Mental Health Referrals From Universities: Therapy Services for Students in Crisis
College life can be one of the hardest transitions to adjust to. The pace of study rises quickly, responsibilities grow alongside it, and the pressure to find your footing can weigh heavily. Feeling out of place in the first months is normal, but it’s also a stage where mental health issues can quietly develop. That’s why understanding the support available is key to having the best college experience possible.
Mental health support is invaluable during times when you feel like you’re struggling to cope alone, and Mission Connection can help you find the right fit for your needs. For this reason, this article looks at:
- What college mental health support entails
- The current state of college mental health support
- Whether students are actually using the mental health support provided
- What happens when campus support isn’t enough
- Inpatient vs outpatient programs
- Your autonomy in college referrals
- Continuing your studies while receiving mental health support
- Where to find the external help you need
What Does College Mental Health Support Entail?
You might have seen posters or emails advertising mental health support on campus, but never felt the need to check them out before now. Or maybe you’ve thought about it and felt a little hesitant. Either way, this is fair. Even though times have changed and it’s more acceptable to talk about mental health now, there are still old attitudes that linger.
For some, these attitudes make it hard to take that first step. For others, the truth is they’re just not sure what support is actually available out there. The following sections cover the types of mental health support often available on college campuses. Your campus might offer variations on these, but they’ll likely work in similar ways.
Wellness Initiatives
Nowadays, most colleges try to make support as approachable as possible. You’ll often find mindfulness sessions, workshops that help with managing stress, or chances to talk things through with other students who’ve been in similar shoes.1
For someone already under pressure, these initiatives can offer some breathing space and a reminder that they’re not alone. For those who aren’t currently struggling, joining in can still make a difference, as they can build habits that might stop small worries from snowballing later on.
Counseling Services
Beyond wellness initiatives, there’s usually the option of counseling with a campus therapist. This counseling is often short-term, usually free, and focused on immediate concerns.2 Think of it as an open door: if you’ve never spoken to a professional before, this is where many students dip their toes in. It won’t always be enough if deeper issues are at play, but it can be the spark that gets someone started on a journey they wouldn’t have taken otherwise.
In many ways, this is the real value of on-campus counseling services. They’re not the end point, but more like the start of a transformative journey. They can help break down stigma, give students an early taste of support, and shine a light on struggles that might stay hidden until they’re much harder to handle.
The State of College Mental Health Resources in the U.S.
With the availability of such great mental health support options on campus, it begs the question: Do all colleges actually have these options in place? It can help to take a closer look at the numbers.
As of 2025, more than 1,700 U.S. postsecondary institutions report offering some form of mental health service,3 which shows that the infrastructure is there. This is excellent news. Especially when you consider that a recent U.S. News/Generation Lab survey of 3,649 students found 70% had struggled with their mental health since starting college.4
So, let’s do a quick recap. Colleges across the country have invested in mental health services. The need is undeniable, with a large portion of students saying they’ve faced struggles. Surely, then, the end result should be that support meets demand? Unfortunately, the reality suggests otherwise.
According to the same research, only 37% of students actually received support on their college campus.
So, what’s going on here? Is it a lack of motivation for uptake, or is availability still a problem? We take a look at potential underlying reasons in the following section.
Are College Students Using On-Campus Mental Health Support?
From the numbers we just looked at, it might seem like students are avoiding the services offered to them. The stereotype of “laziness” often gets thrown around when people talk about college life, but this can be a damaging and unhelpful assumption when it comes to mental health.
Students aren’t ignoring their mental health. In reality, many are trying to use the support available, but the demand is simply too high.
This doesn’t necessarily mean that every student is struggling with severe mental health issues. But what it likely does mean is that today’s generation is far more attuned to their emotional well-being than those who came before.5 For instance, many might drop in for a counseling session to offload stress, while others have deeper, ongoing issues that require more structured support. Both groups add to the numbers seeking support, and this can create pressure on already stretched systems.
In fact, when we take a look at the number of students wanting access to mental health support, the demand itself has skyrocketed. According to Penn State University’s Center for Collegiate Mental Health, the number of students seeking help at campus counseling centers rose by almost 40% between 2009 and 2015. Plus, this number continued to climb until the pandemic disrupted access.5
Unfortunately, though, resources have not expanded at the same pace. As a result, college counselors often carry unsustainable caseloads. Nationally, the average annual caseload for a single full-time counselor is around 120 students, with some centers averaging more than 300.5
This mismatch between need and resources means students may face long wait times, rushed appointments, or limited session availability. While campuses typically do their best, it shows why many students eventually need referrals for additional care.
What Happens When On-Campus Support Isn’t Enough?
As we’ve already established, mental health services at college often serve as the “entry point” into the system. They’re a great way to dip into support, whether this is trying counseling for the first time or joining a wellness initiative to keep stress at bay. But there are times when students either want to take their mental health journey further or find themselves facing issues that campus services simply can’t cover.
College counseling centers are not designed to handle complex or severe mental health conditions. In these cases, students are often referred to external services that can provide deeper, more structured help. Situations where a referral is likely to happen include:
- Experiencing persistent or severe depression that doesn’t improve with short-term therapy
- Struggling with suicidal thoughts or self-harm behaviours
- Living with an anxiety disorder or panic attacks that interfere with daily life
- Developing disordered eating or significant changes in weight and appetite
- Engaging in risky behaviors on a regular basis
- Showing signs of psychosis, mania, or other serious mental health conditions
- Repeatedly reaching crisis points that require urgent intervention.
In these circumstances, on-campus care is still important, but it often isn’t enough on its own. This is where referrals to outside providers come into the frame. Students may be guided toward inpatient treatment programs, residential care designed for young adults in college, or specialized therapy programs tailored to student mental health needs.
