1

26.3

49.5

13.1

2.4

TABLE 6.7Strategies used to support students during the college application process

Percent

Individualized advising and application assistance

94.6

College planning resource/calendar to support time and task management

73.0

Allowing time to complete the application process during the school day

57.1

Encouraging communication between students and admissions offices

84.5

Providing stress-relieving activities during the school year

33.0

Educating students and families about financial aid options and applications

87.8

Advising students to limit number of applications based on their individual circumstances

63.0

TABLE 6.8Changes that would have the most positive impact on student health and well-being during the college application process

Percent ranked #1

Percent ranked #2

Percent ranked #3

Simplifying the process with consistent deadlines and application requirements

37.7

21.7

14.4

Emphasizing fit rather than prestige in college counseling activities and materials

18.6

20.5

15.6

Resources for counselors with easy ways to navigate different college deadlines and requirements

2.1

8.7

11.0

Colleges being transparent about the evaluation process

12.4

19.0

21.3

Individualized advising

11.4

10.8

11.3

Schools allowing time to complete the application during the day

2.6

5.4

8.2

Improved communication between admissions offices and students

1.3

4.4

7.0

Stress-relieving activities during the school year

0.5

0.7

1.6

Hiring more college and school counselors to reduce student caseload numbers

13.4

8.9

9.6

College Choice Stage Complete results for counselors’ responses to the college choice portion of the survey are shown in tables 6.9 through 6.11, including the following:

- More than 40 percent of counselors reported that each of the following had a high impact on student mental health and well-being during the college choice process (table 6.9):

- parent and family pressure and expectations

- focus on prestige rather than fit

- Schools and counselors use a variety of strategies to support students during the college choice process and mitigate any potential negative impact (table 6.10).

- More than 80 percent reported that they focus on fit rather than prestige in college counseling activities and materials, as well as discussing college selection during the application process.

TABLE 6.9Degree of impact on student mental health and well-being during the college choice process

High impact (4)

Moderate impact (3)

Little impact (2)

No impact (1)

Average rating

Lack of understanding of financial aid in general

34.8

45.9

17.9

1.4

3.1

Difficulty interpreting financial aid award letters and comparing options

37.8

42.2

18.5

1.4

3.2

Focus on prestige rather than fit

42.8

32.4

20.5

4.3

3.1

Parent and family pressure on students

44.9

38.8

14.9

1.4

3.3

College incentives that encourage earlier enrollment commitments

24.6

29.9

25.7

4.5

2.9

Navigating placement on waitlists

28.1

39.1

27.9

4.9

2.9

Inability of school/college counselors to provide individual guidance

14.2

21.9

37.1

26.9

2.2

Fear of leaving home and/or familiar environments

12.1

32.6

47.0

8.3

2.5

TABLE 6.10Strategies used to support students during the college choice process

Percent

Focusing on fit rather than prestige in college counseling activities and materials

86.0

Individual counseling sessions after admissions decisions are released

73.7

Discussing college selection during the application process

84.8

Providing parent education around selecting a college

60.5

Providing stress-relieving activities for seniors during the selection process

27.6

Programming related to understanding financial aid awards

58.0

- When asked to rank order what changes would have the most positive impact on students during the college choice process, the largest proportion of counselors chose focusing on fit rather than prestige (35 percent) as the most important, followed by standardizing the process to apply for financial aid (21 percent), and individual counseling sessions (21 percent) (table 6.11).

TABLE 6.11Changes that would have the most positive impact on student health and well-being during the college choice process

Percent ranked #1

Percent ranked #2

Percent ranked #3

Focusing on fit rather than prestige

35.2

13.4

13.1

Individual counseling sessions after admissions decisions are released

20.6

25.2

17.5

Standardizing the process to apply for financial aid

21.2

18.8

13.7

More frequent individual advising/counseling

10.1

16.8

19.3

Discussing college selection during the application process

3.0

9.8

10.6

Professional development for counselors on how to counsel students and families through the selection process

5.2

6.8

11.1

Increasing parent involvement and education

4.2

8.2

11.6

Providing stress-relieving activities for seniors during the selection process

0.5

1.1

3.1

College Transition Stage Complete results for counselors’ responses to the college transition portion of the survey are shown in tables 6.12 through 6.14, including the following:

- More than 75 percent of counselors reported that each of the following had at least moderate impact on student mental health and well-being during the college transition process (table 6.12):

- separation from existing support system

- difficulty with self-advocacy

- lack of understanding of postsecondary life, such as scheduling classes and interacting with professors

- The most common strategies used by counselors to support students in the college transition process were (table 6.13)

- encouraging and supporting students in communicating directly with admissions office and university transition-related services (81 percent)

- destigmatizing seeking therapy and counseling (65 percent)

TABLE 6.12Degree of impact on student mental health and well-being during the college transition process

High impact (4)

Moderate impact (3)

Little impact (2)

No impact (1)

Average rating

Lack of understanding about postsecondary life: scheduling and attending classes, interacting with professors

32.1

45.2

21.2

1.5

3.1

Difficulty finding community and connecting with faculty and students

24.9

47.9

25.7

1.5

3.0

Difficulty navigating campus support services and resources

24.3

48.3

25.5

1.8

3.0

Lack of support in the transition

23.6

42.8

30.8

2.8

2.9

Unexpected out-of-pocket expenses

24.5

27.7

23.5

3.7

2.9

Family expectations

27.7

44.0

26.4

1.9

3.0

Separation from existing support system

34.0

47.1

17.4

1.5

3.1

Lack of information from colleges during the transition

15.8

41.4

38.0

4.8

2.7

Difficulty with self-advocacy

31.6

46.5

20.5

1.3

3.1

TABLE 6.13Strategies used to support students during the college transition process

Percent

Transition programming via workshops and activities

40.2

Destigmatizing seeking therapy and counseling

65.3

Centralized online resource on the transition to college

15.2

Connecting students to current college students before orientation

38.2

Encouraging and supporting students in communicating directly with admissions office and university transition-related services

81.2

Establishing cohorts for students attending the same colleges

12.1

Organizing college visits before enrolling

26.9

TABLE 6.14Changes that would have the most positive impact on student health and well-being during the college transition process

Percent ranked #1

Percent ranked #2

Percent ranked #3

Transition programming via workshops and activities (provided by high schools and/or colleges)

45.2

16.9

13.8

Destigmatizing seeking therapy and counseling

16.4

19.4

12.1

Centralized online resource on the transition to college

7.9

15.8

13.2

Connecting students with current college students before orientation

7.2

15.1

16.8

Collaboration between college departments to consolidate messaging and support

4.1

6.1

8.5

More admissions office involvement in the transition via communication with students and counselors

5.5

9.4

14.0

College admissions offices establishing cohorts for incoming students and creating peer groups for first-year students

10.7

14.1

16.8

Organizing college visits before enrolling

3.0

3.2

4.9

- When asked to rank order what changes would have the most positive impact on students during the college transition process, the largest proportion of counselors chose transition programming via workshops and activities (45 percent) as the most important (table 6.14).

Detailed Results: Postsecondary Survey

College Transition Stage Complete results for college admissions professionals’ responses to the college transition portion of the survey are shown in tables 6.15 through 6.17, including the following:

- More than 40 percent of college admissions professionals reported that each of the following had a high impact on student mental health and well-being during the college transition process (table 6.15):

- unexpected out-of-pocket expenses

- difficulty finding community and connecting with faculty and students

TABLE 6.15Degree of impact on student mental health and well-being during the college transition process

High impact (4)

Moderate impact (3)

Little impact (2)

No impact (1)

Average rating

Lack of understanding about postsecondary life: scheduling and attending classes, interacting with professors

26.5

58.5

15.0

0.0

3.1

Difficulty finding community and connecting with faculty and students

43.5

40.1

15.0

1.4

3.3

Difficulty navigating campus support services and resources

34.0

44.7

19.3

1.8

3.1

Lack of support in the transition

30.6

36.3

30.2

2.7

3.0

Unexpected out-of-pocket expenses

47.4

33.8

17.9

0.7

3.3

Family expectations

31.7

42.9

22.0

2.0

3.1

Separation from existing support system

36.1

44.7

17.2

1.6

3.2

Difficulty with self-advocacy

39.0

42.4

17.0

1.1

3.2

- Colleges use a variety of strategies to support students during the college transition process and mitigate any potential negative impacts (table 6.16).

- More than 70 percent reported that they provide transition programming, communicate with students and counselors during the transition, and work to destigmatize counseling and therapy.

- When asked to rank the changes that would have the most positive impact on students during the college transition process, more than 40 percent of college admission professionals included the following among the top three (table 6.17):

- transition programming via workshops and activities

- connecting students with current college students before orientation

- establishing cohorts for incoming students and creating peer groups for first-year students.

TABLE 6.16Strategies used to support students during the college transition process

Percent

Transition programming via workshops and activities

83.7

Destigmatizing seeking therapy and counseling

74.1

Centralized online resource on the transition to college

39.9

Connecting students to current college students before orientation

52.6

Collaboration between college departments to consolidate messaging and support

49.9

Admissions office involvement in the transition via communication with students and counselors

78.5

Establishing cohorts for incoming students and creating peer groups for first-year students

63.7

Organizing college visits before enrolling

66.7

Facilitating a smooth transition from admissions staff to student affairs

58.7

TABLE 6.17Changes that would have the most positive impact on student health and well-being during the college transition process

Percent ranked #1

Percent ranked #2

Percent ranked #3

Transition programming via workshops and activities

19.7

15.8

17.7

Destigmatizing seeking therapy and counseling

14.7

13.5

11.7

Centralized online resource on the transition to college

11.9

10.1

13.3

Connecting students with current college students before orientation

11.9

16.5

13.5

Collaboration between college departments to consolidate messaging and support

6.2

11.9

11.5

Admissions office involvement in the transition via communication with students and counselors

6.7

6.2

8.5

Establishing cohorts for incoming students and creating peer groups for first-year students

17.9

12.8

11.9

Organizing college visits before enrolling

4.6

4.4

4.6

Improving the transition from admissions staff to student affairs

6.4

8.7

7.3

RECOMMENDED STRATEGIES FOR SUPPORTING STUDENTS

The NACAC ad hoc committee made a series of recommendations based on the survey results and the members’ collective expertise. The recommendations are structured within three main themes: (1) emphasizing fit over prestige in college choice, (2) simplifying the application and financial aid processes, and (3) expanding support for students.

Emphasizing Fit over Prestige in College Choice

A recurring theme in both the survey results and committee discussions related to the detrimental effects of focusing on prestige in college selection. Students and their families are often drawn to rankings and reputation, overlooking the importance of personal and academic fit. Identifying good-fit institutions includes, but is not limited to, consideration of students’ academic and career interests, campus culture, availability of support services, and willingness and ability to travel from home. Misalignment between student needs and the institutional environment can lead to heightened stress during the application process and, in many cases, dissatisfaction and disconnection once enrolled. Counselors reported that emphasizing fit over prestige can result in significant improvements in student well-being and decision-making. Advising related to the importance of fit often needs to involve parents and families, who can be the source of pressure on students to apply to institutions that are perceived as the most prestigious, sometimes due to misinformation about the relationship between selectivity and quality. We acknowledge that this is a challenging issue to address, especially as the mainstream media continues to focus coverage on highly selective institutions (as opposed to the majority of institutions that admit most of the students who apply).[16] However, counseling can help mitigate this growing phenomenon of prioritizing prestige over fit.

Simplicity and Transparency in the College Application and Financial Aid Process

The inconsistencies in college application platforms and the lack of transparency in admissions and financial aid processes further contribute to student anxiety. Committee members identified the lack of consistency in applications and the process, overall, to be a great source of confusion and stress for students. Students who apply to multiple institutions may have to contend with different application portals, deadlines, admissions requirements, and ways of applying, such as early decision or early action. Even among colleges that use the Common App, supplemental essays that differ across institutions may be required. There may also be different deadlines related to housing and financial aid. The NACAC committee recommended creating more uniform application procedures and improving clarity around essay prompts and deadlines. These changes could simplify the process for students and reduce the confusion that often amplifies their stress.

In addition, we recommend institutions of higher education consider lowering the number of essay questions and prompts they currently ask students. Many institutions require several essays and short answer questions. Other institutions require videos or other creative projects. While these can certainly help admissions officers get to know students better, it places an incredible burden on students, who are usually applying to many institutions. The question admissions officers should grapple with is—is the benefit we are receiving from our admissions requirements worth the extraordinary burden they place on students and counselors?

For many years, NACAC has advocated for a more systematic consideration of simplicity to both alleviate undue burdens on students and professionals and to advance equity in the process.[17] In 2022, NACAC partnered with the National Association of Student Financial Aid Administrators (NASFAA) and the Lumina Foundation to reimagine college admissions and financial aid through an equity lens. The resulting report, based on a convening of thought leaders, as well as student interviews, encourages a wholesale reconsideration of how students apply to college and what is required as part of an application.[18]

Across the nation, efforts are underway to heed this call for simplification. Several state higher education systems, including Idaho, Minnesota, and Wisconsin, have implemented some form of system- or statewide direct admissions program.[19] These programs proactively notify students that they have been accepted to one or more institutions and either greatly simplify or eliminate the application, as well as fees. Statewide repositories of academic records allow some institutions to directly admit students, but others may use student-reported information that is then verified through high school transcript submission.[20] While there are variations in how these programs are implemented, they are all designed to reduce the burden on both students and counselors. They also have the benefit of reducing anxiety in the process and encouraging students who may have been uncertain about their admissibility to college.

Although direct admissions programs are not currently an option for many states and institutions, there are still steps toward simplification that can and should be considered. Every step in the application process and every requirement of applying create a burden for students. Removing barriers results in more students completing the process. College admissions offices should regularly evaluate whether all the requirements they ask of students are necessary for making admissions decisions at their institutions and critically examine the cost to students and counselors versus the benefits provided. This should include testing, essays, letters of recommendation, videos, interviews, and more.

Another substantial step toward simplifying the process came with the 2024–25 FAFSA cycle.[21] Ultimately, the improved FAFSA substantially reduces the information that students need to provide to apply for financial aid. Unfortunately, the rollout of the new form was particularly problematic, which placed additional burdens and high degrees of stress on students and families.[22] As a result of the technical difficulties with the new FAFSA rollout, colleges received student information late, which delayed student financial aid offers. For the many students and families who rely on financial aid to be able to afford college, they were unable to make informed choices about where to attend. During this time, NACAC encouraged institutions to consider extending deposit deadlines beyond May 1 (if applicable), and many did so. Improvements to the financial aid application process should continue, with consideration to the verification process, which requires many students who have submitted FAFSA forms to complete an audit-like review process.[23] This process requires additional forms and multiple types of supporting documents, placing an undue burden on the students most likely to need financial aid.[24]

Expanding Support for College Students

Increasing support for students during the college admissions process starts with advocating for the counselors who advise them. Secondary school counselors, particularly those in public schools, are significantly overburdened with high caseloads and fewer resources.[25] In addition to the high caseloads, counselors are expected to fill a variety of roles, leaving even less time for college counseling.[26] Putting more counselors in schools and providing these professionals with proper training in admissions, financial aid, and counseling students from underrepresented backgrounds is critical. Even with reductions in the complexity of the process, students will always need expert assistance to navigate the transition. Individual states and school districts should consider increasing the resources allocated for school counseling and advising, thus lowering the average number of students per counselor. NACAC research shows that students who meet with a college advisor have a higher likelihood of applying to college and completing the financial aid process.[27]

The NACAC ad hoc committee also identified early intervention as critical to student success. Starting college planning in ninth and tenth grades could help students and families better understand the process, alleviate anxiety, and explore a wider range of postsecondary options. Providing accessible resources and consistent messaging about key topics, such as financial aid and the importance of fit, is essential.

The support students need doesn’t end once they are admitted to college or even after high school graduation. According to results of the NACAC ad hoc committee’s work, the next steps in enrolling and transitioning to campus life can be confusing. Students can encounter difficulty finding community and connecting with faculty and students, as well as navigating campus support services and resources. The committee recommended that college admissions offices maintain personalized contact and communication with students and families between high school graduation and college enrollment. They also highlighted the importance of strong connections between admissions and student affairs professionals and recommended that colleges extend and strengthen orientation programs. Information about mental health, disability, and other support services that colleges provide should be shared throughout the recruitment, application, and transition process. The right support as students begin postsecondary education can make the difference between students who continue to have success in college and those who struggle.

Finally, professionals working in both secondary and postsecondary settings can create an environment where therapy and counseling are normalized, stress-management activities are promoted, and mental health support is fully integrated.

A CALL TO ACTION

The transition from high school to college is a pivotal moment in a student’s life, and the responsibility to ease this shift must be shared across all stakeholders in education. By addressing the systemic issues that perpetuate stress and anxiety, we can create a process that is equitable, transparent, and supportive. The recommendations of the NACAC committee offer a road map for fostering a healthier approach to college admissions—one that prioritizes the mental health of students and the professionals who guide them. As we move forward, let us reimagine the college admissions process not as a source of anxiety but as a milestone of opportunity and growth. The college admissions process has not evolved in decades, and it is time for innovation. Maximizing the number of students to succeed in higher education is critical for our nation’s economic prosperity. The jobs of the future will require postsecondary education and training, and we need as many students as possible to be given the opportunity to get into college and succeed. Removing barriers for students and increasing resources for college access professionals is a critical first step in ensuring the nation has a well-educated citizenry. By aligning our practices and resources with the values of equity, compassion, and transparency, we can ensure that every student has the chance to thrive during the transition to postsecondary education.

VOICES FROM THE FIELD

Lauren DeutserClinical Social Worker and Psychotherapist

Lauren Deutser is a clinical social worker and psychotherapist who specializes in supporting college students. She has been in private practice for five years working one-on-one with undergraduates at both the University of Texas at Austin and the University of Colorado Boulder. The deep therapeutic work that she provides for young adults gives her an important vantage point on both how and why they are struggling as they navigate the path to and through college.

A large part of Deutser’s work involves normalizing students’ struggles and helping them to see that they are not alone in experiencing stress, anxiety, and loneliness during college. She helps students understand that their feelings are not only valid but common. Her empathetic approach to supporting young people in moments of transition offers an important opportunity for us to think about how we can meet students’ needs in a developmentally grounded way that respects both their perspective and their lived experience.

SUPPORTING STUDENTS IN TRANSITION

Deutser typically works with students who start college right after high school and are enrolled in college during a distinct developmental stage (age eighteen to twenty-five). As she explains, her students are neither fully independent adults nor adolescents. In this liminal space between childhood and adulthood, she notes that it is important to meet them where they are and to offer them room to grow with appropriate scaffolding in place. Supporting young adults in this transition requires a balance of respecting their autonomy while often still engaging with their parents. To do this, she approaches students through a values-based and goal-oriented framework, helping them define what matters to them and supporting them in making decisions that align with these values. In the process, she focuses on helping students manage anxiety, depression, and adjustment challenges that emerge in the transition to college life and to normalize what is inherently hard in these processes.

Deutser highlights the disconnect between expectations and reality for incoming first-year students, noting that many students arrive on campus expecting college to be the “best four years” of their lives, only to find themselves struggling academically and socially.[1] Encountering these struggles against a backdrop of these heightened expectations can be profoundly disorienting. Deutser explains that this false expectation sets up students for both disillusionment and shame. Many students believe they’re the only ones having a hard time, even when those closest to them are feeling the same way. In her therapeutic practice, Deutser uses personal anecdotes and shares observations from her clinical work with her patients to help them understand that the transition to college is hard for most students and reduce the shame that many feel when they assume that they alone are struggling. Just as importantly, she helps them develop strategies to navigate these challenges and make things better in the process.

SCAFFOLDING LIFE SKILLS

In addition to the realities of college life and the disconnect between expectations and reality, Deutser sees a widespread lack of basic life skills among students as a major source of stress that can be easily addressed with appropriate scaffolding. While some students arrive at college with experience helping at home, those who do not can struggle as they assume unfamiliar responsibilities like household chores, budgeting, time management, and paying bills. Life-skills challenges and the anxiety that they provoke can peak at the start of sophomore year when many of the students she works with move off campus and away from the institutional supports that are found in the dorms. She encourages proactive conversations about cleaning, grocery shopping, budgeting, and other life skills to help students prepare to take on these tasks. She also advocates for encouraging students to have explicit conversations with future roommates about expectations around cleanliness, cost sharing, and privacy both before and after moving in together. Navigating these tasks and potential tensions on top of the other responsibilities of campus life can become overwhelming, so creating the space to have these conversations, develop these skills, and grow into this new role is important for minimizing stress and anxiety.

PREPARING FOR REAL CRISIS

While day-to-day life can cause expected stresses, it is not uncommon for students to encounter single event crises that disrupt their mental health in college as well. Deutser notes that institutions often fail to support students in moments of unexpected crisis, such as navigating the death of a loved one, substance use and abuse, or serious allegations involving peers. She argues that institutions must do more to provide compassionate responses during difficult moments and to use them as opportunities for building both trust and resilience. Of course, building trust with the institution and a robust caring campus community before these moments of crisis can pave the way for meaningful support in these moments as well.

CHAPTER 7
Addressing Anxiety in Planning for Post-Collegiate Life

JOSEPH CATRINO

Dartmouth College

DUSTIN LIU

New York University

Students today are navigating a complex labor market and grappling with competing pressures of economic security and expectations of success embedded within each campus context. Technological advancement, economic volatility, the environmental crisis, and the COVID-19 pandemic combined to disrupt and redefine what it means to navigate a career in the twenty-first century.[1] Traditional employment models, characterized by linear trajectories and long-term occupational stability, have increasingly given way to dynamic, nonlinear, and often unpredictable paths. It is common for students to experience anxiety when faced with an ambiguous labor market and a rapidly transforming landscape of work that makes traditional career guidance feel less relevant and useful. Students today are entering this volatile environment at a time when foundational expectations around work are being questioned.

The World Economic Forum and McKinsey Global Institute emphasize that core competencies, such as critical thinking, collaboration, and adaptability, are essential for success in the future of work.[2] Yet many students report a gap between institutional preparation and the realities of the labor market—an issue exacerbated by the speed of innovation and the rise of artificial intelligence (AI).[3] As a piece on the future of higher education notes, “the future trajectory of higher education is intricately linked to emerging technologies,” with AI reshaping industries and roles before students even enter them.[4]

This state of ambiguity has become a defining feature of modern career experience. A 2023 paper describes this ambiguity as a key stressor in student way finding, challenging the assumption that students can—or should—have fixed career goals early in their academic journeys. Instead, the future of work demands agility, reflection, and the capacity to make iterative decisions over time.[5] However, traditional career education models often promote rigid planning and early specialization, which can intensify pressure and reduce students’ willingness to explore.[6]

The psychological toll of navigating these realities is increasingly well documented. Students today report heightened levels of anxiety, stress, and self-doubt as they attempt to reconcile career aspirations with shifting job markets and societal expectations.[7] The phenomenon of “career paralysis,” the fear of making the wrong choice, has been identified as a common emotional barrier limiting proactive engagement and experimentation.[8] This paralysis can be compounded by social comparison, the opacity of emerging job roles, and a lack of clarity around personal values and strengths.[9]

Higher education is at an inflection point. The convergence of rapid technological change and growing student mental health concerns demands a reimagination of how institutions prepare students for professional life. As the boundaries between career preparation and emotional well-being continue to blur, new models of career education must center the whole student: cognitively, emotionally, and developmentally. In this context, mental health and career readiness are deeply interconnected. Students who lack support in navigating ambiguity may experience diminished well-being, reduced self-efficacy, and a weakened ability to make thoughtful and confident decisions. As such, career education must evolve beyond résumé workshops and job placement strategies. It must include frameworks that cultivate resilience, adaptability, and self-awareness—capacities that allow students to manage transitions while sustaining their mental health. Research-backed innovations, such as Life Design, narrative coaching, and strengths-based advising, offer promising pathways forward.

The future of work is unfolding amid tectonic shifts: technological disruption, climate volatility, economic instability, and social transformation. These disruptions have fundamentally altered not just how people work but how they prepare for work, how they see themselves in work, and how they remain well within work. Today’s college students are no longer navigating a path; they are navigating a landscape that is still being drawn.

This uncertainty has real consequences. Research shows rising anxiety, a growing disconnect between career preparation and emerging job markets, and emotional fatigue from rigid, outdated career education models.[10] What’s needed is a new playbook—one that acknowledges the emotional reality of navigating the unknown and equips students with frameworks and mindsets rooted in adaptability, resilience, and meaning making.

Today’s students in higher education face increasing challenges of ambiguity due to today’s rapidly evolving world. This ambiguity, which has become a defining feature of career way finding, creates new challenges in the student experience.[11] The linear career paths of the past have given way to dynamic, nonlinear journeys shaped by technological advancements, global shifts, and the changing nature of work.

