A Public Health Approach to Student Mental Health


Higher Education finds itself at a crossroads in adapting its mission for the rapidly changing world it seeks to serve. Frank Bruni highlights why such adaptation is becoming more urgent in his NY Times column, “Higher Ed’s Low Moment” (Dec. 30, 2017), “At a time when a college degree is one of the surest harbingers of higher earnings and better economic security, college itself is regarded with skepticism by many Americans and outright contempt by no small number of them … Repair is imperative, because the continued competitiveness of the American economy depends on the skills of our work force, the intellectual nimbleness of our citizens, the boldness of our scientific research and the genius of our inventions. Our colleges and universities are central to that. When they lose students, we all lose.”

Higher Education has all the knowledge, talent, and entrepreneurial spirit to craft innovative technical solutions needed to accomplish the “repair” work Bruni suggests.  However, concurrent with developing technical solutions, is arguably the more important, yet painful adaptive work of examining what attitudes, practices, traditions, customs, and biases hold Higher Education captive to their past approaches.  Without engaging in this deeper self-examination, those technical solutions that Higher Education develops are at risk in supporting “what is and has always been our way of doing things”, just doing them better, yet expecting a different outcome.  A Public Health Approach to Student Mental Health


The reality is that 35% of college students now self-report they felt so depressed sometime in the past 12 months it was difficult to function; 69% of the Directors of College’s Counseling & Psychological Services have seen an increase in crises requiring an immediate response; yet 83% of Campuses maintain the right to refuse treatment to students whose problems are beyond the capabilities of their staff.

Reflecting on the impact of our “social media” driven culture, Janis Whitlock, director of the Cornell Research Program on Self-Injury and Recover states, “If you wanted to create an environment to churn out really ‘angsty’ adolescents, we’ve done it. Sure, parental micromanaging can be a factor, as can school stress,” she says, but Whitlock doesn’t think those things are the main drivers of this epidemic. “It’s that they’re in a cauldron of stimulus they can’t get away from, or don’t want to get away from, or don’t know how to get away from.” Yale Educators Diana Divecha and Robin Stern state,

As educators, we can do better!  Students do need real emotional skills. There is a large and growing body of research that suggest that the skills of emotional intelligence – the ability to reason with and about emotions to achieve goals – are correlated with positive outcomes across the entire age spectrum, from preschool through adulthood … When college students are aware of what they’re feeling, they can make conscious decisions about how to manage those feelings, rather than escalate, act out, or medicate.

Equipping students with emotional intelligence skills adds value both to their lives and to the institutions they attend. For students who stay in school and complete their degrees, they will realize over their lifetime a greater income. For their schools, the institution realizes a return on their investment in the students they have admitted.


Why is student retention so important for Higher Education?  Consider just four statistics from a 2009 Report by McKinsey & Company titled, “The Economic Impact of the Achievement Gap in America’s Schools: Summary of Findings”.

  • Among the 1,669 colleges and universities examined between 2007- 12, the collective lost revenue due to attrition was a staggering $16.5 billion (Raisman, 2013).
  • Of the 1.1 million full-time students who entered college in 2002, the 500,000 who failed to graduate within 6 years cost a combined $4.5 billion in foregone income from federal and state income taxes (Schneider, 2010).
  • Over a 5-year time frame, over $6.2 billion was appropriated to colleges and universities by states to help pay for the education of students who failed to return to school for a second year (Schneider, 2010).
  • These dollars were calculated into the budgets of the schools, but never received as revenue. They remain as losses to revenue and at the very least $16.5 billion dollars was left on the table nationally.

These statistics were collected before the significant uptick in students’ anxiety, depression, and suicide. More recent research suggests that depression is associated with lower grade point averages, and that co-occurring depression and anxiety can increase this association. Depression has also been linked to dropping out of school. Dr. Daniel Eisenberg states, “Every college and university care a lot about its retention rate,” he says. “It’s one of the primary indicators of operating a successful institution — that people want to stay, and that people are succeeding there.” Eisenberg suggests that investing in mental health services for college students can help keep them from dropping out (B.E. Journal of Economic Analysis & Policy, 2009). That’s good news for schools since they want to retain tuition revenue, but more important, it helps secure significantly higher lifetime earnings for the students, Eisenberg says.


Dr. Nance Roy, who is on staff with The JED Foundation, argues for a more expansive approach in her Dec 2018 Higher Education Today article, “The Rise of Mental Health on College Campuses: Protecting the Emotional Health of Our Nation’s College Students”. “Many students are struggling with mental health concerns like anxiety, depression, and substance abuse. But only a small percentage (10–15 percent on average) of these students seek services at their counseling center. Instead, they continue to struggle, which can have a substantial impact on their academic performance. This disconnect requires campuses to rethink their approach to supporting students with mental health concerns, as for some, early intervention may avert the need for professional help.”

Dr. Nance goes on to advocate for a Public Health approach, moving from the tertiary CAPS level (programs targeting students already experiencing significant mental health and/or academic problems), to the secondary Student Wellness level (programs targeting students with risk factors or emerging risk), to the primary or public health level (programs reaching entire populations). “Overall, public health is concerned with protecting the health of entire populations. These populations can be as small as a local neighborhood, or as big as an entire country or region of the world.”  Fundamentally, Dr. Roy is challenging schools to look for a solution to address student mental health that lies outside the current repertoire of solutions available today. The JED Campus Program has already become involved with

Roy writes, “Two guiding principles form the foundation for effecting enduring, systemic change toward this end. First, support for emotional well-being and reduction of suicide and substance abuse must be considered a campus-wide responsibility. Second, it is imperative that senior leadership acknowledge the importance of student mental health and well-being and make this a shared value for the entire campus community.”  She bases her article on the JED Campus model shown below. 

Here are links both to Dr. Roy’s article and the JED Campus’s design and build documentation she references in her article.

Dr. Roy’s article

JED Campus Comprehensive Approach

[1] Strauss, Valerie; “Why college freshmen need to take Emotions 101”, The Washington Post, Sept. 28, 2014.