Fall 2020 Data Report - Healthy Minds Network

Fall 2020 Data Report

ABOUT THE HEALTHY MINDS STUDY (HMS)

STUDY TEAM

Principal Investigators: Daniel Eisenberg, PhD & Sarah Ketchen Lipson, EdM, PhD & Justin Heinze, PhD

Co-investigator: Sasha Zhou, PhD, MPH, MHSA

Project Managers: Amber Talaski, MPH & Akilah Patterson, MPH

REPORT TEAM

Graphic Designer: Sarah Fogel, University of Michigan School of Art and Design, Class of 2014

Report Automation: Paul Schulz & Lingxi Li

TABLE OF CONTENTS

STUDY PURPOSE 1

STUDY DESIGN 1

ABOUT THIS REPORT 2

KEY FINDINGS 3

SAMPLE CHARACTERISTICS 4

PREVALENCE OF MENTAL HEALTH PROBLEMS 5

HEALTH BEHAVIORS AND LIFESTYLE 7

ATTITUDES AND BELIEFS ABOUT MENTAL HEALTH SERVICES 8

USE OF SERVICES 9

REFERENCES 11

APPENDIX: DESCRIPTIVE STATISTICS FOR SURVEY ITEMS 12

STUDY PURPOSE

The Healthy Minds Study provides a detailed picture of mental health and related issues in college student populations.Schools typically use their data for some combination of the following purposes: to identify needs and priorities;benchmark against peer institutions; evaluate programs and policies; plan for services and programs; and advocate forresources.

STUDY DESIGN

The Healthy Minds Study is designed to protect the privacy and confidentiality of participants. HMS is approved by theHealth Sciences and Behavioral Sciences Institutional Review Board at University of Michigan. To further protectrespondent privacy, the study is covered by a Certificate of Confidentiality from the National Institutes of Health.

SAMPLINGEach participating school provides the HMS team with a randomly selected sample of currently enrolled students over theage of 18. Large schools typically provide a random sample of 4,000 students, while smaller schools typically provide asample of all students. Schools with graduate students typically include both undergraduates and graduate students in thesample.

DATA COLLECTIONHMS is a web-based survey. Students are invited and reminded to participate in the survey via emails, which are timed toavoid, if at all possible, the first two weeks of the term, the last week of the term, and any major holidays. The datacollection protocol begins with an email invitation, and non-responders are contacted up to three times by email remindersspaced by 2-4 days each. Reminders are only sent to those who have not yet completed the survey. Each communicationcontains a URL that students use to gain access to the survey.

NON-RESPONSE ANALYSISA potential concern in any survey study is that those who respond to the survey will not be fully representative of thepopulation from which they are drawn. In the HMS, we can be confident that those who are invited to fill out the surveyare representative of the full student population because these students are randomly selected from the full list ofcurrently enrolled students. However it is still possible that those who actually complete the survey are different inimportant ways from those who do not complete the survey. The overall participation rate for the fall 2020 study was 14%.It is important to raise the question of whether the 14% who participated are different in important ways from the 86%who did not participate. We address this issue by constructing non-response weights using administrative data on fullstudent populations. Most of the 36 schools in the fall 2020 HMS were able to provide administrative data about allrandomly selected students. The analysis of these administrative data, separated from any identifying information, wasapproved in the IRB application at Advarra and at each participating school. We used the following variables, whenavailable, to estimate which types of students were more or less likely to respond: sex, race/ethnicity, academic level, andgrade point average. We used these variables to estimate the response propensity of each type of student (based onmultivariate logistic regressions), and then assigned response propensity weights to each student who completed thesurvey. The less likely a type of student was to complete the survey, the larger the weight they received in the analysis,such that the weighted estimates are representative of the full student population in terms of the administrative variablesavailable for each institution. Finally, note that these sample weights give equal aggregate weight to each school in thenational estimates. An alternative would have been to assign weights in proportion to school size, but we decided that wedid not want our overall national estimates to be dominated by schools in our sample with very large enrollments.

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ABOUT THIS REPORT

This data report provides descriptive statistics (percentages, mean values, etc.) from the sample of respondents at yourinstitution for a set of key measures. In addition to the key measures highlighted in this report, an appendix is also includedwith descriptive statistics for each survey item (see below).

APPENDIXThe appendix includes values for most measures in the three standard survey modules that are administered on allparticipating campuses: Demographics, Mental Health Status, and Mental Health Services Utilization/Help-Seeking. Foreach measure, the data tables display the following information: the value table for your institution, the 95% confidenceinterval for your institution's value, the value for the national sample, and an indicator if your institution's value issignificantly higher or lower than the national value. All values in the appendix have been weighted to be representative ofthe full student populations to which they refer (see Non-response Analysis). Also note that for some measures,respondents were allowed to check more than one response category (e.g., they might have gone to more than one typeof provider for mental health services), so the percentages sometimes add up to more than 100% across responsecategories. The 95% confidence intervals give a sense of how much uncertainty there is about each estimated value. Thisuncertainty exists because our estimates are based only on a random sample of students, rather than a complete censusof the student population. However, some schools that had less than 4,000 students (the typical requested sample size),provided their entire population. For consistency sake, these schools were not treated any differently than those schoolsthat provided a 4,000 student sample of their full population. Essentially, the confidence interval tells us that there is a95% probability that the true population value is within this particular range. Because both the school-level and nationalvalues are only estimates based on random sampling, we cannot say for certain that your institution's true value is aboveor below the national value. But in cases where we can say that there is a 95% or higher statistical probability that yourinstitution's value is higher or lower than the national value, we indicate this.

