How Should I Assess College-Bound Students for Mental Health Issues?

Mary E. Muscari, PhD, CPNP, APRN-BC


September 26, 2012

In This Article


Are mental health disorders really more prevalent in college students? If so, how should I assess college-bound students for evidence of mental health disorders?

Response from Mary E. Muscari, PhD, CPNP, APRN-BC
Associate Professor, Decker School of Nursing, Binghamton University, Binghamton, New York; Pediatric Nurse Practitioner, Psychiatric Clinical Specialist, and Forensic Clinical Specialist, Sex Offender Assessment Board/Pennsylvania Board of Probation & Parole, Harrisburg, Pennsylvania

The Growth of Mental Health Issues on Campus

Mental health issues are a growing concern in the college-age population. The stressors of being away from home and dealing with college life can affect mental health. However, the greater concern comes from the knowledge that most lifetime psychiatric disorders have their onset before or during the traditional college age of 18-24 years.[1] Although psychiatric disorders are just as prevalent in the same-aged noncollege population,[2] mental illness has created increased challenges in college and university settings.

According to the 2010 National Survey of Counseling Center Directors, the recent trend toward greater number of students with severe psychological problems continues. They also reported increases in the following problems: crisis issues requiring immediate response; psychiatric medication issues; learning disabilities; alcohol abuse, illicit drug use; self-injury (eg, cutting to relieve anxiety); on-campus sexual assault; eating disorders; career planning issues; and the long-term consequences of sexual abuse.[3]

Results from the 2008 American College Health Association National College Health Assessment (ACHA-NCHA) showed that more than 1 in 3 undergraduate students reported feeling so depressed that it was difficult to function at least once in the previous year, and almost 1 in 10 reported seriously considering suicide in that same time period.[4] Undergraduate students are not the only ones with mental health issues. A study of graduate students at a large university in the western United States showed that almost half of graduate student participants reported having had an emotional or stress-related problem over the past year. Their self-reported mental health correlated with their level of confidence about their financial status, higher functional relationships with their advisors, regular contact with friends, and being married.[5]

The college years are marked by major life changes, character development, decision-making about the future, and added responsibilities, all of which may be compounded by mental illness. Nurse practitioners (NPs) have a unique opportunity to facilitate this transition to adulthood by using the public health model (primary, secondary, and tertiary intervention) to minimize the potentially devastating effects of mental illness in this age group.