How Peer Counseling Can Address Barriers to Student Mental Health

Depressed young student with face mask sitting on floor back at college or university, coronavirus concept.

Depressed young student with face mask sitting and studying on floor back at college or university, coronavirus concept.


When Dr. Sarah Lipson, a Boston University Professor and Associate Director of the Healthy Minds Network, worked in higher education as residential life staff, she soon found that mental health problems on college campuses were more prevalent than commonly thought. “Mental health was the biggest barrier to students thriving in college, both academically and socially.”

While her introduction to the student mental health epidemic occurred over 15 years ago, mental health issues on college campuses have continued to grow, exacerbating college resources, and have led to a dangerous treatment gap which has only been amplified by the pandemic. Colleges have attempted to address this treatment gap in past years; however, one solution that is often overlooked takes the form of peer counseling.

Peer counselors are non-professionals who are trained in active listening and in guiding their peers through emotions without offering specific advice. The goal of peer counseling programs is not to treat symptoms or crises, but to provide a necessary form of community support and intermediate care that could prevent further escalation of poor mental health. Although the practicality of non-professional mental health resources has prompted skepticism, studies suggest that preventative resources such as peer counseling may be an important aspect of campus mental health support systems.

According to Dr. Lipson’s research through the Healthy Minds Network, “About half of students appear to be struggling to some degree, with their mental health.” Despite this, less than 50% of those students struggling actually sought support from counseling resources. Although studies have consistently demonstrated a huge increase in the number of students suffering from mental illnesses, according to data collected by the Association of University and College Counseling Center Directors (AUCCCD), the percentage of students served by counseling services has largely remained the same. Dr. Lipson has seen that this especially affects certain demographics,  “On a population level, on average, first-generation, low-income and students of color have lower rates of accessing treatment.” In response, colleges have been pouring greater resources into hiring new counseling staff, but from the above statistics it is evident that students have been encountering significant barriers to accessing mental health support

Lack of available staff, costs, and stigma are three of the main barriers encountered. Despite increased staffing, counseling sessions remain difficult to secure. According to the AUCCCD, a student can only obtain an appointment after an average wait time of about six days. While a week’s wait may seem standard, for students in mental health crises long wait periods can be deadly— suicide is still the second most common cause of death in college student age groups. Additionally, free counseling sessions are often limited. At Indiana University, students are only allotted two free counseling sessions each semester before having to pay $35 per visit. Stigma surrounding mental illness and seeking psychological support has also remained a large barrier to students accessing care. A study on the relationship between perceived stigma and the inclination to seek mental health support found that perceived stigma especially affects certain minority populations as well as men, causing them to seek resources at much lower rates than other demographics.

By utilizing students as a resource for preventative care, colleges can begin to lessen the burden of clients in their counseling centers. Peer counseling also provides a mental health support system to students that is free of cost and that contains a greater diversity of counselors whose common experiences may help to reduce the perceived stigma of mental health care. Dr. Lipson supports a preventative approach to mental healthcare, “It’s not as if every student who has a positive screen for depression or anxiety necessarily needs intensive one on one therapy… there is a need to have resources and services that meet students all the way across the continuum of mental health.”

Active Minds is one example of a successful peer-based outreach program that has implemented chapters on more than 800 campuses. Through the organization, student leaders hold mental health awareness campaigns and outreach events to college students in hopes of reducing stigma across campus. For Maddie Paoletti, the President of Active Minds at Wellesley College, the value of peer-based mental health resources has become apparent on her campus, “Peer health education groups are able to key into the areas that more established institutions like professional counseling resources can’t reach… Peers just understand each other better than we would adults.” Research has shown that the presence of mental health outreach entities such as Active Minds is associated with increased knowledge of mental health issues and decreased stigma on campuses over time. While research on peer counseling in college education settings is still limited,  a number of studies suggest that peer counseling methods have been linked to decreased hospitalizations, increased social functioning, increased quality of life and decreased self-stigma in adults.

In establishing peer counseling programs institutions must be wary of the potential liabilities of placing students in roles where they risk encountering people in mental health crises. Programs must be implemented in a way that protects both peer counselors and students who are seeking help. While this might be done by investing in adequate training and supervision, colleges and universities must also conduct further research to determine how peer counseling programs can be implemented safely and effectively on their own campuses

Poor mental health has run rampant through our college campuses for too long. As counseling centers remain under-resourced, peer counseling offers a beacon of hope for students and counseling professionals who have struggled with the overwhelming demand for greater mental health resources in the past decade. It is time for college administrations and counseling centers to hear their students and address the need for diversified support systems that are accessible, effective, and can help put an end to this epidemic.


Read the full article on Forbes, (originally published August 11, 2021).

© William A. Haseltine, PhD. All Rights Reserved.