文献出处：Hunt Justin. "Mental health problems and help-eking behavior among college students." Journal of Adolescent Health46.1 (2014): 3-10.
原文
Mental Health Problems and Help-Seeking Behavior Among College Students
Justin Hunt
Although the homicides by mentally disturbed college students at Virginia Tech and Northern Illinois University recently captured popular attention, the are atypical cas within a much broader public health issue. Mental disorders are as prevalent among college students as same-aged nonstudents, and the disorders appear to be increasing in number and verity. College students are often viewed as a privileged population, but they are not immune to the suffering and disability associated with mental illness.
Mental health among college students reprents not only a growing concern but also an opportunity, becau of the large number of people who could be reached during an important period of life. More than 65% of American high school graduates attend postcondary education, Mental disorders accou
nt for nearly one-half of the dia burden for young adults in the United States, and most lifetime mental disorders have first ont by age 24 years. The college years reprent a developmentally challenging transition to adulthood, and untreated mental illness may have significant implications for academic success, productivity, substance u, and social relationships.
父子歌曲Campus have many channels through which they might have a positive effect on mental health. College reprents the only time in many people's lives when a single integrated tting encompass their main activities—both career-related and social—as well as health rvices and other support rvices. Campus, by their scholarly nature, are also well positioned to develop, evaluate, and disminate best practices. In short, colleges offer a unique opportunity to address one of the most significant public health problems among late adolescents and young adults.
A robust ba of rearch evidence is necessary for colleges and our society more generally to ize this opportunity. The purpo of this report is to review the
published studies on college student mental health, while also drawing comparisons to the parallel published data on the general adolescent and young adult populations. Throughout this report we u the term ―college‖ to refer generally to postcondary education, which includes both undergra
duate and graduate students. We take the approach of a narrative review, rather than a more formal systematic review, becau our aim is to weave together multiple disparate topics in a reasonably conci article. In reviewing the rearch evidence, we focus primarily on sources that are likely to generalize to the overall populations of interest: national studies and large multi-campus studies. Specifically, we focus on four primary topics: (1) the current state of mental health in the college student population; (2) risk factors among college students; (3) the apparent worning in recent years of mental health in this population, and potential explanations for this trend; and (4) the extent to which students with mental health problems are receiving treatment. We conclude with a discussion of practices and policies addressing mental health and help eking on college campus, and we highlight potential opportunities for improvement.
Current state of mental health among college students
Mental health problems are highly prevalent among college students, according to veral data sources. In the 2008 National College Health Asssment sponsored by the American College Health Association (ACHA-NCHA), more than one in three undergraduates reported ―feeling so depresd it was difficult to function‖ at least once in the previous year, and nearly one in 10 reported ―riousl y considering attempting suicide‖ in the previous year . According to a study of 2
腊肉炒什么最好吃6,000 students from 70 colleges and universities in 2006, 6% of undergraduates and 4% of graduate students reported having riously considered suicide in the previous 12 months . In our own survey data from random samples at 26 colleges and universities in 2007 and 2009 (the Healthy Minds Study), we found that 17% of students had positive screens for depression according to the Patient Health Questionnaire–9, including 9% for major depression, and 10% of students had a positive Patient Health Questionnaire screen for an anxiety disorder (panic or generalized anxiety disorder).学习国画
Blanco et al compared college students and non–college-attending young adults
across a wide range of psychiatric disorders in a nationally reprentative sample, the 2002–2003 National Epidemiological Survey of Alcohol and Related Conditions (NESARC). They found that college students and their non–college-attending young adult peers had approximately the same overall 12-month prevalence of mental disorders using a validated and fully structured diagnostic interview (Alcohol U Disorder and Associated Disabilities Interview Schedule—DSM-IV version). The overall prevalence of mood and anxiety disorders was also roughly equal across the two groups, although the specific condition of bipolar disorder was less prevalent among students. Almost half of college students met the DSM-IV criteria for at least one mental disorder in the previous year, including 18% for a personality disorder, 12% for an anxiety disorder, and 11% for a m
ood disorder.
