CCMH’s 2023 Annual Report annual report found that college counseling center clients who experienced identity-based discrimination were more likely to have suicidal ideation (SI) at the beginning of treatment. A more recent CCMH Blog also discovered that while clients’ average levels of SI improved regardless of their report of discrimination, there were disparities between those with and without discrimination: clients who reported any discrimination had higher SI at the end of treatment, and this discrepancy was even more pronounced among those with discrimination based on multiple aspects of their identity.

College counseling centers have historically served as the primary psychological treatment resource in institutions of higher education that support the emotional and personal development of college students during their academic journey.  National research has demonstrated that counseling centers are effective in treating students with a broad range of concerns (McAleavey et al., 2019), as well as promoting student success and persistence in school (Trusty et al., 2024).  

The 2025 Annual Report summarizes data contributed to CCMH during the 2024-2025 academic year, beginning July 1, 2024 and ending on June 30, 2025. De-identified data were contributed by 209 college and university counseling centers, describing 162,187 unique college students seeking mental health treatment, 4,694 clinicians, and 1,114,255 appointments.

Many college counseling center clients who experience identity-based discrimination have more severe psychological symptoms and experience disparities in treatment outcomes compared to those without discrimination (Center for Collegiate Mental Health [CCMH], 2023; Paradies et al., 2015; Tan et al., 2025). This is unsurprising, as discrimination can impose significant emotional, social, and cognitive burdens on individuals (Hatzenbuehler, 2009; Major & O’Brien, 2005; Pachankis, 2008). This may be especially true for individuals who have intersectional marginal identities, as they tend to experience greater psychological and physical distress compared to individuals who have discrimination against a singular part of their identity (e.g., Center for Collegiate Mental Health [CCMH], 2023 Denise, 2014; Tan et al., 2025; Vargas et al., 2020).

Suicidal ideation (SI) is a significant problem among college students. In addition to its burden of psychological suffering and distress, SI is associated with negative outcomes, such as increased risk of suicidal behavior and poorer academic performance (De Luca et al., 2016). While studies suggest that psychotherapy can reduce suicidality, some clients continue to have residual SI after a course of psychological treatment (Dunlop et al., 2019; Martin et al., 2023; Rallis et al., 2023; Treatment for Adolescents With Depression Study (TADS) Team, 2009).

College dropout is highly prevalent among first-time, full-time college students. Approximately 39% of students do not complete their degree program within 8 years, and 23.3% of first-year students dropout in the first 12 months (Hanson, 2024). Understanding which students are at risk of dropout and how campus services can promote student success may improve student retention.

CCMH examines the prevalence and trends of mental health concerns among students in college counseling each year. In the 2024 Annual Report, CCMH provided updated mental health data based on both students’ self-report and clinicians’ initial evaluations. Clinicians reported their assessments via the Clinician Index of Client Concerns (CLICC), which is a checklist of 54 common presenting problems experienced by clients receiving counseling services. Data from the CLICC has traditionally been used by CCMH to represent the rate of specific concerns identified by clinicians. However, to date, CCMH has not investigated the prevalence and trends of psychiatric diagnoses assigned by providers.

Between 2000 and 2022, suicide rates in the United States increased by 36% (Center for Disease Control, 2024). While suicide affects every age and demographic group, it is the second leading cause of death for individuals between the ages of 10 and 34, which encompasses the ages of most college students. Indeed, it is estimated that approximately 1,100 college students die by suicide annually (The JED Foundation, 2002).

 Native American Students in College Counseling: Are Symptoms Related to Racial/Ethnic Diversity on Campus?

 Highlights:

• Many Native American students report elevated psychological and academic distress symptoms when they present to university counseling centers.
• Native American clients at more racially/ethnically diverse campuses report slightly lower academic distress than those at less diverse institutions.
• Increasing representation of diverse students at colleges and universities may be one part of a multi-faceted approach to help create a sense of belonging and academic self-efficacy among Native Americans. Supports to address disparities in psychological and academic distress among Native American students are also needed.

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Native American and Alaska Native individuals (hereafter referred to as Native Americans) have made profound contributions to higher education, including in the fields of medicine, public policy, education, and the arts ​(Academic Influence, 2023; American Neurological Association, n.d.)​. Because Native American students have traditionally been marginalized in the U.S. educational system (Fish & Syed, 2018), there have been efforts to increase access to college for the Native community (e.g., American Indian College Fund). However, Native Americans are still substantially under-represented at U.S. colleges and universities ​(Brayboy et al., 2015; Postsecondary National Policy Institute, 2023)​ and often report social isolation, disconnection from cultural traditions, and racial discrimination in college ​(Brayboy et al., 2015; Tachine et al., 2017)​.

