By Saumya Joseph

(Reuters Health) – Suicidal thinking, severe depression and rates of self-injury among U.S. college students more than doubled over less than a decade, a nationwide study suggests.

Looking at data from two large annual surveys of college undergraduates covering the years 2007-2018, researchers found a broad worsening of mental health indicators including depression overall, anxiety, low flourishing and suicidal planning and attempts, particularly in the second half of the study period.

“It suggests that something is seriously wrong in the lives of young people and that whatever went wrong seemed to happen around 2012, or 2013,” said study coauthor Jean Twenge. She noted that this was around the time smartphones became common and social media moved from being optional to mandatory among youngsters.

“It’s difficult to think of any other event that began around that time, and then got stronger on until 2018,” Twenge, a psychology professor at San Diego State University in California and author of the book “iGen,” told Reuters Health by phone.

University counseling centers have been reporting increases in students’ use of campus mental health services. Twenge and her coauthors wanted to explore whether this rise was driven by more students in need seeking help, or actual increases in the number of students with poor mental health.

The team looked at data from two large, voluntary surveys in which students answered questions about recent experiences with symptoms of depression, anxiety, self-harm and other mental health problems.

More than 610,000 undergraduates participated in one survey between the fall semester of 2011 and spring semester of 2018. Their average age was about 21, two-thirds were female and almost three quarters were white. In the other survey, more than 177,000 undergraduates participated between 2007 and 2018. Most were between 18 and 22, 57% were female and 74% were white.

Reports of suicide attempts increased from 0.7% of survey participants in 2013 to 1.8% in 2018, while the proportion of students reporting severe depression rose from 9.4% to 21.1% in the same period.

The rate of moderate to severe depression rose from 23.2% in 2007 to 41.1% in 2018, while rates of moderate to severe anxiety rose from 17.9% in 2013 to 34.4% in 2018.

The study wasn’t designed to determine the causes of the increases in mental health issues among college students, though the authors speculate about a variety of possibilities. Smartphone use, for example, has been associated with poorer sleep quality and fewer face-to-face interactions, both of which are deemed essential for mental health, the researchers write in the Journal of Adolescent Health.

Although colleges have made progress in providing mental health services and treatment to students, the results suggest that current resources on campuses are inadequate, notes Paola Pedrelli, a professor at the Harvard Medical School in Boston, who wasn’t involved in the study.

Students may also avoid using resources on campus because some colleges may expel students who have suicidal ideation or force them to go on medical leave, to avoid liability related to student suicides, she added.

“It’s sort of like a double-edged sword. Sometimes students might report their symptoms, and they might be forced out,” she told Reuters Health in a phone interview.

Daniel Eisenberg of the University of Michigan’s School of Public Health in Ann Arbor believes colleges should also invest in online resources to supplement traditional on-campus counseling services.

“It’s not as simple as simply hiring more counselors or more mental health services. That’s what college campuses have been doing to some degree for many years now, and it doesn’t seem to be reversing this trend,” Eisenberg, who also was not involved in the study, said in a phone interview.

“The solution’s probably going to be a combination of continuing to increase traditional services. But also some newer approaches, technology based or other kinds of creative approaches, possibly involving peer groups or something besides just what we’ve been doing for the last many years.”

SOURCE: Journal of Adolescent Health, online July 3, 2019.