In conjunction with the findings on internalizing disorders, many studies have documented widespread alcohol misu on campus. In the national analysis by Blanco et al, college students had a higher prevalence of alcohol u disorders than their same-age peers but a lower prevalence of drug u disorders and nicotine u. This is consistent with other studies indicating that alcohol u disorders are more prevalent among college students, but nicotine and drug u disorders are more prevalent among same-age nonstudents.
Risk factors among college students
Within the college population certain subgroups have a significantly higher prevalence of mental health problems, which is consistent with studies of the general population. Male undergraduates are at a higher risk for suicide, but female students are more likely to screen positive for major depression and anxiety disorders. Students from lower socioeconomic backgrounds are at a higher risk for depressive and anxiety symptoms. Poor men, low social support, or victimization by xual violence. Although mental health clearly varies across certain demographic and social factors, relatively little is known about how it varies with respect to factors more specific to the college tting,
such as academic workload and competition. Some studies show that personality traits, such as perfectionism, are important moderators determining the amount of psychological distress that students report as a result of their college
studies. The academic environment may be particularly stressful for minority students at predominantly white institutions, according to some studies. We were, however, unable to identify any studies with reprentative samples on how mental health relates to other characteristics of the academic tting, such as enrollment size, lectivity, competitiveness, supportiveness of academic personnel, and field of study. As in the general population of youth, risk factors for mental disorders among students must also be understood in the context of genetic factors and how the pre-existing vulnerabilities interact with environmental factors in college. Rearch on the relationships is still in its infancy for college populations and will warrant incread attention in future work. Learning more about the role of the factors in mental health will be uful for informing efforts to create campus environments that promote better mental health.
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上海普陀山Are mental health problems increasing among college students?甜心空姐
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The epidemiological data summarized above clearly indicate that mental health problems are highly
prevalent among college students. Less clear is whether students are more psychologically disturbed today than they were in the past. Two national surveys are cited frequently when rearchers, clinicians, and policymakers argue there is increasing prevalence of mental illness among students. First, in a 2008 national survey of directors of campus psychological counling centers, 95% of directors reported a significant increa in vere psychological problems among their students. Second, in the ACHA-NCHA national surveys of students, the proportion reporting to have ever. Although impressive and concerning, this evidence may reflect increas in help-eking behavior as oppod to increas in overall prevalence of disorders. In this ction, we consider this alternative explanation in light of available evidence from the general population. We then consider, if the prevalence of disorders has in fact incread, whether such an increa would likely be a result of broader societal trends or factors specific to college populations and ttings. In framing this discussion, we acknowledge the multiple challenges to interpreting the evidence including the confounding of changing stigma associated with mental illness and eking mental health care, changing DSM diagnostic criteria, and possibly improved
screening for mental illness.
To begin, the near unanimity by which college mental health personnel report increasing numbers of
rious mental health problems leaves little doubt that more of the students than ever are coming into contact with campus health rvices. The reports may, however, reprent an increa in help-eking behavior rather than a true increa in prevalence. The same question applies to other evidence of increasing verity or prevalence among campus health rvice and counling clients. In the abnce of consistent data over time on disorders in overall student populations, it is unclear how the overall prevalence and verity have changed.
One strategy for trying to interpret the trends is to examine how the increa in the number of students with mental disorders who are in contact with health providers (e.g., the increa from 10 to 15 with diagnod depression) compares with evidence on increas in help-eking behavior, conditional on having a diagnosable disorder, in general populations. Becau there are no consistent data on mental health treatment over time from reprentative adolescent populations, we examine trends from general adult samples. The Epidemiologic Catchment Area Study was one of the first large-scale studies to provide data on help eking, showing that in 1985 only 19% of respondents with recent mental disorders received any treatment in the year before the interview. In data collected in 1992, the National Comorbidity Survey (NCS) found that 25% of tho diagnod with 12-month disorders received treatment in the year before the interview, indicating an increa re
农村新政策lative to the 1980s. Most recently, the National Comorbidity Survey Replication (NCS-R) fielded in 2002 demonstrated that the increa in help eking continued between the early 1990s and the early 2000s: 41% of the NCS-R respondents meeting criteria for a past-year disorder received treatment in the previous year . Considering that attitudes toward eking mental health treatment em to have improved more in young adults than in older adults , it ems plausible that the increa in help eking, conditional on mental health status, among college students has been at least as large as that in the general adult population.