The evolving nature of work amid immense disruptions occurring across the globe coupled with rising expectations around career preparation and decision-making have contributed to increased anxiety among students navigating career pathways. Traditional career education often focuses on linear trajectories, with students feeling pressure to define their goals early and stick to rigid plans.[12]

Navigating career transitions, developing new skills, and redefining personal and professional identities in response to change can heighten stress, anxiety, and feelings of inadequacy.[13] By helping students build resilience, adaptability, and self-awareness, professionals can equip them with the tools to manage change effectively while maintaining their mental health.

Simply, this can be overwhelming, especially when faced with uncertainties about the future of work, such as the impact of automation, economic instability, explosion of artificial intelligence, and the emergence of new industries. Students may experience “career paralysis,” where the fear of making the wrong choice hinders their ability to explore opportunities and take proactive steps.[14] Career anxiety is also fueled by comparison to peers, societal expectations, and a lack of clarity about their personal strengths and values. Without adequate support and coaching, these stressors can negatively impact a student’s mental health and their ability to make thoughtful, confident, and informed decisions about their futures.[15]

How can students prepare themselves for jobs that don’t yet exist? This question poses a critical issue for higher education and its preparation of students for the future of work.[16] This ambiguity can ultimately create feelings of stress and anxiety as students are faced with a landscape where roles are constantly redefined, industries are disrupted, and future opportunities remain uncertain is commonplace. The reality of this landscape begs for innovation and opportunities to reimagine how higher education can meet students in this moment. These disruptions influence mental health, as individuals face increasing uncertainty and pressure to adapt.

This chapter begins with an overview of Life Design and outlines the beginnings and theoretical foundations of the work. Through case studies, we illustrate how Life Design can address anxiety in planning for post-collegiate life as well as some practical exercises that can be delivered by peers, facilitators, and career counselors. We follow this with a case study of how this work impacted the career offerings at Trinity College to illustrate the application of this curricular approach in context. The primary goal of this chapter is to offer an understanding of Life Design and explore how it can be implemented on college campuses as an additional support for positive student mental health and well-being.

GROWTH AND DEVELOPMENT OF LIFE DESIGN

Life Design was founded at Stanford University, a private, four-year research university located in Stanford, California, with 7,600 undergraduates.[17] The Life Design Lab is grounded in the traditions of design thinking and positive psychology. As defined by Life Design Lab founders Bill Burnett and Dave Evans, the process of Life Design encourages individuals to approach their careers with curiosity, experimentation, and a willingness to prototype new possibilities.[18] Life Design methodologies, which emphasize reflection, prototyping, and purpose-driven exploration, offer a critical foundation for addressing the emotional toll of career exploration fostering clarity and confidence in students’ evolving career journeys.[19] It can be described as both a model and a curricular approach, composed of modules that can be delivered through one-to-one coaching as well as both co-curricular and curricular offerings. While traditional career education and planning focuses on milestones and predefined goals, the process of Life Design embraces a holistic approach that integrates mental health and well-being into its frameworks.

Since being developed at Stanford University through a course, the curriculum and process have been shared through an external training program called the Life Design Studio. As a result, the Life Design process has impacted thousands of students and educators at nearly five hundred educational institutions. As a result, a series of adaptations have been crafted by student affairs professionals based on this foundational work.

As Life Design expands in educational settings, understanding the effectiveness and outcomes of these interventions has become critical. Evaluations at various institutions show promising results, including increased self-efficacy, resilience, and career readiness. These assessment and evaluation efforts target the question of Life Design’s efficacy in improving student well-being and mental health.

Assessment work at California State University Dominguez Hills (CSUDH) focused on the impact of the Design Your Life (DYL) course on 429 transfer students. CSUDH is a public four-year university located in Carson, California, serving 12,599 undergraduates. Each year, 3,482 new enrollees transfer into the school.[20] Transfer students were chosen due to the unique challenges that they face in higher education, specifically the fact that university policies and systems prioritize native students.[21] Furthermore, there were concerns in enrollment data of transfer students that disproportionately impact students of color.[22] As a result, a Life Design program was established at CSUDH as a seminar for transfer students.

The transfer students were given an opportunity to join this transfer seminar course as part of their experience. Of the students who participated, 76 percent were from underrepresented minority groups, 75 percent were first-generation college students, and 81 percent were female. This assessment demonstrated that participation effectively reduced career anxiety, increased career self-efficacy, and improved career search knowledge and resilience compared to the control group (figs. 7.1 and 7.2). Black students showed significant improvement in wellness, and first-generation college students gained more confidence in job searching and career identity resilience.[23]

FIGURE 7.1Mean difference in purpose, hope for the future, and wellness

Source: Heather A. Butler and Marc C. Hunsaker, “A Case for Life Design: An Innovative Seminar to Foster Success for Students Who Transfer Through Career Exploration, Agency, and Readiness,” in Ensuring Success for Students Who Transfer: Collaborating Across Diverse Institutions, ed. Barbara E. Tobolowsky and Margaret J. Cox (University of South Carolina, National Resource Center for The First-Year Experience and Students in Transition, 2024), 43–56.

FIGURE 7.2Mean differences in pre-course and post-course assessments

Source: Butler and Hunsaker, “Case for Life Design,” 43–56.

Two independent studies at Stanford University’s Graduate School of Education have examined the effects of the university’s Life Design curriculum to evaluate the connection between course participation and student well-being.

FIGURE 7.3Mean scale averages for classes

Source: Lindsey N. Oishi, “Enhancing Career Development Agency in Emerging Adulthood: An Intervention Using Design Thinking” (PhD diss., Stanford University, Graduate School of Education, 2012).

Lindsey Oishi evaluated a ten-week Life Design course using pre- and post-course questionnaires to assess changes in career development self-efficacy. Figure 7.3 demonstrates the impact of the intervention, with the study finding that the intervention improves self-efficacy, implicit career beliefs, and their purpose in life. These are key aspects to the career exploration experience that impact mental health and well-being, demonstrating Life Design’s effectiveness in improving student outcomes.[24]

Tim Reilly employed a mixed-methods design to study a similar ten-week course, integrating cross-sectional surveys and longitudinal case studies. Through inductive interviews with five students who participated in the course, Reilly found that activities such as reflective exercises and peer discussions contributed to these improvements. While this was a limited sample size, the qualitative findings indicated that the intervention enhanced personal growth, career decision-making, self-efficacy, and overall well-being. Reilly found that activities that were part of the Life Design curriculum allowed for the acquisition of various coping strategies and greater awareness of their existing constraints. Students who participated described greater use of brainstorming when faced with career decisions and the effective use of a variety of coping strategies to mitigate stress associated with career decision-making.[25]

Across several schools in the Life Design Studio community, there has been an acute focus on the development of mindsets and practices to mitigate feelings of stress and anxiety. This body of research has shown that Life Design can change the conversation about career exploration on college campuses by empowering students and encouraging resilience in the face of ambiguity. When considering the key causes of mental health challenges, we believe that the Life Design framework is an effective intervention to mitigate these challenges.

DESIGNER MINDSETS AND STUDENT CHALLENGES

Life Design is an application of Design Thinking, a human-centered innovation process originally developed within engineering and design disciplines. The emphasis on empathy and human-centered innovation inspired Life Design’s pedagogical foundations, which prioritize self-awareness, experimentation, and flexibility in navigating career and life decisions. Thinking like a designer allows students to leverage the mindsets and practices that are useful to engage in experimentation and creativity.[26]

Design thinking’s emphasis on action over analysis and its acceptance of ambiguity offer a practical pathway for the anxiety students often experience during career exploration. These attributes of the design process have been adopted to encourage students to take an active approach to exercising their individual agency. As students confront rapidly evolving career landscapes, fostering psychological flexibility, resilience, and purpose becomes essential. Life Design operationalizes these insights into a coherent framework that supports both well-being and career exploration simultaneously.

The six mindsets that Life Design aims to encourage are (1) curiosity, (2) bias to action, (3) reframing, (4) radical collaboration, (5) storytelling, and (6) mindfulness of process. In this section, we explore each individual mindset and their connection to student development and well-being.

(1) Curiosity

Curiosity is the psychological foundation of exploration and can be defined as an intrinsic drive to seek novelty, expand understanding, and close gaps in knowledge.[27] Studies have demonstrated that curious individuals are more likely to engage with life’s complexities, demonstrating higher well-being and levels of purpose.[28] In Life Design, curiosity is the starting point that encourages self-inquiry and career experimentation. Further reinforcing the psychological benefits of curiosity, studies have demonstrated that curious individuals are more likely to engage with life’s complexities, demonstrating higher well-being and levels of purpose.[29] This allows students to consider the variety of options that may exist for them directly by generating new options and questioning existing constraints that may exist. When considering the connection to student mental health, a sense of curiosity can offer students the chance to engage in expansive thinking and provide a pathway for self-awareness.

Emily, a junior business major at Stanford University, illustrates how curiosity can support career exploration. As a first-year student, she became interested in accounting in the public sector. By the start of her sophomore year, with the emergence of AI, she began to feel concerned about her long-term career prospects. As she approached her junior internship, she began to feel the weight of these questions against the backdrop of national economic and political uncertainty. Will internships be available? What will she do this summer? How will AI change her interest in this industry?

Emily began exploring careers outside of accounting, a career path she had been fixed on for much of her college experience; the questions that arise are plentiful. We have found that working with students can result in feeling stuck. Activities that cultivate curiosity can invite Emily to scaffold her exploration and encourage experimentation. Curiosity results in students actively seeking new information, thinking more creatively, and opening to new experiences. It may result in Emily deciding to pursue a shadowing opportunity with an alumnus or exploring a new field entirely. For many students, starting from a place of curiosity is often the first step in getting unstuck. Emily found a renewed career interest in fashion after shadowing the aforementioned alumnus and engaging in her own curiosity.

At Trinity College, Matthew was a sophomore student who was pushed into a career in business due to family expectations. As a result of being introduced to Life Design, he began to consider opportunities outside of this discipline. Through a variety of empathy interviews with alumni in different fields, he began to talk about his interests that were typically tempered because of his family expectations. It became clear that he wasn’t authentically able to express his interests due to these constraints. As a result of speaking with a variety of alumni through the empathy interview exercise, Matthew decided to pursue a career in law, leveraging the liberal arts curricular offerings at his institution that he previously had not explored.

(2) Bias to Action

The mindset of a bias to action encourages students to take an active stance and test ideas through experience rather than overthinking or delaying action.[30] As a central tenet of design, this mindset encourages the idea that ideas can’t remain theoretical but rather need to be tested for learning to occur. Research on persistence and sustained passion further affirms that success is less about immediate achievement and more about iterative, purposeful engagement with effort over time.[31] Students, in turn, build agency through the act of doing.

The students that we see in our classrooms and offices have a challenging time translating their career goals and ideas into practical learnings. Many students approach career exploration as a theoretical or intellectual exercise instead of beginning to experiment and actualize these thoughts. In our work with students, we have found that this is the result of a confluence of factors. For one, the career process can be filled with anxiety associated with choice paralysis. Secondly, as a result of choice paralysis, students do not actively pursue an interest they are cultivating. These interests may sometimes become too abstract to explore. This results in students choosing not to choose due to fear of choosing the wrong career path. In contrast, Life Design emphasizes the idea of learning by doing. The simple act of creating more achievable incremental goals can reduce stress and increase the amount of learning a student can gain. It also can illuminate the personal agency the student can have in getting unstuck.

Donald was a senior design student when he took his Life Design course. He shared, through engaging with his curiosity, a deep interest in living abroad, though he had not yet left the country. While he started to do some research, he quickly found himself feeling overwhelmed by the logistics and the number of choices that he could take to move toward his goal. Taking a bias-to-action approach, he began to think about the incremental steps he could take toward pursuing his goal of living abroad.

This decision to move abroad was strictly something that he was considering instead of actively pursuing. When working with his Life Design coach, they began to consider the first next step to move toward this desire, which resulted in coaching sessions focused on selecting a country. He started by listing what he was hoping to learn from the experience before comparing his criteria to a longer list of countries he had interest in moving to in order to narrow the list down. He then engaged in informational interviews with individuals who lived in those countries, and instead of flying to visit, he started by visiting each city using the street view on Google Maps. This series of steps represents what Life Design aims to instill in students: the power of incremental steps leading toward clarity and learning.

Another student at Trinity College, a private, four-year liberal arts college in Hartford, Connecticut, with approximately 2,237 undergraduates, Mary joined a DYL seminar, where she was exposed to activities that began to encourage her ability to seek opportunities on campus.[32] She participated in the marshmallow challenge to build the tallest tower in fifteen minutes with spaghetti, tape, and string that must support a marshmallow. This activity supports students in recognizing the importance of taking incremental steps to gain data and understanding of the problems they are hoping to solve. Many students plan and build until the very end without testing the weight of the marshmallow or the stability of the structure. Mary began to apply this learning to her experience on campus. She actively began reaching out to faculty members, engaging in campus resources, and finding ways to “gain data” on her career interests, including actively engaging with alumni and volunteering in the local community. She benefited by building a network that ultimately resulted in her first internship. Even after graduating, she reflects on how these initial steps allowed her to gain great exposure to her interests.

(3) Reframing

Reframing is defined as the ability to shift one’s perspective on a particular question, context, or constraint. This is a cornerstone to building adaptability in the Life Design curriculum, encouraging students to consider the various frames by which a question or challenge can be understood.[33] Research on framing effects reveals how individuals’ decisions and emotional responses are profoundly shaped by the way information is presented. By changing the frame, people can unlock new options for action and emotional regulation.[34] This connects well with the concept of learned optimism, which argues that reframing adverse events in more hopeful, explanatory terms support persistence and resilience.[35] In Life Design, this kind of reframing supports students in overcoming career paralysis and self-limiting beliefs by encouraging reinterpretation of past challenges, such as learning experiences and future unknowns, as opportunities for agency.

Leah was a sophomore student at Texas A&M Commerce, a public four-year university in Commerce, Texas, with around twelve thousand undergraduate students.[36] Based on conversations with her orientation leader, she became deeply interested in the field of business consulting and began participating in an on-campus consulting group. She quickly became fixated on how a career in consulting would allow her to gain the skills she needed to start her own business. She heard from many peers that this would be an efficient way to move toward her goals. With a highly competitive consulting internship recruitment process, she was ultimately unsuccessful and felt a sense of career paralysis. Through working with her Life Design coach, she engaged in the process of reframing her career questions. Her question moved from “How do I get a job in consulting? to “How do I gain entrepreneurial experience that will support my goals of starting my own business?” This opened the aperture for additional solutions and steps forward. Instead of pursuing a career in consulting, Leah ended up teaching entrepreneurship courses in a nearby community center, working with women who were interested in starting small businesses. As a result, she gained experiences that supported her goal in a meaningful way that further supported her goal of building an entrepreneurial community.

Kevin, at the University of Texas at Austin, a public flagship research university of over forty thousand undergraduate students, similarly benefited from this reframing mindset.[37] As a freshman in the business program, he felt a strong alignment between his major choice and career path, not wanting to pursue opportunities or interests outside of the school of business. In the Designing Your Life course, there is a strong focus on reframing career-major alignment. As a result, Kevin felt empowered to explore his interest in art, which resulted in a career in art auctioning. The reframe around the normative standards that students hold for the relationships between majors and careers on his college campus.

(4) Radical Collaboration

Life Design encourages radical collaboration with an emphasis on how career and vocational way finding cannot happen in isolation. Challenging the myth of the individualist approach to career exploration, radical collaboration is a mindset rooted in a lack of creative ideas that can result from individual ideation. Rather than limiting ideation to just one’s own ideas, radical collaboration invites others to contribute as well. This collaborative spirit ultimately allows for more effective idea generation. It is also a recognition that better decisions, deeper insight, and greater emotional support emerge when individuals design their lives in community with others.

In the Life Design context, collaboration is not a luxury but an imperative as students are asked to engage in ideation sessions, peer coaching, and community problem-solving that encourage greater creativity and imagination. Life Design learning environments strive to cultivate such safety, especially in moments when students confront vulnerability or identity uncertainty in their career exploration. Radical collaboration also serves to normalize the fear, anxiety, and stress that students may be experiencing as they plan for post-collegiate life. When students hear their peers articulate feelings and emotions that they are holding, they are often reminded that uncertainty is a common experience that their peers are facing.

This mindset is actualized in the facilitation and teaching of the Life Design curriculum. Faculty members and facilitators place a specific emphasis on supporting students in collaborating on their questions and interests. Many activities focus on supporting students in building connections and leveraging the wisdom of their peers. Specifically, radical collaboration can help challenge their existing beliefs in themselves and their career exploration. Group exercises and group sharing, as well as facilitated activities for peers to share their perspectives, encourage greater divergent thinking and curiosity for Life Design students.

Carol Crosby is a Life Design educator at Bridgewater State University, a public four-year university located in Bridgewater, Massachusetts, that serves eight thousand undergraduate students, where 45 percent of the students are first generation college students.[38] She designs activities that encourage students to get feedback on their work from their peers. She invites students to pose questions of themselves: What do you see that your peer is not seeing? Are there opportunities on campus they should be pursuing? What advice might you give your peers if you were them? As a result, students can see their peers as sources of support, furthering a culture of help-seeking behavior and vulnerability that can support mental health concerns. Even after the Life Design course ends, students demonstrate a desire and interest in serving as advisors to their peers.

(5) Storytelling

Storytelling is a developmental process. Through sharing and shaping personal narratives, individuals make sense of their past, express their values, and imagine their future selves. The storytelling mind-set focuses on the act of sharing experiences and learning with others. In Life Design, it empowers students to externalize, examine, and ultimately shape the stories they live by. Research argues that narrative is the primary mode through which human beings construct reality. Story can be deeply tied to personal identity and self-perception.[39] In the classroom, this pairs with radical collaboration to offer space for students to share their experiences with Life Design facilitators and their peers.

Like radical collaboration, this is oftentimes embedded as a key part of the Life Design pedagogy. Facilitators will often encourage storytelling to increase student articulation of their desires, needs, and constraints. By practicing with peers and sharing stories of their interests with their peers in the classroom, they are better able to communicate their interests to alumni, faculty, and other stakeholders who might be able to connect them with opportunities that align with their career interests. Storytelling can also be a critical mindset to normalize career exploration challenges that may impact students’ sense of belonging and well-being. It ultimately supports students to feel less alone in these campus challenges, resulting in students sharing more openly in class activities.

(6) Mindfulness of Process

Finally, mindfulness of process as a mindset helps students gain awareness of where they are positioned in the Life Design process. The Design Thinking framework offers steps to identify post-collegiate planning. When students skip a step, they can miss critical data needed to move forward in the process. A process orientation can support students in drawing Life Design tools and techniques in moments of transition to identify where they are in the process and move toward action.[40]

Too often, students jump to generate options for career decisions without considering their own interests, curiosities, and challenges. Students in Life Design courses are encouraged to take the time to empathize with themselves, define a problem they are curious about, and ideate lots of solutions before moving forward in their career exploration process. Instead of jumping toward the first internship available, students are mindful of where they are in the design thinking process to effectively leverage the benefits of thinking like a designer.

Luca, a design student at Stanford University, began searching for design roles in the Palo Alto area because it was what many of his peers were doing. After taking the Designing Your Life course, he began to understand that he had missed the process of self-empathy, defining a key question he was interested in solving, and didn’t ideate options. Instead, he followed the career patterns expressed by his peers. Mindfulness of process requires students to move through the design thinking process, step by step. Luca ended up recognizing that his key interest was working in his hometown of Philadelphia. He began exploring his interest in public service design. As a result, Luca identified opportunities in Philadelphia that matched his interests in design and public service. This allowed for greater coherence and alignment between his interests, values, and skills.

In a context when the future of work demands not just skills but emotional agility and the ability to think creatively about one’s career path, Life Design offers a model of career education that prioritizes growth over certainty, identity over outcome, and progress over perfection.

LIFE DESIGN ACTIVITIES

This section presents a selection of exercises used in Life Design programming that are reflective of how schools implement the framework. Across the Life Design community ecosystem, these exercises are either experientially facilitated or delivered through a coaching conversation.

Odyssey Planning

Odyssey Planning is a flagship exercise of the Designing Your Life curriculum designed to help individuals map out multiple versions of the next five years of their lives. By engaging in Odyssey Planning, participants can consider and broaden their horizons, “unanchoring” from previously calcified career decisions. The exercise encourages students to consider diverse futures and ultimately make more informed, intentional decisions about their life paths. In the context of mitigating career anxiety, the premise of the Odyssey exercise is to create optionality supported by the theoretical foundations of design thinking and career development literature.

FIGURE 7.4Odyssey Planning template

© 2017 by Dave Evans, Bill Burnett, and Stanford University

During this exercise, a facilitator invites students to recognize that there are many divergent paths in front of them to choose from rather than one set path or one “best” path. Facilitators encourage students to think expansively and to not limit their imagination when imagining their futures. Students are asked to consider three radically different lives and are given time in class or as homework to generate at least one professional and one personal milestone in each year of the five-year plan (fig. 7.4). They are then asked to consider the following prompts to generate these three different lives:

Life 1: The story you tell today if everything worked out according to plan.

Life 2: What if that life was no longer possible?

Life 3: No constraints, don’t worry about what others think. What would you do?

After students generate these lives, they are asked to title the path and produce questions that they have as a result. Additionally, they are asked to rate whether they feel like they have adequate resources to make this life come true, how much they like it, how confident they are in their ability to create this life, and how coherent it is to their values and interests. After students individually generate these lives, they are asked to share and get feedback from their peers.

Energy Mapping

Energy Mapping is an exercise designed to help students notice how their regular activities impact their energy levels throughout the day. Students choose a typical week at school and map each activity with a bar to determine whether a particular activity is energy-giving or energy-draining. After mapping these moments throughout their day, they identify patterns and determine factors that contribute to their energy levels. The purpose of this exercise is to enhance self-awareness regarding energy management, enabling individuals to design their daily activities to increase their own energy and engagement. Students gain valuable insights into their daily energy patterns, enabling them to try out incremental changes to improve their daily experience. Going beyond time management, this generates data needed to take a proactive approach to well-being. This exercise, supported by relevant literature on engagement, productivity, and optimal performance, helps students enhance their efficiency and overall well-being.

This activity is facilitated either in a solo or group setting with students being asked to consider a typical week in their college experience. Students are asked to pull up their calendars to map out three to four activities per day on a scale of positive and negative energy using a template (fig. 7.5). Certain activities can be both energy-gaining and energy-draining, resulting in a variety of different-shaped bars throughout the week. As a result, students have a visual representation of their energy levels.

After these data are collected, students are encouraged to identify patterns. Where do you see the highest energy? Where do you see the lowest energy? Are there areas where the bars are completely positive? How do you feel in those moments? The results of those guiding questions allow students to be more aware of how certain activities, classes, people, or things impact their well-being. They are asked to then come up with ways they can improve their energy flows throughout the week. This ranges from moving things around in their calendar to adding additional activities to support greater energy and engagement. After individual exploration, students are given a chance to share their experiments for energy improvement and invite their peers to act as accountability partners.

FIGURE 7.5Energy Engagement Map

© 2017 by Dave Evans, Bill Burnett, and Stanford University

The Balance Assessment

The Energy Engagement Map is often paired with the Balance Assessment, a tool designed to support students in evaluating and improving their overall life balance by using a portfolio approach rather than viewing work and life as a zero-sum game. Students mark their current levels of satisfaction in various areas of their lives, such as love, play, work, and health. The purpose of this exercise is to help students identify what is working well and what is not, enabling them to make small, targeted improvements. By engaging in the Balance Assessment, students have a clearer view on key areas for improvement and take practical steps to enhance their overall well-being. This helps students create tangible changes in their approach to both career exploration and overall well-being. Paired with the Balance Assessment are incremental changes that can support prototypes students may take because of this self-awareness.

FIGURE 7.6Balance Assessment

© 2017 by Dave Evans, Bill Burnett, and Stanford University

Students are invited to reconsider the work-life balance dichotomy that is oftentimes discussed as a primary frame for considering balance. A new paradigm is introduced that considers aspects outside of just work and life, expanding the concept of life to be broken down into love (to include relationships and community), play (which focuses on enjoyment outside of work), and health (encompassing mental, physical, and spiritual health). Students are then asked to use the assessment tool (fig. 7.6) to mark how they are currently feeling in four areas: love, play, work, and health. Students are then invited to consider a fifth category that feels important to their definition of balance. Examples of this other category include spirituality, community, and sleep. Students are then asked to reflect and choose an aspect of this paradigm to improve. When paired with the Energy Engagement Map, students are asked to consider the totality of the data collected to create some incremental changes, which are listed below figure 7.6. Students are encouraged to collaborate with peers to focus on actionable and plausible change. Incremental changes are then put into action across a week, and students are asked to share their learnings in a subsequent class or coaching session.

