Supporting the Mental Health Needs of Community College Students.

The United States faces an unprecedented mental health crisis, with youth and young adults at the center. Even before the COVID-19 pandemic, nearly 50 percent of college students reported at least one mental health concern. The COVID-19 pandemic notably exacerbated these issues and underscored the urgent need to identify and implement ways to ameliorate the youth mental health crisis. In 2021, the National Academies of Sciences, Engineering, and Medicine called on the field of higher education to address growing concerns about student mental health by identifying and elevating emerging and promising approaches that offer a more holistic way to support students' mental health. Serving as the main entry point for more than 40 percent of students seeking a postsecondary degree, community colleges represent a tremendous and untapped opportunity to better address mental health in the United States, particularly for students who have been traditionally underserved (e.g., students of color, first-generation students, and low-income students). However, community colleges have limited evidence and guidance to inform the implementation of multilevel, holistic approaches to support students with varying mental health needs. To address this knowledge gap, this article shares a descriptive study of eight community colleges at the forefront of implementing multilevel approaches (a combination of prevention, early intervention, and treatment services) to support student mental health, as well as key facilitators for and barriers to their success.

California Community College Faculty and Staff Help Address Student Mental Health Issues.

This study determines the preliminary impact of CalMHSA's prevention and early intervention activities on the knowledge, attitudes, and behaviors of California community college faculty and staff regarding supporting students' mental health needs.

2015 Department of Defense Health Related Behaviors Survey (HRBS).

The Health Related Behaviors Survey (HRBS) is the U.S. Department of Defense's flagship survey for understanding the health, health-related behaviors, and well-being of service members. In 2014, the Defense Health Agency asked the RAND Corporation to review previous iterations of the HRBS, update survey content, administer a revised version of the survey, and analyze data from the resulting 2015 HRBS of active-duty personnel, including those in the U.S. Air Force, Army, Marine Corps, Navy, and Coast Guard. This study details the methodology, sample demographics, and results from that survey in the following domains: health promotion and disease prevention; substance use; mental and emotional health; physical health and functional limitations; sexual behavior and health; sexual orientation, transgender identity, and health; and deployment experiences and health. The results presented here are intended to supplement data already collected by the Department of Defense and to inform policy initiatives to help improve the readiness, health, and well-being of the force.

Strengthening College Students' Mental Health Knowledge, Awareness, and Helping Behaviors: The Impact of Active Minds, a Peer Mental Health Organization.

OBJECTIVE: To examine the relationship between college students' familiarity with and involvement in Active Minds, a student peer organization focused on increasing mental health awareness, decreasing stigma, and affecting mental health knowledge, attitudes, and behaviors. METHOD: Students (N = 1,129) across 12 California colleges completed three waves of a web-based survey during the 2016-2017 academic year to assess familiarity with and involvement in Active Minds and mental health attitudes, behaviors, and perceived knowledge. Fixed-effects models assessed relations between changes in organization familiarity and involvement and changes in mental health-related outcomes over time overall and stratified by students' baseline engagement (ie, familiarity/involvement) with Active Minds. RESULTS: Overall, increased familiarity with Active Minds was associated with increases in perceived knowledge (0.40; p < .001) and decreases in stigma over time (-0.33; p < .001). Increased involvement was associated with increases in perceived knowledge (0.40; p < .001) and a range of helping behaviors. Associations differed by students' baseline engagement with Active Minds. For students with low engagement, increased familiarity with Active Minds was associated with decreased stigma and improved perceived knowledge. For students with moderate baseline engagement, increasing involvement with Active Minds was associated with increases in helping behaviors (eg, providing emotional support, connecting others to services) over time. CONCLUSION: Student peer organizations' activities can improve college student mental health attitudes and perceived knowledge and significantly increase helping behaviors. Such organizations can complement more traditional programs and play an important role in improving the campus climate with respect to mental health.

Unmet Mental Health Treatment Need and Attitudes Toward Online Mental Health Services Among Community College Students.

OBJECTIVE: A survey assessed use of and attitudes toward online mental health services among community college students to inform how such services may contribute to reducing unmet treatment need. METHODS: A total of 6,034 students completed a Web-based survey on mental health and use of and attitudes toward mental health services. Logistic regression assessed the relationship between prior mental health treatment and attitudes among students with current serious psychological distress. RESULTS: Among students with psychological distress (N=1,557), 28% reported prior in-person service use and 3% reported online mental health services use; most (60%) reported willingness to use online services. Students with no prior in-person treatment were less likely than those with history of in-person treatment to endorse preferences for in-person services (adjusted odds ratio=.54). CONCLUSIONS: Students reported being open to using online mental health services, but utilization was low. Targeted outreach efforts may be required if these services are to reduce unmet treatment need.

Mental Health Service Utilization Among Lesbian, Gay, Bisexual, and Questioning or Queer College Students.

