Treatment Utilization on College Campuses: Who Seeks Help for What?.

The purpose of this study was to develop a better understanding of why college students seek psychological treatment by examining indicators of psychological distress. A secondary goal was to assess the utility of screening for treatment need via a brief self-report measure of distress. Two samples (I clinical, I nonclinical; N = 8,380) were examined via logistic regression analyses to identify meaningful predictors of treatment-seeking behavior. Clinical applications are discussed. Keywords: college counseling, treatment utilization, mental health screening ********** Mental health problems frequently do not lead individuals to seek the kinds of treatment offered by mental health care professionals. A summary of two national surveys indicated that, although a substantial portion of adults endorse diagnosable mental health problems in any given year, more than 70% do not receive services of any kind, and only 13% reported seeking help from a mental health professional (Howard et al., 1996). A recent survey of college students found similar patterns of utilization (Eisenberg, Hunt, Speer, & Zivin, 2011), wherein 32% of college students endorsed symptoms consistent with a mental health diagnosis, and, of those, 64% did not receive mental health services. These results are consistent with previous work (Blanco et al., 2008), which found that 66% of college students with mood disorders did not receive mental health services for their problems. Addressing the gap between need for treatment and utilization of treatment can have important implications for the welfare of students and the colleges and universities that they attend. Above and beyond the need to address human distress and suffering, there is evidence that collegiate mental health concerns are related to academic retention (Kessler, Foster, Saunders, & Stang, 1995) and substance abuse (Weitzman, 2004). In addition, suicide is the third leading cause of death among college-age Americans (Centers for Disease Control and Prevention, 2013). Furthermore, students who seek help for their mental health problems seem to be well served by college and university counseling centers. College counseling has been shown to reduce symptoms of psychological distress with approximately the same magnitude as treatments practiced in randomized controlled trials (Minami et al., 2009) and to increase retention (Lee, Olson, Locke, Michelson, & Odes, 2009). Given the demonstrated effectiveness of college counseling in alleviating mental health problems, one of the purposes of the current study was to expand knowledge about students with mental health needs who do not seek treatment in order to facilitate targeted outreach and education and increase mental health utilization rates. To this end, the current study explored differences between students just beginning counseling and those not in counseling. This dovetails with recent calls to develop a better understanding of college students' mental health needs more broadly in order to facilitate interventions targeted to the needs of students (Erdur-Baker, Aberson, Barrow, & Draper, 2006). In addition to better understanding the characteristics of students who do and do not seek counseling, it is also important to consider practical means for identifying individuals who may benefit from counseling but who have not yet sought it (Blanco et al., 2008; Eisenberg, Hunt, et al., 2011; Zivin, Eisenberg, Gollust, & Golberstein, 2009). As a secondary purpose, the current study examined one strategy some colleges are adopting for identifying students in need of treatment--that of screening for mental health problems via self-report. A recent survey of counseling center directors found that 62% of colleges and universities currently use online mental health screening measures to help identify students in need of treatment (Barr, Krylowicz, Reetz, Mistier, & Rando, 2011). These measures assess students for a variety of problems, including substance use (Anderson & Gadaleto, 2006), suicidality (Garlow et al. …