Few depressed college students receive adequate care

Less than one in four college students with symptoms of serious depression receives adequate treatment. Current health care services on campus might not be sufficient for delivering good quality mental health care, according to a new study in the journal General Hospital Psychiatry.

The study found that only 22 percent of students who reported symptoms of serious depression in the past year received minimally adequate care. Thirteen percent of students who reported signs of depression had no contact with a healthcare professional about the problem. Among students with depressive symptoms and thoughts of suicide, only 34 percent received minimally adequate care.

"It's a little surprising that adequacy of care is just as low among college students as it is in general adult population," said Daniel Eisenberg, Ph.D., associate professor at the School of Public Health at the University of Michigan in Ann Arbor and lead author of the study. College students are a subgroup who should be getting better treatment than the general public, because they usually have access to healthcare facilities on campus, some of which provide free or low-cost care, he noted.

The study relied on an online survey of nearly 8,500 students at 15 colleges or universities. The survey collected data on several measures of depression and anxiety, and asked respondents whether they had reached out for mental health care and what kind of care they received. Minimally adequate care was defined as at least 2 months of antidepressant use plus at least three follow-up visits to discuss the medication or at least seven mental health-related counseling sessions.

“These findings are not surprising,” said Jerald Kay M.D., professor and chair of the Department of Psychiatry at Wright State University in Dayton, Ohio. The incidence of depression in college students has doubled in the last 20 years and the incidence of suicidal behavior has tripled, he said. “College students, who are usually in good health, are actually more likely to have psychiatric issues than other health problems, whereas most psychiatric problems have their onset in the late teens and young adult years," he added.

The ideal campus mental health care service would be a collaborative one that combines psychiatrists, general physicians and psychologists with other health care providers, said Eisenberg. "Most campuses are not close enough to that ideal."

Kay agreed. College campuses need clinics based on a community mental health center model that provide evaluation, medications, crisis intervention, psychotherapy and hospitalization, if needed, he said.