EXPLORING YOUR DATA FURTHERThere are two options for exploring your data beyond what is in this report. First, you can use statistical software (e.g.,SPSS, Stata, etc.) to analyze the full data set for your students, which has been provided to your school. Second, you willbe able to log on to a user-friendly website with drop-down menus, at data.healthymindsnetwork.org.

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KEY FINDINGSThis section offers a quick look at results from key survey measures.

Perceived public stigma: agrees with "Most people would think less of someone who has receivedmental health treatment."

45%

Personal stigma: agrees with "I would think less of someone who has received mental healthtreatment."

6%

Any mental health therapy/counseling and/or psychiatric medication among students with positivedepression or anxiety screens (past year)

53%

Mental health therapy/counseling (past year) 29%

Psychiatric medication (past year) 24%

Lifetime diagnoses of mental disorders 41%

Suicidal ideation (past year) 13%

Non-suicidal self-injury (past year) 23%

Eating disorder (positive SCOFF screen) 11%

Anxiety disorder (positive GAD-7 screen) 34%

Depression overall, including major and moderate (positive PHQ-9 screen) 39%

Major depression (positive PHQ-9 screen) 21%

Estimated values of selected measures Percentage of students

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SAMPLE CHARACTERISTICS (N=32754)

18 19 20 21 22 23-25 26-30 31-35 36-40 41+

10%

20%16%

15%13%

12%

7%

13%11%

5%3%

5%

Age (years)

Transgender/gender non-conforming0%

Male42%

Female55%

Gender

WHI BLA LAT AMIN ARAB ASIAN PAC OTH

10%

20%

30%

40%

50%

60%

70%

80% 72%

10%13%

2% 1%

10%

1% 2%

Race/ethnicity

OTH Other

PAC Pacific Islander

ASIAN Asian/Asian American

ARAB Arab/Middle Eastern or Arab American

AMIN American Indian/Alaskan Native

LAT Hispanic/Latino

BLA African American/Black

WHI White or Caucasian

Other5%

Parent or guardian's home34%

Off-campus, non-university housing41%

Other university housing5%

Fraternity or sorority house2%

Campus residence hall14%

Living arrangement

ASS BA MA JD MD PHD ND OTH

10%

20%

30%

40%

50%

60%

28%

50%

9%

1% 1%6%

3%5%

Degree program

OTH Other

ND Non-degree student

PHD PhD or equivalent

MD MD

JD JD

MA Master's degree

BA Bachelor's degree

ASS Associate's degree

INP HYB ONL OTH

10%

20%

30%

40%

50%

60%

7%

41%

51%

2%

Class Format

OTH Other

ONL All Online

HYB Hybrid

INP All In-Person

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PREVALENCE OF MENTAL HEALTH PROBLEMS

DEPRESSION SCREENDepression is measured using the Patient Health Questionnaire-9 (PHQ-9), a nine-item instrument based on the symptomsprovided in the Diagnostic and Statistical Manual for Mental Disorders for a major depressive episode in the past twoweeks (Spitzer, Kroenke, & Williams, 1999). Following the standard algorithm for interpreting the PHQ-9, symptom levelsare categorized as severe (score of 15+), moderate (score of 10-14), or mild/minimal (score <10).

21% 19% 39%

Severe depression Moderate depression Any depression

ANXIETY SCREEN

Anxiety is measured using the GAD-7, a seven-item screening tool for screening and severity measuring of generalizedanxiety disorder in the past two weeks (Spitzer, Kroenke, Williams, & Lowe, 2006). Following the standard algorithm forinterpreting the GAD-7, symptom levels are categorized as severe anxiety, moderate anxiety, or neither.

16% 18% 34%

Severe anxiety Moderate anxiety Any anxiety

EATING DISORDER SCREENEating disorders are measured usingthe written U.S. version of the SCOFF,a five-item screening tool designed toidentify subjects likely to have an eatingdisorder (Morgan, Reid, & Lacey, 1999).

Eating disorders

11%

LONELINESSLoneliness is measured using the UCLA three-item Loneliness Scale (Hughes,Waite, Hawkley, & Cacioppo, 2004).

How often do you feel...

that you lackcompanionship

21%

41%

38%

left out

22%

44%

34%

isolated fromothers

Often26%

Some of the time40%

Hardly ever34%

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SUICIDALITY AND SELF-INJURIOUS BEHAVIOR

13% 6% 1% 23%

Suicidal ideation (past year) Suicide plan (past year) Suicide attempt (past year) Non-suicidal self-injury (past year)

LIFETIME DIAGNOSES OF MENTAL DISORDERS

Have you ever been diagnosed with any of the following conditions by a health professional (e.g. primary care doctor, psychiatrist,psychologist, etc.)? (Select all that apply)

59% No, none of these

2% Substance use disorder (e.g., alcohol abuse, abuse of other drugs)

1% Personality disorder (e.g., antisocial personality disorder, paranoid personality disorder, schizoid personality disorder)

0% Psychosis (e.g., schizophrenia, schizo-affective disorder)

3% Eating disorder (e.g., anorexia nervosa, bulimia nervosa)

7% Neurodevelopmental disorder or intellectual disability (e.g., attention deficit disorder, attention deficit hyperactivity disorder, intellectualdisability, autism spectrum disorder)

8% Trauma and Stressor Related Disorders (e.g., posttraumatic stress disorder)

3% Obsessive-compulsive or related disorders (e.g., obsessive-compulsive disorder, body dysmorphia)

31% Anxiety (e.g., generalized anxiety disorder, phobias)

3% Bipolar (e.g., bipolar I or II, cyclothymia)

28% Depression or other mood disorders (e.g., major depressive disorder, persistent depressive disorder)

ACADEMIC IMPAIRMENT

In the past 4 weeks, how many days haveyou felt that emotional or mental difficultieshave hurt your academic performance?

