The Numbers Don't Add Up
Between 2010 and 2023, the number of college students seeking mental health treatment at campus counseling centers increased by roughly 300 percent. Over the same period, universities across the country dramatically expanded their counseling staff, introduced mental health days, embedded wellness into orientation programs, and, in some cases, required mental health training for all incoming students.
The crisis got worse. Consistently, measurably worse.
Anxiety disorders, depression, and suicidal ideation among college students all tracked upward through this period, with the sharpest increases coming in the years with the most intensive intervention. This is not an argument against treating mental illness — people in genuine crisis need genuine help. It's a question about whether the therapeutic apparatus universities have built is actually therapeutic, or whether it's doing something else entirely.
I went to school in the early 2000s, before the wellness infrastructure existed in its current form. We had a small counseling center that saw students in genuine distress. What we didn't have was a campus-wide messaging environment that treated normal human difficulty — academic pressure, social awkwardness, romantic failure, uncertainty about the future — as clinical pathology requiring professional intervention. The difference matters.
Medicalization as a Business Model
Universities have a financial incentive to expand their mental health offerings that has nothing to do with student wellbeing. Accreditation bodies reward institutions that demonstrate "student support services." Rankings methodologies include wellness metrics. Federal funding streams are tied to counseling capacity. The expansion of campus mental health infrastructure is not purely altruistic. It's also revenue protection, liability management, and competitive positioning.
The American College Health Association's annual survey — the primary data source for campus mental health statistics — asks students whether they have "felt overwhelmed" in the past year. In 2024, 74 percent said yes. This is treated as evidence of a mental health crisis. It's equally plausible evidence that asking college students if they feel overwhelmed produces high rates of affirmative responses, because college is supposed to be hard, and because the survey teaches students to interpret normal difficulty through a clinical lens.
Jonathan Haidt and Greg Lukianoff documented this dynamic extensively in "The Coddling of the American Mind." Cognitive behavioral therapy specifically teaches the opposite of what campus culture now reinforces: CBT tells patients to challenge catastrophic thinking, test negative beliefs against reality, and build distress tolerance. Campus culture tells students that distress is itself a sign of injustice, that difficult feelings should be avoided rather than processed, and that the appropriate response to discomfort is removal from the situation rather than engagement with it.
You cannot build resilience by removing every obstacle. The attempt to do so isn't compassion. It's a form of neglect dressed up in clinical language.
What's Actually Happening to These Students
The research on this is uncomfortable for people who've invested their careers in campus wellness programs. A 2022 study published in the Journal of American College Health found that students who received counseling center services showed improvement on standardized measures — but students who accessed peer support showed comparable improvement without the clinical framing. A separate study found that students at schools with extensive trigger warning and safe space infrastructure reported higher levels of anxiety than students at schools without them, after controlling for other variables.
Social media's role is real and documented. Jean Twenge's research across decades of survey data shows that the mental health decline tracks closely with smartphone adoption, particularly among girls. The campus counseling apparatus, however well-intentioned, cannot fix what happens when a student goes back to her dorm room and spends four hours on Instagram comparing her social life to professionally curated highlights from people she barely knows. That's not a counseling problem. That's a cultural problem, and universities are largely afraid to say so because it implicates choices students made and platforms that are politically protected.
The honest answer — the one almost no university administrator will give — is that some percentage of students who enroll today are not ready for college, not because they lack intelligence or work ethic, but because the K-12 system and helicopter parenting culture have not equipped them with the capacity to tolerate uncertainty, manage setbacks, or function without constant adult supervision. Sending those students to counseling does not address the underlying deficit. Demanding that they develop it, with appropriate support, would.
A Different Prescription
Reform doesn't mean abandoning students in genuine crisis. It means distinguishing between crisis and difficulty. It means staffing counseling centers for the former without training students to interpret the latter as the former. It means academic programs that build cognitive resilience rather than teach cognitive fragility. And it means being honest with students that a certain amount of anxiety is not a disorder — it's information. It tells you something about what matters to you, where you need to grow, and what work remains to be done.
Three hundred percent more counseling and the numbers keep going up. At some point, that's the data. Do something different with it.