INCREMENTAL CHANGES

A few kinds of incremental changes you might consider:

1. Change location or tools—your environment and the tools you use to accomplish your tasks can impact your experience, so consider how these affect your energy.

2. Change people—consider how other people affect your energy. Are there interactions that you find more/less energizing?

3. Combine activities (2-for-1)—notice which activities give you more than one benefit, and design them into your day/life.

4. Re-sequence activities—change when you do certain activities, balancing energizing and draining pursuits.

5. Time box—schedule start and stop times per activity, only devoting the time you are willing to spend on each.

6. Reprioritize—change how you allocate time or energy to important parts of your life.

7. Reframe—change your mind, and see the situation from a different perspective. Reframing is a powerful design tool.

8. Compromise and defer—when circumstances change and you must put more time and energy into a part of your life, recalibrate your energy and ways of finding balance, and make this explicit to family and friends.

Idea Boarding

Idea boarding is a powerful collaborative idea-generation process, which, like brainstorming, invites a group to source ideas together. The objective is to radically collaborate to come up with as many ideas as possible. Idea boards are community boards posted in a public space, with a framed question offered to passersby for comments and ideas.

In the Life Design curriculum, this exercise is set up with each student posting a critical question they are thinking about at that time. The owner of the question is anonymous. Students are then invited to add ideas to these questions. At the end of each round, students iterate on the questions based on the answers and ideas they were provided. A student may start with the question such as “How might I create more time for creative outlets?” and end up with the refined question “How might I find an art community?” due to the answers they receive.

Like other activities in this section, a core outcome of these exercises is to support students feeling unstuck. The generation of novel or wild ideas allows students to engage in these questions with a spirit of curiosity rather than feeling stuck individually. Students emerge from this exercise with a greater sense of clarity and accuracy around the question they are asking to invite more useful and practical solutions.

CASE STUDY: TRINITY COLLEGE

Trinity College is a private four-year liberal arts institution in Hartford, Connecticut, with approximately 2,200 undergraduates. Recognizing the increasing challenges students face in college and career transitions heightened by global disruptions like the COVID-19 pandemic, the college established the Career & Life Design Center in 2021. Drawing inspiration from design thinking principles, the center empowers students to approach their careers through iterative processes, fostering adaptability, creativity, and resilience. This approach aligns seamlessly with Trinity’s vision of guiding students and alumni to design meaningful, individualized plans for fulfilling and impactful lives.

The primary motivation for implementing the Life Design curriculum at Trinity College was to enhance student engagement and satisfaction with career development. A 2016 external study of the Career Development Center highlighted these deficiencies, prompting the need for a more effective and engaging approach. The goal was to help students develop a clear sense of purpose and direction, thereby improving retention and supporting students through critical transitions during their college journey.

The Career & Life Design Center (CLDC) launched when several key staff members from the Enrollment and Student Success Division attended the first-ever Stanford University Life Design Studio for Higher Education Professionals in June 2017 and were introduced to Life Design methodologies. This deliberate shift fostered a collaborative culture focused on innovation and adaptability, ultimately enhancing the support available to students as they navigate their career and life pathways and led to the creation of the center’s mission and vision:

- The mission is to support Trinity College students and alumni as they navigate college and career transitions, providing life design coaching, programming and experiential learning opportunities, and global connections.

- The vision is to guide Trinity College students and alumni in designing meaningful, individualized plans for a fulfilling journey—through and beyond Trinity—enabling them to become active global citizens.

Today, the CLDC actively supports Trinity College students’ personal and professional growth through one-on-one coaching, comprehensive programs, and innovative resources and empowers students to design personalized success plans, build valuable networks, craft robust résumés, excel in interviews, and engage in transformative experiential learning opportunities. The CLDC provides a spectrum of support, from the credit-bearing first-year seminar course to personalized one-on-one coaching and dynamic co-curricular programs that foster career readiness and leadership development. These programs are facilitated by the career education staff as well as peer advisors. This integrated approach ensures students engage with Life Design principles through academic coursework, individualized guidance, and experiential learning opportunities throughout their college journey.

The CLDC facilitators, highly trained administrative career and Life Design coaches, play a pivotal role in guiding students through their personal and professional development through Life Design and motivational interviewing. Motivational interviewing, a student-centered, collaborative coaching approach, is central to their practice, enabling facilitators to empower students to explore their values, set meaningful goals, and navigate challenges with confidence. Motivational interviewing, with a robust evidence base in counseling psychology, complements the student-centered Life Design approach by fostering intrinsic motivation and self-efficacy—key factors in both career success and mental health.[41] Together, this dedicated team fosters a supportive environment encouraging self-discovery and informed, intentional decision-making, helping students create purposeful career paths and fulfilling life designs.

The coaches at Trinity College engage in ongoing professional development to ensure they remain at the forefront of career and Life Design practices. Their training includes specialized workshops focused on the latest methodologies in Life Design and motivational interviewing, as well as participation in programs, such as Stanford’s Life Design Studio for Higher Education professionals, and access to continuous learning opportunities to offer students innovative, evidence-based guidance tailored to today’s complex and evolving career landscape. We continue this chapter by exploring specific program offerings at the CLDC that support the student experience throughout their career-discernment journey.

Designing Your Future Work: A First-Year Seminar

One aspect of the Life Design curriculum at Trinity is the course Designing Your Future Work, an optional first-year seminar for incoming first-year and transfer students. This innovative, credit-bearing course introduces students to fundamental Life Design concepts early in their Trinity experience, setting the stage for intentional career and personal development throughout college. In the course, students apply design thinking and career development theory to better understand the link between their liberal arts education and their life after college. Throughout the course, students identify individual goals, assess skills and talents, explore career options, analyze the job market, effectively use employment search tools, and contemplate and investigate how meaning and purpose can be infused into any career. Furthermore, students rely on self-reflection and understanding the value of experiential education in the exploration and decision-making process. Finally, students evaluate how to design their lives in the changing landscape of work. Throughout the semester, students engage actively with readings, class discussions, and assignments. At the end of the semester, students design a plan that will guide their career and academic decision-making throughout the remainder of their Trinity College experience.

Throughout the semester, students are introduced to key Life Design activities, such as Energy Mapping (fig. 7.5), where students assess their daily activities to identify what energizes them versus what drains them, fostering the self-awareness necessary for sustainable work and life balances. Students also engage in Odyssey Planning (fig. 7.4), a creative exercise that encourages them to imagine multiple future career and life scenarios, thereby expanding their sense of possibility and reducing anxiety around making one “right” decision. At the onset of the semester, students are introduced to designer mindsets, such as Curiosity (encouraging exploration without judgment), being Bias to Action (emphasizing rapid prototyping of ideas), Storytelling (helping students articulate their evolving narratives), Reframing (teaching students to view challenges as opportunities for growth), Radical Collaboration (highlighting the value of diverse perspectives), and Mindfulness of Process (inviting students to stay reflective and adaptive throughout their journey). Life Design mindsets—including reframing and mindfulness of process—cultivate students’ psychological flexibility and resilience, which are critical for maintaining mental well-being amid career uncertainty.

By grounding first-year students in these frameworks, the course helps them develop resilience, openness, and clarity during a critical transition period. It complements the broader support provided by the Career & Life Design Center in managing academic and personal challenges in their first year.

Kelter Career Leadership Program

For students looking to deepen their engagement with career design and leadership skills, Trinity offers the Kelter Center Leadership Program (KCLP), a selective, cohort-based initiative that operates within the Career & Life Design Center. Named in honor of a generous benefactor, the KCLP is designed to cultivate leadership capacities essential for the future of work, such as adaptability, ethical decision-making, strategic networking, and conscious self-management.

Participants in the KCLP are introduced to Life Design and then participate in a series of experiential workshops, leadership challenges, and reflection sessions structured around those Life Design principles and design thinking mindsets. Activities include a short-term internship (approximately six weeks in length) with local, Hartford-based organizations, mentorship with upper-class students, and personalized coaching that develops students’ career narratives and goal setting. Integral to the program are repeated encounters with Life Design tools like Odyssey Planning and Energy Mapping (figs. 7.4 and 7.5), which are revisited at different stages to track growth and realign priorities as students progress academically and personally.

Through the KCLP, students build a tool kit of design mind-sets and practices, emphasizing radical collaboration by working intimately with peers from diverse academic and cultural backgrounds, as well as practicing reframing to navigate uncertainty and ambiguity inherent in leadership roles. The program culminates in a personal branding and storytelling activity where students tell their career stories from the work, lessons learned, and goals established throughout the program.

The Center and Mental Health

The Career & Life Design Center recognizes that mental health plays a critical role in students’ academic and personal success, especially during the pivotal first-year transition. Through comprehensive support initiatives, the staff is focused on helping students navigate the gap between what they planned for their college experience and the reality they encounter. For many first-year students, this involves learning to manage expectations, develop key organizational skills, set intentional and strategic goals, and build resilience as they adjust to the challenges of independence and academic rigor. The Career & Life Design Center at Trinity College actively supports students through these stages by providing tailored resources and guidance. Workshops and coaching focused on time management, goal setting, and building support systems equip students with practical tools to navigate the complexities of their first year. Programs addressing such common challenges as procrastination, organization, and finding a sense of belonging are designed to help students adapt effectively and develop resilience. By fostering meaningful connections and offering a framework for aligning personal and academic goals, the center ensures students experience a smoother transition and a more fulfilling first-year journey.

The Career & Life Design Center’s approach focuses on empowering students to develop time-management and organization skills, critical for balancing academic, personal, and extracurricular demands. Students are guided through strategies for planning, prioritizing, and goal setting, helping them align their daily actions with their long-term aspirations. Workshops and one-on-one coaching address the tension between productivity and procrastination, providing students with tools to overcome barriers and maintain momentum. Additionally, the coaching staff emphasizes the importance of developing a strong support system and finding community whether through student organizations, peer groups, or mentorship opportunities. These efforts ensure that students not only manage their workload effectively but also feel connected and supported, fostering both academic success and mental well-being.

CAREER & LIFE DESIGN COACHING

The Career & Life Design Center offers two distinct coaching models tailored to meet a wide range of student needs. Holistic coaching focuses on developing essential life and academic skills, such as time management, organization, and effective goal setting, helping students create balanced and productive routines supporting both personal well-being and academic success. A deeper level of coaching, specialty coaching, provides more targeted support for specific career-related challenges, including mapping out individualized career journeys, navigating significant transitions like internships or study abroad, and offering dedicated advising for international students and scholars to address their unique needs. Within specialty coaching, the center has also established Career Communities, which are organized around industries rather than majors. These communities foster deeper engagement by connecting students with peers, alumni, faculty, and employers who share common professional interests, enabling students to develop industry-specific skills, gain insights into career paths, and access tailored resources and networking opportunities. Importantly, coaching and participation in Career Communities are accessible not only to current Trinity students but also to alumni, creating a lifelong support system that encourages continuous learning, growth, and connection throughout their professional lives. These communities create a sense of belonging and shared purpose, helping reduce feelings of isolation and stress. This network of support not only facilitates career exploration and skill building but also offers emotional encouragement and resilience during times of academic and personal challenge. Through ongoing engagement in Career Communities, students gain both professional resources and meaningful social connections contributing to their overall well-being and success, on a path to designing a life of meaning and purpose.

Through a combination of coaching, experiential learning, and mentorship, students report greater clarity in their career goals and confidence in navigating transitions. In the 2023–24 academic year, the Career & Life Design Center held 2,876 one-on-one coaching appointments with students and alumni, reaching over 1,000 total unique individuals, and hosted more than sixty programs and events throughout the 2024 fiscal year, in which over 2,200 students were in attendance and participated. In previous academic years, coaching appointments were closer to 2,000 students. This sustained growth in engagement reflects the center’s deepening role as a vital resource in student development and career readiness. As a result, Trinity College graduates are increasingly equipped with the skills and networks necessary to thrive in a rapidly changing professional landscape.

A CALL TO ACTION

The integration of Life Design methodologies into career education represents a transformative approach to addressing the pervasive anxiety associated with planning for post-collegiate life. The research and case studies presented underscore the value of a human-centered, iterative framework that equips students with practical tools for navigating a rapidly evolving work environment. By fostering self-awareness, resilience, and adaptive problem-solving, Life Design initiatives not only mitigate the emotional toll of uncertainty but also enhance career decision-making efficacy. These findings suggest that such interventions are instrumental in shifting the focus from rigid, linear career trajectories toward more flexible, purpose-driven pathways that align with the complexities of modern professional life.

Institutions like Trinity College exemplify how the adoption of Life Design principles can lead to substantial improvements in student outcomes. The success of the Career & Life Design Center, as evidenced by extensive one-on-one coaching sessions and high levels of student engagement, highlights the potential of these practices to support holistic development.

Life Design is simply one model of how career education will need to evolve to the current moment. As higher education continues to evolve in response to global disruptions and technological advancements, further investment into the development of students who can navigate ambiguity and complexity will become ever more important. Such investments will not only refine these approaches but also contribute to a more resilient, well-prepared generation of graduates capable of thriving amid ongoing change.

VOICES FROM THE FIELD

Jordan FriedmanHealth Educator and Founder of The Stress Coach

Jordan Friedman, “The Stress Coach,” is a leading expert in stress reduction with over three decades of experience supporting college students. He has unique insights into how we can create a caring campus community that he developed both through his work inside of higher education and through running a national program, The Stress Coach, which he founded in 2004 to offer stress-reduction courses, webinars, and one-on-one trainings. He delivers content via The Chill Factory podcast.

He also launched the Stressbusters Wellness Program on college campuses to deliver stress-reduction training, promote relaxation, and elevate the visibility of wellness initiatives with campus health ambassadors.[1] This national program and online app trained more than 500,000 students and staff in their methodology in the first twenty years, with a protocol grounded on the American Foundation for Suicide Prevention recommendations. The program has been shown to successfully reduce student stress—in one campus study (N=1,100), overall stress scores dropped by 40 percent after participation in Stressbusters, with corresponding decreases in negative emotions like frustration and worry and increases in coping skills.

Before launching The Stress Coach and Stressbusters, Friedman served as Director of Columbia University’s Health Education Program, where he was the Director of Go Ask Alice!, a groundbreaking website that debuted in 1993 to provide evidence-based answers to health-related questions.[2] Originally created to support Columbia students, the site offers anonymous, candid responses about physical, mental, and sexual health and became a public resource in 1994. Today, Go Ask Alice! is the longest-running health Q&A site on the internet.[3] Building on its success, Friedman coauthored The Go Ask Alice Book of Answers: A Guide to Good Physical, Sexual, and Emotional Health (1998), further advancing efforts to make trustworthy health information widely accessible.

CREATING LOW-STAKES OPPORTUNITY FOR ENGAGEMENT

While students continue to want friendship and connections, Friedman has observed a notable change over the past three decades—students are less likely to show up for in-person programs even when they have demonstrated an interest in the topic or activity. While students continue to advocate for opportunities to connect and spend time together in person, they are less likely to actually show up.[4] Friedman explains that programs must now account for these paradoxical behaviors and understand their roots, which may include students’ competing demands, digital fatigue, and time-management challenges. We need to make decisions about what programs to offer knowing that low turnout may limit impact and streamlining our offerings can help boost engagement.[5]

Friedman’s work with Stressbusters demonstrates the power of meeting students where they are—both physically and emotionally. The program offers casual, drop-in programming in high-traffic areas on campus, which helps to spark curiosity and engagement. Students can stop by without signing up in advance and with a minimal time commitment—sometimes as short as five minutes. This approach offers students opportunities to engage in ways that do not feel overwhelming. Further, these engagements serve to build trust, incentivize future participation by removing the fear of the unknown, and introduce students to more formal mental health supports that are available to them. Any flexible, low-commitment opportunity like this can serve as effective entry points for building a caring campus.

TECHNOLOGY HAS DEMOCRATIZED ACCESS BUT COMPLICATED TRUST

Friedman was at the forefront of democratizing access to mental and physical health information through Go Ask Alice! and saw firsthand how useful this anonymous, evidence-based system empowered students to receive accurate and important health information. He is concerned about today’s fragmented, unfiltered digital landscape in which students now have access to an overwhelming volume of content and must figure out which sources are trustworthy. The explosion of misinformation, especially
on social media, makes it harder than ever for students to differentiate between reliable mental health resources and unvetted or harmful advice.[6]

Additionally, generative AI technology now gives students the opportunity to “talk” to a virtual AI bot to get help and advice. While this technology can be incredibly useful for reflection, ideation, and problem solving, concerns exist about limited benefits and the potential for real harm.[7] Since waiting times for counseling appointments can be long, students may turn to online resources for help in the interim. Thus, it is more important than ever to recognize that technology—which may have limited benefits or even detrimental effects—will fill that void in the meantime.

Student behaviors, tech platforms, and cultural expectations are changing rapidly. Friedman cautions that programs now need to be redesigned much more frequently to stay relevant. Successful programs must walk a fine line—staying nimble enough to adapt but also remaining rooted enough to preserve effective strategies that help to create a caring campus community.

Notes

Introduction

1.Sarah Ketchen Lipson, Emily G. Lattie, and Daniel Eisenberg, “Increased Rates of Mental Health Service Utilization by U.S. College Students: 10-Year Population-Level Trends (2007–2017),” Psychiatric Services 70, no. 1 (2019), https://doi.org/10.1176/appi.ps.201800332; Peter LeViness, Kim Gorman, Lynn Braun, Linda Koenig, and Carolyn Bershad, Association for University and College Counseling Center Directors, Annual Survey: 2019 (Washington, DC: AUCCCD, 2020), https://www.aucccd.org/assets/documents/Survey/2019%20AUCCCD%20Survey-2020-05-31-PUBLIC.pdf.

2.Chronicle of Higher Education, Overwhelmed: The Real Campus Mental Health Crisis and New Models for Well Being (Washington, DC: Chronicle of Higher Education, March 2020), https://store.chronicle.com/products/overwhelmed.

3.Zara Abrams, “Student Mental Health Is in Crisis: Campuses Are Rethinking Their Approach,” Monitor on Psychology 53, no. 7 (October 2022), https://www.apa.org/monitor/2022/10/mental-health-campus-care.

4.Mary Ellen Flannery, “The Mental Health Crisis on College Campuses,” neaToday, March 29, 2023, https://www.nea.org/nea-today/all-news-articles/mental-health-crisis-college-campuses.

5.Natalia Gatdula, Christine B. Costa, Mayra S. Rascón, Cathleen M. Deckers, and Mara Bird, “College Students’ Perceptions of Telemental Health to Address Their Mental Health Needs,” Journal of American College Health 72 (2022): 515–21, https://doi.org/10.1080/07448481.2022.2047697.

6.Tammy Toscos, Maria Carpenter, Michelle Drouin, Amelia Roebuck, Connie Kerrigan, and Michael Mirro, “College Students’ Experiences with, and Willingness to Use, Different Types of Telemental Health Resources: Do Gender, Depression/Anxiety, or Stress Levels Matter?,” Telemedicine and e-Health 24, no.12 (2018): 998–1005, https://doi.org/10.1089/tmj.2017.0243.

7.Sarah J. Peterson, Brooke J. Arterberry, and Megan E. Patrick, “Barriers to and Benefits of Mental Health Services in College Students with and Without Depression, Anxiety, and Hazardous Alcohol Use,” Journal of College Student Mental Health 39, no. 3 (2024): 479–97, https://doi.org/10.1080/28367138.2024.2373946; Daniel Eisenberg, Ezra Golberstein, and Sarah E. Gollust, “Help-Seeking and Access to Mental Health Care in a University Student Population,” Medical Care 45, no. 7 (2007): 594–601, https://doi.org/10.1097/MLR.0b013e31803bb4c1.

8.Rebecca A. Vidourek, Keith A. King, Laura A. Nabors, and Ashley L. Merianos, “Students’ Benefits and Barriers to Mental Health Help-Seeking,” Health Psychology and Behavioral Medicine 2, no. 1 (2014): 1009–22, doi:10.1080/21642850.2014.963586.

9.Emalinda McSpadden, “I’m Not Crazy or Anything: Exploring Culture, Mental Health Stigma, and Mental Health Service Use Among Urban Community College Students,” Community College Journal of Research and Practice 46, no. 3 (2021): 202–14, doi:10.1080/10668926.2021.1922321.

10.Elizabeth Redden, “Panel Focuses on Mental Health Needs of International Students,” Inside Higher Ed, May 30, 2019, https://www.insidehighered.com/news/2019/05/31/panel-focuses-mental-health-needs-international-students.

11.Flannery, “Mental Health Crisis”; Fiona Wu, Ginger Freeman, Steve Wang, and Ingred Flores, “The Future of College Student Mental Health: Student Perspectives,” Journal of College Student Mental Health 38, no. 4 (2024): 975–1010, https://doi.org/10.1080/28367138.2024.2400612.

12.Emily Camacho, “Minority Student Perceptions of Mental Health,” Journal of Undergraduate Research 14 (2016): article 6, http://openprairie.sdstate.edu/jur/vol14/iss1/6.

13.Jeffrey A. Hayes, Soo Jeong Youn, Louis G. Castonguay, et al., “Rates and Predictors of Counseling Center Use Among College Students of Color,” Journal of College Counseling 14, no. 2 (2011): 105–16, https://doi.org/10.1002/j.2161-1882.2011.tb00266.x; Seanna Leath and Martinique Jones, “Racial Climate and Mental Health Service Utilization Among Black College Students at Diverse Institutions,” Currents: Journal of Diversity Scholarship for Social Change 2, no. 1 (2022), https://doi.org/10.3998/ncidcurrents.1777; Eun-Jin Lee, Nicole Ditchman, Mandy W. M. Fong, Lauren Piper, and Maia Feigon, “Mental Health Service Seeking Among Korean International Students in the United States: A Path Analysis,” Journal of Community Psychology 42, no. 6 (2014): 639–55, https://doi.org/10.1002/jcop.21643.

14.Sharon Shapiro, “College Mental Health Crisis Demands Preventative Approaches,” Facilitating Change (blog), Psychology Today, April 26, 2025, https://www.psychologytoday.com/us/blog/facilitating-change/202504/college-mental-health-crisis-demands-preventative-approaches.

Chapter 1

1.Zara Abrams, “Kids’ Mental Health Is in Crisis: Here’s What Psychologists Are Doing to Help,” American Psychological Association 54, no. 1 (2023): 63, https://www.apa.org/monitor/2023/01/trends-improving-youth-mental-health; Youth Risk Behavior Survey Data Summary and Trends Report: 2013–2023, Centers for Disease Control and Prevention, 2024, https://www.cdc.gov/yrbs/dstr/index.html.

2.Ashley Mowreader, “Experts Weigh In on College Student Mental Health Crisis,” Inside Higher Ed, August 19, 2024, https://www.insidehighered.com/news/student-success/health-wellness/2024/08/19/experts-weigh-college-student-mental-health-crisis.

3.Vicky McKeever, “Nearly Half of Young People Worldwide Say Climate Change Anxiety Is Affecting Their Daily Life,” CNBC, September 14, 2021, https://www.cnbc.com/2021/09/14/young-people-say-climate-anxiety-is-affecting-their-daily-life.html.

4.2024 US National Survey on the Mental Health of LGBTQ+ Young People, The Trevor Project, 2024, https://www.thetrevorproject.org/survey-2024/.

5.“Welcome to the United States of Suppression,” Teen Vogue, https://www.teenvogue.com/united-states-of-suppression; Jeffrey Brown and Mike Fritz, “How Trump’s College Crackdown Is Raising Concerns About Free Speech and Academic Freedom,” PBS, May 6, 2025, https://www.pbs.org/newshour/show/how-trumps-college-crackdown-is-raising-concerns-about-free-speech-and-academic-freedom.

6.Leila Fadel, Taylor Haney, Arezou Rezvani, and Kyle Gallego-Mackie, “ ‘Citizenship Won’t Save You’: Free Speech Advocates Say Student Arrests Should Worry All,” NPR, April 8, 2025, https://www.npr.org/2025/04/08/nx-s1-5349472/students-protest-trump-free-speech-arrests-deportation-gaza; Annie Ma, Makiya Seminera, and Christopher L. Keller, “Visa Cancellations and Deportations Sow Panic for International Students,” PBS, April 16, 2025, https://www.pbs.org/newshour/politics/visa-cancellations-and-deportations-sow-panic-for-international-students; Olivia Sanchez, “What Will Happen to 400,000 Undocumented College Students Under Trump?,” Teen Vogue, January 15, 2025, https://www.teenvogue.com/story/trump-administration-undocumented-college-students-limbo; Molly Finnegan, “Read the Full Letter from Universities Opposing ‘Government Intrusion,’ ” PBS, April 22, 2025, https://www.pbs.org/newshour/education/read-the-full-letter-from-universities-opposing-government-intrusion.