6 or more days28%

3 - 5 days26%

1 - 2 days29%

None17%

POSITIVE MENTAL HEALTH

Positive mentalhealth

38%

Positive mental health (psychologicalwell-being) is measured using The FlourishingScale, an eight-item summary measure of therespondent's self-perceived success inimportant areas such as relationships,self-esteem, purpose, and optimism (Diener,Wirtz, Tov, Kim-Prieto, Choi, Oishi, &Biswas-Diener , 2009). The score ranges from8-56, and we are using 48 as the thresholdfor positive mental health.

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HEALTH BEHAVIORS AND LIFESTYLE

Drug use

Over the past 30 days, have you used any of the following drugs? (Select all that apply)

79% No, none of these

1% Other drugs without a prescription

0% Athletic performance enhancers (anything that violates policies set by school or any athletic governing body)

0% Kratom

2% Psilocybin (also known as magic mushrooms, boomers, shrooms)

1% LSD (also known as acid)

0% Ketamine (also known as K, Special K)

0% MDMA (also known as Ecstasy or Molly)

1% Other stimulants (such as Ritalin, Adderall) without a prescription or more than prescribed

0% Methamphetamines (also known as speed, crystal meth, or ice)

0% Benzodiazepenes

0% Opioid pain relievers (such as Vicodin, OxyContin, Percocet, Demerol, Dilaudid, codeine, hydrocodone, methadone, morphine) without aprescription or more than prescribed

0% Heroin

1% Cocaine (any form, including crack, powder, or freebase)

20% Marijuana

Binge drinking

The following questions ask about how much you drink.A "drink" means any of the following:

A 12-ounce can or bottle of beer A 4-ounce glass of wine A shot of liquor straight or in a mixed drink

During the last two weeks, how many times have youhad 4 (female), 5 (male), 4 or 5 (transgender/gendernon-conforming) or more drinks in a row? (among thosewith any alcohol use)

10 or more times2%

6 to 9 times3%

3 to 5 times13%

Twice17%

Once24%

None40%

Exercise

In the past 30 days, about how many hours per week on averagedid you spend exercising? (include any exercise of moderate orhigher intensity, where "moderate intensity" would be roughlyequivalent to brisk walking or bicycling)

5 or more24%

3-415%

1-226%

Less than 135%

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ATTITUDES AND BELIEFS ABOUT MENTAL HEALTH SERVICES

KNOWLEDGE

SCHOOL CLIMATE

Knowledge of campus mental health resources

If I needed to seek professional help for my mental oremotional health, I would know where to go to accessresources from my school.

Strongly disagree9%

Disagree13%

Somewhat disagree8%

Somewhat agree21%

Agree27%

Strongly agree21%

Perceived need (past year)

In the past 12 months, I needed help for emotional ormental health problems such as feeling sad, blue,anxious or nervous.

Strongly disagree19%

Disagree15%

Somewhat disagree6%

Somewhat agree17%

Agree18%

Strongly agree25%

Perceived need (current)

I currently need help for emotional or mental healthproblems such as feeling sad, blue, anxious or nervous.

Strongly disagree3%

Disagree9%

Somewhat disagree10%

Somewhat agree28%

Agree24%

Strongly agree25%

Anti-racism

I believe my school actively works towards combatingracism within the campus community.

Agree84%

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USE OF SERVICES

Psychotropic medication use, all students (past year)

In the past 12 months have you taken any of the following types of medications? Please count only those you took, or are taking, severaltimes per week. (Select all that apply)

76% None

2% Other medication for mental or emotional health

4% Sleep medications (e.g., zolpidem (Ambien), zaleplon (Sonata), etc.)

3% Mood stabilizers (e.g., lithium, valproate (Depakote), lamotrigine (Lamictal), carbamazapine (Tegretol), etc.)

7% Anti-anxiety medications (e.g., lorazepam (Ativan), clonazepam (Klonopin), alprazolam (Xanax), buspirone (BuSpar), etc.)

1% Anti-psychotics (e.g., haloperidol (Haldol), clozapine (Clozaril), risperidone (Risperdal), olanzapine (Zyprexa), etc.)

17% Anti-depressants (e.g., fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), escitalopram (Lexapro), venlafaxine (Effexor), buproprion(Wellbutrin), etc.)

6% Psychostimulants (e.g., methylphenidate (Ritalin, or Concerta), amphetamine salts (Adderall), dextroamphetamine (Dexedrine), etc.)

Psychotropic medication use among students with positive depression or anxiety screens (past year)

In the past 12 months have you taken any of the following types of medications? Please count only those you took, or are taking, severaltimes per week. (Select all that apply)

65% None

4% Other medication for mental or emotional health

6% Sleep medications (e.g., zolpidem (Ambien), zaleplon (Sonata), etc.)

4% Mood stabilizers (e.g., lithium, valproate (Depakote), lamotrigine (Lamictal), carbamazapine (Tegretol), etc.)

