Abstract
In recent years, the number of college students diagnosed with mental illness has been rising steadily. Suicide has been identified as the second leading cause of death among college-aged students, and psychiatric disorders are the fastest-growing area of disability in college students. However, data suggest that the majority of psychiatric issues among college students go untreated. Barriers to psychiatric treatment engagement and adherence are identified. Strategies to increase treatment engagement and adherence are discussed.
Keywords
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Gogtay N, Giedd JN, Lusk L, Hayashi KM, Greenstein D, Vaituzis AC, et al. Dynamic mapping of human cortical development during childhood through early adulthood. Proc Natl Acad Sci. 2004;101(21):8174–9.
Cohen AO, Breiner K, Steinberg L, Bonnie RJ, Scott ES, Taylor-Thompson K, et al. When is an adolescent an adult? Assessing cognitive control in emotional and nonemotional contexts. Psychol Sci. 2016;27(4):549–62.
Blanco C, Okuda M, Wright C, Hasin DS, Grant BF, Liu S-M, et al. Mental health of college students and their non-college-attending peers: results from the National Epidemiologic Study on Alcohol and Related Conditions. Arch Gen Psychiatry. 2008;65(12):1429–37.
Pinder-Amaker S, Bell C. A bioecological systems approach for navigating the college mental health crisis. Harv Rev Psychiatry. 2012;20(4):174–88.
Kadison R, DiGeronimo TF. College of the overwhelmed: the campus mental health crisis and what to do about it. San Francisco: Jossey-Bass; 2004.
Kruisselbrink Flatt A. A suffering generation: six factors contributing to the mental health crisis in North American higher education. Coll Q. 2013;16(1):n1.
Gallagher RP. National survey of counseling center directors 2014, The International Association of Counseling Services, Inc., Monograph Series 8N. Pittsburgh: University of Pittsburg. Retrieved; 2015.
Association ACH. American College Health Association-National College Health Assessment II: reference group executive summary spring 2017. Hanover: American College Health Association; 2017.
Braider L, La Lima C, Crimarco N, Hollander B, Reid-Russell A, Kane J, et al. Characterization of psychiatrically hospitalized college students. J Am Coll Health. 2018; https://doi.org/10.1080/07448481.2018.1500471.
Rosecan AS, Goldberg RL, Wise TN. Psychiatrically hospitalized college students: a pilot study. J Am Coll Health. 1992;41(1):11–5.
Schwartz AJ. College student suicide in the United States: 1990–1991 through 2003–2004. J Am Coll Health. 2006;54(6):341–52.
Kisch J, Leino EV, Silverman MM. Aspects of suicidal behavior, depression, and treatment in college students: results from the Spring 2000 National College Health Assessment Survey. Suicide Life Threat Behav. 2005;35(1):3–13.
Belch HA. Understanding the experiences of students with psychiatric disabilities: a foundation for creating conditions of support and success. New Dir Stud Serv. 2011;2011(134):73–94.
Eudaly J. A rising tide: students with psychiatric disabilities seek services in record numbers. Washington, DC: National Clearinghouse on Post-secondary Education for Individuals with Disabilities; 2002.
Eisenberg D, Hunt J, Speer N. Help seeking for mental health on college campuses: review of evidence and next steps for research and practice. Harv Rev Psychiatry. 2012;20(4):222–32.
Breslau J, Lane M, Sampson N, Kessler RC. Mental disorders and subsequent educational attainment in a US national sample. J Psychiatr Res. 2008;42(9):708–16.
Freudenberg N, Ruglis J. Reframing school dropout as a public health issue. Preventing chronic disease: public health research, practice, and policy. Prev Chronic Dis (Centers for Disease Control and Prevention, USA). 2007;4(4):A107.
Eisenberg D, Golberstein E, Hunt JB. Mental health and academic success in college. BE J Econ Anal Policy. 2009;9(1):Article 40.
Kitzrow MA. The mental health needs of today’s college students: challenges and recommendations. NASPA J. 2003;41(1):167–81.
Edlund MJ, Wang PS, Berglund PA, Katz SJ, Lin E, Kessler RC. Dropping out of mental health treatment: patterns and predictors among epidemiological survey respondents in the United States and Ontario. Am J Psychiatr. 2002;159(5):845–51.
Schuman-Olivier Z, Weiss RD, Hoeppner BB, Borodovsky J, Albanese MJ. Emerging adult age status predicts poor buprenorphine treatment retention. J Subst Abus Treat. 2014;47(3):202–12.
