大學生心理健康

References
• Abelson, S., Lipson, S. K., & Eisenberg, D. (2022). Mental
health in college populations: A multidisciplinary review
of what works, evidence gaps, and paths
forward. Higher education: Handbook of theory and
research, 133-238.
• Curtis, A., Bearden, A., & Turner, J. P. (2023). Post‐
secondary student transitions and mental health:
Literature review and synthesis. New Directions for
Higher Education, 2023(201-202), 63-86.
High and rising prevalence of
mental health problems
• First onset of mental health problems typically occurs before or
during the traditional college years (ages 18–24); 75% of
lifetime mental illnesses emerge by age 24.
• Student mental health is a significant predictor of many
important functional outcomes, including social connectedness,
academic performance, and future workplace productivity.
• Arab/Arab American students, an understudied group, have a
higher prevalence of mental health symptoms than other
racial/ethnic groups.
• Across fields of study, higher rates of mental health problems
among students are in the arts and humanities.
Risk and protective factors
• Among students who report their financial situation as
“always stressful” or “often stressful,” 60% and 45%,
respectively, have apparent mental health symptoms
relative to 29% of those reporting “never stressful.”
• Coping skills are well-established protective factors.
Students with high levels of psychological flexibility
have better mental health outcomes (17% prevalence)
relative to students with low flexibility (91%
prevalence).
Individual-level interventions
• Psychoeducational interventions: provide information targeting
students’ knowledge of and attitudes toward stress, coping, mental
health symptoms, and mental health resources.
• Coaching interventions: change behavior through goal-directed,
collaborative strategies, often through motivational interviewing.
• Skill-training interventions: teach students social, emotional, and
coping skills. Extensive evidence suggests that skill-training
interventions effectively promote positive adjustment and prevent
negative adjustment in college students.
• Identity-support interventions: support students’ sense of identity,
including but not limited to racial, ethnic, sexual, or gender identity.
Interpersonal interventions
• Peers impact student well-being in numerous ways, with well-
documented effects on behavior, health, and academic
outcomes. Peers are “the single most potent source of
influence” on student affective and cognitive growth and
development during college.
• Peer interventions are a low-cost strategy with potential to
contribute positively to college mental health efforts,
benefitting peer leaders and participants alike.
• Recent evidence emphasizes the role of mentoring in
improving student mental health, by supporting broader
exposure to nurturing relationships, career options, and
various social identities.
Community-level interventions
• Gatekeeper trainings are universal, primary prevention programs
that seek to (a) increase knowledge about mental health
disorders along with gatekeepers’ abilities to intervene, thereby
(b) promoting help-seeking among the target population.
• Gatekeeper trainings are typically brief; the most well-known
programs run from 1 to 3 h. Students (particularly resident
advisors [RAs]), faculty, staff, and coaches are trained as
gatekeepers in higher education.
• Screening interventions can change how the college community
responds to students experiencing mental health symptoms.
Helping campus health centers identify and respond to students
with mental health symptoms is especially important.
Institutional interventions
• Evidence suggests institutional transformation, rather than isolated
interventions, is the most promising path to enhancing the health
of members. Healthy structures foster healthy interpersonal
processes, which foster healthy students.
• Changing the “surround” to reduce student stressors and increase
student resources has considerable potential for improving mental
health.
• Colleges and universities can enhance emotional well-being
through the built environment. Best designs for healthy physical
spaces are being developed and applied in higher education
settings. These include connecting buildings to nature and
providing access to natural light, opportunities for social
interaction, and control over furniture choices.
Interpersonal and intrapersonal
challenges
• Post-secondary students are challenged to adjust to
new academic standards, they must also regulate
newfound personal and financial freedom, manage new
responsibilities, form, and maintain new interpersonal
relationships, deal with the loss of pre-existing social
support networks, and navigate new and often complex
environments.
• Successful adaptation to higher education is influenced
by factors at both the individual and institutional levels.
Mental health and transition to
college
• Educational research consistently finds that depression is
a significant indicator of student dropout.
• Younger adults are a particularly high-risk population for
mental health problems. Research has demonstrated that
suicide is the second leading cause of death for
Canadians aged 15–25.
• When averaged, the overall proportion of students
meeting the criteria for a DSM-IV disorder was 20.3%
(one-fifth). Of the many disorders identified, anxiety was
found to be the most prevalent (11.7%), followed by
mood disorders (6.0%), and substance disorders
Institutional characteristics
• Chen (2012) indicated a variety of risk factors for first year
dropout; these predictors include: (1) low SES; (2) low first
year GPA; (3) poor academic and social on-campus
integration; (4) insufficient amount of financial aid; and (5)
lack of an educational plan.
• Although mental health and resilience in the post-secondary
context is unquestionably influenced by factors at the student
level, adaptation to post-secondary is equally determined by
institutional characteristics, such as the degree and quality of
health related-programming available on campus, provision of
financial aid, quality of faculty-student relationships, academic
policy, and the quality of academic programming.
Student help seeking
• A longitudinal study conducted in Ireland found that college
students with low-to-average well-being scores were less
inclined to seek formal mental health services than students
with higher well-being scores.
• Goodwin and colleagues (2016) reported that the most
prominent barrier to utilization of services provided on campus
was an overall lack of student understanding regarding the
role of the counselling center.
• Factors such as a lack of familiarity, mistrust of healthcare
providers, lack of communication, lack of perceived urgency,
skepticism, and stigma, have all been recognized as barriers
to both service delivery and access on campus.
Existing initiatives
• Resilience-building models and programs that have
been developed are evidence-based; however, many of
them are not consistently evaluated, therefore, it is
difficult to confidently infer the impact or effectiveness
of these programs.
• We are lacking in a foundational definition of wellness;
many of the youth mental health programs around
North America are based on a variety of different
models that focus on only a few elements of well-being.
Limitations to existing programming
• A considerable number of institutions are lacking in services
and initiatives aimed at the identification of low income and at-
risk students.
• Many institutions lack in initiatives to monitor their on-campus
mental health services; far less than half of the institutions
reported having policies in place to monitor their own mental
health services and initiatives; this is largely due to uncertainty
surrounding how to successfully evaluate such services.
• Smaller institutions were less likely to initiate targeted
promotion programs such as alcohol and drug abuse, eating
disorders, depression, suicide, bipolar disorder, and stress or
anxiety—most likely due to budgetary limitations.
US institutions
• Primary services offered by on-campus mental health
clinics are short-term mental health counselling,
psychiatric evaluation, drug and alcohol treatment,
referrals to community resources, and crisis
intervention.
• A lack of funding was reported as a barrier to service
delivery on campus.