7.“Using Insights to Support Older Learners,” National Student Clearing House, September 25, 2024, https://www.studentclearinghouse.org/nscblog/using-insights-to-support-older-learners; “Today’s Students,” Lumina Foundation, https://www.luminafoundation.org/campaign/todays-student.

8.“University Facts,” UC Irvine, https://uci.edu/university-facts/index.php.

9.The Hope Center 2023–2024 Student Basic Needs Survey Report, Hope Center for Student Basic Needs at Temple University, 2025, https://hope.temple.edu/research/hope-center-basic-needs-survey/2023-2024-student-basic-needs-survey-report; Ashley Mowreader, “College Programs Support Holistic Student Basic Needs,” Inside Higher Ed, May 12, 2025, https://www.insidehighered.com/news/student-success/health-wellness/2025/05/12/college-programs-support-holistic-student-basic.

10.Eleanor Eckerson Peters, Madeline Rowe, and Lauren McLeese, How Student Experience and Belonging Interventions Can Impact Postsecondary Outcomes (Institute for Higher Education Policy, 2024), https://www.ihep.org/publication/student-experience-and-belonging-strong-outcomes/.

11.Gulsah Dost and Laura Mazzoli Smith, “Understanding Higher Education Students’ Sense of Belonging: A Qualitative Meta-Ethnographic Analysis,” Journal of Further and Higher Education 47, no. 6 (2023): 822–49, https://doi.org/10.1080/0309877X.2023.2191176; Drisana Hughes, “The Proven Impact of Affinity Spaces,” Race, Research, and Policy Portal of the IARA Project, https://rrapp.spia.princeton.edu/how-to-guide/the-proven-impact-of-affinity-spaces/.

12.“Prince George’s Community College Overview,” US News & World Report, https://www.usnews.com/education/community-colleges/prince-george-s-community-college-CC06975.

13.“Walters State Increases Enrollment by 6.5%,” Walters State Community College, September 11, 2023, https://ws.edu/news/2023/walters_state_enrollment_increases.aspx.

14.Office of the University Registrar, “Student Body Diversity,” Washington University in St. Louis, September 25, 2024, https://registrar.wustl.edu/student-data/student-body-diversity/.

15.Mariah Solis, “ ‘There Is Not Enough of Me to Go Around’: Schools Need More Counselors,” neaToday, February 15, 2024, https://www.nea.org/nea-today/all-news-articles/schools-need-more-counselors.

16.Office of Academic Planning and Accountability, “Just the Facts 2024–2025,” University of Louisville, March 2025, https://louisville.edu/oapa/institutional-research-and-planning/quick-facts/2025JusttheFactsADAV1.pdf.

Chapter 2

1.Sara Abelson, Sarah Ketchen Lipson, and Daniel Eisenberg, “Mental Health in College Populations: A Multidisciplinary Review of What Works, Evidence Gaps, and Paths Forward,” Higher Education: Handbook of Theory and Research 37 (2022): 133–238, https://doi.org/10.1007/978-3-030-66959-1_6-1; Sarah Ketchen Lipson, Sasha Zhou, and Sara Abelson, “Trends in College Student Mental Health and Help-Seeking by Race/Ethnicity: Findings from the National Healthy Minds Study, 2013–2021,” Journal of Affective Disorders 306 (2022): 138–47, https://doi.org/10.1016/j.jad.2022.03.038.

2.Abelson, Lipson, and Eisenberg, “Mental Health in College”; Rachel A. Smith and Amanda Applegate, “Mental Health Stigma and Communication and Their Intersections with Education,” Communication Education 67, no. 3 (2018): 382–93, https://doi.org/0.1080/03634523.2018.1465988.

3.Abelson, Lipson, and Eisenberg, “Mental Health in College.”

4.Jennifer Abbasi and Yulin Hswen, “US Surgeon General Vivek Murthy: To Protect Adolescents, Social Media Needs Warning Labels,” JAMA 332, no. 9 (2024): 689–91, https://doi.org/10.1001/jama.2024.14245; Emily G. Lattie, Sarah Ketchen Lipson, and Daniel Eisenberg, “Technology and College Student Mental Health: Challenges and Opportunities,” Frontiers in Psychiatry 10 (2019): 246, https://doi.org/10.3389/fpsyt.2019.00246.

5.Hanjoo Kim, Gavin N. Rackoff, Ellen E. Fitzsimmons-Craft, et al. “College Mental Health Before and During the COVID-19 Pandemic: Results from a Nationwide Survey,” Cognitive Therapy and Research 46, no.1 (2022): 1–10, https://doi.org/10.1007/s10608-021-10241-5; Nahal Salimi, Bryan Gere, William Talley, and Bridget Irioogbe, “College Students Mental Health Challenges: Concerns and Considerations in the COVID-19 Pandemic,” Journal of College Student Psychotherapy 37, no. 1 (2023): 39–51, https://doi.org/10.1080/87568225.2021.1890298; Angela Stowe, Kalani Upshaw, Claire Estep, and Robin Gaines Lanzi, “Getting to the Sandbar: Understanding the Emotional Phases of COVID-19 Among College and University Students,” Psychological Reports 125, no. 6 (2022): 2956–80, https://doi.org/10.1177/00332941211028105.

6.John MacPhee, Kamla Modi, Sara Gorman, et al., “Strengthening Safety Nets: A Comprehensive Approach to Mental Health Promotion and Suicide Prevention for Colleges and Universities,” NAM Perspectives, June 2021, https://doi.org/10.31478/202106b.

7.Sarah Besse, Andréa Kaniuka, Sasha Zabelski, Annelise Mennicke, Kaley Meyer, and Robert J. Cramer, “The Holistic Prevention and Intervention Model: A Public Health Approach to College Mental Health and Suicide Prevention,” Journal of American College Health 72, no. 9 (2024): 3079–83, https://doi.org/10.1080/07448481.2022.2155467; Jason Parcover, Sally Mays, and Amy McCarthy, “Implementing a Public Health Approach to Addressing Mental Health Needs in a University Setting: Lessons and Challenges,” Journal of College Student Psychotherapy 29, no. 3 (2015): 197–210, https://doi.org/10.1080/87568225.2015.1045781.

8.Abelson, Lipson, and Eisenberg, “Mental Health in College”; MacPhee et al., “Strengthening Safety Nets.”

9.Fay C. Payton, Lynette K. Yarger, and Anthony T. Pinter, “Text Mining Mental Health Reports for Issues Impacting Today’s College Students: Qualitative Study,” JMIR Mental Health 5, no. 4 (2018): e10032, https://doi.org/10.2196/10032.

10.Sarah Besse et al., “Holistic Prevention and Intervention”; Jed Foundation, A Decade of Improving College Mental Health Systems: JED Campus Impact Report (2024), https://jedfoundation.org/jed-campus-impact-report-2024/.

11.Sarah Besse et al., “Holistic Prevention and Intervention”; Jed Foundation, JED Campus Impact Report.

12.Abelson, Lipson, and Eisenberg, “Mental Health in College”; M. Dolores Cimini and Estela M. Rivero, Promoting Behavioral Health and Reducing Risk Among College Students (Routledge, 2018), https://doi.org/10.4324/9781315175799.

13.Marian Reiff, Meeta Kumar, Batsirai Bvunzawabaya, et al., “I CARE: Development and Evaluation of a Campus Gatekeeper Training Program for Mental Health Promotion and Suicide Prevention,” Journal of College Student Psychotherapy 33, no. 2 (2019): 107–30, https://doi.org/10.1080/87568225.2018.1433570; Lipson, Sarah Ketchen, Nicole Speer, Steven Brunwasser, Elisabeth Hahn, and Daniel Eisenberg, “Gatekeeper Training and Access to Mental Health Care at Universities and Colleges,” Journal of Adolescent Health 55, no. 5 (2014): 612–19, https://doi.org/10.1016/j.jadohealth.2014.05.009.

14.MacPhee et al., “Strengthening Safety Nets.”

15.Alan I. Leshner, “Target Student Mental Well-Being,” Science 371, no. 6527 (2021): 325, https://doi.org/10.1126/science.abg5770; Nance Roy, “The Rise of Mental Health on College Campuses: Protecting the Emotional Health of our Nation’s College Students,” Higher Education Today, December 17, 2018, https://www.higheredtoday.org/2018/12/17/rise-mental-health-college-campuses-protecting-emotional-health-nations-college-students/.

16.National Academies of Sciences, Engineering, and Medicine, Mental Health, Substance Use, and Wellbeing in Higher Education: Supporting the Whole Student (National Academies, 2021), https://doi.org/10.17226/26015.

17.Victor Schwartz, “Preventing Suicide and Promoting Mental Health Among College Students: The Jed Foundation,” in College Psychiatry: Strategies to Improve Access to Mental Health, ed. Michelle B. Riba and Meera Menon (Springer International, 2021), 135–40, https://doi.org/10.1007/978-3-030-69468-5_10.

18.Schwartz, “Preventing Suicide.”

19.Kerry L. Knox, Steven Pflanz, Gerald W. Talcott, et al., “The US Air Force Suicide Prevention Program: Implications for Public Health Policy,” American Journal of Public Health 100, no. 12 (2010): 2457–63, https://doi.org/10.2105/AJPH.2009.15987.

20.Schwartz, “Preventing Suicide.”

21.MacPhee et al., “Strengthening Safety Nets.”

22.Jed Foundation, JED Campus Impact Report.

23.Jed Foundation.

24.Jed Foundation.

25.Steve Fund and Jed Foundation, Equity in Mental Health Framework: Recommendations for Colleges and Universities to Support the Emotional Well-Being and Mental Health of Students of Color (Steve Fund and Jed Foundation, 2017), https://jedfoundation.org/wp-content/uploads/2024/10/Equity-in-Mental-Health-Framework.pdf.

26.Improving Mental Health of Student Parents: A Framework for Higher Education (Ascend, 2021), https://ascend.aspeninstitute.org/wp-content/uploads/2021/05/MentalHealthFramework_Final.pdf.

27.MacPhee et al., “Strengthening Safety Nets.”

28.Seth Abrutyn and Anna S. Mueller, “The Socioemotional Foundations of Suicide: A Microsociological View of Durkheim’s Suicide,” Sociological Theory 32, no. 4 (2014): 327–51, https://doi.org/10.1177/0735275114558633.

29.Joseph A. Durlak, Roger P. Weissberg, Allison B. Dymnicki, Rebecca D. Taylor, and Kriston B. Schellinger, “The Impact of Enhancing Students’ Social and Emotional Learning: A Meta-Analysis of School-Based Universal Interventions,” Child Development 82, no. 1 (2011): 405–32, https://doi.org/10.1111/j.1467-8624.2010.01564.x; Roisin P. Corcoran, Alan C. K. Cheung, Elizabeth Kim, and Chen Xie, “Effective Universal School-Based Social and Emotional Learning Programs for Improving Academic Achievement: A Systematic Review and Meta-Analysis of 50 Years of Research,” Educational Research Review 25 (2018): 56–72, https://doi.org/10.1016/j.edurev.2017.12.001.

30.Richard Spoth, Cleve Redmond, Chungyeol Shin, Mark Greenberg, Mark Feinberg, and Linda Trudeau, “PROSPER Delivery of Universal Preventive Interventions with Young Adolescents: Long-Term Effects on Emerging Adult Substance Misuse and Associated Risk Behaviors,” Psychological Medicine 47, no. 13 (2017): 2246–59, https://doi.org/10.1017/S0033291717000691; Rebecca D. Taylor, Eva Oberle, Joseph A. Durlak, and Roger P. Weissberg, “Promoting Positive Youth Development Through School-Based Social and Emotional Learning Interventions: A Meta-Analysis of Follow-Up Effects,” Child Development 88, no. 4 (2017): 1156–71, https://doi.org/10.1111/cdev.12864.

31.Mark T. Greenberg, Celene E. Domitrovich, Roger P. Weissberg, and Joseph A. Durlak, “Social and Emotional Learning as a Public Health Approach to Education,” Future of Children 17, no. 1 (2017): 13–32, https://doi.org/10.1353/foc.2017.0001.

32.Lauren C. Hensley, Christopher A. Wolters, Sungjun Won, and Anna C. Brady, “Academic Probation, Time Management, and Time Use in a College Success Course,” Journal of College Reading and Learning 48, no. 2 (2018): 105–23, https://doi.org/10.1080/10790195.2017.1411214.

33.Jordan Badger, Paula A. Quatromoni, and Jesse Stabile Morrell, “Relationship Between Stress and Healthy Lifestyle Factors of College Students,” Health Behavior and Policy Review 6, no. 1 (2019): 43–55, https://doi.org/10.14485/HBPR.6.1.4.

34.Abelson, Lipson, and Eisenberg, “Mental Health in College”; Janis Whitlock, Peter A. Wyman, and Sarah R. Moore, “Connectedness and Suicide Prevention in Adolescents: Pathways and Implications,” Suicide and Life-Threatening Behavior 44, no. 3 (2014): 246–72, https://doi.org/10.1111/sltb.12071.

35.Allison Paolini, “Social Emotional Learning: Role of the School Counselor in Promoting College and Career Readiness,” Anatolian Journal of Education 4, no. 1 (2019): 1–12.

36.Kathryn A. Larin, Supplemental Nutrition Assistance Program: Estimated Eligibility and Receipt Among Food Insecure College Students; Report to Congressional Requesters, GAO-24-107074 (US Government Accountability Office, 2024).

37.Raffaella Calati, Chiara Ferrari, Marie Brittner, et al., “Suicidal Thoughts and Behaviors and Social Isolation: A Narrative Review of the Literature,” Journal of Affective Disorders 245 (2019): 653–67, https://doi.org/10.1016/j.jad.2018.11.022.

38.Yujin Sun, “The Relationship Between College Students’ Interpersonal Relationship and Mental Health: Multiple Mediating Effect of Safety Awareness and College Planning,” Psychology Research and Behavior Management 16 (2023): 261–70, https://doi.org/10.2147/PRBM.S396301; Whitlock, Wyman, and Moore, “Connectedness.”

39.Badger, Quatromoni, and Morrell, “Stress and Healthy Lifestyle.”

40.Emma M. Seppälä, Christina Bradley, Julia Moeller, Leilah Harouni, Dhruv Nandamudi, and Marc A. Brackett, “Promoting Mental Health and Psychological Thriving in University Students: A Randomized Controlled Trial of Three Well-Being Interventions,” Frontiers in Psychiatry 11 (2020): 534776, https://doi.org/10.3389/fpsyt.2020.00590.

41.MacPhee et al., “Strengthening Safety Nets.”

42.Calati et al., “Suicidal Thoughts.”

43.Whitlock, Wyman, and Moore, “Connectedness.”

44.Sarah Ketchen Lipson, Adam Kern, Daniel Eisenberg, and Alfiee M Breland-Noble, “Mental Health Disparities Among College Students of Color,” Journal of Adolescent Health 63, no. 3 (2018): 348–56, https://doi.org/10.1016/j.jadohealth.2018.04.014.

45.Whitlock, Wyman, and Moore, “Connectedness.”

46.Robert C. Dempsey, Sophia E. Fedorowicz, and Alex M. Wood, “The Role of Perceived Social Norms in Non-Suicidal Self-Injury and Suicidality: A Systematic Scoping Review,” PLOS One 18, no. 6 (2023): e0286118, https://doi.org/10.1371/journal.pone.0286118.

47.Jazmin A. Reyes-Portillo, Alison M. Lake, Marjorie Kleinman, and Madelyn S. Gould, “The Relation Between Descriptive Norms, Suicide Ideation, and Suicide Attempts Among Adolescents,” Suicide and Life-Threatening Behavior 49, no. 2 (2019): 535–46, https://doi.org/10.1111/sltb.12446.

48.Whitlock, Wyman, and Moore, “Connectedness.”

49.Jessica Samuolis, Angela J. Harrison, and Karen Flanagan, “Evaluation of a Peer-Led Implementation of a Suicide Prevention Gatekeeper Training Program for College Students,” Crisis: The Journal of Crisis Intervention and Suicide Prevention 41, no. 5 (2019): 331–36, https://doi.org/10.1027/0227-5910/a000638.

50.Abelson, Lipson, and Eisenberg, “Mental Health in College.”

51.MacPhee et al., “Strengthening Safety Nets.”

52.Abelson, Lipson, and Eisenberg, “Mental Health in College.”

53.Marco Solmi, Joaquim Radua, and Miriam Olivola, “Age at Onset of Mental Disorders Worldwide: Large-Scale Meta-Analysis of 192 Epidemiological Studies,” Molecular Psychiatry 27, no.1 (2022): 281–95, https://doi.org/10.1038/s41380-021-01161-7.

54.Ewa K. Czyz, Adam G. Horwitz, Daniel Eisenberg, Anne Kramer, and Cheryl A. King, “Self-Reported Barriers to Professional Help Seeking Among College Students at Elevated Risk for Suicide,” Journal of American College Health 61, no. 7 (2013): 398–406, https://doi.org/10.1080/07448481.2013.820731.

55.Beth Han, Wilson M. Compton, Daniel Eisenberg, Laura Milazzo-Sayre, Richard McKeon, and Art Hughes, “Prevalence and Mental Health Treatment of Suicidal Ideation and Behavior Among College Students Aged 18–25 Years and Their Non-College-Attending Peers in the United States,” Journal of Clinical Psychiatry 77, no. 6 (2016): 815, https://doi.org/10.4088/JCP.15m09929.

56.Nancy Downs, Elyse Galles, Brian Skehan, and Sarah Ketchen Lipson, “Be True to Our Schools—Models of Care in College Mental Health,” Current Psychiatry Reports 20 (2018): 1–8, https://doi.org/10.1007/s11920-018-0935-6.

57.Kate Wolitzky-Taylor, Richard T. LeBeau, Marcelina Perez, Elizabeth Gong-Guy, and Timothy Fong, “Suicide Prevention on College Campuses: What Works and What Are the Existing Gaps? A Systematic Review and Meta-Analysis,” Journal of American College Health 68, no. 4 (2020): 419–29, https://doi.org/10.1080/07448481.2019.1577861; Besse et al., “Holistic Prevention and Intervention.”

58.MacPhee et al., “Strengthening Safety Nets.”

59.Abelson, Lipson, and Eisenberg, “Mental Health in College.”

60.Robert L. Spitzer, Kurt Kroenke, Janet B. W. Williams, and Bernd Löwe, “A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7,” Archives of Internal Medicine 166, no. 10 (2006): 1092–97, https://doi.org/10.1001/archinte.166.10.1092; Kurt Kroenke, Robert L. Spitzer, and Janet B. Williams, “The PHQ-9: Validity of a Brief Depression Severity Measure,” Journal of General Internal Medicine 16, no. 9 (2001): 606–13, https://doi.org/10.1046/j.1525-1497.2001.016009606.x.

61.Paul G. Quinnett, “The Certified QPR Pathfinder Training Program: A Description of a Novel Public Health Gatekeeper Training Program to Mitigate Suicidal Ideation and Suicide Deaths,” Journal of Prevention 44, no. 6 (2023): 813–24, https://doi.org/10.1007/s10935-023-00748-w; Mining Liang, Qiongni Chen, Jincai Guo, et al., “Mental Health First Aid Improves Mental Health Literacy Among College Students: A Meta-Analysis,” Journal of American College Health 71, no. 4 (2023): 1196–205, https://doi.org/10.1080/07448481.2021.1925286.

62.Abelson, Lipson, and Eisenberg, “Mental Health in College.”

63.Abelson, Lipson, and Eisenberg.

64.Besse et al., “Holistic Prevention and Intervention.”

65.Sarah Ketchen Lipson, Sasha Zhou, Sara Abelson, et al., “Trends in College Student Mental Health and Help-Seeking by Race/Ethnicity: Findings from the National Healthy Minds Study, 2013–2021,” Journal of Affective Disorders 306 (2022): 138–47.

66.Paige Dunley and Andrew Papadopoulos, “Why Is It So Hard to Get Help? Barriers to Help-Seeking in Postsecondary Students Struggling with Mental Health Issues: A Scoping Review,” International Journal of Mental Health and Addiction 17 (2019): 699–715, https://doi.org/10.1007/s11469-018-0029-z; Jed Foundation, Unraveling the Stigma: Exploring Barriers to Mental Health Support Among US Teens (Jed Foundation, 2024), https://jedfoundation.org/unraveling-the-stigma-report.

67.Anna Turosak and Julie Siwierka, “Mental Health and Stigma on Campus: Insights from Students’ Lived Experience,” Journal of Prevention and Intervention Community 49, no. 7 (2019): 1–16, https://doi.org/10.1080/10852352.2019.1654264.

68.Melissa Withers, Tasfia Jahangir, Ksenia Kubasova, and Mao-Sheng Ran, “Reducing Stigma Associated with Mental Health Problems Among University Students in the Asia-Pacific: A Video Content Analysis of Student-Driven Proposals,” International Journal of Social Psychiatry 68, no. 4 (2022): 827–35, https://doi.org/10.1177/00207640211007.

69.Madison Taylor, Michelle Liu, Sara Abelson, Daniel Eisenberg, Sarah K Lipson, and Stephen M Schueller, “The Reach, Effectiveness, Adoption, Implementation, and Maintenance of Digital Mental Health Interventions for College Students: A Systematic Review,” Current Psychiatry Reports 26 (2024): 683–93, https://doi.org/10.1007/s11920-024-01545-w; Sharon Jalene, Jennifer Pharr, Manoj Sharma, and Brach Poston, “Depression, Fitness, and Student Willingness to Pursue University Counseling and Alternative Antidepressant Options,” Journal of Education and Health Promotion 10, no. 1 (2021), https://doi.org/10.4103/jehp.jehp_1421_20.

70.Russell Fulmer, Angela Joerin, Breanna Gentile, Lysanne Lakerink, and Michiel Rauws, “Using Psychological Artificial Intelligence (Tess) to Relieve Symptoms of Depression and Anxiety: Randomized Controlled Trial,” JMIR Mental Health 5, no. 4 (2018): e9782, https://doi.org/10.2196/mental.9782; Taylor et al., “Digital Mental Health Interventions.”

71.Yuying Tsong, Jennifer T. Young, Jane Duong Killer, Mary Ann Takemoto, and Brad Compliment, “Suicide Prevention Program on a Diverse College Campus: Examining the Effectiveness of a Peer-to-Peer Model,” Journal of College Student Psychotherapy 33, no. 2 (2018): 131–44, https://doi.org/10.1080/87568225.2018.1434716; Samuolis, Harrison, and Flanagan, “Peer-Led Implementation.”

72.Besse et al., “Holistic Prevention and Intervention.”

73.Jeannine Johnson, Connie Bauman, and Sarah Pociask, “Teaching the Whole Student: Integrating Wellness Education into the Academic Classroom,” Student Success 10, no. 3 (2019): 92–103, https://doi.org/10.5204/ssj.v10i3.1418.

74.Justin A. Chen, Courtney Stevens, Sylvia H. M. Wong, and Cindy H. Liu, “Psychiatric Symptoms and Diagnoses Among US College Students: A Comparison by Race and Ethnicity,” Psychiatric Services 70, no. 6 (2019): 442–49, https://doi.org/10.1176/appi.ps.20180038.

75.Lattie, Lipson, and Eisenberg, “Technology”; Taylor et al., “Digital Mental Health Interventions”; Fulmer et al., “Artificial Intelligence.”

76.Fulmer et al., “Artificial Intelligence.”

77.Taylor et al., “Digital Mental Health Interventions.”

78.Besse et al., “Holistic Prevention and Intervention.”

79.Sara B. Oswalt, Alyssa M. Lederer, Kimberly Chestnut-Steich, Carol Day, Ashlee Halbritter, and Dugeidy Ortiz, “Trends in College Students’ Mental Health Diagnoses and Utilization of Services, 2009–2015,” Journal of American College Health 68, no. 1 (2020): 41–51, https://doi.org/10.1080/07448481.2018.1515748.

80.MacPhee et al., “Strengthening Safety Nets.”

81.Besse et al., “Holistic Prevention and Intervention.”

82.Abelson, Lipson, and Eisenberg, “Mental Health in College.”

83.Abelson, Lipson, and Eisenberg.

84.Besse et al., “Holistic Prevention and Intervention.”

85.Jennifer J. Carroll, Cameron Mullins, Georgia Burnham-Lemaire, et al., “Student Perceptions of a University Medical Amnesty Policy Are Impacted by Race and Racism: A Qualitative Study,” Substance Use and Misuse 56, no. 2 (2020): 185–91, https://doi.org/10.1080/10826084.2020.1846199.

86.Besse et al., “Holistic Prevention and Intervention.”

87.Abelson, Lipson, and Eisenberg, “Mental Health in College.”

88.Besse et al., “Holistic Prevention and Intervention.”

89.MacPhee et al., “Strengthening Safety Nets.”