Pekarik G. Posttreatment adjustment of clients who drop out early vs. late in treatment. J Clin Psychol. 1992;48(3):379–87.
Regier DA, Hirschfeld RM, Goodwin FK, Burke JD, Lazar JB, Judd LL. The NIMH Depression Awareness, Recognition, and Treatment Program: structure, aims, and scientific basis. Am J Psychiatry. 1988;145(11):1351–7.
Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):593–602.
Eisenberg D, Downs MF, Golberstein E, Zivin K. Stigma and help seeking for mental health among college students. Med Care Res Rev. 2009;66(5):522–41.
Sabaté E. Adherence to long-term therapies: evidence for action. Geneva: World Health Organization; 2003.
Foster A, Sheehan L, Johns L. Promoting treatment adherence in patients with bipolar disorder. Curr Psychiatr Ther. 2011;10(7):45.
Jin J, Sklar GE, Oh VMS, Li SC. Factors affecting therapeutic compliance: a review from the patient’s perspective. Ther Clin Risk Manag. 2008;4(1):269.
Wong M, Chen E, Lui S, Tso S. Medication adherence and subjective weight perception in patients with first-episode psychotic disorder. Clin Schizophr Relat Psychoses. 2011;5(3):135–41.
Velligan D, Sajatovic M, Valenstein M, Riley W, Safren S, Lewis-Fernandez R, et al. Methodological challenges in psychiatric treatment adherence research. Clin Schizophr Relat Psychoses. 2010;4(1):74–91.
Kane JM, Perlis RH, DiCarlo LA, Au-Yeung K, Duong J, Petrides G. First experience with a wireless system incorporating physiologic assessments and direct confirmation of digital tablet ingestions in ambulatory patients with schizophrenia or bipolar disorder. J Clin Psychiatry. 2013;74(6):e533–40.
Julius RJ, Novitsky MA Jr, Dubin WR. Medication adherence: a review of the literature and implications for clinical practice. J Psychiatr Pract. 2009;15(1):34–44.
Chung H, Klein MC, Silverman D, Corson-Rikert J, Davidson E, Ellis P, et al. A pilot for improving depression care on college campuses: results of the College Breakthrough Series–Depression (CBS-D) Project. J Am Coll Health. 2011;59(7):628–39.
Klein MC, Ciotoli C, Chung H. Primary care screening of depression and treatment engagement in a university health center: a retrospective analysis. J Am Coll Health. 2011;59(4):289–95.
Cammin-Nowak S, Helbig-Lang S, Lang T, Gloster AT, Fehm L, Gerlach AL, et al. Specificity of homework compliance effects on treatment outcome in CBT: evidence from a controlled trial on panic disorder and agoraphobia. J Clin Psychol. 2013;69(6):616–29.
Kazantzis N, Deane FP, Ronan KR. Homework assignments in cognitive and behavioral therapy: a meta-analysis. Clin Psychol Sci Pract. 2000;7(2):189–202.
Mausbach BT, Moore R, Roesch S, Cardenas V, Patterson TL. The relationship between homework compliance and therapy outcomes: an updated meta-analysis. Cogn Ther Res. 2010;34(5):429–38.
Rees CS, McEvoy P, Nathan PR. Relationship between homework completion and outcome in cognitive behaviour therapy. Cogn Behav Ther. 2005;34(4):242–7.
Schmidt NB, Woolaway-Bickel K. The effects of treatment compliance on outcome in cognitive-behavioral therapy for panic disorder: quality versus quantity. J Consult Clin Psychol. 2000;68(1):13.
Copeland WE, Shanahan L, Davis M, Burns BJ, Angold A, Costello EJ. Increase in untreated cases of psychiatric disorders during the transition to adulthood. Psychiatr Serv. 2015;66(4):397–403.
Olfson M, Marcus SC, Druss B, Pincus HA. National trends in the use of outpatient psychotherapy. Am J Psychiatr. 2002;159(11):1914–20.
Reetz D, Bershad C, LeViness P, Whitlock M. The Association for University and College Counseling Center Directors Annual Survey. AUCCCD; 2016.
Health CfCM. Center for collegiate mental health: 2017 annual report. Center for Collegiate Mental Health University Park; 2018. Report No.: STA 18-166.
McCabe SE, Teter CJ, Boyd CJ. Medical use, illicit use, and diversion of abusable prescription drugs. J Am Coll Heal. 2006;54(5):269–78.