12% Anti-anxiety medications (e.g., lorazepam (Ativan), clonazepam (Klonopin), alprazolam (Xanax), buspirone (BuSpar), etc.)

2% Anti-psychotics (e.g., haloperidol (Haldol), clozapine (Clozaril), risperidone (Risperdal), olanzapine (Zyprexa), etc.)

26% Antidepressants (e.g., fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), escitalopram (Lexapro), venlafaxine (Effexor), buproprion(Wellbutrin), etc.)

9% Psychostimulants (e.g., methylphenidate (Ritalin, or Concerta), amphetamine salts (Adderall), dextroamphetamine (Dexedrine), etc.)

Mental health care access

How has your access to mental health care been affected by the COVID-19 pandemic?

41% Don't know or not applicable (have not tried to access care)

1% Much less difficult or limited access

1% Somewhat less difficult or limited access

27% No significant change in access

18% Somewhat more difficult or limited access

11% Much more difficult or limited access

10

Mental health counseling/therapy, all students(past year)

In the past 12 months have you received counselingor therapy for your mental or emotional health from ahealth professional (such as psychiatrist, psychologist,social worker, or primary care doctor)?

29%

Mental health counseling/therapy amongstudents with positive depression or anxietyscreens (past year)

In the past 12 months have you received counseling ortherapy for your mental or emotional health from ahealth professional (such as psychiatrist, psychologist,social worker, or primary care doctor)?

40%

Mental health counseling/therapy, all students(lifetime)

Have you ever received counseling or therapy for mentalhealth concerns?

48%

Mental health counseling/therapy amongstudents with positive depression or anxietyscreens (lifetime)

Have you ever received counseling or therapy for mentalhealth concerns?

62%

Informal help-seeking

In the past 12 months have you received counseling or support foryour mental or emotional health from any of the following sources?(Select all that apply)

2% Staff member

4% Faculty member/professor

35% None of the above

1% Other non-clinical source

2% Support group

4% Religious counselor or other religious contact

37% Family member

30% Significant other

40% Friend (who is not a roommate)

14% Roommate

Barriers to help-seeking

In the past 12 months, which of the following factors have causedyou to receive fewer services (counseling, therapy, or medications)for your mental or emotional health than you would have otherwisereceived? (Select all that apply)

15% No barriers

7% Other

4% People providing services don't understand me

2% Privacy concerns

21% Prefer to deal with issues on my own or with support fromfamily/friends

7% Difficulty finding an available appointment

13% Not sure where to go

18% Not enough time

17% Financial reasons (too expensive, not covered by insurance)

40% No need for services

4% I haven't had the chance to go but I plan to

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REFERENCES

MENTAL HEALTH SCREENSCenter for Collegiate Mental Health (2015). CCAPS User Manual. University Park, PA.

Diener, E., Wirtz, D., Tov, W., Kim-Prieto, C., Choi, D., Oishi, S., & Biswas-Diener, R. (2009). New measures of well-being:Flourishing and positive and negative feelings. Social Indicators Research, 39, 247-266.

Morgan, J. F., Reid, F., & Lacey, J. H. (1999). The SCOFF questionnaire: assessment of a new screening tool for eatingdisorders BMJ, 319(7223), 1467-1468.

Spitzer, R. L., Kroenke, K., Williams, J. B., & Patient Health Questionnaire Primary Care Study Group. (1999). Validation andutility of a self-report version of PRIME-MD: the PHQ primary care study. JAMA, 282(18), 1737-1744.

Spitzer, R. L., Kroenke, K., Williams, J. B., & LÃ¶we, B. (2006). A brief measure for assessing generalized anxiety disorder:the GAD-7. Archives of Internal Medicine, 166(10), 1092-1097.

Hughes, M.E., Waite, L.J., Hawkley, L.C., & Cacioppo, J.T. (2004). A short scale for measuring loneliness in large surveys:Results from two population-based studies. Research on Aging, 26(6), 655-672.

SELECTED ARTICLES PUBLISHED WITH HMS DATAEisenberg, D., Golberstein, E., Hunt, J. (2009). Mental Health and Academic Success in College. B.E. Journal of EconomicAnalysis & Policy 9(1) (Contributions): Article 40.

Eisenberg, D., Hunt, J.B., Speer, N., Zivin, K. (2011). Mental Health Service Utilization among College Students in theUnited States. Journal of Nervous and Mental Disease 199(5): 301-308.

Eisenberg, D., Chung, H. (2012). Adequacy of Depression Treatment in College Student Populations. General HospitalPsychiatry 34(3):213-220.

Eisenberg, D., Speer, N., Hunt, J.B. (2012). Attitudes and Beliefs about Treatment among College Students with UntreatedMental Health Problems. Psychiatric Services 63(7): 711-713.

Eisenberg, D., Hunt, J.B., Speer, N. (2013). Mental Health in American Colleges and Universities: Variation across StudentSubgroups and across Campuses. Journal of Nervous and Mental Disease 201(1): 60-67.

Lipson, S., Gaddis, S.M., Heinze, J., Beck, K., Eisenberg, D. (2015). Variations in Student Mental Health and TreatmentUtilization Across US Colleges and Universities. Journal of American College Health, 63(6): 388-396.

Lipson, S., Zhou, S., Wagner, B., Beck, K., Eisenberg, D. (2016). Major differences: Variations in student mental health andservice utilization across academic disciplines. Journal of College Student Psychotherapy, 30(1), 23-41.

Lipson, S, Lattie, E, & Eisenberg, D (2018). Increased rates of mental health service utilization by U.S. college students:10-year population-level trends (2007-2017). Psychiatric Services, 70(1), 60-63.

