The Community College Imperative: Designing Solutions to Promote the Mental Health of Students

By Annelle B. Primm, M.D., MPH  Jan. 102019

Community college, an important gateway to social mobility, is becoming more accessible especially in several states which are establishing plans to permit students to attend tuition-free. Removing barriers and increasing opportunities for people to receive a community college education is a laudable goal that will help meet the demand for skilled workers in our economy. 

One important, yet often overlooked factor in successful community college experience is student mental health and well-being. While many community college students face mental health challenges, they often don’t seek help or help is not available. There is a significant need for support and services that could help students thrive academically, socially, and emotionally.

Public two-year community college students constitute nearly half of the 16 million students enrolled in college in the U.S. Nearly 50% of community college attendees are students of color and 36% are the first in their families to attend college, according to the American Association of Community Colleges.

The 2016 report, Too Distressed to Learn, found that community college students are more likely than students in 4-year colleges to experience risk factors associated with mental health concerns such as food and housing insecurity. In fact, 50% of community college students have a current or recent mental health condition, such as anxiety or depression, which can have a negative impact on academic performance and graduation. Community college students of color experience additional challenges to their mental health associated with racial discrimination, xenophobia, and hate crimes which have become more common in a polarized national environment.

Community colleges are facing a challenge in the disconnect between the high need for mental health services among students and the limited services on most campuses. Counselor to student ratios at community colleges (1:3000) are nearly half that of 4-year colleges (1:1600).  As a result, 10% or less of community college students use on-campus mental health services compared to 50% of 4-year college students. Unmet mental health needs can have an adverse impact on overall health, relationships, economic status, and human potential.

The well-being of community college students took center stage at a recent Kaiser Permanente Community Health-sponsored convening in Oakland, California called, Mental Health and Well-Being by Design:  Leveraging and Scaling High Impact Solutions to Support Community College Students of Color and All At-Risk Students. This design initiative, led by the Steve Fund, a non-profit focused on the mental health and social and emotional development of young people of color, brought together community college administrators and students, mental health experts, and mental health technologists. Participants tackled the challenge of meeting the mental health needs of community college students and designed potential solutions.

Attendees heard from a racially and ethnically diverse panel of community college students who shared their experiences of overcoming challenges to their mental health. The takeaway message from the students was loud and clear:  solutions to the unmet mental health needs of community college students must include the use of peer support. Connecting with peers helps to remove the barrier of stigma usually associated with mental health help-seeking and provides a leadership role for people who have navigated the system and had their needs met. Peer connections may be especially important for men who are less likely than women to seek health and mental health services.

Indeed, emerging from the design process were several pilot projects which hinge upon face-to-face interactions with peer ambassadors and technology-enabled peer support. Other pilots included online screening to raise mental health awareness and online therapy to increase availability of and access to mental health services for community college students.

The anticipated implementation of these pilot projects provides hope that solutions responding to the mental health needs of community college students are within reach. Successful implementation of these pilots will require collaborative efforts including:  1) students who have the lived experience and know the realities of being in community college and balancing life challenges; 2) community college administrators who understand the boundaries, limits, capacities, and ecology of the community college landscape;  3) mental health professionals who understand the spectrum of mental health concerns among community college students and the extensive cultural diversity represented in that setting; 4) technology experts who can adapt innovative approaches to meet the mental health needs of community college students; 5) supporting organizations–the Steve Fund and Kaiser Permanente. Kaiser has been a leader in supporting innovative, upstream strategies to promote health and well-being in communities.

With community colleges being such an important stepping stone to work opportunities and economic independence, investments in solutions that attend to and maximize the mental health of community college students is a national priority which will ultimately yield a positive economic and social return.

Annelle B. Primm, M.D., MPH is currently senior medical adviser to the Steve Fund, and senior psychiatrist adviser to Hope Health Systems and several other organizations. During her career, Dr. Primm has been Deputy Medical Director of the American Psychiatric Association; Director of the Johns Hopkins Hospital Community Psychiatry Program; an editor of the books, Disparities in Psychiatric Careand Women in Psychiatry: Personal Perspectives; and a lecturer and video producer on the mental health of diverse and underserved populations.