Addressing collegiate mental health amid COVID-19 pandemic.

College students encounter unique challenges leading to poor mental health in the wake of the COVID-19 outbreak. Before the pandemic started, one in five college students experienced one or more diagnosable mental disorders worldwide. The fact that the COVID-19 pandemic affects collegiate mental health underscores the urgent need to understand these challenges and concerns in order to inform the development of courses of action and public health messaging that can better support college students in this crisis. This article provides recommendations that prepare higher education institutions and health professionals for addressing collegiate mental health needs and challenges posed by COVID-19.

Dear Editor,

College students are facing a variety of challenges in the wake of the COVID-19 outbreak. The pandemic has been escalating and threatening the welfare of human beings globally, and this public health emergency generates fear and leads to a spectrum of psychological consequences (Liu et al., 2020), ranging from distress responses such as anxiety, depression, and substance abuse, to behavioral changes such as difficulty sleeping and stress eating. Before the pandemic started, one in five college students have experienced one or more diagnosable mental disorders worldwide (Auerbach et al., 2016), and the psychological effects of COVID-19 can increase this number and exacerbate collegiate mental health issues.

The impact of COVID-19 on collegiate mental health

Many universities decided to suspend in-person classes and evacuate students in responding to the intensifying concerns surrounding COVID-19. This action can lead to negative psychological consequences among college students. For example, college students often experience compounded negative emotions during the school “closure” (Van Bortel et al., 2016). Some students who find the campus homelike and welcoming harbor intense feelings such as frustration, anxiety, and betrayal. Some may struggle with loneliness and isolation while sheltering in place because of disconnections from friends and partners. For those who receive counseling services on campus, they can no longer access counseling services, which exacerbates their psychological symptoms and increase some students’ risk for suicide and substance abuse.

College students experience distress contributed by the uncertainty and abrupt disruption of the semester in addition to the anxiety caused by school closure. As more universities transitioning to remote learning after the spring break, some students suffer from poor mental health due to the disruption of academic routine (Agnew et al., 2019). Many students have to cease their research projects and internships when universities evacuated them from campus. Moreover, disruptions of their research projects and internships jeopardize their program of study, delay their graduation, and undermine their competitiveness on the job market, which in turn fuels anxiety among college students. They may also struggle with the cost of returning home and managing belongings.

Many college students have lost their on-campus jobs due to the evacuation, and the pending issue of room and board fees can aggravate their financial hardship and mental health outcomes. They also have concerns and fears of infection and transmission of COVID-19 to their family members when they return home. Given that youth can be asymptomatic carriers (Pan et al., 2020), students may be worried about putting their elder family members at increased risk for infection with severe complications from COVID-19. The fact that the COVID-19 pandemic affects collegiate mental health only underscores the urgent need to understand these challenges and concerns in order to inform the development of courses of action and public health messaging that will support college students during this difficult time.

Courses of action

Universities serve an essential role in supporting college students and accommodating their health, education, and safety needs. During the pandemic, the courses of action implemented by universities significantly affect students’ mental health and wellbeing. It is commendable that many universities have responded promptly to the unprecedented situation. They flipped the switch and focused on remote education instead of in-person classes. Although this transition can lead to acute stress among some students due to the lack of time for adjustment, remote learning allows college students to sustain their academic routine which is found to benefit mental health and psychological resilience in the long run (Drake and Whitley, 2014). In addition, college students may experience less anxiety because remote learning helps them continue to manage their academic routine on a regular basis (Wang et al., 2020).

Many universities decided to evacuate students in responding to the pandemic. Given the population density in university residence halls, some universities have delayed plans to allow students to visit campuses and retrieve their belongings, which helps ease students’ anxiety associated with the fears and concerns of contracting COVID-19. This decision can also relieve students’ financial hardship by reducing the cost of travel. Further, some universities are considering refunding money from room and board (i.e., residence hall contracts, dining hall meal plans) on a prorated basis, which may support students financially and mitigate distress.

Recommendations

Notwithstanding that some universities have responded to the public health emergency, universities should continue to develop courses of action and public health messaging to better address collegiate mental health issues caused by the disruptions of education and career trajectory. First, in addition to remote education, student advising should continue and transition to telecommunication (e.g., phone call, online meeting) in order to provide academic support for students. Faculty and staff should consider offering virtual office hours to students, and they need to work together to maintain the connection and help students process and address academic concerns caused by the disruption of the semester. Second, for students whose internships or research projects were affected by the pandemic, internship site supervisors and research advisors should actively engage in helping students seek alternative plans, enabling them to work from home to maximize internship and research experiences. Third, universities should work on innovative methods to support students to move research projects and capstones forward so that students can fulfil graduation requirements; meanwhile, university career centers should switch to virtue services, continuing to facilitate career development for college students.

Of importance is that university counseling centers should set up options to continue to provide college students with counseling services at a distance (i.e., telemental health counseling) within the constraints of the pandemic outbreak. Telemental health has been found effective in treating anxiety and depressive symptoms (Brenes et al., 2015), and implementing telemental health will facilitate the delivery of counseling services to address students’ pressing mental health concerns (Dorsey and Topol, 2020). University counseling centers can also provide options for students to join online support groups that enable them to share common concerns and receive social support (Rollman et al., 2018). Further, university counseling centers and other departments should rally to develop and pass public health messaging onto students, sharing coping resources, and encouraging them to take action to protect their mental health.

Conclusion

COVID-19 and its accompanying effects will continue impacting collegiate mental health and wellbeing profoundly; meanwhile, mental health serves a crucial role in combating the epidemic. It is thus imperative for universities to build awareness of students’ mental health needs and concerns, and to empower their students to seek help and support during this biological disaster. College students should tailor coping strategies to meet their specific needs and promote their psychological resilience. Considerable efforts made by universities should be dedicated to helping students thrive in this crisis. With the experience attained supporting students in this pandemic, universities will be well positioned to help college students stay well in mind, body, and spirit during other challenging times.

Role of the funding source

There is no funding source.

The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.

CRediT authorship contribution statement

Yusen Zhai: Conceptualization, Writing - original draft, Writing - review & editing. Xue Du: Writing - review & editing.

Declaration of Competing Interest

We declare no competing interests.