PURPOSE: College students are at high risk for mental health problems, yet many do not receive treatment even when services are available. Treatment needs may be even higher among sexual minority students, but little is known about how these students differ from heterosexual peers in terms of mental health needs and service utilization. METHODS: A total of 33,220 California college students completed an online survey on mental health needs (e.g., current serious psychological distress and mental health-related academic impairment) and service utilization. Using logistic regressions, we examined differences in student characteristics, mental health service use, and perceived barriers to using on-campus services by sexual minority status. RESULTS: Approximately 7% of students self-identified as sexual minorities. Compared with heterosexual students, sexual minority students endorsed higher rates of psychological distress (18% vs. 26%, p < .001) and mental health-related academic impairment (11% vs. 17%, p < .001) but were 1.87 (95% confidence interval: 1.50-2.34) times more likely to use any mental health services. Sexual minority students were also more likely to report using off-campus services and to endorse barriers to on-campus service use (e.g., embarrassed to use services and uncertainty over eligibility for services). CONCLUSIONS: Sexual minority individuals represent a sizeable minority of college students; these students use mental health services at higher rates than heterosexual peers but have high rates of unmet treatment need. Efforts to address commonly reported barriers to on-campus service use, foster sexual minority-affirmative campus environments, and promote awareness of campus services may help reduce unmet treatment need in this population.

Simplified Novel Application (SNApp) framework: a guide to developing and implementing second-generation mobile applications for behavioral health research.

Advances in mobile technology and mobile applications (apps) have opened up an exciting new frontier for behavioral health researchers, with a "second generation" of apps allowing for the simultaneous collection of multiple streams of data in real time. With this comes a host of technical decisions and ethical considerations unique to this evolving approach to research. Drawing on our experience developing a second-generation app for the simultaneous collection of text message, voice, and self-report data, we provide a framework for researchers interested in developing and using second-generation mobile apps to study health behaviors. Our Simplified Novel Application (SNApp) framework breaks the app development process into four phases: (1) information and resource gathering, (2) software and hardware decisions, (3) software development and testing, and (4) study start-up and implementation. At each phase, we address common challenges and ethical issues and make suggestions for effective and efficient app development. Our goal is to help researchers effectively balance priorities related to the function of the app with the realities of app development, human subjects issues, and project resource constraints.

Factors Affecting Mental Health Service Utilization Among California Public College and University Students.

OBJECTIVE: Unmet need for mental health treatment among college students is a significant public health issue. Despite having access to campus mental health providers and insurance to cover services, many college students do not receive necessary services. This study examined factors influencing college students' use of mental health services. METHODS: Online survey data for 33,943 students and 14,018 staff and faculty at 39 college campuses in California were analyzed by using logistic regressions examining the association between students' use of mental health services and student characteristics, campus environment, and the presence of a formal network of campus mental health clinics. RESULTS: Nineteen percent of students reported current serious psychological distress in the past 30 days, and 11% reported significant mental health-related academic impairment in the past year. Twenty percent reported using mental health services while at their current college, 10% by using campus services and 10% off-campus services. Students on campuses with a formal network of mental health clinics were more likely than students at community colleges to receive mental health services (odds ratio [OR] range=1.68-1.69), particularly campus services (OR=3.47-5.72). Students on campuses that are supportive of mental health issues were more likely to receive mental health services (OR=1.22), particularly on campus (OR=1.65). Students with active (versus low) coping skills were consistently more likely to use mental health services. CONCLUSIONS: Establishing more campus mental health clinics, fostering supportive campus environments, and increasing students' coping skills may reduce unmet need for mental health services among college students.

Student Mental Health in California's K-12 Schools: School Principal Reports of Common Problems and Activities to Address Them.

Reports results of a survey of K-12 principals to take inventory of student mental health and wellness needs and the types of programs schools are most often implementing to help students in California's public schools.

Payoffs for California College Students and Taxpayers from Investing in Student Mental Health.

Reports results of a survey to assess the impact of CalMHSA's investments in mental health programs at California public colleges and estimates the return on investment in terms of student use of treatment, graduation rates, and lifetime earnings.

Evaluation of CalMHSA Student Mental Health Online Resources.

Analysis of visitors to CalMHSA-funded student mental health websites shows that visitors at educational institutions comprised the largest audience segment and promotional campaigns likely increased traffic.

Characterizing the longitudinal relations between depressive and menstrual symptoms in adolescent girls.

