Tulane research examines unique needs of U.S. college students during the COVID-19 pandemic

Dr. Alyssa Lederer, assistant professor and program director for the Health Education and Communication MPH Program at Tulane School of Public Health and Tropical Medicine, was the lead author on a perspective piece discussing the toll that COVID-19 has taken on college students.

Almost 20 million students are enrolled in institutions of higher education annually, comprising 40% of the U.S. population aged 18 to 24. The college population has become increasingly diverse, with growing numbers of “nontraditional” students, who are older in age and typically have work, familial, and other responsibilities that pose added challenges to their academic success. Forty percent of students are now over the age of 25, 44% are students of color, and 34% are first-generation students.

Before the pandemic, students were already experiencing substantial mental health concerns, putting both their health and academic success in jeopardy. Of primary concern was that college students suffered from high and increasing rates of mental health conditions, especially depression and anxiety. In 2017, 36% of college students reported having a lifetime mental health diagnosis compared to 22% in 2007. In 2019, almost a quarter of college students had been diagnosed or treated for anxiety or depression in the previous 12 months.

With the pandemic, Lederer and colleagues are concerned that college students now face increasing housing and food insecurity, financial hardships, a lack of social connectedness and sense of belonging, uncertainty about the future, and technology and other access issues that impede their academic performance and well-being. There is also reason to believe that COVID-19 is worsening inequalities for students of color and low-income students.

"In the piece we argue that COVID-19 has likely exacerbated students' ongoing health needs and amplified existing inequities," said Lederer. "We provide recommendations to college administrators for how to best address student health concerns in the era of COVID-19 moving forward." Their recommendations are as follows:

Use Data to Inform Decision Making

Colleges and universities should use data to guide decision making to determine priorities moving forward. In an effort to support schools, the American College Health Association–National College Health Assessment III and Healthy Minds Study, two national college health surveys, added questions about students’ COVID-19 beliefs, behaviors, and experiences to gain preliminary information about the impact of COVID-19 on students’ mental health in spring 2020. All perspective piece authors were affiliated with the two surveys listed above and Dr. Lederer is the chair of the ACHA-NCHA Advisory Committee.

Communicate Clearly

A recent study found that college students had insufficient knowledge about COVID-19, with their primary sources of information being the internet and social media. Institutions of higher education can be a trusted source of information and support by providing frequent, consistent, clear, reliable, and compassionate communication to students, particularly through the channels that they utilize most readily.

Prioritize Student Support Services

Prioritize health centers, counseling centers, health promotion offices, student affairs staff, and other support services for other underrepresented student populations, such as students of color, LGBT students, students with disabilities, and international students. As institutions endure budget cuts due to COVID-19, these entities should be prioritized as a critical investment in student success.

Use telehealth and telephonic services to help students maintain their access to care or for students to initiate treatment, aided by continued and expanded legislation that permits service provision across state lines.

Train faculty, a vital but underutilized resource, with new or enhanced methods to recognize students in need and connect them to care.

Employ Equitable Systems

Recruit and retain diverse and culturally competent mental health providers and other student affairs staff, and college health professionals should do targeted promotion of culturally tailored resources, particularly among groups known to underutilize services. Widespread efforts should be made to ensure that all institutional members are aware of and can refer students to the services available.

 “Comprehensive plans should be devised recognizing and responding to the toll that COVID-19 has and will continue to take on students,” said Lederer.  “Their health and academic success depend on it.”