Goodwill, J., & Zhou, S. (2019). Association between perceived public stigma and suicidal behaviors among collegestudents of color in the U.S. Journal of Affective Disorders, 262, 1-7.

Email: [email protected]: www.healthymindsnetwork.org

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APPENDIX: DESCRIPTIVE STATISTICS FOR SURVEY ITEMSMEASURE All Students 95% CONFIDENCE INTERVAL

Respondent Characteristics

Response RateNSample

14%32754

Transgender/gender non-conformingMaleFemaleGender

0%42%55%

(0%, 1%)(42%, 43%)(54%, 56%)

OtherPacific IslanderAsian / Asian AmericanArab / Middle EasternAmerican IndianHispanic / LatinoBlack / African AmericanWhite / CaucasianRace/Ethnicity

2%1%10%1%2%13%10%72%

(1%, 2%)(1%, 1%)(9%, 10%)(1%, 2%)(2%, 2%)(13%, 14%)(10%, 11%)(71%, 73%)

InternationalUS Resident / CitizenCountry

4%96%

(4%, 4%)(96%, 96%)

OtherParent or guardian's homeOff-campus / non-university housingOther campus housingFraternity / sorority houseCampus residence hallResidence

5%34%41%5%2%14%

(4%, 5%)(33%, 34%)(40%, 42%)(4%, 5%)(2%, 2%)(14%, 15%)

Non-degreeOtherPhD or equivalentMDJDMastersBachelorsAssociatesAcademic level

3%5%6%1%1%9%50%28%

(2%, 3%)(5%, 6%)(6%, 6%)(1%, 1%)(1%, 1%)(8%, 9%)(50%, 51%)(27%, 29%)

Ever trained for or served in the military(Armed Forces, Reserves, or NationalGuard)

3% (2%, 3%)

31+26-3023-2518-22Age

14%11%13%63%

(14%, 15%)(10%, 11%)(12%, 13%)(62%, 63%)

Graduate degreeCollege degreeHigh school degreeLess than high school degree

Highest educational attainment of eitherparent

29%41%25%5%

(28%, 30%)(40%, 41%)(25%, 26%)(4%, 5%)

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MEASURE All Students 95% CONFIDENCE INTERVAL

Respondent Characteristics

Very unimportantUnimportantNeutralImportantVery importantReligiosity

16%14%25%22%23%

(15%, 16%)(13%, 15%)(24%, 26%)(22%, 23%)(22%, 24%)

Never StressfulRarely StressfulStressfulOften stressfulAlways stressfulCurrent financial situation

6%18%35%24%16%

(6%, 7%)(18%, 19%)(35%, 36%)(23%, 25%)(16%, 17%)

Never StressfulRarely StressfulStressfulOften stressfulAlways stressfulFinancial situation growing up

14%27%29%18%12%

(13%, 14%)(27%, 28%)(28%, 30%)(17%, 18%)(12%, 13%)

DivorcedMarried or domestic partnershipIn a relationshipSingleRelationship status

1%15%33%50%

(1%, 2%)(14%, 15%)(32%, 34%)(49%, 51%)

OtherQuestioningQueerGay / lesbianBisexualHeterosexualSexual orientation

3%3%3%3%10%81%

(3%, 4%)(3%, 3%)(2%, 3%)(2%, 3%)(10%, 11%)(80%, 81%)

Other chronic disease (please specify)Other autoimmune disorder (please specify)HIV/AIDSHigh cholesterolCancersSeizure disorders (e.g., epilepsy)Sickle cell anemiaArthritis

Gastrointestinal disease (e.g., Crohn'sDisease, Ulcerative Colitis)

Thyroid disease (e.g., hypothyroid orhyperthyroid)

AsthmaHigh blood pressureDiabetesChronic disease

5%2%0%2%1%1%0%2%

2%

3%15%4%2%

(4%, 5%)(2%, 3%)(0%, 0%)(2%, 3%)(1%, 1%)(1%, 1%)(0%, 0%)(2%, 2%)

(2%, 2%)

(3%, 4%)(14%, 15%)(3%, 4%)(1%, 2%)

Race/Ethnicity Subcategories

OtherAfro-Latina/o/xAfrican CarribeanAfrican AmericanAfricanBlack

6%5%11%73%17%

(4%, 7%)(4%, 6%)(9%, 12%)(70%, 75%)(15%, 19%)

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Race/Ethnicity Subcategories

OtherFilipina/o/x

South Asian (eg Indian, Pakistani, Nepalese,Sri Lankan)

Southeast Asian (eg Cambodian,Vietnamese, Hmong)

East Asian (eg Chinese, Japanese, Korean,Taiwanese)

Asian

2%15%

22%

19%

46%

(2%, 3%)(13%, 17%)

(20%, 25%)

(16%, 22%)

(44%, 49%)

OtherCarribeanSouth AmericanCentral AmericanMexican/Mexican AmericanHispanic

11%14%18%12%49%

(10%, 12%)(13%, 16%)(16%, 20%)(10%, 14%)(46%, 51%)

Mental Health Measures

Flourishing Scale (8-56)Positive Mental Health

43.2 (43.0, 43.4)

Depression overallOther depression (positive screen)Major depression (positive screen)In severe range (20-27)In moderately severe range (15-19)In moderate range (10-14)Overall score (0-27)Depression (PHQ-9)