Czyz EK, Horwitz AG, Eisenberg D, Kramer A, King CA. Self-reported barriers to professional help seeking among college students at elevated risk for suicide. J Am Coll Health. 2013;61(7):398–406.
Pekarik G, Wierzbicki M. The relationship between clients’ expected and actual treatment duration. Psychother Theory Res Pract Train. 1986;23(4):532.
Schwartz VI. College mental health: how to provide care for students in need: successful practice relies on understanding the unique vicissitudes of student life. Curr Psychiatr Ther. 2011;10(12):22.
Pai ALH, Ostendorf HM. Treatment adherence in adolescents and young adults affected by chronic illness during the health care transition from pediatric to adult health care: a literature review. Child Health Care. 2011;40(1):16–33.
Davis M, Sondheimer DL. State child mental health efforts to support youth in transition to adulthood. J Behav Health Serv Res. 2005;32(1):27–42.
Singh SP. Transition of care from child to adult mental health services: the great divide. Curr Opin Psychiatry. 2009;22(4):386–90.
Skehan B, Davis M. Aligning mental health treatments with the developmental stage and needs of late adolescents and young adults. Child Adolesc Psychiatr Clin N Am. 2017;26(2):177–90.
La Greca AM, Auslander WF, Greco P, Spetter D, Fisher EB Jr, Santiago JV. I get by with a little help from my family and friends: adolescents’ support for diabetes care. J Pediatr Psychol. 1995;20(4):449–76.
Mistler LA, Sheidow AJ, Davis M. Transdiagnostic motivational enhancement therapy to reduce treatment attrition: use in emerging adults. Cogn Behav Pract. 2016;23(3):368–84.
Buckner JD, Schmidt NB. A randomized pilot study of motivation enhancement therapy to increase utilization of cognitive-behavioral therapy for social anxiety. Behav Res Ther. 2009;47(8):710–5.
Grote NK, Swartz HA, Geibel SL, Zuckoff A, Houck PR, Frank E. A randomized controlled trial of culturally relevant, brief interpersonal psychotherapy for perinatal depression. Psychiatr Serv. 2009;60(3):313–21.
Givens JL, Tjia J. Depressed medical students’ use of mental health services and barriers to use. Acad Med. 2002;77(9):918–21.
LeViness P, Bershad C, Gorman K. The association for university and college counseling center directors annual survey. 2017. Retrieved from https://www.aucccd.org/assets/documents/Governance/2017%20aucccd%20surveypublic-apr26pdf.
Neary M, Schueller SM. State of the field of mental health apps. Cogn Behav Prac. 2018;25:531–7.
Gulliver A, Griffiths KM, Christensen H. Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiatry. 2010;10(1):113.
Lattie EG, Schueller SM, Sargent E, Stiles-Shields C, Tomasino KN, Corden ME, et al. Uptake and usage of IntelliCare: a publicly available suite of mental health and well-being apps. Internet Interv. 2016;4(2):152–8.
Davies EB, Morriss R, Glazebrook C. Computer-delivered and web-based interventions to improve depression, anxiety, and psychological well-being of university students: a systematic review and meta-analysis. J Med Internet Res. 2014;16(5):e130.
Botella C, Gallego MJ, Garcia-Palacios A, Guillen V, Baños RM, Quero S, et al. An Internet-based self-help treatment for fear of public speaking: a controlled trial. Cyberpsychol Behav Soc Netw. 2010;13(4):407–21.
Sethi S, Campbell AJ, Ellis LA. The use of computerized self-help packages to treat adolescent depression and anxiety. J Technol Hum Serv. 2010;28(3):144–60.
Christensen H, Griffiths K, Groves C, Korten A. Free range users and one hit wonders: community users of an Internet-based cognitive behaviour therapy program. Aust N Z J Psychiatry. 2006;40(1):59–62.
Khasanshina EV, Wolfe WL, Emerson EN, Stachura ME. Counseling center-based tele-mental health for students at a rural university. Telemed J E Health. 2008;14(1):35–41.
Williams A, Larocca R, Chang T, Trinh NH, Fava M, Kvedar J, et al. Web-based depression screening and psychiatric consultation for college students: a feasibility and acceptability study. Int J Telemed Appl. 2014;2014:580786.
Krueger KP, Berger BA, Felkey B. Medication adherence and persistence: a comprehensive review. Adv Ther. 2005;22(4):313–56.