90.MacPhee et al.

91.Abelson, Lipson, and Eisenberg, “Mental Health in College.”

92.MacPhee et al., “Strengthening Safety Nets.”

93.Abelson, Lipson, and Eisenberg, “Mental Health in College.”

94.Besse et al., “Holistic Prevention and Intervention.”

Chapter 3

1.Teresa Watanabe, “Good Salary, Little to No Debt: A California College Guide to Top-Value Majors,” Los Angeles Times, October 3, 2024, https://www.latimes.com/california/story/2024-10-03/college-majors-salaries-vs-costs; Brooklyn Draisey, “Higher Education Leaders Seek Clarification on ‘Return on Investment’ for New Iowa House Committee,” Iowa Capital Dispatch, January 2, 2025, https://iowacapitaldispatch.com/2025/01/21/higher-education-leaders-seek-clarification-on-return-on-investment-for-new-iowa-house-committee/.

2.Melanie Hanson, “Average Cost of College by Year,” Education Data Initiative, 2024, https://educationdata.org/average-cost-of-college-by-year.

3.Jonathan Law, Suzanne Lyman, and Avery Cambridge, Affording a College Degree: Is the Cost Curve Bending? (McKinsey, 2024), https://www.mckinsey.com/industries/education/our-insights/affording-a-college-degree-is-the-cost-curve-bending.

4.Ann Coles, Laura Keane, and Brendan Williams, Beyond the College Bill: The Hidden Hurdles of Indirect Expenses (uAspire, 2020), https://www.uaspire.org/documents/publications/beyond-the-college-bill.

5.Carla Fletcher, Allyson Cornett, and Jeff Webster, State of Student Aid and Higher Education in Texas (Trellis, 2022), https://www.trelliscompany.org/wp-content/uploads/2022/09/SOSA-2022.pdf; Digest of Education Statistics, “Table 331.60 Percentage of Full-Time, Full-Year Undergraduates Receiving Financial Aid, by Type and Source of Aid and Control and Level of Institution: Selected Academic Years, 1992–93 Through 2019–20,” National Center for Education Statistics, US Department of Education, 2023, https://nces.ed.gov/programs/digest/d22/tables/dt22_331.60.asp.

6.Digest of Education Statistics, “Table 331.60.”

7.Congressional Budget Office, The Volume and Repayment of Federal Student Loans: 1995 to 2017 (Congressional Budget Office, 2020), https://www.cbo.gov/publication/56754.

8.College Board, Trends in College Pricing and Student Aid (College Board, 2024), https://research.collegeboard.org/media/pdf/Trends-in-College-Pricing-and-Student-Aid-2024-ADA.pdf.

9.Tenille Metti, “College and University Food Bank Alliance,” Swipe Out Hunger, October 21, 2021, https://www.swipehunger.org/cufba/.

10.Taylor Nichols, “The Shrinking Value of Pell Grants,” OnlineU, September 11, 2024, https://www.onlineu.com/magazine/the-shrinking-value-of-pell-grants.

11.Allyson Cornett, Carla Fletcher, and Bryan Ashton, “Fall 2023 Student Financial Wellness Survey Results” (unpublished tables) (Trellis Strategies, 2023).

12.Sallie Mae and Ipsos, How America Completes College 2024: Understanding What Helps Students Graduate (Sallie Mae and Ipsos, 2024), https://www.salliemae.com/about/leading-research/how-america-completes-college/.

13.Cornett, Fletcher, and Ashton, “Student Financial Wellness.”

14.Lee Waller and Sharon Waller, eds., Higher Education—New Approaches to Accreditation, Digitalization, and Globalization in the Age of Covid (IntechOpen, 2022), https://doi.org/10.5772/intechopen.95220.

15.May Helena Plumb, Research Brief: The Value of College (Trellis Strategies, 2024), https://www.trellisstrategies.org/wp-content/uploads/2024/08/Research-Brief_TSSEPT24_ValueOfCollege.pdf; Melissa Emrey-Arras, Higher Education: More Information Could Help Student Parents Access Additional Federal Student Aid, Report to Congressional Requesters, GAO-19-522 (US Government Accountability Office, 2019).

16.Emrey-Arras, More Information Could Help.

17.Cornett, Fletcher, and Ashton, “Student Financial Wellness.”

18.Emrey-Arras, More Information Could Help.

19.National Center for Education Statistics, “College Student Employment,” in Condition of Education (US Department of Education, Institute of Education Sciences, 2022) https://nces.ed.gov/programs/coe/indicator/ssa.

20.Cornett, Fletcher, and Ashton, “Student Financial Wellness.”

21.Penn Wharton Budget Model, “College Employment and Student Performance,” UPenn, October 4, 2021, https://budgetmodel.wharton.upenn.edu/issues/2021/10/4/college-employment-and-student-performance.

22.Cornett, Fletcher, and Ashton, “Student Financial Wellness.”

23.Robert H. Scott III and Steven Bloom, “Student Loan Debt and First-Time Home Buying in USA,” International Journal of Housing Markets and Analysis 15, no. 1 (2022): 80–93, https://doi.org/ 10.1108/IJHMA-09-2020-0118; William Elliott, Michal Grinstein-Weiss, and Il Sung Nam, “Student Debt and Declining Retirement Savings,” CSD Working Paper No. 13–34 (Center for Social Development, Washington University in St. Louis, 2013), https://openscholarship.wustl.edu/csd_research/385/.

24.Sonya L. Britt, Melanie R. Mendiola, Gregory H. Schink, Racquel H. Tibbetts, and Scott H. Jones, “Financial Stress, Coping Strategy, and Academic Achievement of College Students,” Journal of Financial Counseling and Planning 27, no. 2 (2016), https://doi.org/10.1891/1052-3073.27.2.172.

25.While the student loan repayment phase comes with its own mental health challenges, our focus in this chapter is primarily on financial strain and its connection to student mental health while enrolled in college.

26.Cornett, Fletcher, and Ashton, “Student Financial Wellness.”

27.Cornett, Fletcher, and Ashton.

28.Cornett, Fletcher, and Ashton.

29.Cornett, Fletcher, and Ashton.

30.Cornett, Fletcher, and Ashton.

31.Cornett, Fletcher, and Ashton.

32.Cornett, Fletcher, and Ashton.

33.Cornett, Fletcher, and Ashton.

34.Jinhee Kim and Swarn Chatterjee, “Financial Debt and Mental Health of Young Adults,” Journal of Financial Counseling and Planning 32, no. 2 (2021): 187–201, https://doi.org/10.1891/JFCP-18-00048; Elizabeth Sweet, Arijit Nandi, Emma K. Adam, and Thomas W. McDade, “The High Price of Debt: Household Financial Debt and Its Impact on Mental Health and Physical Health,” Social Science and Medicine 91 (2013): 94–100, https://doi.org/10.1016/j.socscimed.2013.05.009.

35.Cornett, Fletcher, and Ashton, “Student Financial Wellness.”

36.Chris Fernandez, Jeff Webster, and Allyson Cornett, Studying on Empty: A Qualitative Study of Low Food Security Among College Students (Trellis, 2019), https://www.trelliscompany.org/wp-content/uploads/2019/09/Studying-on-Empty.pdf.

37.Soomin Ryu and Lu Fan, “The Relationship Between Financial Worries and Psychological Distress Among U.S. Adults,” Journal of Family and Economic Issues 44, no. 1 (2023): 16–33, https://doi.org/10.1007/s10834-022-09820-9.

38.Healthy Minds Network, Healthy Minds Study: 2024 National Report (University of Michigan, 2024), https://healthymindsnetwork.org/wp-content/uploads/2024/09/HMS_national_report_090924.pdf; Cornett, Fletcher, and Ashton, “Student Financial Wellness.”

39.Healthy Minds Network, Healthy Minds Study.

40.Healthy Minds Network.

41.Youngmi Kim and Jennifer Murphy, “Mental Health, Food Insecurity, and Economic Hardship Among College Students During the COVID-19 Pandemic,” Health and Social Work 48, no. 2 (2023): 124–32, https://doi.org/10.1093/hsw/hlad006.

42.Our analysis is based on the NPSAS:20 data, which were the most recent available at time of publication.

43.US Government Accountability Office, Student Financial Wellness: Education Needs to Improve Oversight of Colleges’ Use of Federal Funds to Support Students’ Basic Needs, GAO-24-107074 (US Government Accountability Office, 2004), https://www.gao.gov/assets/gao-24-107074-highlights.pdf.

44.Kristy Archuleta, Anita Dale, and Scott Spann, “College Students and Financial Distress: Exploring Debt, Financial Satisfaction, and Financial Anxiety,” Journal of Financial Counseling and Planning 24, no. 2 (2013): 50–62, https://files.eric.ed.gov/fulltext/EJ1043230.pdf; Bernice Andrews and John Wilding, “The Relation of Depression and Anxiety to Life-Stress and Achievement in Students,” British Journal of Psychology 95, no. 4 (2004): 509–21, https://doi.org/10.1348/0007126042369802; Dayna O. H. Walker, Verónica Caridad Rabelo, Oscar Jerome Stewart, and Drew N. Herbert, “Social Determinants of Mental Health: The Roles of Traumatic Events, Financial Strain, Housing Instability, Food Insecurity, and Commute Time,” Journal of American College Health 72, no. 9 (2024): 3591–602, https://doi.org/10.1080/07448481.2023.2185454.

45.Amanda Baker and Catherine Montalto, “Student Loan Debt and Financial Stress: Implications for Academic Performance,” Journal of College Student Development 60, no. 1 (2019): 115–20, https://doi.org/10.1353/csd.2019.0008; Walker et al., “Social Determinants of Mental Health”; Cliff Robb, “College Student Financial Stress: Are the Kids Alright?,” Journal of Family and Economic Issues 38, no. 3 (2017): 514–27, https://doi.org/10.1007/s10834-017-9527-6.

46.The Student Financial Wellness Survey includes a six-item, validated scale from the US Department of Agriculture to measure food security within the prior thirty days. It also incorporates modified, short-form instruments for screening generalized anxiety disorder (GAD-2) and major depressive disorder (PHQ-2), which assess the frequency of anxiety and depressive symptoms over the past fourteen days. Both scales use the same scoring system: “Not at all” (0), “Several days” (1), “More than half the days” (2), and “Nearly every day” (3). Scores range from 0 to 6, with 3 being the optimal cut point for identifying major depressive disorder and generalized anxiety disorder.

47.Cornett, Fletcher, and Ashton, “Student Financial Wellness.”

48.Cornett, Fletcher, and Ashton.

49.Cindy W. Leung, Sara Farooqui, Julia A. Wolfson, and Alicia J. Cohen, “Understanding the Cumulative Burden of Basic Needs Insecurities: Associations with Health and Academic Achievement Among College Students,” American Journal of Health Promotion 35, no. 2 (2021): 275–78, https://doi.org/10.1177/0890117120964122; Allyson Cornett and Carla Fletcher, “The Impacts of COVID-19 on the Experiences of Students with Basic Needs Insecurity: Evidence from a National Survey,” Journal of Student Financial Aid 51, no. 1 (2022): article 1, https://doi.org/10.55504/0884-9153.1780.

50.Sarah Lipson, Yareliz Diaz, Jayne Davis, and Daniel Eisenberg, “Mental Health Among First-Generation College Students: Findings from the National Healthy Minds Study, 2018–2021,” Cogent Mental Health 2, no. 1 (2023), https://doi.org/0.1080/28324765.2023.2220358.

51.Cornett, Fletcher, and Ashton, “Student Financial Wellness.”

52.Carla Fletcher, Financial Insecurity and Time Poverty Among Modern Learners (Trellis Strategies, 2024), https://www.trellisstrategies.org/wp-content/uploads/2024/04/Research-Brief_TSApr24-AdultLearners_FINAL.pdf.

53.Jack Peltz, Jamie S. Bodenlos, Julie N. Kingery, and Ronald D. Rogge, “The Role of Financial Strain in College Students’ Work Hours, Sleep, and Mental Health,” Journal of American College Health 69, no. 6 (2021): 577–84, https://doi.org/ 10.1080/07448481.2019.1705306.

Voices from the Field: Adrian Gonzales

1. 1.“San Diego Miramar College,” Data USA, https://datausa.io/profile/university/san-diego-miramar-college.

2. 2.S. Michael Gaddis, Daniel Ramirez, and Erik L. Hernandez, “Contextualizing Public Stigma: Endorsed Mental Health Treatment Stigma on College and University Campuses,” Social Science and Medicine 197 (2018): 183–91, https://doi.org/10.1016/j.socscimed.2017.11.029.

3. 3.The Hope Center 2023–2024 Student Basic Needs Survey Report (Hope Center for Student Basic Needs at Temple University, February 26, 2025).

4. 4.“Jet Fuel Resource Center (Basic Needs),” San Diego Miramar College, archived webpage from 2024, https://sdmiramar.edu/evidence/2024-ISER/ST2/IIC4-09_Basic_Needs_Webpage.pdf.

5. 5.“Food and Nutrition Programs,” San Diego Miramar College, https://sdmiramar.edu/basicneeds/pantry.

6. 6.“Jet Fuel Resource Center (Basic Needs),” San Diego Miramar College, https://sdmiramar.edu/basicneeds.

7. 7.“Newly Expanded Veterans Resource Center to Open at Miramar College,” San Diego Miramar College, February 2, 2025, https://sdmiramar.edu/newsroom/2025-02-20/newly-expanded-veterans-resource-center-open-miramar-college.

Chapter 4

1.“AACC Fast Facts 2024,” American Association of Community Colleges, https://www.aacc.nche.edu/wp-content/uploads/2024/02/Fast_Facts_2024.pdf.

2.Sarah Ketchen Lipson, Megan V. Phillips, Nathan Winquist, Daniel Eisenberg, and Emily G. Lattie, “Mental Health Conditions Among Community College Students: A National Study of Prevalence and Use of Treatment,” Psychiatric Services 72, no. 10 (2021): 1126–33, https://doi.org/10.1176/appi.ps.202000437.

3.Daniel Seth Katz and Karen Davison, “Community College Student Mental Health: A Comparative Analysis,” Community College Review 42, no. 4 (2014): 307–26, https://doi.org/10.1177/0091552114535466.

4.Daniel Eisenberg, Ezra Golberstein, and Justin B. Hunt, Too Distressed to Learn? Mental Health Among Community College Students (Wisconsin Hope Lab, 2016), https://saragoldrickrab.com/wp-content/uploads/2023/06/Too_Distressed_to_Learn_Mental_Health_Am.pdf.

5.Eisenberg et al., Too Distressed.

6.Lipson et al., “Mental Health Conditions”; Eisenberg et al., Too Distressed.

7.Alyse C. Hachey, Claire Wladis, Catherine A. Manly, and Katherine M. Conway, “Health Challenges and Community College Student Outcomes Before and During the COVID-19 Pandemic,” American Behavioral Scientist 67, no. 13 (2023): 1591–610, https://doi.org/10.1177/00027642221118295.

8.Amanda O. Latz, Community College Student Mental Health: Faculty Experiences and Institutional Actions (Roman & Littlefield, 2023); Danielle Melidona, Morgan Taylor, and Ty C. McNamee, 2021 Fall Term Pulse Point Survey of College and University Presidents (American Council on Education, 2021), https://www.acenet.edu/Documents/Pulse-Point-Survey-Fall2021.pdf.

9.Hachey et al., “Health Challenges”; Daniel Eisenberg, Ezra Golberstein, and Justin B. Hunt, “Mental Health and Academic Success in College,” B. E. Journal of Economic Analysis and Policy 9, no. 1 (2009): 1–40, https://doi.org/10.2202/1935-1682.2191.

10.“AACC Fast Facts 2024.”

11.Lindsey E. Malcom-Piqueux, “Student Diversity in Community Colleges: Examining Trends and Understanding the Challenges,” in Understanding Community Colleges, 2nd ed., ed. John S. Levin and Susan T. Kater (Routledge, 2018), 21–44.

12.Gail O. Mellow and Cynthia Heelan, Minding the Dream: The Process and Practice of the American Community College (Rowman & Littlefield, 2008), 257.

13.“AACC Fast Facts 2024.”

14.“AACC Fast Facts 2024.”

15.“AACC Fast Facts 2024.”

16.Xueli Wang, Kelly Wickersham, Nicole Contreras García, and Peiwen Zheng, “ ‘Let’s Lift You up Rather Than Just Getting You off the Ground’: A Transformative Qualitative Study of Community College Student Mental Health and Success,” Teachers College Record 126, no. 11–12 (2025): 90–125, https://doi.org/10.1177/01614681251317828.

17.“Trend Generator,” National Center for Education Statistics, https://nces.ed.gov/ipeds/trendgenerator/.

18.American Association of Community Colleges, The Voluntary Framework for Accountability: Developing Measures of Community College Effectiveness and Outcomes (American Association of Community Colleges, 2012), https://vfa.aacc.nche.edu/Documents/VFAOutcomesReportWebFINAL.pdf.

19.Robin G. Isserles, The Costs of Completion: Student Success in Community College (Johns Hopkins University Press, 2021).

20.Carrie B. Kisker, Arthur M. Cohen, and Florence B. Brawer, The American Community College, 7th ed. (Jossey-Bass, 2023), 425.

21.Lauren Schudde, “Short- and Long-Term Impacts of Engagement Experiences with Faculty and Peers at Community Colleges,” Review of Higher Education 42, no. 2 (2021): 385–426, https://doi.org/10.1353/rhe.2019.0001.

22.Schudde, “Short- and Long-Term Impacts.”

23.Eisenberg et al., “Mental Health and Academic Success.”

24.Lisa Sontag-Padilla, Denise Williams, Holly Kosiewicz, et al., “Supporting the Mental Health Needs of Community College Students,” RAND Health Quarterly 10, no. 4 (September 15, 2023): 6, https://www.rand.org/pubs/periodicals/health-quarterly/issues/v10/n4/06.html.

25.Merry Sleigh, Donna Nelson, Alyssa Nelson, and Meridee Ritzer, “College Students’ Trauma and Stress Enhance Benefits of Warm-Tone Syllabus,” Journal of Effective Teaching in Higher Education 7, no. 2 (2024): 83–101, https://jethe.org/index.php/jethe/article/view/396.

26.Pamela L. Eddy and Kim E. Vanderlinden, A Blueprint for Equity-Driven Community College Leadership (Harvard Education Press, 2024), 78.

27.“AACC Competencies for Community College Leaders,” American Association of Community Colleges, https://www.aacc.nche.edu/publications-news/aacc-competencies-for-community-college-leaders/.

28.Eddy and Vanderlinden, Blueprint, 78.

29.“The Assault on DEI,” Chronicle of Higher Education, https://www.chronicle.com/package/the-assault-on-dei; “Map: Attacks on Gender-Affirming Care by State,” Human Rights Campaign, https://www.hrc.org/resources/attacks-on-gender-affirming-care-by-state-map.

30.Helen Pearson, “The Rise of Eco-Anxiety,” Nature 8007, no. 628 (April 11, 2024): 256–58.

31.Sontag-Padilla et al., “Supporting the Mental Health.”

32.Latz, Community College.

33.Kurt Kroenke, Robert L. Spitzer, and Janet B. W. Williams, “The PHQ-9: Validity of a Brief Depression Severity Measure,” Journal of General Internal Medicine 16, no. 9 (2001): 606–13, https://doi.org/10.1046/j.1525-1497.2001.016009606.x; Robert L. Spitzer, Kurt Kroenke, and Janet B. W. Williams, “A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7,” Archives of Internal Medicine 166, no. 10 (2006): 1092–97, https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/410326.

34.Paris Scott Strom, Robert Duane Strom, Tricia Sindel-Arrington, Renee V. Rude, and Chih-Hsuan Wang, “Gender Differences in Stress of Community College Students,” Community College Journal of Research and Practice 46, no. 7 (2022): 472–87, https://doi.org/10.1080/10668926.2021.1873872; John C. Fortney, Geoffrey M. Curran, Justin B. Hunt, et al., “Mental Health Treatment Seeking Among Veteran and Civilian Community College Students,” Psychiatric Services 68, no. 8 (2017): 851–55, https://doi.org/10.1176/appi.ps.201600240; Meekyung Han and Helen Pong, “Mental Health Help-Seeking Behaviors Among Asian American Community College Students: The Effect of Stigma, Cultural Barriers, and Acculturation,” Journal of College Student Development 56, no. 1 (2015): 1–14, https://doi.org/10.1353/csd.2015.0001.

35.Judith Borghouts, Elizabeth V. Eikey, Gloria Mark, et al., “Understanding Mental Health App Use Among Community College Students: Web-Based Survey Study,” Journal of Medical Internet Research 23, no. 9 (2021), https://doi.org/10.2196/27745.

36.“Mindhealth Navigator,” Holmes Community College, https://holmescc.edu/student-services/mindhealth-navigator/.

37.Michael T. Kalkbrenner, “Recognizing and Supporting Students with Mental Health Disorders: The REDFLAGS Model,” Journal of Education and Training 3, no. 1 (2016): 5, https://www.macrothink.org/journal/index.php/jet/article/view/8141/6709.

38.“Mental Health First Aid,” National Council for Mental Wellbeing, https://www.mentalhealthfirstaid.org/.

39.“Be There Certificate,” https://www.betherecertificate.org/.

40.“Question. Persuade. Refer.,” QPR Institute, https://qprinstitute.com/.

41.Latz, Community College; Amanda O. Latz, “More Than Referral: The Role of Faculty in Supporting Community College Student Mental Health,” New Directions for Community Colleges 2024, no. 208 (Winter 2024): 19–25, https://doi.org/10.1002/cc.20648.

42.Latz, “More Than Referral.”

43.Regan A. R. Gurung and Noelle R. Galardi, “Syllabus Tone, More Than Mental Health Statements, Influence Intentions to Seek Help,” Teaching of Psychology 49, no. 3 (2022): 218–23, https://doi.org/10.1177/0098628321994632.

Voices from the Field: Julie Lee

1. 1.Carmen Hei Man Shek, Sally Wai Chi Chan, Michelle Anne Stubbs, and Regina Lai Tong Lee, “Promoting International Students’ Mental Health Unmet Needs: An Integrative Review,” International Journal of Mental Health Promotion 26, no. 11 (2024): 905–24, https://doi.org/10.32604/ijmhp.2024.055706; Jobi Tat Shing Yeung, Sunah Hyun, Emily Zhang, et al., “Prevalence and Correlates of Mental Health Symptoms and Disorders Among US International College Students,” Journal of American College Health 70, no. 8 (2022): 2470–75, https://doi.org/10.1080/07448481.2020.1865980.

2. 2.Kun Yan and David C. Berliner, “An Examination of Individual Level Factors in Stress and Coping Processes: Perspectives of Chinese International Students in the United States,” Journal of College Student Development 52, no. 5 (2011): 523–42, https://doi.org/10.1353/csd.2011.0060.

3. 3.Lanxi Huang, Margaret L. Kern, and Lindsay G. Oades, “Strengthening University Student Wellbeing: Language and Perceptions of Chinese International Students,” International Journal of Environmental Research and Public Health 17, no. 15 (2020): 5538, https://doi.org/10.3390/ijerph17155538.

4. 4.Xiang Zhou, Anne Q. Zhou, and Xiaoning Sun, “Prevalence of Common Mental Concerns and Service Utilization Among International Students Studying in the US,” Counselling Psychology Quarterly 35, no. 3 (2021): 1–21, https://doi.org/10.1080/09515070.2021.1875400.

5. 5.Kirk Carapezza, “US Colleges Need International Students: Trump’s Policies May Drive Them Away,” GBH, May 13, 2025, https://www.wgbh.org/news/education-news/2025-05-13/us-colleges-need-international-students-trumps-policies-may-drive-them-away.

Chapter 5

1.Timothy Black, Marvin J. Westwood, and Michael N. Sorsdal, “From the Front Line to the Front of the Class: Counseling Students Who Are Military Veterans,” in Special Populations in College Counseling: A Handbook for Mental Health Professionals (American Counseling Association, 2007), 3–20.

2.Julia I. O’Loughlin, Daniel W. Cox, John Ogrodniczuk, and Carl A. Castro, “The Association Between Traditional Masculinity Ideology and Predictors of Military to Civilian Transition Among Veteran Men,” Journal of Men’s Studies 28, no. 3 (October 2020): 318–38, https://doi.org/10.1177/1060826520911658.