39%19%21%8%10%17%8.9

(38%, 40%)(18%, 19%)(20%, 21%)(8%, 9%)(10%, 11%)(16%, 17%)(8.8, 9.0)

Extremely difficultVery difficultSomewhat difficultNot difficult at allImpairment from depression (1)

8%17%51%23%

(8%, 9%)(17%, 18%)(50%, 52%)(22%, 24%)

Probable anxiety disorder (positive screen)In severe range (15-21)In moderate range (10-14)Overall score (0-21)Generalized anxiety (GAD-7)

34%16%18%7.7

(33%, 35%)(15%, 17%)(17%, 19%)(7.5, 7.8)

Depression or anxiety disorderDepression/Anxiety

47% (46%, 48%)

Think you are very underweightNeed to be very thin to feel good about selfProbable eating disorder (3+ on SCOFF)Disordered eating and body image

2%25%11%

(1%, 2%)(24%, 26%)(10%, 11%)

6 or more days3-5 days1-2 daysNone

Academic impairment from mentalhealth, past 4 weeks (2)

28%26%29%17%

(27%, 28%)(26%, 27%)(28%, 30%)(16%, 18%)

(1) How difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?

(2) How many days have you felt that emotional or mental difficulties have hurt your academic performance?

15


Self-Injury and Suicide

OtherPunching or banging wall or objectRubbing sharp objects on skinCarving words or symbols in skinInterfering with wound healingBiting selfPulling one's hairScratching selfPunching or banging selfBurning selfCutting selfAnyNon-suicidal self-injury, past year

1%7%3%1%8%4%8%8%10%2%5%23%

(1%, 2%)(7%, 8%)(2%, 3%)(1%, 1%)(8%, 9%)(4%, 5%)(8%, 8%)(8%, 9%)(9%, 10%)(1%, 2%)(5%, 6%)(22%, 24%)

Nearly everyday, or everyday3 to 5 days a weekOnce or twice a week2 or 3 times a monthOnce a month or lessOnce or twice

Frequency of self-injury, past year(among those with any)

1%3%6%13%25%52%

(1%, 2%)(2%, 3%)(5%, 7%)(12%, 14%)(24%, 27%)(50%, 54%)

Attempted suicide, past year

Made a plan for attempting suicide, pastyear

Seriously thought about attempting suicide,past year

Suicidality

1%

6%

13%

(1%, 2%)

(5%, 6%)

(13%, 14%)

16


Previous Diagnoses of Mental Disorders

AnyMental disorders

41% (40%, 42%)

Premenstrual dysphoric disorderDysthymiaMajor depressionAnyDepression or mood disorder

1%2%14%28%

(1%, 1%)(2%, 3%)(14%, 15%)(27%, 29%)

Cyclothymic disorderBipolar II disorderBipolar I disorderAnyBipolar and related disorders

0%1%1%3%

(0%, 0%)(1%, 2%)(1%, 1%)(3%, 3%)

Social anxiety disorder or social phobiaSpecific phobiaAgorophobiaPanic disorderGeneralized anxiety disorderAnyAnxiety disorder

7%1%0%5%25%31%

(6%, 7%)(0%, 1%)(0%, 1%)(4%, 5%)(24%, 25%)(30%, 32%)

Obsessive-compulsive disorderAny

Obsessive-compulsive or relateddisorders

4%5%

(3%, 4%)(4%, 5%)

Acute stress disorderPosttraumatic stress disorderAnyTrauma and stressor related disorders

1%7%8%

(0%, 1%)(6%, 7%)(7%, 8%)

SchizophreniaAnyPsychotic disorder

0%0%

(0%, 0%)(0%, 1%)

Autism spectrum disorderOther intellectual disabilityADHDAny

Neurodevelopmental disorder orintellectual disability

1%0%6%7%

(1%, 2%)(0%, 0%)(6%, 7%)(7%, 8%)

Binge eating disorderBulimia nervosaAnorexia nervosaAnyEating disorder

1%1%2%3%

(1%, 1%)(1%, 1%)(1%, 2%)(3%, 4%)

AnyPersonality disorder

1% (1%, 2%)

Alcohol abuse disorderAnySubstance abuse disorder

1%2%

(1%, 1%)(1%, 2%)

17


Health Behaviors and Lifestyle

Other drugs without a prescription

Athletic performance enhancers (anythingthat violates policies set by school or anyathletic governing body)

Kratom

Psilocybin (also known as magicmushrooms, boomers, shrooms)

LSD (also known as acid)Ketamine (also known as K, Special K)MDMA (also known as Ecstasy or Molly)

Other stimulants without a prescription ormore than prescribed

MethamphetaminesBenzodiazepenes

Opioid pain relievers without a prescriptionor more than prescribed

HeroinCocaineMarijuanaVape pen or E-CigaretteCigarettesSubstance use, past 30 days

1%

0%0%

2%1%0%0%

1%0%0%

0%0%1%20%15%7%

(1%, 1%)

(0%, 0%)(0%, 1%)

(1%, 2%)(1%, 1%)(0%, 0%)(0%, 0%)

(1%, 2%)(0%, 0%)(0%, 1%)

(0%, 1%)(0%, 0%)(1%, 1%)(19%, 21%)(14%, 15%)(6%, 7%)

More than 3 timesMore than one time

In the past 2 weeks, about how manytimes did you have 4 [female]/5 [male]/4or 5 [transgender/gendernon-conforming] or more alcoholicdrinks in a row? (1 drink is a can of beer,a glass of wine, a wine cooler, a shot ofliquor, or a mixed drink.)

