How Mental Health and Substance Use Shape the College Experience

In the United States, mental health is a prominent issue with an estimated one in five U.S. adults living with a mental illness (NIMH, 2023). Among college aged students, 18-24 years old, many studies show similar, if not higher, rates of mental health illnesses. Yet, as many as 75% of students who struggle with depression and anxiety are reluctant to seek help. This increases the risk of harmful outcomes, such as dropping out of college, poor academic performance, suicide, and substance abuse (Mayo Clinic Health System, 2022). This relationship between mental health and substance use is especially prevalent among college students that are often under high levels of stress and positioned in environments that offer easy access to alcohol and drugs.

How the Covid-19 pandemic changed college experiences:

As a result of the pandemic, many individuals around the United States and world experienced worsening mental health as family members were lost, isolation was enforced, and daily interactions decreased (National Institutes of Health, 2022). This was especially the case for college students who had to balance classes with potential health complications on them or their families. Simultaneously, substance use increased during the pandemic as individuals experienced increased loneliness and isolation. This was especially prevalent for students who had their entire college environments shifted to online learning. Data from 2021 reports that 46.3 million people ages 12 and up - 16.5% of the population - met criteria for having a substance use disorder (SUD) in the past year (SAMHSA, 2021)

What are social determinants of health?

Social determinants of health encompass the conditions in which individuals are born, how they grow up, where they work, how they live, and the conditions in which they age. It includes neighborhoods and built environments, access to education, economics, healthcare, and more, all of which can impact the college experience. Examples of social determinants of health in the context of this issue include economic stability, social connection, race, built infrastructure, access to healthcare and transportation, and more. Understanding how these social determinants contribute to such challenges is crucial for developing effective interventions and support systems.

How social determinants of health impact college experiences:

Many of the common determinants of health experienced by students can drastically shape mental health and the likelihood of an individual developing substance use disorders. Unique stressors that can contribute to substance use and mental health issues include financial constraints, limited access to resources, and a lack of social support. These stressors may increase the likelihood of turning to substances as a coping mechanism and can exacerbate existing mental health conditions (Lipson, S. K., et., 2022) The nature of a university itself with increasing demands on time and focus can create immense pressure on students, leading to stress, anxiety, and depression. Academic expectations, coupled with the fear of failure, can significantly impact mental well-being (Barbayannis, 2022).

Social support in the form of friendships, family, and relationships play a critical role in maintaining mental well-being and reducing depression or anxiety. For many, the college environment can be overwhelming and isolating, particularly for students who lack strong social networks. This absence of social support can contribute to substance use and mental health issues, as individuals may turn to substances as a means of fitting in.

As universities grow well beyond their boundaries with an ever-increasing demand for higher enrollment, unsafe or unstable housing situations, such as overcrowding or homelessness, are becoming more commonplace and can have a detrimental impact on mental health. Students lacking stable living arrangements often face increased stress and uncertainty, which can contribute to substance use as a coping mechanism. These challenging living conditions further compound the existing pressures of college life, increasing the risk of mental health issues.

What improvements are being made?

Although mental health and substance use disorders are a prominent issue, many schools have begun implementing improvements. Several colleges have found success in conducting in person orientation sessions that all students have to go through, with training on how to identify the symptoms of mental illness, where to find resources on campus, and how to go about talking to a friend who might be struggling (Eva, 2019). Programs like this one are a great step in addressing mental health head-on, holding sessions discussing the reality of mental health and working to de-stigmatize it. Many schools have also increased their funding for their counseling departments, opening new offices, increasing the number of counselors, and offering longer working hours. This allows students to seek out and obtain on-campus mental health resources. This is very beneficial since many students do not have access to a car in their earlier years of college and are generally unable to find or afford the needed help. While greater efforts need to be made in many settings, these are positive early steps to address the issue and bring greater awareness to the challenge’s mental health and substance use disorders pose to students all over the globe.

References:

Barbayannis, G., Bandari, M., Zheng, X., Baquerizo, H., Pecor, K. W., & Ming, X. (2022). Academic Stress and Mental Well-Being in College Students: Correlations, Affected Groups, and COVID-19. Frontiers in Psychology, 13(886344). https://doi.org/10.3389/fpsyg.2022.886344 

Eva, A. (2019, January 11). How Colleges Today Are Supporting Student Mental Health. Greater Good. https://greatergood.berkeley.edu/article/item/how_colleges_today_are_supporting_student_mental_health 

Lipson, S. K., Zhou, S., Abelson, S., Heinze, J., Jirsa, M., Morigney, J., Patterson, A., Singh, M., & Eisenberg, D. (2022). Trends in college student mental health and help-seeking by Race/ethnicity: Findings from the National Healthy Minds Study, 2013–2021. Journal of Affective Disorders, 306, 138–147. https://doi.org/10.1016/j.jad.2022.03.038 

Mayo Clinic Health System. (2022, July 19). College students and depression. Mayo Clinic Health System. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/college-students-and-depression#:~:text=Unfortunately%2C%20as%20many%20as%2075%25%20of%20students%20who 

National Institutes of Health. (2022, August 24). COVID-19 Mental Health Information and Resources | National Institutes of Health. NIH COVID-19 Research. https://covid19.nih.gov/covid-19-topics/mental-health 

NIMH. (2023, May). Mental Illness. National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/statistics/mental-illness#:~:text=It%20is%20estimated%20that%20more%20than%20one%20in

2021 National Survey of Drug Use and Health (NSDUH) releases. SAMHSA.gov. (n.d.). https://www.samhsa.gov/data/release/2021-national-survey-drug-use-and-health-nsduh-releases       

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