3.Trish Oberweis and Matthew Bradford, “From Camouflage to Classrooms: An Empirical Examination of Veterans at a Regional Midwestern University,” Journal of Continuing Higher Education 65, no. 2 (May 4, 2017): 106–14, https://doi.org/10.1080/07377363.2017.1320181; Katie Sullivan and Kay Yoon, “Student Veterans’ Strengths: Exploring Student Veterans’ Perceptions of Their Strengths and How to Harness Them in Higher Education,” Journal of Continuing Higher Education 68, no. 3 (September 1, 2020): 164–80, https://doi.org/10.1080/07377363.2020.1806013; Lesley McBain, Young M. Kim, Bryan J. Cook, and Kathy M. Snead, From Soldier to Student II: Assessing Campus Programs for Veterans and Service Members (American Council on Education, 2012), https://www.acenet.edu/Documents/From-Soldier-to-Student-II-Assessing-Campus-Programs.pdf.

4.Nicholas J. Osborne, “Veteran Ally: Practical Strategies for Closing the Military-Civilian Gap on Campus,” Innovative Higher Education 39, no. 3 (June 2014): 247–60, https://doi.org/10.1007/s10755-013-9274-z; Donna Ames, Zachary Erickson, and Nagy A. Youssef, “Moral Injury, Religiosity, and Suicide Risk in U.S. Veterans and Active Duty Military with PTSD Symptoms,” Military Medicine 184, no. 3–4 (March 1, 2019): e271–78, https://doi.org/10.1093/milmed/usy148; Vivek H. Murthy, Together: The Healing Power of Human Connection in a Sometimes Lonely World (HarperCollins, 2020).

5.Adam E. Barry, “Student Service Members/Veterans Participating in Higher Education: What We Know to Date,” Journal of American College Health 63, no. 7 (October 3, 2015): 415–17, https://doi.org/10.1080/07448481.2015.1072777.

6.Nancy D. Harada, JoAnn Damron-Rodriguez, Valentine M. Villa, Nancy Reifel, and Ruth Bayhaylle, “Veteran Identity and Race/Ethnicity: Influences on VA Outpatient Care Utilization,” Medical Care 40, no. 1 (January 2002): 117–28.

7.Chris A. Cate, Millions Record Project: A Review of Veteran Achievement in Higher Education (Student Veterans of America, 2014); Jan Arminio, Tomoko Kudo Grabosky, and Josh Lang, Student Veterans and Service Members in Higher Education, Key Issues on Diverse College Students (Taylor and Francis, 2014); Veterans’ Education Benefits: Enhanced Guidance and Collaboration Could Improve Administration of the Post-9/11 GI Bill Program (US Government Accountability Office, 2011), https://www.gao.gov/products/gao-11-356r.

8.Chris A. Cate, Jared S. Lyon, James Schmeling, and Barret Y. Bogue, National Veteran Education Success Tracker: A Report on the Academic Success of Student Veterans Using the Post-9/11 GI Bill (Student Veterans of America, 2017).

9.Ellen Moore, Grateful Nation: Student Veterans and the Rise of the “Military-Friendly” Campus (Duke University Press, 2017).

10.Moore, Grateful Nation.

11.Moore; Sullivan and Yoon, “Student Veterans’ Strengths.”

12.Rebecca K. Blais and Keith D. Renshaw, “Stigma and Demographic Correlates of Help-Seeking Intentions in Returning Service Members,” Journal of Traumatic Stress 26, no. 1 (February 2013): 77–85, https://doi.org/10.1002/jts.21772.

13.Moore, Grateful Nation.

14.Harada et al., “Veteran Identity”; Lana Zinger and Andrea Cohen, “Veterans Returning from War into the Classroom: How Can Colleges Be Better Prepared to Meet Their Needs,” Contemporary Issues in Education Research (CIER) 3, no. 1 (November 5, 2010): 39, https://doi.org/10.19030/cier.v3i1.160.

15.Marcia Baxter Magolda, “The Evolution of Self-Authorship,” in Knowing, Knowledge, and Beliefs, ed. by Myint Swe Khine (Springer Netherlands, 2008), 45–64, https://doi.org/10.1007/978-1-4020-6596-5_3; Elisa S. Abes, Susan R. Jones, and Marylu K. McEwen, “Reconceptualizing the Model of Multiple Dimensions of Identity: The Role of Meaning-Making Capacity in the Construction of Multiple Identities,” Journal of College Student Development 48, no. 1 (2007): 1–22, https://doi.org/10.1353/csd.2007.0000;

16.Black, Westwood, and Sorsdal, “From the Front.”

17.Carolyn Heward, Wendy Li, Ylona Chun Tie, and Pippa Waterworth, “A Scoping Review of Military Culture, Military Identity, and Mental Health Outcomes in Military Personnel,” Military Medicine 189 (November 2024): e2382–93, https://doi.org/10.1093/milmed/usae276; Carl Andrew Castro and Sara Kintzle, “Suicides in the Military: The Post-Modern Combat Veteran and the Hemingway Effect,” Current Psychiatry Reports 16, no. 8 (August 2014): 460, https://doi.org/10.1007/s11920-014-0460-1.

18.Gerald P. Krueger, “Military Culture,” in Encyclopedia of Psychology, vol. 5 (American Psychological Association, 2000), 252–59, https://doi.org/10.1037/10520-11.

19.Herbert A. Exum, Jose E. Coll, and Eugenia L. Weiss, A Civilian Counselor’s Primer for Counseling Veterans, 2nd ed. (Linus, 2011); Sullivan and Yoon, “Student Veterans’ Strengths.”

20.Heward et al., “Scoping Review”; Kimberle Crenshaw, “Demarginalizing the Intersection of Race and Sex: A Black Feminist Critique of Antidiscrimination Doctrine, Feminist Theory and Antiracist Politics,” University of Chicago Legal Forum, vol. 1989, art. 8, http://chicagounbound.uchicago.edu/uclf/vol1989/iss1/8; Abes, Jones, and McEwen, “Reconceptualizing the Model.”

21.Osborne, “Veteran Ally.”

22.Arminio, Grabosky, and Lang, Student Veterans and Service Members.

23.Chris A. Cate, Jared S. Lyon, James Schmeling, and Barret Y. Bogue, National Veteran Education Success Tracker: A Report on the Academic Success of Student Veterans Using the Post-9/11 GI Bill (Student Veterans of America, 2017).

24.Cate et al., National Veteran.

25.Sullivan and Yoon, “Student Veterans’ Strengths.”

26.Sullivan and Yoon.

27.Wade G. Livingston, Pamela A. Havice, Tony W. Cawthon, and David S. Fleming, “Coming Home: Student Veterans’ Articulation of College Re-Enrollment,” Journal of Student Affairs Research and Practice 48, no. 3 (2011): 315–31, https://doi.org/10.2202/1949-6605.6292.1; Timothy Olsen, Karen Badger, and Michael D. McCuddy, “Understanding the Student Veterans’ College Experience: An Exploratory Study,” U.S. Army Medical Department Journal (October–December 2014): 101–8.

28.Megan Louise Pedler, Royce Willis, and Johanna Elizabeth Nieuwoudt, “A Sense of Belonging at University: Student Retention, Motivation and Enjoyment,” Journal of Further and Higher Education 46, no. 3 (2021): 397–408, https://doi.org/10.1080/0309877X.2021.1955844.

29.Sullivan and Yoon, “Student Veterans’ Strengths.”

30.Sullivan and Yoon.

31.John T. Cacioppo, Stephanie Cacioppo, Amy B. Adler, et al., “The Cultural Context of Loneliness: Risk Factors in Active Duty Soldiers,” Journal of Social and Clinical Psychology 35, no. 10 (December 2016): 865–82, https://doi.org/10.1521/jscp.2016.35.10.865.

32.Geerte W. A. Hoffstede, “Culture’s Consequences: Comparing Values, Behaviors, Institutions, and Organizations across Nations,” Behaviour Research and Therapy 41, no. 7 (July 2003): 861–62, https://doi.org/10.1016/S0005-7967(02)00184-5; Dennis McGurk, Dave I. Cotting, Thomas W. Britt, and Amy Adler, “Joining the Ranks: The Role of Indoctrination in Transforming Civilians to Service Members,” in Military Life: The Psychology of Serving in Peace and Combat: Operational Stress, vol. 2 (Praeger Security International, 2006), 13–31.

33.Sullivan and Yoon, “Student Veterans’ Strengths”; Lynette Cook Francis and Amanda Kraus, “Developing a Student Veterans Center: The Confluence of Academic and Military Cultures,” About Campus: Enriching the Student Learning Experience 17, no. 4 (September 2012): 11–14, https://doi.org/10.1002/abc.21087; Meredith A. Rausch and Megan M. Buning, “Student Veterans’ Perspectives of Higher Education Contexts: Beyond the Non-Traditional Student,” College Teaching 72, no. 2 (April 2, 2024): 106–16, https://doi.org/10.1080/87567555.2022.2106469; Livingston et al., “Coming Home”; Olsen, Badger, and McCuddy, “Understanding.”

34.D. Vacchi, “Perceptions of Veteran-Friendliness: Giving Student Veterans a Voice,” research paper (annual conference of the New England Educational Research Organization, Portsmouth, NH, April 2013).

35 Moore, Grateful Nation; Sullivan and Yoon, “Student Veterans Strengths”; David DiRamio, Robert Ackerman, and Regina L. Mitchell, “From Combat to Campus: Voices of Student-Veterans,” NASPA Journal 45, no. 1 (January 1, 2008): 73–102, https://doi.org/0.2202/1949-6605.1908; Arminio, Grabosky, and Lang, Student Veterans and Service Members.

36 Corey B. Rumann and Florence A. Hamrick, “Supporting Student Veterans in Transition,” New Directions for Student Services 2009, no. 126 (June 2009): 25–34, https://doi.org/10.1002/ss.313.

37.Noosha Niv and Lauren Bennett, “Veterans’ Mental Health in Higher Education Settings: Services and Clinician Education Needs,” Psychiatric Services 68, no. 6 (June 1, 2017): 636–39, https://doi.org/10.1176/appi.ps.201600065; Susan R. Jones and Elisa S. Abes, Identity Development of College Students: Advancing Frameworks for Multiple Dimensions of Identity (Jossey-Bass, 2013); Nancy K. Schlossberg, Counseling Adults in Transition: Linking Practice with Theory, 4th ed. (Springer, 1984).

38.Amy Novotney, “The Risk of Social Isolation,” Monitor on Psychology 50, no. 1 (May 2019): 32, https://www.apa.org/monitor/2019/05/ce-corner-isolation; Arminio, Grabosky, and Lang, Student Veterans and Service Members; Murthy, Together.

39.Rumann and Hamrick, “Supporting Student Veterans.”

40.Castro and Kintzle, “Suicides.”

41.Murthy, Together.

42.Novotney, “Risk.”

43.Lisa F. Berkman, Thomas Glass, Ian Brissette, and Teresa E. Seeman, “From Social Integration to Health: Durkheim in the New Millennium,” Social Science and Medicine 51, no. 6 (September 2000): 843–57, https://doi.org/10.1016/S0277-9536(00)00065-4; Bessel A. Van der Kolk, The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma (Penguin Books, 2015); Christopher B. Frueh, Alok Madan, J. Christopher Fowler, et al., “ ‘Operator Syndrome’: A Unique Constellation of Medical and Behavioral Health-Care Needs of Military Special Operation Forces,” International Journal of Psychiatry in Medicine 55, no. 4 (July 2020): 281–95, https://doi.org/10.1177/0091217420906659; DiRamio, Ackerman, and Mitchell, “From Combat.”

44.Van der Kolk, Body; Murthy, Together; 2023 Annual Report, STA 24–147 (Center for Collegiate Mental Health, January 2024).

45.Murthy, Together.

46.Murthy.

47.Cacioppo et al., “Cultural Context of Loneliness.”; Lixia Ge, Chun Wei Yap, Reuben Ong, and Bee Hoon Heng, “Social Isolation, Loneliness and Their Relationships with Depressive Symptoms: A Population-Based Study,” PLOS ONE 12, no. 8 (August 23, 2017): e0182145, https://doi.org/10.1371/journal.pone.0182145; Eric Klinenberg, “Social Isolation, Loneliness, and Living Alone: Identifying the Risks for Public Health,” American Journal of Public Health 106, no. 5 (May 2016): 786–87, https://doi.org/10.2105/AJPH.2016.303166.

48.Emile Durkheim, Suicide (Free Press, 1951).

49.Joseph M. Currier, Ryon C. McDermott, and Brook M. Sims, “Patterns of Help-Seeking in a National Sample of Student Veterans: A Matched Control Group Investigation,” General Hospital Psychiatry 43 (November 2016): 58–62; Wade G. Livingston, Pamela A. Havice, Tony W. Cawthon, and David S. Fleming, “Coming Home: Student Veterans’ Articulation of College Re-Enrollment,” Journal of Student Affairs Research and Practice 48, no. 3 (2011): 315–31, https://doi.org/10.2202/1949-6605.6292.1; Olsen, Badger, and McCuddy, “Understanding.”

50.Suzanne Guthrie-Gower and Gemma Wilson-Menzfeld, “Ex-Military Personnel’s Experiences of Loneliness and Social Isolation from Discharge, Through Transition, to the Present Day,” PLOS ONE 17, no. 6 (June 6, 2022): e0269678, https://doi.org/0.1371/journal.pone.0269678; Gemma Wilson, Michael Hill, and Matt Kiernan, “Loneliness and Social Isolation of Military Veterans: Systematic Narrative Review,” Occupational Medicine 68, no, 9 (2018): 600–609, https://doi.org/10.1093/occmed/kqy160.

51.Sullivan and Yoon, “Student Veterans’ Strengths.”; Francis and Kraus, “Developing a Student Veterans”; David C. DiRamio and Kathryn Jarvis, eds., Veterans in Higher Education: When Johnny and Jane Come Marching to Campus, ASHE Higher Education Report, vol. 37, no. 3 (Wiley/Jossey-Bass, 2011).

52.Chris Basel, in discussion with author, September 2024; Magdalen P. J. Harris, P. Christopher Palmedo, and Sasha A. Fleary, “ ‘What Gets People in the Door’: An Integrative Model of Student Veteran Mental Health Service Use and Opportunities for Communication,” Journal of American College Health 72, no. 8 (2022): 2764–74, https://doi.org/10.1080/07448481.2022.2129977.

53.Chris Basel, in discussion with author, September 2024; Harris, Palmedo, and Fleary, “Integrative Model.”

54.Arminio, Grabosky, and Lang, Student Veterans and Service Members; Daniel W. Cox and Julia O’Loughlin, “Posttraumatic Stress Mediates Traditional Masculinity Ideology and Romantic Relationship Satisfaction in Veteran Men,” Psychology of Men and Masculinity 18, no. 4 (October 2017): 382–89, https://doi.org/10.1037/men0000067.

55.Cox and O’Loughlin, “Posttraumatic”; Gregory C. Alfred, Joseph H. Hammer, and Glenn E. Good, “Male Student Veterans: Hardiness, Psychological Well-Being, and Masculine Norms,” Psychology of Men and Masculinity 15, no. 1 (January 2014): 95–99, https://doi.org/10.1037/a0031450.

56.Abby Adler, Shari Jager-Hyman, Gregory K. Brown, et al., “A Qualitative Investigation of Barriers to Seeking Treatment for Suicidal Thoughts and Behaviors Among Army Soldiers with a Deployment History,” Archives of Suicide Research 24, no. 2 (April 2, 2020): 251–68, https://doi.org/10.1080/13811118.2019.1624666.

57.Cox and O’Loughlin, “Posttraumatic”; Susanne W. Gibbons, Laurie Migliore, Sean P. Convoy, Shawna Greiner, and Patrick H. DeLeon, “Military Mental Health Stigma Challenges: Policy and Practice Considerations,” Journal for Nurse Practitioners 10, no. 6 (June 2014): 365–72, https://doi.org/10.1016/j.nurpra.2014.03.021.

58.Adler et al., “Qualitative Investigation.”

59.Cox and O’Loughlin, “Posttraumatic”; Gibbons et al., “Military Mental Health.”

60.Ted C. Bonar, “Mental Health and Military-Connected Students on Campus: Culture, Challenges, and Success,” New Directions for Student Services 2016, no. 156 (December 2016): 41–51, https://doi.org/10.1002/ss.20190.

61.James Pease, “Integrating College Student Veterans on Campus Through Peer Mentorship Programs,” Journal of College Orientation, Transition, and Retention 28, no. 3 (November 1, 2021): https://doi.org/10.24926/jcotr.v28i3.4037.

62.Cacioppo et al., “Cultural Context of Loneliness.”

63.John R. Christian, James R. Stivers, and Morgan T. Sammons, “Training to the Warrior Ethos: Implications for Clinicians Treating Military Members and Their Families,” in Living and Surviving in Harm’s Way: A Psychological Treatment Handbook for Pre- and Post Deployment of Military Personnel (Routledge/Taylor & Francis, 2009), 27–49.

64.Arminio, Grabosky, and Lang, Student Veterans and Service Members.

65.Arminio, Grabosky, and Lang; Francis and Kraus, “Developing”; Sullivan and Yoon, “Student Veterans’ Strengths.”

66.Lenaya C. Hezel, “Changes: Understanding How Military-connected Students Acquire Social and Cultural Capital in Higher Education” (PhD diss., George Mason University, 2024).

67.Murthy, Together; Henry G. Harder, Travis Holyk, Virginia L. Russell, and Tammy Klassen-Ross, “Nges Siy (I Love You): A Community-Based Youth Suicide Intervention in Northern British Columbia,” International Journal of Indigenous Health 10, no. 2 (December 17, 2015): 21–32, https://doi.org/10.18357/ijih.102201514309.

68.Patrick L. Hill, Gabriel Olaru, and Mathias Allemand, “Do Associations Between Sense of Purpose, Social Support, and Loneliness Differ Across the Adult Lifespan?,” Psychology and Aging 38, no. 4 (2023): 345–55, https://doi.org/10.1037/pag0000733.

69.Ted C. Bonar and Paula L. Domenici, “Counseling and Connecting with the Military Undergraduate: The Intersection of Military Service and University Life,” Journal of College Student Psychotherapy 25, no. 3 (July 2011): 204–19, https://doi.org/10.1080/87568225.2011.581925; Barry, “What We Know.”

70.Lisa K. B. Richardson, Christopher Frueh, and Ronald Acierno, “Prevalence Estimates of Combat-Related Post-Traumatic Stress Disorder: Critical Review,” Australian and New Zealand Journal of Psychiatry 44, no. 1 (January 2010): 4–19, https://doi.org/10.3109/00048670903393597; Adam E. Barry, Shawn D. Whiteman, and Shelley MacDermid Wadsworth, “Student Service Members/Veterans in Higher Education: A Systematic Review,” Journal of Student Affairs Research and Practice 51, no. 1 (January 2014): 30–42, https://doi.org/10.1515/jsarp-2014-0003; Terri Tanielian, Lisa H. Jaycox, Terry L. Schnell, et al., Invisible Wounds of War: Summary and Recommendations for Addressing Psychological and Cognitive Injuries (RAND, 2008); Philip S. Anton, Raj Raman, Jan Osburg, and James G. Kallimani, An Update of the Nation’s Long-Term Strategic Needs for NASA’s Aeronautics Test Facilities (RAND, 2009).

71.Vincent Mysliwie, Leigh McGraw, Roslyn Pierce, Patrick Smith, Brandon Trapp, and Bernard J. Roth, “Sleep Disorders and Associated Medical Comorbidities in Active Duty Military Personnel,” Sleep 36, no. 2 (February 2013): 167–74, https://doi.org/10.5665/sleep.2364; Nita Lewis Shattuck and Stephanie A. T. Brown, “Wounded in Action: What the Sleep Community Can Learn from Sleep Disorders of US Military Service Members,” Sleep 36, no. 2 (February 2013): 159–60, https://doi.org/10.5665/sleep.2356; Arminio, Grabosky, and Lang, Student Veterans and Service Members.

72.David M. Rudd, Jeffrey Goulding, and Craig J. Bryan, “Student Veterans: A National Survey Exploring Psychological Symptoms and Suicide Risk,” Professional Psychology: Research and Practice 42, no. 5 (2011): 354–60, https://doi.org/10.1037/a0025164.

73.Jacob K. Farnsworth, Kent D. Drescher, Wyatt Evans, and Robyn D. Walser, “A Functional Approach to Understanding and Treating Military-Related Moral Injury,” Journal of Contextual Behavioral Science 6, no. 4 (October 2017): 391–97, https://doi.org/10.1016/j.jcbs.2017.07.003; Jeremy D. Jinkerson, “Defining and Assessing Moral Injury: A Syndrome Perspective,” Traumatology 22, no. 2 (June 2016): 122–30, https://doi.org/10.1037/trm0000069.

74.Jinkerson, “Moral Injury.”

75.Josephine G. Pryce, David H. Pryce, and Kimberly K. Shackelford, The Costs of Courage: Combat Stress, Warriors, and Family Survival (Oxford University Press, 2016).

76.Nathan D. Ainspan, Craig Bryan, and Walter E. Penk, eds., Handbook of Psychosocial Interventions for Veterans and Service Members: A Guide for the Non-Military Mental Health Clinician (Oxford University Press, 2016), https://doi.org/10.1093/med:psych/9780199353996.001.0001.

77.“How Common Is PTSD in Veterans?,” US Department of Veterans Affairs, https://www.ptsd.va.gov/understand/common/common_veterans.asp;

78.Lawrence Schonfeld, Lawrence A. Braue, Sheryl Stire, Amber M. Gum, Brittany L. Cross, and Lisa M. Brown, “Behavioral Health and Adjustment to College Life for Student Service Members/Veterans,” Journal of American College Health 63, no. 7 (October 3, 2015): 428–36, https://doi.org/10.1080/07448481.2014.963106.

79.Katie Prizeman, Netta Weinstein, and Ciara McCabe, “Effects of Mental Health Stigma on Loneliness, Social Isolation, and Relationships in Young People with Depression Symptoms,” BMC Psychiatry 23, no. 1 (July 21, 2023): 527, https://doi.org/10.1186/s12888-023-04991-7.

80.Bonar and Domenici, “Counseling and Connecting.”

81.2023 Annual Report, Center for Collegiate Mental Health.

82.Frueh et al., “Operator Syndrome.”

83.Ames et al., “Moral Injury”; C. Alex Brake, Sasha M. Rojas, Christal L. Badour, Courtney E. Dutton, and Matthew T. Feldner, “Self-Disgust as a Potential Mechanism Underlying the Association Between PTSD and Suicide Risk,” Journal of Anxiety Disorders 47 (April 2017): 1–9, https://doi.org/10.1016/j.janxdis.2017.01.003; Robert E. Meagher, Killing from the Inside Out: Moral Injury and Just War (Cascade Books, 2014); Roopali B. Parikh, Yusef Canaan, and Juan D. Oms, “Addressing PTSD and Suicide in US Veterans,” Journal of Clinical Psychiatry 76, no. 8 (August 26, 2015): e1037, https://doi.org/10.4088/JCP.15lr09830.

84.Kennedy Kirkpatrick, Mashfee H. Khan, Yi Deng, and Krishna Shah, “A Review of Stellate Ganglion Block as an Adjunctive Treatment Modality,” Cureus 15, no. 2 (February 2023): e35174, https://doi.org/10.7759/cureus.35174.

85.Magolda, “Self-Authorship”; Arminio, Grabosky, and Lang, Student Veterans and Service Members.

86.Lauren M. Sippel and Judith A. Lyons, “Facilitating Growth After Trauma,” in Handbook of Psychosocial Interventions for Veterans and Service Members, ed. Nathan D. Ainspan, Craig Bryan, and Walter E. Penk (Oxford University Press, 2016), 257–66, https://doi.org/10.1093/med:psych/9780199353996.003.0021.

87.Black, Westwood, and Sorsdal, “From the Front”; Bonar and Domenici, “Counseling and Connecting”; Carrie M. Farmer, Sierra Smucker, Natalie C. Ernecoff, and Hamad Al-Ibrahim, Recommended Standards for Delivering High-Quality Care to Veterans with Invisible Wounds (RAND, May 9, 2022), https://www.rand.org/pubs/research_reports/RRA1728-1.html; Sarah W. Kroenlein and David L. Wilson, “Cultural Humility in Veteran Research and Practice,” New Horizons in Adult Education and Human Resource Development 37, no. 2 (2024), https://doi.org/10.1177/19394225241277079; Christian, Stivers, and Sammons, “Training.”

88.Black, Westwood, and Sorsdal, “From the Front”; Bonar and Domenici, “Counseling and Connecting”; Farmer et al., Recommended Standards; Kroenlein and Wilson, “Cultural Humility.”

89.Osborne, “Veteran Ally”; Philip J. Quartana, Joshua E. Wilk, Jeffrey L. Thomas, et al., “Trends in Mental Health Services Utilization and Stigma in US Soldiers from 2002 to 2011,” American Journal of Public Health 104, no. 9 (September 2014): 1671–79, https://doi.org/10.2105/AJPH.2014.301971; Blais and Renshaw, “Stigma.”

