مشاوره دانشجویی دانشگاه و بهداشت روانی در ایالات متحده: روندها و چالش

This article reviews the status of the delivery of counseling and mental health services at colleges and universities in the United States. It provides an overview of historical and current trends of student mental health concerns and of the ways in which campus counseling services have responded to these challenges. Data from several sources are referenced to demonstrate both the increasing numbers of students seeking counseling services and the increasing severity of their concerns. Examples are provided for how these trends have influenced the delivery of counseling services and how they are changing college and university communities.

The mental health needs of university students have become a national focus of attention in the United States during the past decade. A series of highly publicized, tragic incidents at a number of educational institutions, including campus shootings and murders at Virginia Tech University and, more recently, the University of California, Santa Barbara, for example, have brought national attention to the unmet mental health needs of students. Widespread concern has focused on the safety of university campuses throughout the United States and on the role of university counseling and mental health services in addressing students at risk. This article provides an overview of historical and current trends in university-based student counseling and mental health services in the United States. It presents the current status of students׳ mental health as evidenced through reviews of utilization data from university counseling centers and through national surveys of students and university counseling service directors. It also provides specific examples from the University of California, Berkeley׳s Counseling and Psychological Services to illustrate a number of themes that are common nationwide. Two specific trends are highlighted in particular: increasing numbers of students are seeking out counseling services and the level of severity of their mental health concerns is increasing as well. The impact of these trends has transformed the ways in which counseling services are designed and delivered in the United States. Furthermore, these trends have begun to change the landscape of American higher education itself.

Although counseling services in colleges and universities across the United States vary as widely as the types of institutions to which they belong, they share a common history that has lead to common structures for delivering care. Almost all share the pressure to reevaluate and redesign their services to effectively meet dramatically shifting needs of students. Students are seeking out counseling services in numbers that are unprecedented in the history of student counseling. The acuity and complexity of their presenting concerns have been rising for years, outstripping counseling centers׳ staffing levels and resources. Furthermore, the changing demographics of college and university students continue to challenge traditional models of care and the limits of staff expertise. Larger numbers of students are coming to campus with previously diagnosed mental health conditions; increasing numbers of international students are enrolling; and significant numbers of students are seeking medication management and follow up care. In addition, the roles of counseling center professionals have expanded considerably. Today, they routinely include not only individual counseling and assessment but also prevention, training, collaboration with medical providers, consultation with student affairs professionals and threat assessment and management. Counseling centers have become a key resource, not only for helping students with problems that interfere with learning, but also for keeping the campus safe. Counseling center directors have become, in fact, the chief mental health officers for the campus community. The work of counseling centers in the United States has been transformed over the past decade and the models of care will continue to evolve quickly given the fast pace with which changes are occurring in the student populations and in the systems for delivery of care. These challenges are not unique to the United States, however. Similar trends and challenges are occurring in colleges and universities globally. This article attempted to draw attention to a few examples of how some counseling services in the United States have begun to respond to these demands. It is only a beginning, however, of a much larger and in-depth discussion that is needed on an international level if we are to thoughtfuly and adequately address the pressing counseling and mental health needs that interfere with our students׳ ability to learn and thrive academically.