9%28%

(8%, 9%)(28%, 29%)

More than 20 hours/week16-20 hours/week11-15 hours/week6-10 hours/week3-5 hours/week1-2 hours/weekLess than 1 hour/weekTime studying/doing homework

15%13%17%28%20%6%2%

(14%, 15%)(12%, 14%)(17%, 18%)(27%, 29%)(19%, 21%)(5%, 6%)(1%, 2%)

Did anyone strike or physically injure you?Violence (past 12 months)

6% (6%, 6%)

Attitudes and Beliefs about Services

Most people...I...

...think less of someone who hasreceived mental health treatment.

45%6%

(44%, 46%)(5%, 6%)

Agree or strongly agreeknow where to go to access resources

70% (69%, 70%)

Believes therapy is helpful or very helpfulfor depression

Believes medication is helpful or veryhelpful for depression

Beliefs about effectiveness of treatmentfor depression

84%

60%

(83%, 85%)

(60%, 61%)

18


Help-Seeking

Strongly disagreeDisagreeSomewhat disagreeSomewhat agreeAgreeStrongly agree

Think you needed help for emotional ormental health problems, past year

19%15%6%17%18%25%

(18%, 19%)(15%, 16%)(5%, 6%)(16%, 18%)(17%, 19%)(25%, 26%)

Don't knowNo prescriptionOther type of health providerPsychiatrist

General practitioner/nursepractitioner/primary care physician

Prescriber (among those with anypast-year medication use)

1%4%4%36%

62%

(1%, 2%)(3%, 5%)(4%, 5%)(34%, 37%)

(61%, 64%)

More than 5 times3-5 times1-2 timesNot at all

Discussed medication with provider, pastyear (among those with medication use)

22%27%40%9%

(20%, 23%)(26%, 29%)(38%, 42%)(8%, 10%)

No oneOther non-clinical sourceSupport groupReligious counselor / other religious contactFamily memberSignificant otherFriend (who is not a roommate)RoommateProfessional clinician

Whom you would talk to, if you wereexperiencing serious emotional distress

9%1%4%7%43%35%43%15%33%

(9%, 10%)(1%, 2%)(3%, 4%)(6%, 7%)(43%, 44%)(34%, 35%)(42%, 43%)(14%, 15%)(32%, 34%)

CurrentPast yearTherapy or counseling for mental health

14%29%

(14%, 15%)(29%, 30%)

More than 107-94-61-3Visits in past year, among those with any

7%13%20%39%

(6%, 8%)(12%, 14%)(19%, 21%)(37%, 40%)

Other

Provider in another location (such ashometown)

Provider in the local community (not oncampus)

Partial hospitalization programInpatient psychiatric hospitalPsychiatric emergency servicesCampus Provider CCampus Provider BCampus Provider A

Use of specific providers for therapy orcounseling for mental health

2%

11%

9%1%1%1%2%1%10%

(2%, 2%)

(11%, 12%)

(9%, 10%)(1%, 1%)(1%, 1%)(1%, 1%)(2%, 3%)(1%, 1%)(9%, 10%)

CurrentPast year

Any medication or therapy for mentalhealth

26%39%

(26%, 27%)(38%, 40%)

19


Help-Seeking

CurrentPast year

Any medication or therapy, among thosewith positive depression or anxietyscreen

38%53%

(37%, 39%)(52%, 54%)

Past yearAny visit to a health provider

71% (70%, 71%)

None of the aboveOther non-clinical sourceSupport groupReligious contactFamily memberSignificant otherFriend (other than roommate)Roommate

Received counseling or support formental health from these sources, pastyear

35%1%2%4%37%30%40%14%

(34%, 36%)(1%, 1%)(2%, 3%)(4%, 5%)(36%, 37%)(30%, 31%)(39%, 41%)(13%, 14%)

Not helpfulSomewhat helpfulHelpfulVery helpful

How helpful, overall, do you think themedication(s) was or has been for yourmental or emotional health?

8%22%32%38%

(7%, 10%)(20%, 23%)(30%, 34%)(36%, 40%)

Not helpfulSomewhat helpfulHelpfulVery helpful

How helpful, overall, do you thinktherapy or counseling was or has beenfor your mental or emotional health?

13%25%27%36%

(12%, 13%)(24%, 26%)(26%, 28%)(34%, 37%)

Both in-person and remote

Remote/telehealth only (digital videoconferencing, text/app chat, etc.)

In-person only

Of the places you reported receivingcounseling or therapy, how were yourcounseling or therapy sessionsconducted?

36%

29%35%

(34%, 38%)

(27%, 30%)(34%, 37%)

20


Satisfaction with Therapy, Campus Providers

Very satisfiedSatisfiedSomewhat satisfiedSomewhat dissatisfiedDissatisfiedVery dissatisfiedConvenient hours

24%42%19%7%5%3%

(22%, 27%)(39%, 44%)(17%, 21%)(5%, 8%)(4%, 6%)(2%, 4%)

Very satisfiedSatisfiedSomewhat satisfiedSomewhat dissatisfiedDissatisfiedVery dissatisfiedLocation

27%47%15%6%3%2%

(24%, 29%)(44%, 49%)(13%, 17%)(5%, 7%)(2%, 4%)(2%, 3%)

Very satisfiedSatisfiedSomewhat satisfiedSomewhat dissatisfiedDissatisfiedVery dissatisfiedQuality of therapists

