Home > Mental health, substance use, and wellbeing in higher education: supporting the whole student.

National Academies of Sciences, Engineering, and Medicine. (2021) Mental health, substance use, and wellbeing in higher education: supporting the whole student. Washington DC: The National Academies Press. https://doi.org/10.17226/26015..

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In June 2019, National Academies of Sciences, Engineering, and Medicine launched an 18-month consensus study to examine the degree to which the support systems on campuses provide services, programming, and other resources to students and the faculty, staff, and health systems with whom students interact. Under the auspices of the Board on Higher Education and Workforce, and in collaboration with the Health and Medicine Division, the National Academies appointed a committee of experts to examine the most current research and consider the ways that institutions of higher education, including community colleges, provide treatment and support for the mental health and wellbeing of undergraduate and graduate students in all fields of study. 

For the purposes of this report, the term mental health will be used to refer to mental health and emotional and behavioral issues. The term mental illness will be used specifically in reference to diagnosed serious mental disorders, including depression, schizophrenia, bipolar disorder, or anxiety disorder. By contrast, wellbeing is a holistic concept referring to both physical and mental health. It includes a sense of personal safety and security, emotional support and connection, mechanisms to cope with stressors, and access to services when appropriate for short- and long-term care. 

The committee believes that institutions have a responsibility both to enhance the wellbeing of all students and to provide additional support to a subset of students with more severe emotional distress and mental illness. Over the course of the study, the committee:

  • Identified and reviewed programs, practices, resources, and policies that institutions of higher education have developed to treat mental health issues and to support wellbeing on campuses;
  • Analyzed the challenges institutions face—including financial, cultural, and human resource obstacles and methods to address these challenges;
  • Investigated factors related to the funding of and access to mental health services and support for student wellbeing, such as student academic performance and campus climate;
  • Examined, to the extent possible, the relationship between student mental health, wellbeing, and rates of alcohol and drug use, and recommend ways in which institutions can address substance use and its effects on campus climate; and
  • Produced a consensus report with recommendations that will be broadly distributed on campuses, at professional society meetings, and in other venues. 

This report presents the findings of the Committee on Supporting the Whole Student: Mental Health, Substance Abuse, and Wellbeing in Higher Education and the recommendations it developed that, if followed, would improve the delivery of mental health, wellness, and substance use services by the nation’s institutions of higher education. This report also contains the committee’s suggestions for further research on student wellbeing and mental health and on the delivery of such services to benefit all students. While the committee acknowledges throughout the report the potential for the COVID-19 pandemic to exacerbate mental health issues for this population, this was not the focus of the report. The report contains some information on graduate students and medical students, but focuses primarily on undergraduate students. Even though the committee was asked to investigate mental health issues among science, technology, engineering, mathematics, and medical (STEMM) students where feasible, most of the data relevant to this study are not disaggregated by field. In addition, the issues of mental health, substance use, and wellbeing affect all students in all disciplines, as do the campus services provided to deal with them. 

Similarly, although mental health issues affect students in all professional fields of study, the committee was explicitly asked by the study sponsors to focus on medical students. It has provided some information on medical students, although, given the broad scope of the study, that information is necessarily brief. In its focus on medical students, the committee acknowledges that the mental health issues facing this population frequently also apply to other health professionals, including students pursuing degrees in other health-related fields. These mental health issues have likely been exacerbated by the COVID-19 crisis, where all health professionals are facing front line stresses related to the diagnosis, treatment, and care of patients, and have been found to be at higher risk of developing psychological distress and other mental health symptoms.

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