90.Adler et al., “Qualitative Investigation”; Cox and O’Loughlin, “Postraumatic”; Eunice C. Wong, Molly Waymouth, and Ryan K. McBain, Perceptions of Mental Health Confidentiality Policies and Practices in the U.S. Military (RAND, December 17, 2024), https://www.rand.org/pubs/research_reports/RRA2681-1.html.

91.Adler et al., “Qualitative Investigation.”

92.Adler et al.; Cox and O’Loughlin, “Posttraumatic”; Kroenlein and Wilson, “Cultural Humility.”

93.Joseph M. Biddix, Catherine I. Fogel, and Beth Perry Black, “Comfort Levels of Active Duty Gay/Bisexual Male Service Members in the Military Healthcare System,” Military Medicine 178, no. 12 (December 2013): 1335–40, https://doi.org/10.7205/MILMED-D-13-00044.

94.Niv and Bennett, “Veterans’ Mental Health”; Kaye Horne Whitley and Paul F. Tschudi, “Life Beyond War: Supporting the Mental Health Needs of Student Veterans,” Career Planning and Adult Development Journal 30, no. 3 (Fall 2014): 162–71.

95.Wong et al., Perceptions.

96.Wong et al.; Tirzah Parrish LeFeber and Bernadette Solorzano, “Putting Suicide Policy Through the Wringer: Perspectives of Military Members Who Attempted to Kill Themselves,” International Journal of Environmental Research and Public Health 16, no. 21 (November 4, 2019): 4274, https://doi.org/10.3390/ijerph16214274.

97.Wong et al., Perceptions.

98.Bonar and Domenici, “Counseling and Connecting.”

99.Niv and Bennett, “Veterans’ Mental Health”; Charles W. Hoge, Carl A. Castro, Stephen C. Messer, Dennis McGurk, Dave I. Cotting, and Robert L. Koffman, “Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care,” New England Journal of Medicine 351, no. 1 (2004): 13–22.

100.Harris, Palmedo, and Fleary, “What Gets People.”

101.Scott L. Johnston, Jennifer A. Webb-Murphy, and Jagruti P. Bhakta, “Lesbian, Gay, and Bisexual Service Members,” in Handbook of Psychosocial Interventions for Veterans and Service Members: A Guide for the Non-Military Mental Health Clinician, ed. Nathan D. Ainspan, Craig Bryan, and Walter E. Penk (Oxford Academic, June 2016), 45–52, https://doi.org/10.1093/med:psych/9780199353996.003.0005; Amy E. Street, Dawne Vogt, and Lissa Dutra, “A New Generation of Women Veterans: Stressors Faced by Women Deployed to Iraq and Afghanistan,” Clinical Psychology Review 29, no. 8 (December 2009): 685–94, https://doi.org/10.1016/j.cpr.2009.08.007.

102.Arminio, Grabosky, and Lang, Student Veterans and Service Members.

103.Harris, Palmedo, and Fleary, “What Gets People.”

104.Murthy, Together; Brian Simpson, “How to Prevent Social Isolation from Making Loneliness Worse,” Johns Hopkins, Bloomberg School of Public Health, April 3, 2020, https://publichealth.jhu.edu/2020/how-to-prevent-social-isolation-from-making-loneliness-worse.

105.Sullivan and Yoon, “Student Veterans’ Strengths.”

106.Hoge et al., “Combat Duty”; Vacchi, “Perceptions.”

107.Shaun R. Harper and Stephen John Quaye, eds., Student Engagement in Higher Education: Theoretical Perspectives and Practical Approaches for Diverse Populations (Routledge, 2010), https://doi.org/10.4324/9780203894125; Rachaele Pope and L. Le Peaum, “The Influence of Institutional Context and Culture,” in Why Aren’t We There Yet? Taking Personal Responsibility for Creating an Inclusive Campus, ed. Jan L. Arminio, Vasti Torres, and Raechele L. Pope (Stylus, 2012), 103–30; Sullivan and Yoon, “Student Veterans’ Strengths.”

108.Sullivan and Yoon, “Student Veterans’ Strengths.”

109.Arminio, Grabosky, and Lang, Student Veterans and Service Members.

110.Arminio, Grabosky, and Lang.

111.Moore, Grateful Nation.

112.Arminio, Grabosky, and Lang, Student Veterans and Service Members; Hezel, Changes.

113.Shane P. Hammond, “Complex Perceptions of Identity: The Experience of Student Combat Veterans in Community College,” Community College Journal of Research and Practice 40, no. 2 (2015): 146–59; Aynsley M. Diamond, “The Adaptive Military Transition Theory: Supporting Military Students in Academic Environments” (PhD diss., Johnson and Wales University, 2012).

114.Annemarie Vaccaro, “ ‘It’s Not One Size Fits All’: Diversity Among Student Veterans,” Journal of Student Affairs Research and Practice 52, no. 4 (2015): 347–58, https://doi.org/10.1080/19496591.2015.1067224; Hoge et al., “Combat Duty.”

115.Pease, “Integrating College Student Veterans.”

116.Arminio, Grabosky, and Lang, Student Veterans and Service Members; Francis and Kraus, “Developing”; Sullivan and Yoon, “Student Veterans’ Strengths.”

117.Arminio, Grabosky, and Lang, Student Veterans and Service Members.

118.Bonar and Domenici, “Counseling and Connecting.”

119.Arminio, Grabosky, and Lang, Student Veterans and Service Members.

120.Sullivan and Yoon, “Student Veterans’ Strengths.”

121.Jessica M. LaCroix, Adam Walsh, Mark A. Baggett, et al., “Three Department of Defense–Funded Public Health Approaches to Reduce Military Suicide,” Suicide and Life-Threatening Behavior 51, no. 2 (April 2021): 334–43, https://doi.org/10.1111/sltb.12709; Sullivan and Yoon, “Student Veterans’ Strengths.”

122.Zinger and Cohen, “Veterans Returning”; Schlossberg, Counseling Adults.

123.Harada et al., “Veteran Identity”; Zinger and Cohen, “Veterans Returning”; Arminio, Grabosky, and Lang, Student Veterans and Service Members; Exum, Coll, and Weiss, Civilian Counselor’s Primer; Sullivan and Yoon, “Student Veterans’ Strengths.”

124.McBain et al., From Soldier to Student.

125.R. J. Jenkins, in discussion with author, January 2025.

Chapter 6

1.Accidental Death and Suicides in India 2022 (National Crime Records Bureau, Ministry of Home Affairs, Government of India, 2023), 209, https://www.ncrb.gov.in/uploads/files/AccidentalDeathsSuicidesinIndia2022v2.pdf; Lakshmi Vijayakumar, Prabha S. Chandra, Munirathinam Suresh Kumar, et al., “The National Suicide Prevention Strategy in India: Context and Considerations for Urgent Action,” Lancet Psychiatry 9, no. 2 (February 2022): 164, https://doi.org/10.1016/S2215-0366(21)00152-8.

2.Enrollment and the Emotional Well-Being of Prospective Student (RNL, 2024), https://learn.ruffalonl.com/rs/395-EOG-977/images/2024_Enrollment_Emotional_Well-Being_Students.pdf?version=0; Understanding and Addressing the Mental Health of High School Students: Views of School Administrators, Caregivers, and Students (Jed Foundation, 2020), 3, https://jedfoundation.org/wp-content/uploads/2021/08/High-School-Student-Mental-Health-Report_JED-and-Fluent_FINAL.pdf; NACAC College Admission Process Survey (NACAC, August 2023), https://www.nacacnet.org/wp-content/uploads/NACAC-College-Admission-Process-Research_FINAL.pdf.

3.National College Progression Rates, High School Benchmark Series (National Student Clearinghouse Research Center, December 2021), 3, https://nscresearchcenter.org/wp-content/uploads/2021_HSBenchmarksReport.pdf.

4.Current Term Enrollment Estimates (CTEE) Expanded Edition: Fall 2024, CTEE Series (National Student Clearinghouse Research Center, January 2025), https://public.tableau.com/app/profile/researchcenter/viz/CTEEFall2024dashboard/CTEEFall2024.

5.Rodney Hughes, Elyse Armstrong, Mark Freeman, et al., End-of-Season Report, 2023–2024: First-Year Application Trends (Common App, August 2024), 9, https://www.commonapp.org/files/FY_application_trends_end_season_report_23-24.pdf; Brian Kim, Mark Freeman, Trent Kajikawa, Honeiah Karimi, and Preston Magouirk, First-Year Applications per Applicant (Common App, December 2022), 2, https://www.commonapp.org/files/Common-App-Brief-First-Year-Applications-Per-Applicant.pdf.

6.“Apply to College,” Common App, https://www.commonapp.org/apply.

7.Margaux Cameron, Ruby Johnson, T. Austin Lacy, et al., 2019–20 National Postsecondary Student Aid Study (NPSAS:20): First Look at Student Financial Aid Estimates for 2019–20 (National Center for Education Statistics, July 2023), https://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2023466.

8.Annmarie Weisman, Dear Colleague Letter: FAFSA Simplification Act Changes for Implementation in 2024–25, GEN-23-11 (US Government Accountability Office, August 2023), https://fsapartners.ed.gov/knowledge-center/library/dear-colleague-letters/2023-08-04/fafsa-simplification-act-changes-implementation-2024-25; Testimony Before the Subcommittee on Higher Education and Workforce Development, Committee on Education and the Workforce, House of Representatives, Statement of Melissa Emrey-Arras: FAFSA Education Needs to Improve Communications and Support around the Free Application for Federal Student Aid, GAO-24-107407 (US Government Accountability Office, September 2024), https://www.gao.gov/assets/gao-24-107407.pdf.

9.“National FAFSA Completion Rates for High School Seniors and Graduates,” National College Attainment Network, https://www.ncan.org/page/NationalFAFSACompletionRatesforHighSchoolSeniorsandGraduates; Testimony Before the Subcommittee on Higher Education.

10.“About CSS Profile,” College Board, https://cssprofile.collegeboard.org/about.

11.“Increasing Access,” College Board, https://highered.collegeboard.org/financial-aid/css-profile/increase-access; Eric Hoover, “The Most Onerous Form in College Admissions,” Chronicle of Higher Education, February 23, 2021, https://www.chronicle.com/article/the-most-onerous-form-in-college-admissions.

12.Madilynne Medina, “California Teens Forced to Travel Hundreds of Miles to Take the SAT,” SFGATE, June 7, 2024, https://www.sfgate.com/bayarea/article/california-teens-travel-hundreds-miles-sat-19497696.php; “Requesting Sunday Testing,” College Board, https://satsuite.collegeboard.org/sat/registration/additional-registration-options/sunday-testing.

13.Student-to-School-Counselor Ratio 2023–2024 (ASCA, 2025), https://www.schoolcounselor.org/getmedia/f2a319d5-db73-4ca1-a515-2ad2c73ec746/Ratios-2023-24-Alpha.pdf.

14.National Student to School Counselor Ratio 1986–2023 (ASCA, 2025), https://www.schoolcounselor.org/getmedia/06e49241-5a9e-47a4-881d-cfca5ca61cce/National-Ratios-30-year.pdf; “School Counselor Roles & Ratios,” ASCA, https://www.schoolcounselor.org/About-School-Counseling/School-Counselor-Roles-Ratios.

15.The Counselor Perspective: Insights from EAB’s 2023 Survey of High School Counselors (EAB, 2023), 8, https://www.nacacnet.org/nacac-eab-search-and-enrollment-survey/.

16.Melissa Clinedinst, 2019 State of College Admission (NACAC, 2020), https://nacacnet.org/wp-content/uploads/2022/10/soca2019_all.pdf.

17.“Advocacy, College Access and Affordability, Need-Based Financial Aid,” National Association for College Admission Counseling, https://www.nacacnet.org/advocacy/college-access-and-affordability/need-based-financial-aid/.

18.Toward a More Equitable Future for Postsecondary Access (NACAC and NASFAA, 2022), https://nacacnet.org/wp-content/uploads/2022/08/nacac_nasfaa_lumina_report_0122_10.pdf.

19.Danielle Douglas-Gabriel, “More State Colleges Are Admitting Students—Before They Apply,” Washington Post, March 6, 2025, https://www.washingtonpost.com/education/2025/03/06/state-colleges-direct-admissions-programs-high-school-students/.

20.A Guide to the Direct Admission Landscape (EAB, 2024), https://attachment.eab.com/wp-content/uploads/2024/04/PDF-E360-A-Guide-to-the-Direct-Admission-Landscape_.pdf.

21.2024–25 FAFSA® Specifications Guide, vol. 1 (US Department of Education, Federal Student Aid, June 2024), https://fsapartners.ed.gov/sites/default/files/2023-09/202425FAFSASpecVol1SummaryofChanges.pdf.

22.Testimony Before the Subcommittee on Higher Education.

23.“Chapter 4,” in 2024–25 Federal Student Aid Handbook (US Department of Education, Federal Student Aid, January 2024), https://fsapartners.ed.gov/knowledge-center/fsa-handbook/2024-2025/application-and-verification-guide/ch4-verification-updates-and-corrections.

24.The Burden of Proof: Impact of and Solutions for FAFSA Verification (NCAN and NASFAA, November 2021), https://cdn.ymaws.com/collegeaccess.site-ym.com/resource/resmgr/publications/burdenofproof_11.8.21.pdf.

25.Student-to-School-Counselor Ratio 2023–2024.

26.Counselor Perspective.

27.Erin Dunlop Velez, How Can High School Counseling Shape Students’ Postsecondary Attendance? Exploring the Relationship Between the High School Counseling Context and Students’ Subsequent Postsecondary Enrollment (NACAC, 2020), https://nacacnet.org/wp-content/uploads/2022/10/hsls-phase-iii-1.pdf.

Voices from the Field: Lauren Deutser

1. 1.Rainesford Stauffer, “The Best Four Years of Your Life?,” Vox, July 27, 2021, https://www.vox.com/the-highlight/22573842/the-best-four-years-of-your-life.

Chapter 7

1.Thuy Balliester and Abdoulaye Elsheikhi, “The Future of Work: A Literature Review,” Working Paper 29 (Research Department, International Labour Organization, Geneva, 2018).

2.Marco Dondi, Julia Klier, Frédéric Panier, and Jörg Schubert, Defining the Skills Citizens Will Need in the Future World of Work (McKinsey, 2021).

3.Michelle Weise, Allison Hanson, Rob Sentz, and Yustina Saleh, Robot-Ready: Human+ Skills for the Future of Work (Strada Education Network, 2018).

4.Mirza A. Baig, “The Future of AI in Higher Education: Opportunities and Challenges Ahead,” in The AI Frontiers for Pakistan, ed. Rashib Aftab and Rahmat Ullah (forthcoming), https://doi.org/10.31224/3903.

5.Hao Xu, “Career Decision-Making in an Uncertain World: A Dual-Process Framework,” Current Psychology 42, no. 5 (2023): 3978–90.

6.Nancy Sheldon and Melissa Wallace, “Career Paths: Challenges and Opportunities,” in Workforce Development: Perspectives and Issues, ed. Roger Harris and Tom Short (Springer, 2014), 57–74.

7.Sherry E. Sullivan and Afra Al Ariss, “Making Sense of Different Perspectives on Career Transitions: A Review and Agenda for Future Research,” Human Resource Management Review 31, no. 1 (2021): article 100727, https://doi.org/10.1016/j.hrmr.2019.100727.

8.Mark L. Savickas, “Career Construction Theory and Practice,” in Career Development and Counseling: Putting Theory and Research to Work, 2nd ed., ed. Steven D. Brown and Robert W. Lent (Wiley, 2013), 147–83.

9.Ryan D. Duffy and Bryan J. Dik, “Research on Calling: What Have We Learned and Where Are We Going?,” Journal of Vocational Behavior 83, no. 3 (2013): 428–36, https://doi.org/10.1016/j.jvb.2013.06.006.

10.Sullivan and Ariss, “Making Sense.”

11.Xu, “Career Decision-Making.”

12.Sheldon and Wallace, “Career Paths.”

13.Sullivan and Ariss, “Making Sense.”

14.Savickas, “Career Construction.”

15.Duffy and Dik, “Research on Calling.”

16.Weise et al., Robot-Ready.

17.Stanford University, “Undergraduate Student Profile,” Stanford Facts, https://facts.stanford.edu/academics/undergraduate-profile/.

18.Bill Burnett and Dave Evans, Designing Your Life: How to Build a Well-Lived, Joyful Life (Knopf, 2016).

19.Roxana Oros, Samantha Sim, Sebastian Kernbach, and Miguel Pina E. Cunha, “Efficacy of Career and Life Design Interventions: A Systematic Review,” in EURAM Conference Proceedings (European Academy of Management, 2024).

20.“2023–2024 Fact Sheet,” California State University Dominguez Hills, https://www.csudh.edu/Assets/csudh-sites/about/docs/CSUDH-Facts%202023-2024.pdf.

21.Kathleen Manning, Jillian Kinzie, and John H. Schuh, One Size Does Not Fit All: Traditional and Innovative Models of Student Affairs Practice, 2nd ed. (Routledge, 2013), https://doi.org/10.4324/9781315885353; “California State University–Dominguez Hills Transfer Profile,” CollegeTransfer, AcademyOne, https://www.collegetransfer.net/CaliforniaStateUniversityDominguezHills/TransferProfile/tabid/145.

22.Gloria Crisp and Anne-Marie Nuñez, “Understanding the Racial Transfer Gap: Modeling Underrepresented Minority and Nonminority Students’ Pathways from Two- to Four-Year Institutions,” Review of Higher Education 37, no. 3 (2014): 291–320, https://doi.org/10.1353/rhe.2014.0017.

23.Heather A. Butler and Marc C. Hunsaker, “A Case for Life Design: An Innovative Seminar to Foster Success for Students Who Transfer Through Career Exploration, Agency, and Readiness,” in Ensuring Success for Students Who Transfer: Collaborating Across Diverse Institutions, ed. Barbara E. Tobolowsky and Margaret J. Cox (University of South Carolina, National Resource Center for the First-Year Experience and Students in Transition, 2024), 43–56.

24.Lindsey N. Oishi, “Enhancing Career Development Agency in Emerging Adulthood: An Intervention Using Design Thinking” (PhD diss., Stanford University, Graduate School of Education, 2012).

25.Thomas S. Reilly, “Designing Life: Studies of Emerging Adult Development” (PhD diss., Stanford University, Graduate School of Education, 2013).

26.Rim Razzouk and Valerie Shute, “What Is Design Thinking and Why Is It Important?,” Review of Educational Research 82, no. 3 (2012): 330–48, https://doi.org/10.3102/0034654312457429.

27.Burnett and Evans, Designing Your Life.

28.Todd B. Kashdan and Paul J. Silvia, “Curiosity and Interest: The Benefits of Thriving on Novelty and Challenge,” in Oxford Handbook of Positive Psychology, 2nd ed., ed. Shane J. Lopez and C. R. Snyder (Oxford University Press, 2009), 367–74.

29.Todd B. Kashdan and Michael F. Steger, “Curiosity and Pathways to Well-Being and Meaning in Life: Traits, States, and Everyday Behaviors,” Motivation and Emotion 31, no. 3 (2007): 159–73, https://doi.org/10.1007/s11031-007-9068-7.

30.Burnett and Evans, Designing Your Life.

31.Angela Duckworth, Grit: The Power of Passion and Perseverance (Scribner, 2016).

32.“Demographics,” in Trinity College Factbook (Trinity College), https://www.trincoll.edu/asic/wp-content/uploads/sites/125/2020/11/Demographics.pdf.

33.Burnett and Evans, Designing Your Life.

34.Daniel Kahneman and Amos Tversky, “Prospect Theory: An Analysis of Decision Under Risk,” Econometrica 47, no. 2 (1979): 263–91, https://doi.org/10.2307/1914185.

35.Martin E. P. Seligman, Learned Optimism: How to Change Your Mind and Your Life (Knopf, 1991).

36.Fast Facts Institutional Research: Academic Year 2023–2024 (Texas A&M University Commerce, 2024), https://www.etamu.edu/wp-content/uploads/2024/06/Updated-Fast-Facts-2023.pdf.

37.“Facts & Figures,” University of Texis at Austin, https://www.utexas.edu/about/facts-and-figures.

38.“BSU Facts,” Bridgewater State University, https://www.bridgew.edu/about-us/bsu-facts.

39.Jerome Bruner, “The Narrative Construction of Reality,” Critical Inquiry 18, no. 1 (1991): 1–21.

40.Burnett and Evans, Designing Your Life.

41.Colleen S. Conley, Sarah E. Broner, Amanda L. Ruggieri, Sarah Ketchen Lipson, and Daniel Eisenberg, “Wellness Advising: Academic Support Services Staff Evoking Students’ Motivation to Improve Mental Health,” Journal of Student Affairs Research and Practice 62, no. 3: 314–34, https://doi.org/10.1080/19496591.2025.2472345.

Voices from the Field: Jordan Friedman

1. 1.Paul Massari, “Calming Influence,” Harvard Gazette, January 4, 2012, https://news.harvard.edu/gazette/story/2012/01/students-try-to-rub-out-tension; Jamie Donnelly, “Reducing Stress One Student at a Time,” Daily Wildcat, September 17, 2018, https://wildcat.arizona.edu/109349/arts/reducing-stress-one-student-at-a-time.

2. 2.“About Go Ask Alice,” Columbia Health, https://goaskalice.columbia.edu/about-go-ask-alice; Shira Boss, “Alice! Offers Students a Source for Advice,” Columbia College Today, February 2000, https://www.college.columbia.edu/cct_archive/feb00/feb00_quads3.html.

3. 3.Columbia Health, “Alice! Health Promotion Celebrates 25 Years of Answering Students’ Health Questions on Go Ask Alice!,” Columbia Health, January 21, 2020, https://www.health.columbia.edu/news/alice-health-promotion-celebrates-25-years-answering-students-health-questions-go-ask-alice.

4. 4.Melissa Ezarik, “Extracurricular Involvement Barriers to Bust,” Inside Higher Ed, October 1, 2024, https://www.insidehighered.com/news/student-success/college-experience/2024/10/01/survey-college-student-involvement-rates.

5. 5.Alicia Wodika, Jacqueline Lanier, Jim Almeda, Aubrey Richter, and Gabriella Schalasky, “Helping Students Make Meaningful Connections: A Cross-Sectional Survey of College Student Loneliness,” American Journal of Health Education 56, no. 4 (2024): 291–304, https://doi.org/10.1080/19325037.2024.2396586; Johanna Alonso, “The New Plague on Campus: Loneliness,” Inside Higher Ed, November 8, 2023, https://www.insidehighered.com/news/students/physical-mental-health/2023/11/08/new-epidemic-gripping-college-campuses-loneliness.

6. 6.Isabella Starvaggi, Clare Dierckman, and Lorenzo Lorenzo-Luaces, “Mental Health Misinformation on Social Media: Review and Future Directions,” Current Opinion in Psychology 56 (2024), https://doi.org/10.1016/j.copsyc.2023.101738.

7. 7.Khondoker Tashya Kalam, Jannatul Mabia Rahma, Rabiul Islam, and Syed Masudur Rahman Dewan, “ChatGPT and Mental Health: Friends or Foes?,” Health Science Reports 7, no. 2 (2024): e1912, https://doi.org/10.1002/hsr2.1912.

Acknowledgments

This book would not have been possible without the unique contributions of the incredible scholar-practitioners featured in this volume. I am deeply grateful for their commitment to sharing their research and offering meaningful, actionable guidance for our readers.

The Professional Education team at the Harvard Graduate School of Education played a vital role in launching the course that inspired this book. Their support helped build a powerful classroom community and a team of faculty whose ideas form the heart of this volume. I’m thankful to Lisa Kaminski, director of the Harvard Institutes for Higher Education, for being such a generous collaborator. Additional thanks to Jamie Ruggiero, Caroline Case, and Kevin Brustle for helping to bring our shared vision to life.

Special thanks to the team at Harvard Education Press. Jayne Fargnoli helped spark this project with her enthusiasm and dedication to sharing ideas beyond the classroom. I’m grateful to Jessica Thomson and Molly Cerrone for their steadfast support, thoughtful collaboration, and for championing this work and its authors throughout the process.

My profound thanks to my faculty assistant, Kit Von Campe, who was an incredible thought partner and support in preparing this manuscript. This book would not have been possible without their dedication to the project and attention to detail.

I am grateful to Sebastian Alvarez, Kelly Fattman, Willord Simmons, Dustin Liu, and Pau Vazquez for their insights and support bringing my vision for the cover to life.

