Help-seeking and access to mental health care in a university student population

Studies show that the incidence of mental illness on college campuses is rising, and a new survey of 2,785 college students indicates that more than half of students with significant symptoms of anxiety or depression do not seek help.

This is despite the fact that resources are available at no cost on campus, said Daniel Eisenberg, assistant professor at the University of Michigan School of Public Health. Eisenberg and doctoral students Sarah Gollust and Ezra Golberstein conducted the Web-based survey in an attempt to quantify mental health service use and factors associated with whether or not students seek help. A study looking at the same issues at 12-15 universities nationwide will begin this fall, Eisenberg said.

At U-M where the study occurred, students have access to free mental health and counseling services. Yet, among those with significant symptoms of depressive or anxiety disorders, anywhere from 37 to 84 percent of students didn't seek treatment, depending on the disorder. However, 72 percent of students with positive screens for major depression did acknowledge they needed help for their mental health. Overall, about 10 percent of students surveyed said they received therapy, and the same percentage said they took some type of psychotropic drug.

"We can't assume that reducing financial barriers is enough," Eisenberg said. The study found that one of the biggest predictors of whether a student sought help was socioeconomic background---students who reported growing up in poor families were almost twice as likely not to seek help. Poor students were also much more prone to symptoms of depression and anxiety disorders.

Other factors associated with not seeking treatment included lack of perceived need, being unaware of services or insurance coverage, skepticism about effectiveness, or being Asian or Pacific Islander. Women were more likely to realize they need treatment and seek it, he said.

It's important to understand what motivates students to seek help or not for several reasons, Eisenberg said. Most mental disorders first occur before age 24, and those problems often have long-term implications into adulthood. Studying a university setting lends insight into what other factors besides affordability keep people from seeking help.

U-M is a national leader in efforts to reach students and educate them about resources available, Eisenberg said. The University recently developed a mental health assessment instrument that will be used by a national network of counseling centers, conducted a stigma reduction campaign called "Real Men, Real Depression," developed a mental health resources web site, and hosts a Depression on College Campuses conference annually.

Eisenberg stressed that even though the incidence of mental disorders on college campuses is rising, studying the conditions surrounding the phenomenon presents an opportunity.

"Often college student mental health is framed as a problem on the rise," Eisenberg said. "One can also think of it as a unique opportunity because college campuses offer several ways to reach students and affect their lives positively."

The study, "Help-seeking and access to mental health care in a university student population" appears online in the journal Medical Care on June 24.