These options go beyond the short-term focus of campus counseling and provide the kind of intensive, ongoing care that can help a student stabilize and move forward in a healthier way.
Inpatient vs. Outpatient Programs
When a college refers a student for additional support, one of the first decisions is whether an inpatient program or an outpatient program is the right option. Both involve therapy tailored to student mental health needs, but the main difference is where the care takes place.
Let’s take a closer look at these:
Inpatient Programs
Inpatient care, sometimes called “residential treatment,” means staying at a dedicated facility for a period of time. The idea of stepping away from campus might sound daunting at first, but the purpose is clear: to create a safe and structured space where you can put your well-being first.
An inpatient program usually brings together:
- 24/7 support and supervision
- One-to-one therapy with a clinician who takes the time to understand your situation
- Group sessions with peers who are also navigating challenges
- Workshops that focus on skills for managing issues like anxiety, depression, or trauma
- A steady routine that blends therapy with time for rest and reflection
- Medication management, when needed
This type of care is often recommended when things feel too overwhelming to handle alone or when safety becomes a concern. For example, if you are living with persistent depression, experiencing thoughts of self-harm, or coping with behaviours that put you or others at risk.
Inpatient care can also provide the right support for you if you’re coping without strong networks at home or if your current environment makes recovery more difficult.
Outpatient Programs
Outpatient care gives you access to many of the same therapeutic options as inpatient treatment, but without needing to stay at a facility. You attend your scheduled sessions during the day or evening and then return home afterward, staying connected to your homelife while still receiving structured support.
This type of care can be a good fit if you feel steady enough to continue with classes or work but want regular guidance to help you manage your mental health. It often works best if you already have supportive friends or family around you and can maintain a level of stability outside of treatment.
Your outpatient program will be shaped around your needs, which includes a slightly more flexible structure than inpatient treatment. For some, a few sessions each week provide the right level of support. For others, a more intensive schedule works better. Either way, you’ll be able to practice new coping skills in real time while knowing that professional help is there to guide you through challenges and build your resilience.
Do I Have a Say in College Mental Health Referrals?
Ultimately, both inpatient and outpatient programs are designed to help students stabilize and grow, and both have their place depending on what you’re currently experiencing. The choice isn’t one you have to make alone, as your college referrer will talk through the options with you and guide you toward what’s most suitable.
However, in many cases, you’ll have the freedom to decide which route feels right for you. In more pressing situations, professionals may strongly recommend inpatient care to ensure safety and stability.
But this doesn’t mean control will be taken away; your voice will still likely be considered. It just means that you will be supported with a level of care that will give you the best chance of feeling better.
I’ve Been Referred for Inpatient Treatment – What Happens to My Studies?
College is already a balancing act, so it makes sense to worry about what happens to your classes if you take time away for your mental health. You might wonder: Can I pause my studies? Or, Will I fall behind? The good news is that you usually can take a medical or mental health leave of absence and pick things up again when you’re ready.6
Universities understand that recovery needs time, and most offer an official leave of absence. This lets you step away temporarily without losing your student status. When you’re ready, you’re typically welcomed back to finish the semester and pick up where you left off.
Always remember, though, these policies aren’t a penalty. They’re compassionate, structured pauses designed to give you the space to heal, so you can return when you’re able to fully engage again.
Taking a break can sometimes be the smartest move you can make. It’s easy to forget how much your mental health matters, especially when you’re buried in deadlines and expectations. The truth is, the toughest parts of your degree are almost impossible to tackle without the right headspace.
Hitting pause gives you the best chance to move forward with clarity and confidence. Approaching your campus student union regarding your need for a leave of absence will likely signpost you in the right direction of who you need to talk to.
Mission Connection: Outpatient Support Tailored for College Students
At Mission Connection, we’ve designed our outpatient programs so they fit around the demands of college life, giving you support without pulling you away from the things that matter most.
Many students come to us when anxiety makes it hard to concentrate in class or when depression leaves them struggling to keep up with daily routines. Others are living with bipolar symptoms that can make life unpredictable, while some face different challenges altogether that still affect their ability to thrive at college. Whatever the concern, we make sure our treatment feels approachable and focused on you.
In our outpatient programs, CBT is often used to challenge thought patterns that make stress or low mood harder to manage, while DBT helps students build steadier ways of handling strong emotions. These therapies are proven to work and can be adapted to fit the unique pressures of student life. Depending on your needs, other approaches may be blended in too, but the focus always remains on what could help you most.
With outpatient care, you don’t have to choose between your education and your well-being; you can strengthen both at the same time.
References
- Ascione, L. (2025, February 28). Why campus mental health support is critical for students. ECampus News. https://www.ecampusnews.com/student-wellbeing/2025/02/28/why-campus-mental-health-support-is-critical-for-students/
- National Alliance on Mental Illness. (2025, June 17). Mental health in college. https://www.nami.org/kids-teens-and-young-adults/young-adults/mental-health-in-college/
- Aluri, J., Terzian, A., Mojtabai, R., & Arria, A. (2025). Prevalence of on-campus student mental health services at U.S. colleges and universities: A web-based analysis. Psychiatric Services. Advance online publication. https://doi.org/10.1176/appi.ps.20240479
- Wood, S. (2024, June 6). Mental health on college campuses: Challenges and solutions. U.S. News & World Report. https://www.usnews.com/news/education-news/articles/mental-health-on-college-campuses-challenges-and-solutions
- Abrams, Z. (2022, October 1). Student mental health is in crisis. Campuses are rethinking their approach. American Psychological Association. https://www.apa.org/monitor/2022/10/mental-health-campus-care
- Mental Health America. (2025, January 8). Taking a leave of absence: What you need to know. https://mhanational.org/resources/taking-a-leave-of-absence-what-you-need-to-know/