36%33%14%8%5%4%

(34%, 39%)(30%, 35%)(12%, 15%)(6%, 9%)(4%, 6%)(3%, 6%)

Very satisfiedSatisfiedSomewhat satisfiedSomewhat dissatisfiedDissatisfiedVery dissatisfiedRespect for privacy concerns

49%38%8%2%1%2%

(46%, 51%)(35%, 40%)(7%, 9%)(1%, 3%)(1%, 1%)(1%, 3%)

Very satisfiedSatisfiedSomewhat satisfiedSomewhat dissatisfiedDissatisfiedVery dissatisfied

Scheduling appointments w/o longdelays

33%36%15%7%5%5%

(30%, 35%)(33%, 38%)(13%, 16%)(5%, 8%)(4%, 6%)(4%, 6%)

Note: the confidence intervals are wide for these numbers, because the sample sizes are small (these questions were only asked of service users).

21


Satisfaction with Therapy, Non-Campus Providers

Very satisfiedSatisfiedSomewhat satisfiedSomewhat dissatisfiedDissatisfiedVery dissatisfiedConvenient hours

27%43%19%7%3%1%

(25%, 30%)(40%, 45%)(17%, 21%)(6%, 8%)(3%, 4%)(1%, 2%)

Very satisfiedSatisfiedSomewhat satisfiedSomewhat dissatisfiedDissatisfiedVery dissatisfiedLocation

29%43%16%6%3%2%

(28%, 31%)(41%, 45%)(15%, 18%)(5%, 7%)(2%, 3%)(2%, 3%)

Very satisfiedSatisfiedSomewhat satisfiedSomewhat dissatisfiedDissatisfiedVery dissatisfiedQuality of therapists

41%31%14%6%4%3%

(39%, 43%)(29%, 33%)(13%, 16%)(6%, 7%)(3%, 4%)(3%, 4%)

Very satisfiedSatisfiedSomewhat satisfiedSomewhat dissatisfiedDissatisfiedVery dissatisfiedRespect for privacy concerns

53%35%7%2%1%1%

(51%, 54%)(34%, 37%)(6%, 8%)(2%, 3%)(1%, 1%)(1%, 2%)

Very satisfiedSatisfiedSomewhat satisfiedSomewhat dissatisfiedDissatisfiedVery dissatisfied

Scheduling appointments w/o longdelays

38%34%14%6%4%4%

(36%, 40%)(32%, 35%)(12%, 15%)(6%, 7%)(4%, 5%)(3%, 4%)

22


Barriers and Facilitators to Help-Seeking

No barriersOther

Prefer to deal with issues on my own orwith support from family/friends

Difficulty finding an available appointmentNot sure where to goNot enough timeFinancial reasonsNo need for servicesI haven't had the chance to go but I plan to.

Reasons for receiving no or fewerservices for mental health

15%7%

21%7%13%18%17%40%4%

(15%, 16%)(6%, 7%)

(20%, 22%)(7%, 8%)(12%, 13%)(17%, 18%)(17%, 18%)(39%, 40%)(4%, 5%)

Other reasonsHealth professional recommended helpA campus advisor referred me to seek help

I acquired more information about myoptions

A campus advisor mandated me to seekhelp by campus staff

Other person encouraged or pressured me

Family member encouraged or pressuredme

Friend encouraged or pressured meDecided on my ownReasons for seeking help

4%13%3%

1%

1%5%

36%18%71%

(3%, 5%)(12%, 14%)(3%, 4%)

(1%, 2%)

(1%, 1%)(5%, 6%)

(34%, 37%)(17%, 20%)(69%, 72%)

Insured but uncertain of sourceUncertain whether insuredPublic insuranceIndividual marketEmbassy or other international sourceStudent planSpouse's employerOwn employerParent's employerNone (uninsured)Source of health insurance

3%1%10%2%0%5%4%9%47%5%

(3%, 4%)(1%, 2%)(9%, 10%)(2%, 3%)(0%, 0%)(5%, 6%)(4%, 4%)(8%, 9%)(47%, 48%)(5%, 6%)

No, it definitely would notI think it would not but am not sureI have no ideaI think it would but am not sureYes, it definitely would

Plan provides any coverage for localmental health visits (among those with aplan)

3%7%30%29%31%

(3%, 4%)(7%, 8%)(29%, 31%)(28%, 30%)(30%, 32%)

No, the coverage is inadequate to meet myneeds

Yes, everything I have needed is coveredHave not needed plan to cover services

Plan meets needs for mental healthservices (among those with a plan)

10%32%58%

(9%, 10%)(31%, 33%)(57%, 59%)

23


Supportiveness of Academic and Social Environment

Talked with any academic personnelabout mental health problems affectingperformance

14% (13%, 14%)

Very unsupportiveNot supportiveSupportiveVery supportive

Supportiveness of response by academicpersonnel

2%7%41%51%

(1%, 2%)(5%, 8%)(38%, 43%)(48%, 53%)

No oneOtherDean of Students or Class DeanStudent services staffTeaching assistantAnother faculty memberAcademic advisorProfessor from one of classes

Whom would you talk to about mentalhealth problems affecting academicperformance

32%4%3%10%1%5%27%30%

(32%, 33%)(4%, 5%)(2%, 3%)(10%, 11%)(1%, 2%)(5%, 6%)(26%, 27%)(30%, 31%)

Am confident I will finish my degree nomatter the challenges

Persistence/retention74% (74%, 75%)

Documents

Fall 2020 Data Report - Healthy Minds Network