How Community Colleges Can Support Student Mental Health Needs

The United States faces an unprecedented mental health crisis, with youth and young adults at the center. Even before the coronavirus disease 2019 (COVID-19) pandemic, nearly 50 percent of college students reported at least one mental health concern. Without adequate mental health support, college students, including those at community colleges, may be at risk for a variety of academic and nonacademic consequences that negatively affect their overall well-being, including lower college completion rates, higher rates of substance use, and lower lifetime earning potential.

In a recent study, RAND researchers examining eight community colleges from across the United States found that, although the institutions did offer mental health services, most lacked a clear organizing framework for those efforts, and that financial challenges limited the support offered to students. The research also highlighted the importance of community college leaders explicitly prioritizing student mental health, as well as broad staff buy-in to the effort.

Funding, Leadership, and Structured Approaches Are Key

The RAND report Supporting Mental Health Needs of Community College Students highlighted several opportunities for community colleges to improve the implementation and effectiveness of student mental health support systems. These opportunities include enhanced leadership support, use of guiding frameworks and data-driven decisionmaking, and cross-disciplinary collaboration to support planning and implementation.

To address the financial challenges that constrain community colleges' ability to provide more-comprehensive mental health support, institutions should consider reallocating existing financial resources and pursuing additional funding for mental health initiatives. Funding from federal, state, and local agencies is also necessary to support these institutions' efforts. Developing both consistent and long-term funding sources and incentives for community colleges to implement mental health programs and services will help create sustainable and comprehensive mental health supports for students.

Studying an Untapped Mental Health Opportunity

Community colleges serve more than 7 million students each year, making them the main entry point for more than 40 percent of students seeking a postsecondary education degree. Additionally, community colleges serve a higher percentage of students of color and low-income students (who are at increased risk for mental health challenges) than do four-year universities. This being the case, community colleges present a tremendous untapped opportunity for the United States to better address mental health and health equity, particularly for those who have been historically underserved.

RAND researchers, with collaborators from the Institute of Education Sciences' (IES) College Completion Network and the University of Texas, Dallas, conducted a descriptive study of eight community colleges belonging to the JED Foundation and Active Minds networks that are implementing multilevel approaches to support student mental health (i.e., a combination of prevention, early intervention and/or treatment services). The JED Foundation and Active Minds are both nonprofit organizations leading nationwide efforts to support student mental health by promoting mental health awareness, reducing stigma, and introducing suicide prevention strategies on college campuses.

In collaboration with Active Minds and the JED Foundation, the researchers identified and recruited eight community colleges within the Active Minds and JED Campus networks implementing multilevel approaches to support student mental health. (The four-year JED Campus program provides technical assistance to four- and two-year colleges in developing comprehensive plans that address a diversity of student mental health challenges.) Focusing on colleges that are likely "ahead of the curve" on implementing more-holistic strategies to support student mental health allowed the research team to conduct a more focused and in-depth exploration of potentially replicable solutions for community colleges across the country. The selected schools are geographically diverse and serve large proportions of students of color or low-income students.

Between February and July 2022, the researchers conducted interviews with representatives from each of the eight colleges (15 interviews with 28 individuals: 19 mental health counselors or other staff and nine administrators). The researchers analyzed the interview data using a combination of deductive approaches (comparing data with findings from the existing research base and insights from mental health experts) and inductive approaches (identifying themes and patterns that could not be categorized by a priori knowledge).

The study aimed to

• describe how community colleges support student mental health across a continuum of care from prevention to treatment
• describe how community colleges are addressing student mental health through the broader college environment
• identify challenges and facilitators that these community colleges encountered in addressing student mental health.

Lesson: Community Colleges Offer Many Mental Health Supports but Largely Lack an Organizing Framework

The researchers found that colleges implemented a wide variety of efforts to support student mental health across the spectrum from well-being to illness. These efforts included student-centric programs (e.g., stress reduction seminars or educating students about available resources), faculty- and staff-focused efforts (e.g., gatekeeper training or educating staff on the link between mental health and academic success), and institution-wide efforts (e.g., forming mental health task forces to explore strategies to support student mental health). Yet most colleges did not have a clear institutional vision or strategic plan for how mental health supports could be coordinated and delivered.

Community colleges should consider adopting and formalizing a strategic plan or framework to improve coordination and collaboration across efforts, reduce redundancies, and guide decisionmaking about resource allocation. Those frameworks can be based on the Public Health Prevention Framework (Figure 1) or the Ecological Systems Theory (Figure 2), which considers mental health interventions at the individual, interpersonal, communal, institutional, and policy-oriented levels. These frameworks may assist community colleges in identifying, developing, and implementing efforts that are most likely to have a positive effect on students' well-being and success.

