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The Mental Health Crisis on College Campuses

By Eric M. Coles
Eric M. Coles is a second-year doctor of public health candidate at the T. H. Chan School of Public Health.

One in five students at Harvard could be in danger, according to a new study by Harvard Medical School Professor Cindy Hsin-Ju Liu. She and colleagues found that 20 percent of college students reported suicidal ideation — defined as thinking about, considering, or planning suicide — based on a national survey of over 65,000 undergrads. This is twice the rate of the general population.

Suicidal ideation was, unfortunately, just the tip of the iceberg: One in four students reported being diagnosed with or treated for a mental health disorder in the prior year, one in 10 reported having attempted suicide, and one in five reported self-injury. Mental health problems were more prevalent in some non-heterosexual and non-cisgender groups, prompting Liu to write of the urgent need for strategies to reduce student stress.

A bachelor’s degree does not fix these issues. The University of California surveyed graduate students across its 10 locations. Using a random stratified sampling of 13,400 students, they received over 5,000 responses. They found that 35 percent of students had symptoms of clinical depression, far higher than the general population. Students rated mental health as the highest priority for the administration to address, even above career development.

These studies clearly indicate that mental health must be taken more seriously on college campuses. As a member of the Harvard Chan Mental Health Student Alliance at the School of Public Health, I have seen improvements, but more must be done. Harvard should be a global leader in addressing student mental health, just as we are a global leader in academics.

Each of the last two years, MHSA has surveyed students to identify mental health problems. We then used the findings to recommend changes to the school. Our most recent survey, in Spring 2018, mirrored the national results: About 50 percent of Harvard Chan students reported poor to fair mental health. We also found high rates of negative experiences, such as feeling disrespected or overwhelmed. However, as budding social scientists, we know that extrapolating our findings is tenuous because of a low response rate (15 percent) and a self-selected sample.

Nevertheless, we made three recommendations. First, we recommend promoting a culture of wellness that prioritizes healthy habits. Over 70 percent of students reported having challenges in maintaining a healthy lifestyle. It is difficult to put your wellbeing first when you are pulling all-nighters to finish papers or eating leftover pizza at 3 a.m. But these “rites of passage” can be harmful to mental and physical health and should be identified as such.

Our second recommendation is to hold open discussions with students about structural barriers and how to overcome them. We live in changing times. Previous support systems, such as chaplains, may no longer work. The school has offered innovative solutions to meet student needs, such as Let’s Talk and iHope. But less than half of students knew of them, according to our survey. (Are you aware?) Open forums would allow the school to hear directly from students and better adapt existing resources to meet students’ needs.

Finally, we recommend institutionalizing a mental health survey managed by the school. Harvard must take responsibility for measuring mental health needs, rather than relying on student-led surveys. Fortunately, there is a solution. Harvard University Health Services offers a mental health survey available at any Harvard school, if the dean, or department chair, approves it. However, only a few places have offered it. We urge every Harvard school to work with students to implement the HUHS survey and use the findings to create change.

Members of the Harvard community are starting to pay attention. The 2018 Harvard Presidential Task Force’s report on inclusion and belonging recommended adding resources to enhance mental health services. It was one of three high-impact recommendations. Moreover, MHSA has worked with the Chan School of Public Health’s administration to make changes. In response to our first survey, the school added a mental health professional to our Longwood Campus and supported our second survey. Finally, the Harvard Graduate Student Union is advocating for additional mental health resources as part of their union agreement.

These current efforts are promising, but more needs to be done. The research has found a large mental health burden in higher education. If you believe the adage, “you can’t manage what you don’t measure,” then a single survey across Harvard institutions would be a great start to design evidence-based interventions. Students need more mental health support. There are too many lives in danger.

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