Interian A, Martinez I, Rios LI, Krejci J, Guarnaccia PJ. Adaptation of a motivational interviewing intervention to improve antidepressant adherence among Latinos. Cult Divers Ethn Minor Psychol. 2010;16(2):215–25.
Dobber J, Latour C, de Haan L, Scholte Op Reimer W, Peters R, Barkhof E, et al. Medication adherence in patients with schizophrenia: a qualitative study of the patient process in motivational interviewing. BMC Psychiatry. 2018;18(1):135.
Hooper LM, Huffman LE. Associations among depressive symptoms, well-being, patient involvement, provider cultural competency, and treatment nonadherence: an exploratory study among university student-patients. Couns Psychol Q. 2014;27(3):241–63.
Borsari B, Carey KB. Effects of a brief motivational intervention with college student drinkers. J Consult Clin Psychol. 2000;68(4):728.
Baer JS, Marlatt GA, Kivlahan DR, Fromme K, Larimer ME, Williams E. An experimental test of three methods of alcohol risk reduction with young adults. J Consult Clin Psychol. 1992;60(6):974.
Marlatt GA, Baer JS, Kivlahan DR, Dimeff LA, Larimer ME, Quigley LA, et al. Screening and brief intervention for high-risk college student drinkers: results from a 2-year follow-up assessment. J Consult Clin Psychol. 1998;66(4):604.
McCambridge J, Strang J. The efficacy of single-session motivational interviewing in reducing drug consumption and perceptions of drug-related risk and harm among young people: results from a multi-site cluster randomized trial. Addiction. 2004;99(1):39–52.
Interian A, Lewis-Fernandez R, Gara MA, Escobar JI. A randomized-controlled trial of an intervention to improve antidepressant adherence among Latinos with depression. Depress Anxiety. 2013;30(7):688–96.
McKenzie K, Chang YP. The effect of nurse-led motivational interviewing on medication adherence in patients with bipolar disorder. Perspect Psychiatr Care. 2015;51(1):36–44.
Drymalski WM, Campbell TC. A review of Motivational Interviewing to enhance adherence to antipsychotic medication in patients with schizophrenia: evidence and recommendations. J Ment Health. 2009;18(1):6–15.
Barkhof E, Meijer CJ, de Sonneville LM, Linszen DH, de Haan L. The effect of motivational interviewing on medication adherence and hospitalization rates in nonadherent patients with multi-episode schizophrenia. Schizophr Bull. 2013;39(6):1242–51.
Eisenberg D, Chung H. Adequacy of depression treatment among college students in the United States. Gen Hosp Psychiatry. 2012;34(3):213–20.
Kearney LK, Draper M, Barón A. Counseling utilization by ethnic minority college students. Cult Divers Ethn Minor Psychol. 2005;11(3):272.
Lotstein DS, Inkelas M, Hays RD, Halfon N, Brook R. Access to care for youth with special health care needs in the transition to adulthood. J Adolesc Health. 2008;43(1):23–9.
Duru OK, Vargas RB, Kermah D, Pan D, Norris KC. Health insurance status and hypertension monitoring and control in the United States. Am J Hypertens. 2007;20(4):348–53.
Brozyna A. Justice in the health care provider and patient relationship: appraisals of multicultural competence, procedural justice, and distributive justice. Gainesville: University of Florida; 2006.
Pinder-Amaker S, Auerbach R, Rauch S. Matching institutional needs with epidemiological demands: addressing the mental health crisis across college campuses. Harv Health Policy Rev. 2012;13(Spring Issue):21–6.
Ahrnsbrak R, Bose J, Hedden S, Lipari R, Park-Lee E. Key substance use and mental health indicators in the United States: results from the 2016 National Survey on Drug Use and Health. Rockville: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration; 2017.
Peters EN, Leeman RF, Fucito LM, Toll BA, Corbin WR, O’Malley SS. Co-occurring marijuana use is associated with medication nonadherence and nonplanning impulsivity in young adult heavy drinkers. Addict Behav. 2012;37(4):420–6.
Swanson AJ, Pantalon MV, Cohen KR. Motivational interviewing and treatment adherence among psychiatric and dually diagnosed patients. J Nerv Ment Dis. 1999;187(10):630–5.
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Bardin, A., Cheney, B., Braider, L. (2019). Increasing Psychiatric Treatment Engagement and Adherence in the College Population. In: Fornari, V., Dancyger, I. (eds) Psychiatric Nonadherence. Springer, Cham. https://doi.org/10.1007/978-3-030-12665-0_5
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