A pyramid with Tier 1 at the base that narrows to Tier 3

Tier 1: Prevention

Universal programs and resources for all students to promote mental health wellness and improve knowledge and attitudes related to mental illness

Examples: stigma-reduction campaigns, stress management program, positive psychology seminar

Tier 2: Early Intervention

Secondary prevention for students at risk for mental health challenges

Examples: small group interventions, gate-keeper training, skills training for at-risk students

Tier 3: Treatment

Intensive intervention for students with identified mental disorders

Examples: treatment services, crisis lines, telehealth

SOURCE: Adapted from Lise Fox, Judith Carta, Phillip Strain, Glen Dunlap, and Mary Hemmeter, "Response to Intervention and the Pyramid Model," Infants & Young Children, Vol. 23, No. 1, 2009; and Sara Abelson, Sarah Ketchen Lipson, and Daniel Eisenberg, "Mental Health in College Populations: A Multidisciplinary Review of What Works, Evidence Gaps, and Paths Forward," in Laura W. Perna, ed., Higher Education: Handbook of Theory and Research, Vol. 37, Springer International Publishing, 2022.

A series of nested circles from the outside in:

• History, society, and policy
• Institution
• Campus community
• Interpersonal
• Individual

SOURCE: Adapted from Urie Bronfenbrenner, "Ecological Systems Theory (1992)," in Urie Bronfenbrenner, ed., Making Human Beings Human: Bioecological Perspectives on Human Development, Sage Publications, 2005; and Abelson et al., 2022.

Lesson: Integrate Mental Health Services Into the Broader College

Staff at all of the surveyed colleges attested to the importance of integrating mental health supports and services within the whole college environment. Their efforts included

• integrating information on mental health resources at the college into the broader environment, including course syllabi or lessons, classrooms, academic advising, basic needs support, and financial assistance services
• staff education on the importance of student mental health and what to do when interacting with a distressed student
• colocation of mental health and academic or basic needs services
• establishing cross-disciplinary task forces
• more-explicit referral and screening processes and supports between instructors, academic counselors, and mental health counseling staff.

These efforts have the potential to demonstrate the institution's commitment to student mental health to students, faculty, and staff and help foster a supportive campus environment for all.

Lesson: College Leaders and Staff Should Consider Prioritizing Student Mental Health

The prioritization of student mental health by campus leadership was reported as critical for securing increased financial support for programs, ensuring institutionalization of mental health counselor positions, and enhancing buy-in and support from faculty and staff. Many study participants noted that faculty and staff outside fields related to mental health (e.g., psychology, social work, nursing) have not widely adopted the idea that supporting mental health is part of their role in educating students. Additionally, institutions should consider establishing or maintaining a team representing all sectors of the college that oversees strategic planning efforts to coordinate and support mental health efforts on campus.

Lesson: Limited Resources Constrain Colleges' Efforts

Many study participants shared that limited staff capacity presents a major challenge to fulfilling the increasing demand for mental health supports and services. Despite the use of a variety of approaches to expand access to mental health services (e.g., telehealth, grant-based funding to hire more counselors, community-based partnerships), many study participants noted challenges in reaching students in need, particularly historically marginalized populations who that need additional support.

To address these challenges, community colleges should consider reallocating existing financial resources and seeking additional financial resources to increase capacity to support student mental health. To streamline processes and lighten the burden on mental health counselors, community-college administrators should consider conducting an audit or needs assessment to reduce redundancy and improve the efficacy of their existing efforts. In addition, they should consider simultaneously integrating campus-wide support systems, elevating efforts that have been most successful at reaching students, and identifying key opportunities to better engage and support students most at risk (e.g., students of color; lesbian, gay, bisexual, transgender, and queer/questioning students; first-generation students; and low-income students).

Lesson: Existing Financial Resources Largely Are Not Sufficient

Community colleges struggle to find financial resources to support their efforts (even among a sample of community colleges likely ahead of the curve on addressing student mental health). A few participants described successes in obtaining grants from local, state, and federal agencies. Although these resources are helpful, they did not appear to adequately support these colleges' mental health initiatives. The responsibility to maintain a constant flow of grant dollars places a tremendous burden on counseling and student success staff.

Establishing consistent and long-term funding sources to support community colleges may be necessary to create sustainable and comprehensive mental health supports for students. Government agencies and philanthropies should consider prioritizing funding mental health supports and services on campuses. Additionally, national, state, and local funders of higher education should consider incentivizing community colleges to provide support for students' mental health across the continuum of care (prevention through treatment). Finally, states should consider modifying insurance laws or regulations to allow institutions to use general funds and/or designated health fees for expenses that are not covered by students' personal insurance.

Context for the Study's Findings

These findings must be considered within the context of the study's limitations. First, the study drew on a relatively small sample of community colleges, which may have excluded other community colleges that might also have a multilevel and holistic approach to supporting student mental health. In addition, the researchers relied on a relatively small sample size of eight colleges and feedback from 28 college faculty and staff. As a result, the findings may not represent emerging approaches or approaches that are more broadly promising.

With those limitations in mind, the evidence and analysis support several conclusions. First, enhanced leadership support for student mental health services and the use of structured frameworks to guide decisionmaking and implementation can improve outcomes. Likewise, data-driven decisionmaking and cross-disciplinary collaboration to support planning and implementation efforts are likely to benefit student mental health programs.

The research team's findings also highlight the need for continued investment in large-scale and rigorous evaluations on system- and campus-level efforts to identify effective and scalable programs and to address major gaps in our understanding of student mental health supports at community colleges.