Scalable approaches such as digital cognitive-behavioural therapy guided self-help (D-CBTgsh) may help close the treatment gap for college students with mental disorders. In a randomized clinical trial across 26 US colleges, populations were offered a mental health screen (39,194 assessed). Students with clinical levels or high risk for anxiety, depression and/or eating disorders (N = 6,205) were randomized to screening+D-CBTgsh or screening+referral-to-college-provided-care groups.

Findings: Screening+D-CBTgsh reduced prevalence of any mental disorder (primary outcome) at 6 weeks, 6 months, and 2 years. Services uptake was greater in screening+D-CBTgsh (74.4%) versus screening+referral (30.2%) at 6 months and 2 years, including for minoritized groups. Screening+D-CBTgsh (versus screening+referral to college-provided care) also improved dimensional outcomes of generalized anxiety, social anxiety, depression, eating disorder symptoms and mental health functioning. Findings supported transdiagnostic prevention and intervention benefits of screening+D-CBTgsh and its viability as a scalable, population-based approach.

This article features Daniel Eisenberg, director of mental health at the UCLA Center for Health Policy Research.
 

This study uses 2022–2024 California Health Interview Survey (CHIS) data to examine substance use among California adolescents ages 
12–17 and its links to psychological distress and suicide risk.

Findings: Nine percent of California adolescents currently use substances, most commonly marijuana/other THC (6%), alcohol (binge drinking) (4%), or e-cigarettes (3%). Adolescents who use substances are significantly more likely to have experienced serious (46%) or moderate (21%) psychological distress or to have thought about or attempted suicide in the past year (28%) than adolescents who did not use substances (27%, 13%, and 8%, respectively). Adolescents with both substance use and psychological distress had the highest risk of past-year suicidal thoughts and attempts (47%) compared to adolescents with psychological distress alone (24%) and adolescents with substance use alone (8%). Taken together, these trends emphasize the need for prioritizing youth-centered prevention, early intervention, and treatment for adolescents who have both substance use and psychological distress. 

Early identification of mental health problems is key to ensuring adolescents receive timely and appropriate support and strengthen their long-term mental health. The current study uses a population-based state survey to answer two research questions: (1) Do adolescents with elevated levels of psychological distress perceive that they need mental health help? and (2) Which adolescent groups are most vulnerable to high levels of distress and perceived need for help? Using data from the 2019 California Health Interview Survey (CHIS), the estimated population-based sample was 3.1 million adolescents. Half were female (50.9%); sample was racially and ethnically diverse (Latinx, 40.1%; white, 38%; Asian, 12.8%). CHIS included social determinants of health questions, the Kessler-6 psychological distress measure, and a question on perceived need for mental health help.

Findings: Among youth with moderate or serious psychological distress, 45.5% denied needing mental health help. Adolescents with moderate to distress had higher odds of perceived need than youth with subclinical distress levels. Compared to males, females had higher odds of having moderate or serious psychological distress, and a perceived need for help. White youth had higher odds of serious psychological distress than Asian adolescents, and of perceived need compared to Latinx, Asian, and multiracial adolescents. Although distress and need were seemingly concordant, discrepancies existed as some adolescents experienced clinical-level distress but denied need. Comprehensive screening is critical for systems to connect all adolescents to appropriate supports. 

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 for resources.

Findings: A selection of results show that in 2025, 37% of students reported moderate to severe depressive symptoms, with 18% of that group reporting severe depression. Nearly one-third (32%) of students reported having moderate to severe anxiety, 1 in 10 (11%) reported suicidal ideation, and 1 in 4 felt isolated from others.