Dear Alice,

How many college students seek counseling?

— Educated neuroses?

Dear Educated neuroses?,

The exact number of college students that seek counseling any given year is not fully known, but the National Survey of College Counseling Centers does regularly collect data from 275 college counseling centers in the United States and Canada. According to the most recent survey data, out of 3.3 million students eligible for counseling services at these centers, eleven percent either sought individual counseling or participated in a group counseling session. In addition to counseling services, 30 percent of the eligible students were seen in other contexts by counseling center staff, such as at workshops, orientations, and presentations. But, it’s good to note that these numbers don’t include the students who receive mental health services outside of their school’s counseling center. In addition, these numbers reflect the amount of students who received overall counseling services — which is typically short-term personal counseling or academic and career counseling services. Lastly, while some students might need counseling and support, many don’t seek it out do to the stigma surrounding counseling. So, as far as how many students actually sought out services and either did or didn’t receive them, it’s hard to know. To fully answer your question though, it could also be beneficial to look into some of the barriers for why some college students don’t seek counseling.

Though the term “college students” tends to be associated with young adults, it actually represents a wide range of age, race, gender, and socio-economic class. As such, college students come from different life experiences, identify with different cultures, and live by different sets of norms. So, it’s easy to see that they would have different beliefs and approaches to help-seeking behaviors (such as seeking counseling). For example, one study regarding help-seeking behavior found that Asian American college students, those who strongly identify with American culture are more likely to seek professional counseling services and report feeling more open to discuss personal issues and concerns. On the other hand, Asian American college students who adhere strongly to Asian cultural values are less likely to seek these services, which is attributed to a cultural emphasis on greater self-control and conformity to family and community. This pattern of underutilizing mental health services is not just unique to Asian American students — many other racial and ethnic minority students face the same issue, too. However, this may be exacerbated by a lack of access to culturally competent and appropriate mental health providers. Furthermore, social discrimination and stereotypes can play a role in shaping how some people view mental health struggles and seeking appropriate help — or stigma.

Though a lot of progress has been made in recent years, overall stigma surrounding mental health and seeking help for it remains a major barrier to accessing and using mental health services. In addition to the different cultural norms and ideas, gender norms seem to shape such stigma in a big way. Specifically, the belief that masculinity centers around being stoic, controlled, and self-sufficient (at least in the Western context) generally goes against help-seeking behaviors that involve showing vulnerability and expressing emotions. It’s not surprising then that people who identify as men in the United States generally seek psychological services less often than people who identify as women. Though research behind this phenomenon is unclear, it’s speculated that there may some differences in how mental health providers approach and provide counseling based on the gender identity of the client. Affordability is another barrier in seeking and using mental health services. Some college counseling centers might require a fee, and some student health insurance plans don’t fully cover the cost of private treatment, if any at all. As a result, students may encounter out-of-pocket fees for these services, making affordability an issue for some.

Though some of these barriers are closely tied to how people see and understand their social world, and therefore may seem daunting to tackle, there are effective solutions to mitigate them. As with any relationship, developing trusting bonds, and communicating effectively with counselors may improve the counseling experience. Seeking a professional who understands and can relate to a similar world view and life experiences allows more room to open up and build trust. If in-person counseling is not the right option, online and phone options are also available. If cost is an issue, there are concrete ways to address affordability. Multiple local government agencies offer free or low-cost counseling for people who qualify. And, other sources outside of counseling centers also provide affordable, more targeted counseling, such as faith-based organizations, community centers for the homeless, youth, or elderly, and LGBTQ resource centers.

Take care,

Alice!

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