OBJECTIVE: This study examined the association between depressive and menstrual symptoms in adolescent girls in a 3-year longitudinal study. It was hypothesized that menstrual symptoms would increase in early adolescence and decrease in later adolescence, that girls with greater depressive symptoms would report greater menstrual symptoms, and that effects would persist after adjusting for general somatic complaints. METHODS: A community sample of girls (n = 262) enrolled in an observational study by age cohort (11, 13, 15, 17 years) completed three annual visits. At each time point, girls completed the Menstrual Symptom Questionnaire, Children's Depression Inventory, and the Youth Self Report to assess general somatic complaints. RESULTS: Menstrual symptoms increased significantly across adolescence (p = .006) and began to plateau in later adolescence (p = .020). Depressive symptoms at study entry were significantly associated with menstrual symptoms (p < .001). When general somatic complaints were included in the models, the effect of depressive symptoms on menstrual symptoms remained significant for the sum score (p = .015) and the menstrual somatic symptoms subscale (p = .001). After adjusting for somatic complaints, initial report of depressive symptoms predicted change in menstrual symptoms only for girls with the lowest menstrual symptoms sum score (p = .025). Initial report of somatic complaints predicted change in menstrual symptoms (p = .020). CONCLUSIONS: Girls with higher depressive symptoms and higher somatic complaints are at greater risk for experiencing menstrual symptoms and increasing symptoms across adolescence, with a heightened vulnerability for girls with lower baseline menstrual symptoms.

Longitudinal reliability of self-reported age at menarche in adolescent girls: variability across time and setting.

Age at menarche is critical in research and clinical settings, yet there is a dearth of studies examining its reliability in adolescents. We examined age at menarche during adolescence, specifically, (a) average method reliability across 3 years, (b) test-retest reliability between time points and methods, (c) intraindividual variability of reports, and (d) whether intraindividual variability differed by setting or individual characteristics. Girls (n = 253) were enrolled in a cross-sequential study in age cohorts (11, 13, 15, and 17 years). Age at menarche was assessed using 3 annual, in-person clinician interviews followed by 9 quarterly phone interviews conducted by research assistants. Reliability of age at menarche across time was moderate and varied by method. In-person interviews showed greater reliability (intraclass correlation coefficient [ICC] = .77) versus phone interviews (ICC = .64). Test-retest reliability in reports did not decrease across time. However, average differences in reported age varied as much as 2.3 years (SD = 2.2 years), with approximately 9% demonstrating differences greater than 4.5 years. Pubertal timing category (i.e., early, late) changed for 22.7% if categorized at the final versus the first report of age at menarche. Reliability was moderate, but average differences in reported age were notable and concerning. Using in-person clinician interviews may enhance reliability. Researchers and clinicians should be cognizant of the implications of using different methods measuring age at menarche when interpreting research findings.

Interventions to Improve Student Mental Health: A Literature Review to Guide Evaluation of California's Mental Health Prevention and Early Intervention Initiative.

The authors review data on the prevalence of youth mental health disorders and schools' use of student mental health (SMH) programs. They also describe the role of schools in addressing SMH concerns and outline a conceptual model for guiding evaluation of SMH programs. Finally, they touch on issues related to evaluation of cross-system collaborations that can influence students' access to resources and services and then review some of the challenges associated with evaluating SMH programs. They determine that SMH programs can be effective and can improve staff, faculty, and student knowledge of mental health problems; provide skills for identifying and referring students with mental health and social and emotional difficulties; and change attitudes toward mental health problems.

Executive functioning, cortisol reactivity, and symptoms of psychopathology in girls with premature adrenarche.

The study examined the interaction between early maturational timing (measured by premature adrenarche [PA]) and executive functioning and cortisol reactivity on symptoms of psychopathology. The study included 76 girls aged 6 through 8 years (mean = 7.50, SD = 0.85) with PA (n = 40) and on-time adrenarche (n = 36). Girls completed a battery of psychological and neuropsychological tests and blood sampling for cortisol. Parents completed the Child Behavior Checklist. The results demonstrated that girls with PA with lower levels of executive functioning had higher externalizing and anxious symptoms compared to other girls. In addition, girls with PA who demonstrated increases in serum cortisol had higher externalizing symptoms than those with stable patterns. Finally, girls with PA who demonstrated decreases in cortisol reported higher depressive symptoms. The findings from this study provide important information concerning the impact of cognitive functioning and stress reactivity on adjustment to early maturation in girls with PA. The results of this research may inform screening and intervention efforts for girls who may be at greatest risk for emotional and behavioral problems as a result of early maturation.

Enhancing cross-system collaboration for caregivers at risk for depression.

In the United States, many health care systems function independently from one another. Increasing coordination across systems has the potential to vastly improve services and patient outcomes, yet implementing these changes can be challenging, requiring increased communication, interaction, and coordination across systems that typically function independently. Parental depression is one health issue that could benefit greatly from a comprehensive systems approach. The Helping Families Raise Healthy Children initiative is a cross-system quality improvement initiative aimed at improving identification and treatment of families faced with the dual challenge of caregiver depression and early childhood developmental delays. Four main techniques were used to foster and sustain cross-system collaboration and communication: cross-system trainings, regular meetings of collaborative partners, a cross-system learning collaborative for service providers, and two cross-system facilitators. The initiative achieved successful cross-system collaboration, suggesting that these methods may be used in other initiatives to foster similar types of collaboration across systems.