The Hamas attack on Israeli civilians on 10/7/2023 and subsequent war in Gaza has had a profound regional and global impact. While the devastating effects from the events since 10/7/2023 are too vast and complex to summarize in this blog, one of the many areas of ongoing concern is the loss of safety experienced by members of religious communities, particularly those who identify as Jewish and Muslim. In fact, the Anti-Defamation League (2023) reported an increase in antisemitic incidents within the United States since 10/7/2023, which has involved assaults, property damage, harassment, and threats. Additionally, the Council on American Islamic Relations (2023) reported a substantial rise in reports against those who identify as Muslim, including assaults, threats of bodily injury, intimidation, harassment, and workplace discrimination.

First-generation college students (i.e., those who are the first in their family to attend college) make up nearly 1 in 4 clients presenting to college counseling centers in the United States (Center for Collegiate Mental Health, 2024). First-generation students often face challenges and risk factors that impede academic success, such as financial concerns, lack of familiarity with higher education systems, and complex emotional reactions to being the first in their family to receive higher education (Covarrubias et al., 2021).  Conversely, many also bring strengths that can be leveraged in academic and mental health treatment settings to foster resilience, including diverse life experiences (Ives & Castillo-Montoya, 2020). In terms of mental health, general student body surveys have produced mixed results in terms of how first-generation students compare to continuing-generation students (Rockwell & Kimle, 2023; Soria et al., 2022). However, differences in demographic and clinical characteristics between first-generation and continuing-generation students who seek treatment in college counseling have not been reported on a national level. A better understanding of first-generation students’ characteristics when they present to counseling could help clinicians and administrators better serve students within this population. As such, this blog compared the following characteristics between first-generation and continuing-generation students who sought treatment at college counseling centers nationally:

International students make up a significant proportion of the U.S. college student population. Despite a decrease in the number of total international students in 2020-2021 after the onset of the COVID-19 pandemic, the 2021 Open Door report revealed that there were 914,095 international students enrolled in a U.S. higher education institution during that year, constituting 4.63% of the total college student population in the United States (Institute of International Education, 2021).

The CCAPS-Screen is an all-in-one screening instrument that assesses eight of the most common areas of distress experienced by college students and varsity athletes....

Previous research has demonstrated that discrimination is associated with elevated mental health symptoms (e.g., Bravo et al., 2023; CCMH, 2023; Oh et al., 2018; Paradies et al., 2015).  In the CCMH 2023 Annual Report, we examined the relationship between identity-based discrimination and mental health symptoms in a large national sample of college students seeking treatment at university/college counseling centers (UCCs) between 2021 and 2023.  Discrimination was strongly related to increased general distress, social isolation, and suicidal ideation. Counseling centers were shown to effectively treat student clients with experiences of discrimination: those who reported discrimination showed similar levels of improvement in symptoms of distress, social isolation, and suicidal ideation during services as students with no discrimination. However, students who reported discrimination consistently began and ended treatment with higher average levels of distress, demonstrating a persistent outcome disparity. 

The COVID-19 pandemic had a substantial long-term impact on how mental health services were delivered across the country.  College counseling centers, similar to most other mental health facilities, were forced to abruptly transition to remote services in March of 2020.  To better understand this unprecedented systemic migration to remote care, CCMH began collecting data on the service modalities (in-person, video, audio, and text) offered at centers during the early phases of the pandemic.  At the time, there were ongoing questions regarding the staying power of telehealth services once students resumed a more typical academic instruction environment, which eventually occurred in 2021-2022. Now, approximately four years after the onset of the COVID-19 pandemic, CCMH completed an initial investigation evaluating in-person, video, and hybrid (combined) services, answering the following questions:

The demography of higher education institutions in the United States has notably changed over the last two decades.  For example, the proportion of college students who identify as racially/ethnically diverse has shifted nationally, rising from 45.3% of the general student population in 2010 to 52.1% in 2022 (National Center for Education Statistics, NCES, 2010; 2022).  Notably, in the same time period, the percentage of college students who identify as Hispanic/Latino/a/x increased from 11.8% to 18.9%, and the representation of Asian American/Asian students rose from 5.5% to 6.6%.  Additionally, there has been movement in the percentage of students from other traditionally marginalized groups, such as the LGBQQ+ (Lesbian, Gay, Bisexual, Queer, Questioning, plus others) and TGNB+ communities (e.g., Transgender, Non-binary, plus others).  The proportion of students identifying as TGNB+ in the general student body increased from 1% in 2014 to 4% in 2023 (Healthy Minds Study, HMS, 2014; 2023).  Likewise, the American College Health Association (ACHA) noted changes in the proportion of college students who identify as LGBQQ+, rising from 6.6% in 2008 to 19.6% in 2019.