The study, by Elissa R. Weitzman, a researcher in the Department of Society, Human Development and Health, is the first published report from a nationally representative sample of colleges and college students describing these patterns. The study appears in the April issue of The Journal of Nervous and Mental Disease.

“We know from numerous studies that young or ‘emergent’ adulthood is a time of great opportunity, risk and social developmental transition for young people,” said Weitzman. “The period roughly defined as young adulthood, ages 18-24, also coincides with what are now recognized as the peak years for onset and intensification of the most common mental health problems among youth – those related to alcohol, tobacco and other drug use, depression and anxiety disorders and suicide.  One out of every three young adults in this country makes the transition to young adulthood in college settings, making this an important context within which to study these problems.”

Among the study’s key findings are:

• Across the 119 four-year colleges surveyed, the average prevalence of poor mental health or depression was 5.01 percent as self-reported by the students. The survey posed a set of questions in an accepted mental health scale that provides a valid indication but not medical diagnosis of depression. This estimate is consistent with the 5.8 percent prevalence reported among community dwelling adolescents and young adults in the National Comorbidity Survey, an ongoing study supported in part by the National Institute of Mental Health and based at Harvard Medical School.
• There was a considerable range of depression prevalence by school, from less than one percent to greater than 13 percent, which was not explained by standard differences in the institutions such as coeducational state, enrollment size, geographic region, public or private status or academic competitiveness.
• Students from lesser status groups – women, racial and ethnic minorities, and students whose parents did not attend college –were at elevated risk for depression.
• Alcohol use was highly prevalent among students reporting poor mental health/depression: 81.7 percent of them drink alcohol. The students with poor mental health/depression were less likely than their peers to report lifetime abstinence (18.3 percent vs. 19.5 percent), more likely to report drinking but not heavy episodic drinking (41 percent vs. 36 percent), and more likely to report drinking to get drunk (56 percent vs. 51 percent).
• Students with poor mental health/depression who drink reported high levels of harm from alcohol: 29 percent reported falling behind in their school work; 14 percent reported having unsafe sex, 12 percent reported vandalizing property and 23 percent reported having five or more harms from drinking. These levels are all higher than among their peers who did not have poor mental health. Risks for harm were especially pronounced among young women who are depressed and who drink alcohol, making alcohol for them a kind of “double jeopardy.”
• Students with poor mental health/depression were more likely than their peers to meet DSM-IV criteria for alcohol abuse even after controlling for heavy episodic or “binge” drinking.

“Co-occurring patterns of depression and alcohol abuse are not surprising,” said Weitzman, “but this extra risk for abuse among depressed youth in college, and especially among young women, is troubling given the heavy drinking norms in college. College youth who suffer from depression may be especially vulnerable to complications with alcohol. This is a warning sign for families and for colleges –to offer extra support around drinking issues to youth who may be prone to depression.”

“The finding that some schools have very low levels and others very high challenges us to consider whether features of the college and the educational experience may protect youth or place them at risk. We know very little about this important issue.”

This study was supported in part by a grant from the Robert Wood Johnson Foundation.