As always, I offer my deepest appreciation to the extraordinary members of my teaching and research teams: Justin Balog, Lauren Barlow, Ryan Braeger, Liliana “Lily” Castro, Julius DiLorenzo, Richard Flahive, Nicole Garcia, MacKenzie Griffin, Mackenzie Gross, Lucy Kane, Belle Lee, Annie Lewis, Dustin Liu, Kanoe Lum, Adam Milano, Sheridan Miller, Kayli Minear, Anabella Morabito, Christina Moreland, Mathew Nicola, Abby Polott, Olivia Raykovich, Zach Seek, Nikita Sethi, Willord Simmons, Cecily Spindel, Grant Stream-Gonzalez, Laney Umland, Chelsea Vickers, Angela Wang, Alysha Johnson Williams, and Catherine Zhang. You expand my thinking about what it means to create caring communities in our classrooms and on our campuses through your thoughtfulness and passion for student affairs.

To our College Student Development community at HGSE—my gratitude for shaping these ideas through your passionate commitment to ensuring every student feels seen, heard, valued, and encouraged. You continue to inspire me through your work beyond Appian Way.

My deepest thanks to Emily Weinstein, an invaluable thought partner and cheerleader on this journey. I will never take for granted what a gift it is to have you in my corner.

And for my family: A special thank you to my beloved wife, Dorie, who is a constant source of strength, love, and encouragement. You are the best person I know, and I am so lucky to have you by my side. To our boys, Phil and Heath, who bring so much joy and laughter to our lives. And to our moms, Cheri and Gail, who inspire us both with their wisdom, strength, and love.

About the Editor

Dr. Alexis Redding is a developmental psychologist and the faculty co-chair of Higher Education at the Harvard Graduate School of Education (HGSE), where she teaches courses on college student development, student affairs, and higher education research. She is the recipient of the 2023 Morningstar Family Teaching Award in recognition of her teaching and mentorship.

An expert on college and career transitions with more than twenty-five years of experience, Redding is a TEDx speaker and delivers frequent keynotes on college student mental health, the undergraduate experience, and the transition from college to the workforce. She is the founding director of the Mental Health in Higher Education professional development program at HGSE, a pioneering cross-disciplinary program for student affairs educators and higher education leaders.

Redding is the coauthor of The End of Adolescence: The Lost Art of Delaying Adulthood (Harvard University Press, 2021). Her research has been published in The Journal of College Admission, Ethics & Behavior, About Campus, and the American Psychological Association Handbook of Pediatric Psychology, Developmental-Behavioral Pediatrics, and Developmental Science. She is a frequent contributor to The Atlantic, the Harvard Business Review, and Fast Company, and her research has been featured in The New York Times and Teen Vogue.

A presidential scholar at Harvard University, Redding earned her doctorate in human development and education at HGSE. She also holds an EdM in human development and psychology from HGSE, an AB from Harvard College, and a Graduate Certificate in College Counseling from UCLA.

About the Contributors

Bryan Ashton, EdM, is the chief strategy and growth officer at Trellis and head of Trellis Strategies, where he oversees research, consulting, government affairs, and skill alignment work focused on improving outcomes across the higher education landscape. He is also the cofounder of the Higher Education Financial Wellness Alliance and a nationally recognized speaker on college access, affordability, and outcomes.

Esha Bajwa is a fourth-year computer science and engineering major at the University of Louisville. She is the president of the Asian Pacific Islander Student Union.

Lauren Barton is a graduate of Walters State Community College who studied mass communication. Today they study communication studies at East Tennessee State University.

Joseph Catrino, PhD, is the inaugural executive director of the Dartmouth Center for Career Design at Dartmouth College and a facilitator for the Life Design Studio for University Educators at Stanford University. He previously served as the executive director of the Career & Life Design Center at Trinity College–Hartford, where he led the development and implementation of a comprehensive career and Life Design program.

Melissa Clinedinst is the associate director of research initiatives and partnerships at the National Association for College Admission Counseling (NACAC), where she leads multistakeholder projects, data-driven studies, and collaborative research efforts to enhance equity and access in college admissions.

Allyson Cornett, MPH, is the director of research at Trellis Strategies, where she leads the design and implementation of national survey projects, including the Student Financial Wellness Survey. She has extensive experience conducting research on students’ basic needs to better understand how higher education institutions can improve success for vulnerable populations.

Laura Erickson-Schroth, MD, is a psychiatrist and the chief medical officer at The Jed Foundation and a clinical associate professor at the NYU Langone Health Department of Psychology. Erickson-Schroth is the coauthor of Gender: What Everyone Needs to Know (Oxford University Press, 2021) and You’re in the Wrong Bathroom: And 20 Other Myths and Misconceptions About Transgender and Gender Nonconforming People (Beacon, 2017), a coeditor of The GLMA Handbook on LGBT Mental Health (Praeger, 2019), and editor of Trans Bodies, Trans Selves (Oxford University Press, 2022).

Amanda O. Latz, EdD, is a professor of Higher Education and Community College Leadership at Ball State University, where she also serves as director of the Student Affairs Administration in Higher Education master’s program and director of the Graduate Certificate in Community College Leadership. She is the author of Community College Student Mental Health: Faculty Experiences and Institutional Actions (Rowman & Littlefield, 2023) and coauthor of Community College Is College: Destigmatizing the Option for High-Achieving Learners (Routledge, 2024).

Dustin Liu, EdM, is the senior associate director of the NYU Stern School of Business Initiative on Purpose and Flourishing. Prior to his arrival at NYU, Dustin was a lecturer at Stanford University and the associate director of the Stanford Life Design Lab.

Adam Pierson Milano, DSW, is a clinical instructor in the University of North Carolina at Chapel Hill School of Social Work, where he also serves as the coordinator for the SSW Global Engagement Programs and core faculty of Global Social Development Innovations. He is a veteran, who maintains his commitment to service by working as a consultant, advisor, and clinician committed to the mental health, well-being, and success of service members and the organizations that support them.

Angel Pérez, PhD, is the CEO of the National Association for College Admission Counseling (NACAC) and a nationally recognized thought leader on issues of equity and access to higher education. Prior to his arrival at NACAC, he served for twenty-two years as a leader in higher education. He most recently served as vice president for Enrollment and Student Success at Trinity College (CT), where he also taught in the Educational Studies department. He is the author of The Hottest Seat on Campus: A Roadmap for Mastering Leadership in College Admission (Harvard Education Press, 2025).

Rainesford Stauffer is a writer and reporter who is the author of An Ordinary Age: Finding Your Way in a World That Expects Exceptional (Harper Perennial, 2021)and All the Gold Stars: Reimagining Ambition and the Ways We Strive (Hachette, 2023). Her work has appeared in Teen Vogue, Esquire, The Guardian, The Washington Post, and other publications. She was a 2022–23 Rosalynn Carter Fellow for Mental Health Journalism.

Mira Ugwuadu is an undergraduate student studying philosophy-neuroscience-psychology at Washington University in St. Louis. She is a John B. Ervin and James E. McLeod scholar who intends to pursue an MD/MPH in the future.

Janis Whitlock, PhD, is a developmental psychologist and public health specialist who focuses on adolescent and young adult mental health and well-being. She is research scientist emerita at Cornell University’s Bronfenbrenner Center for Translational Research, where she founded the Cornell Research Program on Self-Injury and Recovery (CRPSIR). Whitlock coauthored Healing Self-Injury: A Compassionate Guide for Parents and Other Loved Ones (Oxford University Press, 2019) and coedited The Oxford Handbook of Nonsuicidal Self-Injury (Oxford University Press, 2024).

Index

- action, bias to, 174–175, 188
- admissions process, 137–159
- call to action to improve, 159

- college application in, 138, 140, 142–143, 144–145, 147–148, 155–157

- college choice in, 142–143, 148–150, 155

- college search in, 142–143, 144, 145, 146

- college transition following, 142–143, 150–154, 158, 161–162

- counselor and guidance advising for, 139, 143, 157–158

- financial aid in, 138, 157

- overview of stressors in, 6–7, 137–140

- strategy recommendations for student support in, 155–158

- surveys on, 140–154

- tests in, 137–138, 139

- All the Gold Stars: Reimagining Ambition and the Ways We Strive (Stauffer), 12

- ambition, 12, 14, 27
- anonymous services, 51
- assessments

- of community-college student mental health, 98–99

- of comprehensive mental health promotion and suicide prevention initiatives, 57

- of connectedness, 44
- for distress identification, 47–49
- of financial wellness and strains, 67–75
- of student veteran mental health needs, 123

- Bajwa, Esha, 27–30
- Balance Assessment, 182–183
- Barton, Lauren, 19–21
- basic needs, 15, 72–73, 75, 76–77, 82–83
- behavioral intervention teams, 54–55
- Be There Certificate, 102
- bias to action, 174–175, 188

- BIPOC (Black, Indigenous, and people of color) students

- barriers to mental health supports for, 2

- as community-college students, 87, 99

- comprehensive mental health promotion and suicide prevention among, 36, 45

- costs of college for, 76–77
- Life Design framework benefiting, 169–170
- mental health experiences of, 16, 22, 29
- resources to support, 83
- burnout, 27–30

campus culture of care
cross-disciplinary research on creating, 3–7
goal of cultivating, 3
mental health supports creating (see mental health supports)

Voices from the Field on creating (see Voices from the Field)

campus personnel. See faculty-based support systems; leadership endorsement of initiatives; staff-based support systems
career, anxiety on transition into. See post-collegiate transition anxiety

Career Communities, 190–191
Center of Deployment Psychology, 127
coaching models, 190–191
collaboration. See connection and collaboration
collegiate mental health issues. See mental health issues; student mental health experiences
collegiate mental health supports. See campus culture of care; mental health supports
communication skills, 41, 115

Community College Student Mental Health: Faculty Experiences and Institutional Actions (Latz), 5, 98
community-college students, 85–106
access to opportunities for, 91
context for, 86–87, 96–97
coping skills for, 105
data collection on, 98–99
equitable futures for, dreaming of, 105–106
faculty-based supports for, 5–6, 89, 90, 100–101, 102–104
fundraising for mental health supports for, 99–100
graduation rates among, 88
leaders and administrators supporting, 96–101
learning by, 88–89
mental health apps to assist, 100
mental health support importance for, 87–96
overview of issues facing, 85–86
persistence and retention of, 91–92
relationship building by, 89
resources for, 89–91, 104–105
shared vision and framework to support, 97–98
staff-based supports for, 100–102
vignette on, 92–96
community service initiatives, 43, 119, 124–125
comprehensive mental health promotion and suicide prevention, 33–61
accessibility of effective, 52–53
barrier reduction for, 50–52
connectedness and positive culture promotion for, 43–47
crisis management systems for, 53–55
data and technology leveraged for, 59–60
distress recognition and response for, 47–49
factors necessitating, 33–34
future directions and emerging trends in, 60–61
guiding principles for, 37–38
impacts of, 36–37
implementation and integration of, 56–60
Jed Foundation framework as, 4, 34, 35–39
key domains of, 37–39
lethal means access reduction for, 55–56
life skills education for, 39–43
overview of, 4–5, 34, 61
reasons for using, 34–35
resources for, 58–60
confidentiality, 51, 122–123
connection and collaboration
Career Communities for, 190–191
comprehensive mental health promotion and suicide prevention via, 43–47
connection concern systems for, 44
cross-departmental, 45, 57–58
radical, in Life Design framework, 176–178, 188
spaces to foster, 45, 83, 118–119, 126–127
structures to foster belonging and, 132–133
student mental health experiences improved with, 14–16, 23–26, 29, 31–32
student veterans experiencing, 116–119, 124–127
coping skills, 105, 118, 171
costs of college, 65–79
call to action to address, 77–78
for community-college students, 87, 92
competing life demands and, 5, 67–69, 78, 79
financial pressures with, 5, 65–67, 69–75, 76–79, 92, 138, 157 (see also financial pressures)

overview of, 5, 79
for vulnerable student communities, 75–77
crisis management systems, 53–55, 163
CSS Profile, 138
Cuevas, Saywonza, 126–127
curiosity, 172–174, 188
curriculum
Life Design (see Life Design framework)
life skills in, 41–42
mental health integration into, 51

- data and statistics

- on community-college students, 87, 88, 98–99

- on comprehensive mental health promotion and suicide prevention efficacy, 57

- for connection assessment, 44
- on costs of college, 65, 67–78, 87
- for distress identification, 48

- leveraging of, for comprehensive mental health promotion and suicide prevention, 59–60

- on student mental health experiences, 12, 14, 33, 72–75

- on student veterans, 116–117
- on suicide ideation and attempts, 13, 33
- debt, student, 66, 69–71, 92
- decision-making skills, 40
- demographic analysis, 44–45

- Design Thinking, 172–179. See also Life Design framework

- Deutser, Lauren, 161–163

- digital resources, 42, 51, 52, 59–60, 100, 194–195

- disabilities, students with

- as community-college students, 87, 90

- comprehensive mental health promotion and suicide prevention for, 53

- mental health experiences of, 17–18

- resources for, 30, 90

- distress, recognition of and response to, 47–49, 101–102

- emotional regulation, 40, 175

- employed students, 12–13, 67–69, 71–72, 76–77

- employment, anxiety on transition into. See post-collegiate transition anxiety

- Energy Mapping, 181–182, 188
- engagement, opportunities for, 43, 45, 194
- experiential learning, 90–91

- faculty-based support systems

- community-college students benefiting from, 5–6, 89, 90, 100–101, 102–104

- comprehensive mental health promotion and suicide prevention with, 46, 57

- leaders and administrators supporting, 100–101

- student mental health experiences improved with, 15, 25

- student veteran support by, 119

- training for, 101

- FAFSA (Free Application for Federal Student Aid), 138, 157

- failure, freedom to experience, 19–21
- financial pressures
- community-college students with, 92

- costs of college and, 5, 65–67, 69–75, 76–79, 92, 138, 157

- costs of mental health services creating, 51

- financial aid and, 13, 20–21, 66, 70–71, 78, 115, 138, 157

- financial literacy skills to manage, 40–41
- mental health support by addressing, 78
- public assistance to meet, 71
- student debt as, 66, 69–71, 92

- student employment due to, 12–13, 67–69, 71–72, 76–77

- student veterans facing, 115
- firearms, reducing access to, 55–56
- first-generation students
- as community-college students, 87
- costs of college for, 76
- data and statistics on, 14
- Life Design framework benefiting, 170
- mental health experiences of, 12, 15–16

- Free Application for Federal Student Aid (FAFSA), 138, 157

- Friedman, Jordan, 193–195

- Gonzales, Adrian, 81–83

- guns, reducing access to, 55–56

- hope signage, 56

- idea boarding, 184–185
- international students
- barriers to mental health supports for, 2

- comprehensive mental health promotion and suicide prevention for, 53

- mental health experiences of, 107–109

- interpersonal skills, 41

- Jed Foundation Comprehensive Approach to Mental Health Promotion and Suicide Prevention for Colleges and Universities, 4, 34, 35–39. See also comprehensive mental health promotion and suicide prevention

- Kelter Center Leadership Program, 188–189

- leadership endorsement of initiatives, 45, 57, 96–101

- learned optimism, 175
- leave policies, 53
- Lee, Julie, 107–109
- lethal means access reduction, 55–56

- LGBTQ+ (lesbian, gay, bisexual, transgender, queer or questioning) students

- barriers to mental health supports for, 2

- comprehensive mental health promotion and suicide prevention for, 53

- costs of college for, 76–77
- resources to support, 83
- as student veterans, 123
- suicide ideation among, 13
- Life Design framework
- Balance Assessment in, 182–183
- bias to action in, 174–175, 188
- call to action to integrate, 191–192
- case study on application of, 185–191
- coaching in, 190–191
- curiosity in, 172–174, 188
- designer mindsets in, 172–179

- Designing Your Future Work seminar following, 187–188

- Energy Mapping in, 181–182, 188
- growth and development of, 168–172
- idea boarding in, 184–185
- incremental changes in, 183–184

- Kelter Center Leadership Program based on, 188–189

- mental health management and, 189–190
- mindfulness of process in, 178–179, 188
- Odyssey Planning in, 179–181, 188
- overview of, 7
- radical collaboration in, 176–178, 188
- reframing in, 175–176, 184, 188
- storytelling in, 178, 188
- life skills, fostering of, 39–43, 162
- life-work balance, 182–183

- medical leave policies, 53

- Mental Health First Aid, 102

- Mental Health in Higher Education: A Theory-to-Practice Approach for Student Well-Being, 3

- mental health issues

- costs of college effects on (see costs of college; financial pressures)

- overview of, 1–3

- student experiences with (see student mental health experiences)

- support systems for (see campus culture of care; mental health supports)

- transitions affecting (see post-collegiate transition anxiety; postsecondary education transition)

- mental health supports. See also campus culture of care

- barriers to, generally, 1–3

- basic needs support and, 15, 72–73, 75, 76–77, 82–83

- campus personnel role in (see faculty-based support systems; leadership endorsement of initiatives; staff-based support systems)

- community-college student need for (see community-college students)

- comprehensive approach to developing (see comprehensive mental health promotion and suicide prevention)

- costs of college necessitating (see costs of college; financial pressures)

- cross-disciplinary research on creating, 3–7

- Life Design framework for (see Life Design framework)

- representation and diversity in, 2–3, 53

- student mental health experiences and need for (see student mental health experiences)

- student veteran need for (see student veterans)

- superficial feel of, 13–14
- targeted universalism for, 3
- telehealth services as, 2

- transitions necessitating (see post-collegiate transition anxiety; postsecondary education transition)

- trauma-informed practices in (see trauma-informed practices)

- Voices from the Field on (see Voices from the Field)

- mentoring, 46, 108, 125

- military-affiliated students. See student veterans

- mindfulness of process, 178–179, 188
- Morabito, Anabella, 131–133
- motivational interviewing, 186

- National Association for College Admission Counseling (NACAC), 139, 140, 141

- needs, basic, 15, 72–73, 75, 76–77, 82–83

- network mapping, 45

- Odyssey Planning, 179–181, 188
- optimism, learned, 175
- organizational skills, 40, 190
- organizations, student, 43

parents, students as. See student parents
peer support
comprehensive mental health promotion and suicide prevention with, 42, 46, 51
idea boarding as, 184–185
for international students, 108–109
life skills education via, 42
radical collaboration on career exploration as, 177–178, 188
student mental health experiences improved with, 16–18, 24–26
physical environment
to foster connectedness, 45, 83, 118–119, 126–127
safety protocols for, 55–56
physical health and wellness, 41, 42–43, 117
positive culture, promotion of, 43–47
post-collegiate transition anxiety, 165–192
ambiguity and uncertainty creating, 166–168, 172

Balance Assessment mitigating, 182–183
bias to action lowering, 174–175, 188
call to action to address, 191–192
career paralysis with, 166, 167–168, 174, 175–176
case study on managing, 185–191
coaching mitigating, 190–191
curiosity curbing, 172–174, 188

Designing Your Future Work seminar alleviating, 187–188

Energy Mapping mitigating, 181–182, 188
idea boarding mitigating, 184–185
incremental changes to address, 183–184

Kelter Center Leadership Program mitigating, 188–189

Life Design framework to address, 7, 168–192 (see also Life Design framework)

mental health management and, 189–190
mindfulness of process lowering, 178–179, 188
Odyssey Planning mitigating, 179–181, 188
overview of, 7, 165–168
radical collaboration alleviating, 176–178, 188
reframing shifting, 175–176, 184, 188
storytelling reshaping, 178, 188
postsecondary education transition, 137–159
call to action to improve, 159
college application process in, 138, 140, 142–143, 144–145, 147–148, 155–157
college choice process in, 142–143, 148–150, 155
college search process in, 142–143, 144, 145, 146
college transition process in, 142–143, 150–154, 158, 161–162
counselor and guidance advising for, 139, 143, 157–158
financial aid in, 138, 157
overview of stressors in, 6–7, 137–140
strategy recommendations for student support in, 155–158
surveys on, 140–154
tests in, 137–138, 139
post-traumatic stress disorder (PTSD), 99, 120–121
postvention protocols, 36, 55
problem-solving skills, 40
PsychArmor, 127–128

PTSD (post-traumatic stress disorder), 99, 120–121

- Question. Persuade. Refer. (QPR), 48, 102

- radical collaboration, 176–178, 188
- REDFLAGS model, 102
- referrals, for mental health care, 49, 53
- reframing, 175–176, 184, 188
- resources

- awareness of and access to, affecting student mental health experiences, 14–15, 16, 21, 24–26, 29–30, 31

- for basic needs support, 82–83

- for community-college students, 89–91, 104–105

- for comprehensive mental health promotion and suicide prevention implementation, 58–60

- digital, 42, 51, 52, 59–60, 100, 194–195

- for student veterans, 83, 128

screening, for mental health issues, 47–49, 98–99
social-emotional learning interventions, 39
spaces, to foster connectedness, 45, 83, 118–119, 126–127. See also physical environment
staff-based support systems
for community-college students, 100–102
leaders and administrators supporting, 100–101
for student veterans, 119, 127
training for, 44, 48, 49, 57, 58–59, 101–102
Star Behavioral Health Providers, 127–128
stigmas
anti-stigma campaigns, 50
comprehensive frameworks reducing, 35, 36–37, 50
destigmatizing mental health conversations, 81–82
student efforts to dismantle, 26
student experiences of, 29
student veterans subject to, 112–113, 114–115, 121–123, 127, 129–130
storytelling, 178, 188
stress management, 40
student mental health experiences. See also mental health issues
actionable supports based on, 30–32
ambition effects on, 12, 14, 27
of BIPOC students (see BIPOC [Black, Indigenous, and people of color] students)

burnout as, 27–30
of community-college students (see community-college students)

connection and collaboration improving, 14–16, 23–26, 29, 31–32
costs of college impacting (see costs of college)

data and statistics on, 12, 14, 33, 72–75
of disability-affected students (see disabilities, students with)

of first-generation students (see first-generation students)

freedom to fail changing, 19–21
holistic approach to addressing, 24–26
of international students (see international students)

of LGBTQ+ students (see LGBTQ+ [lesbian, gay, bisexual, transgender, queer or questioning] students)

overview of, 1–3, 4, 12–14
peer support improving, 16–18, 24–26
personal stories of, 11–32
policies for student wellness reflecting, 31
post-collegiate transition anxiety effects on (see post-collegiate transition anxiety)

postsecondary education transition effects on (see postsecondary education transition)

resource awareness and access affecting, 14–15, 16, 21, 24–26, 29–30, 31
of student parents (see student parents)

support systems for (see campus culture of care; mental health supports)

of veterans (see student veterans)
student organizations, 43
student parents
as community-college students, 87
comprehensive mental health promotion and suicide prevention among, 38, 45
costs of college for, 66, 68, 76–77
mental health experiences of, 12–13
student veterans, 111–130
active-duty community and, 129
call to action to support, 124–130
community and connection for, 116–119, 124–127
as community-college students, 99
financial pressures for, 115
identities of, in campus context, 113–116, 124–127, 129–130
mental health care strategies for, 115–130
mental health trends and treatment attitudes among, 119–123, 130
overview of mental health needs of, 6, 111–113

PTSD among, 99, 120–121
questions to consider to support, 124
resources to support, 83, 128
stereotypes of, 118
stigmas faced by, 112–113, 114–115, 121–123, 127, 129–130
terminology for, 111n, 113, 130
transitions for, 114, 126, 129–130
substance misuse, 36, 54, 55–56, 105
suicide
comprehensive approach to prevention of (see comprehensive mental health promotion and suicide prevention)

connectedness lowering likelihood of, 117
financial stress and ideation of, 71
postsecondary education transition leading to, 137–138
staff training to address potential, 102
statistics on suicide ideation and attempts, 13, 33
student mental health experiences with thoughts of, 13, 23
student veteran ideation of, 120, 121
US Air Force addressing, 35–36
syllabus, tone of, 94, 95–96, 103–104

- targeted universalism, 3
- technology. See digital resources
- telehealth services, 2
- time management, 40, 190
- time poverty, 67–69, 78, 79

- transition periods. See post-collegiate transition anxiety; postsecondary education transition

- trauma-informed practices

- community-college students benefiting from, 5, 102, 104

- student veteran need for, 99, 116, 117, 120–122, 127

- Ugwuadu, Mira, 22–26

- US Air Force programs, 35–36

- veterans, as students. See student veterans
- Voices from the Field
- on belonging as imperative, 132–133
- on college transition, 161–162
- on crisis management systems, 163

- on destigmatizing mental health conversations, 81–82

- by Lauren Deutser, 161–163
- on engagement opportunities, 194
- by Jordan Friedman, 193–195
- by Adrian Gonzales, 81–83
- on holistic vs. siloed supports, 131–132

- on international student mental health needs, 107–109

- by Julie Lee, 107–109
- on life skills scaffolding, 162
- by Anabella Morabito, 131–133
- overview of, 7
- on technology impacts, 194–195
- on whole student supports, 82–83

- wellness ambassador initiatives, 46

- work, anxiety on transition into. See post-collegiate transition anxiety

- working students, 12–13, 67–69, 71–72, 76–77

- work-life balance, 182–183