Executive Summary
The policy analysis is based on the increasing numbers of cases on mental health issues in college and university campuses. The topic is supported by evidential data collected from various studies and peer-reviewed articles that show the statistical prevalence of the most common forms of mental health issues seen among the students, which shows that the prevalence rate is ever-increasing. The methodologies recommended for implementation include increased availability of resources and facilitating the accessibility of these resources through overcoming barriers. Some policy options have been suggested for consideration and recommendations have been made accordingly. The fiscal impact has also been considered and suggestions have been made for alternative budgeting and funding resources.
Background
Starting a new journey while attending colleges and universities can bring a lot of challenges for the students and may affect their mental health while they go through this transition in lifestyle. [1] Unfortunately, studies have shown that the cases of mental health issues in campuses are ever-rising. This goes for both the traditional and non-traditional students who attend colleges and universities. Though the challenges that they face may vary, the impact on their mental health is nonetheless the same. [2]
Studies have shown that 1 out of every 4 students suffer from mental illness while 3 out of every 4 cases will develop in their mid-twenties. The range of mental health issues also varies widely among the students. Some of the most common issues, with their prevalence, include: [2, 3]
Mental Health Issues Prevalence (%)
Anxiety disorders 11.9
Depression 7 – 9
Suicide ideation 6.7
Suicide planning 1.6
Attempting suicide 0.5
Eating disorders 9.5
Attention deficit hyperactivity disorder (ADHD) 2 – 8
Furthermore, statistics have shown that 20% of the affected campus students schedule for as much as half of the counselling sessions, while twice as much students will never seek help. [3, 4] However, regardless the availability and accessibility of resources, many students feel discouraged towards accessing these services due to fear of adverse consequences, which may eventually have a huge negative impact on their future. [1, 5] Aside from the issue of availability and accessibility of services, another challenge is the lack of community awareness that adds to the threat against the mental health status of many students. [6] To add to the concern, most of the states in USA have scored poorly in the mental health report i.e. out of all 51 states, a total of 45 states scored either a C, D or F, but none scored an A. [7]
Options for Change
PEI. The Prevention and Early Intervention (PEI) programs are developed to address and prevent the potential manifestation of mental illnesses and for early detection and intervention at the initial stages of manifestation. This programs are designed for community intervention and therefore can be implemented in campuses to provide help and support to the students in need. However, these programs lack stable funding resources which makes it difficult to sustain. Though there is scarce nationwide availability, these programs, if implemented, may provide community incentives to battle the mental crisis through behavioral health education, stigma reduction, training family and faculty for enhanced support and many more. [8, 9, 10]
Health Insurance Coverage. Currently, the coverage for preventive services only cover services in traditional settings i.e. the healthcare or clinical setting. However, services are only provided in these settings when damage has already been done. Therefore, expanding the healthcare coverage for preventive services in non-traditional settings will enhance mental wellbeing through accessibility of programs like the PEI programs. [10]
Student Club(s). The establishment student-run groups on campus through the support and alliances of the mental health organizations will help to raise awareness among the students. Examples include clubs such as “NAMI on Campus” and “Active Minds”. Since these are student-run clubs, these are usually low-budget establishments and the liaison with external organizations helps provide community resources for mental health services. This also provides a comfortable setting for students to open up about their problems with friends or groups and thus raise awareness and reduce the stigma. [11, 12]
ACHA Programs. The American College Health Association (ACHA) programs, in liaison with various campus communities, provide their professional expertise through advocating for policies, advocating for and educating students, and conducting research. [13, 14]
List of Key Legislations
Garrett Lee Smith Memorial Act Reauthorization of 2011 (S. 740): Increasing the suicide prevention programs across campuses and community nationwide by renewal and expansion of provisions under this legislation. [4, 6, 15]
Mental Health on Campus Improvement Act (H.R. 1833): Assist the campus community to cater to the students’ needs by improving the accessibility to mental health resources throughout campuses. [15]
The Americans with Disabilities Act (ADA): Provide protection to individuals with disabilities, including mental disabilities and illness, against discrimination. [1, 5, 21]
Patient Confidentiality Rights (HIPAA): Protect patient privacy and rights by keeping health information safe and secure. [3, 17, 20]
Family Educational Rights and Privacy Act (FERPA): Protects the privacy of record of students’ education by prohibiting disclosure of information to third parties without consent from a parent of “eligible” student. [3, 18, 20]
Affordable Care Act: The “Patient’s Bill of Rights” under this legislation puts individuals in control of their healthcare choices by providing the flexibility and stability to make informed decisions. [3, 19]
Recommendations
The availability of basic mental resources on campus should be mandated nationwide. In addition to counseling services, intervention programs and awareness campaigns should be implemented along with coalition with various mental health groups and organizations to help fight the stigma and raise awareness among the students and the community against the gravity of the issue surrounding mental health. Furthermore, the facilitation of greater accessibility of these resources should be made not only by expanding health coverage but also removing the barriers to accessibility. This includes involvement of a legal team working campus faculty and mental health community to help establish campus policies that ensures safe environment for its students to seek help openly and without hesitation or fear of harsh consequences due to discrimination. [1, 5, 8-14, 20]
Implementation
Implementing the recommended actions would require budgeting and funding. However, sustaining the new changes will be difficult if the financial sources fall short or are cut off entirely. In preparation for such circumstances, alternative financial resources should be obtained funding reserves should be established within the campus administration. Furthermore, the low-budget student-run programs are more feasible in long-term. Other alternatives include drawing portions of tuition expenses to support the funds internally. [1, 5, 11, 12, 21]