Building a Repository of Public Health Evidence around Best Practices for Mental Health in College Populations

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?Summary ?

We are beginning the development of a comprehensive, sustainable, publicly accessible repository of evidence about the effectiveness of preventive interventions (programs, services, policies) that address college student mental wellbeing. This work is in partnership with the Mary Christie Institute (MCI), and we look forward to partnering with other leading organizations. The proposed repository and network will represent a novel and highly significant contribution to the current landscape of student mental health. Currently there are no comprehensive databases or repositories of evidence regarding what works for student mental health interventions in higher education. Furthermore, the proposed repository will be different from most existing repositories for other topics and populations in that it will be paired with an active learning network. As a public, national resource emphasizing a population-level, public health approach, this initiative has potential to benefit millions of students at thousands of institutions each year. For questions or comments on the proposed repository, please contact Healthy Minds Principal Investigators Daniel Eisenberg ([email protected]) and Sarah Lipson ([email protected]). ?

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I. Need for this Resource?

?Young people in the U.S. are experiencing mental health problems in ever-rising numbers and severity. Rates of depression and anxiety have approximately doubled among college students since 2010, and campuses are struggling to offer mental health services to meet these needs. These issues intersect with persistent inequities: students of color, students from lower income families, and students at schools with fewer resources have lower access to services and face disproportionate stressors such as discrimination, food and housing insecurity, and exposure to trauma. The COVID-19 pandemic exacerbated these challenges in many ways. There is little reason to believe that rates of distress will decline without transforming how we support college mental health. Higher education leaders, including college and university presidents, are well aware of the need to prioritize student mental health, but there is less clarity around effective solutions, particularly from a public health perspective. The proposed repository of evidence, in combination with an accompanying network of experts and partners supporting its use, will help leaders of higher education make sense of the vast and growing array of programs and strategies and enable them to invest in those that are most likely to support student mental health effectively. Although campus leaders and administrators will likely be the primary users of the repository, we also anticipate that other audiences such as families, students, and researchers will be regular users. For example, families and students could potentially use the repository and the surrounding network to learn about what types of programs and services are available at colleges and universities. In addition, researchers and funders could see where the evidence is most lacking for certain types of programs, and redirect their efforts accordingly. Population-level, preventive interventions can potentially reach large numbers of students at low cost. Such interventions include, for example, coping skills courses and training, digital programs, peer groups and programs, and strategies to foster social connections and sense of belonging in student communities. These, and other public health interventions, are spreading rapidly throughout higher education, but there is a lack of clarity about the evidence on which ones actually achieve intended outcomes. With the worsening of student mental health and the demand for effective responses, the sector is awash in new products, tools, and services. The quality, effectiveness, and evidence base for these interventions vary widely. The national repository will introduce quality control and standards into the sector, incentivize the use of evidence in the development of new tools, and will act as a form of consumer report for the field. ?

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II. Key Features of the Resource ?

There is an opportunity to improve mental health among students on a large scale, by increasing access to and use of knowledge about the effectiveness of specific preventive strategies. Because information and knowledge can be shared at little or no cost, building a repository of evidence for prevention-oriented best practices represents one of the most cost-effective investments in student mental health. We propose to build this repository and surround it with an active learning network of experts (e.g., counseling center directors) and partners that can work together as well as with practitioners, administrators, parents, students and the public. In this way, the initiative will generate a feedback loop between practice and research, whereby researchers and program developers will be able to see more clearly the gaps in evidence that would be most valuable to address. The proposed resource consists of two key interlocking components. 1. Searchable Database. The first component is a repository, or database, that summarizes and critically assesses all available evidence, and the strength of that evidence, regarding the effectiveness of interventions that address student mental health. This repository will be freely available online. The focus will be on population-level, public health strategies to address student mental health. Building this repository will require compiling and synthesizing information from academic articles, white papers, unpublished reports, and other sources reporting outcomes for the relevant programs and services. 2. Active Learning Network of Experts and Peers. The second and equally important component of the “product” is an active network of experts and partners supporting the effective use of the repository. Whereas most repositories of evidence and best practices tend to sit passively on a website, our vision includes a highly engaged network of people and organizations who will bring the information and guidance to life for all users. A user of the repository, such as a campus leader or administrator, will be able to talk with experts and peer leaders/administrators about the evidence for various programs and experiences with implementing these programs. These conversations and interactions will enhance the feedback loop whereby the information in the repository becomes even more useful and engaging over time, as we learn more about successes and challenges in identifying and implementing interventions in campus settings. The active feedback loop and access to experts within the learning community are key differentiators. Other parallel resources, such as the CollegeAIM guide for drugs and alcohol prevention, offer a database of evidence but not an active collaborative learning network. ?

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User Example ?

A hypothetical user can help illustrate the repository and surrounding network. Suppose a campus mental health task force is interested in peer-based programs; they want to offer more support for students with mild to moderate symptoms who otherwise would need to wait several weeks during peak periods for therapy at the campus counseling center. Members of the task force could view the repository website and filter the results to hone in on peer programs with strong evidence of effectiveness. They could further filter their search of where and how the programs have been evaluated, including by institutional type (e.g., four-year or community colleges) and population groups (e.g., effectiveness for Black or Latinx students). They will be able to view not only the evidence for these programs, but also find contact information for peer institutions, organizations, and experts who are available to correspond about their experiences and perspectives on these programs. As the campus mental health task force uses the repository and network to select and implement a program, they will become part of the growing network, and their input will be invited to help improve the content and useability of the repository moving forward.?