There is great interest on college campuses in increasing peer support as a mental health resource for students. But more research is needed to establish guidelines for programs, given concerns about accountability, training, and the risks associated with student-led efforts.
That’s according to a new report from the Mary Christie Institute, a think tank focused on the well-being of college students. The report was commissioned by the Institute and the Ruderman Family Foundation.
Peer support should be taken seriously as part of a public health approach to treating student mental health, especially as college counseling centers struggle to meet the demand for services, the report’s authors say. Based on case studies, expert interviews, a literature review, and a survey of counseling center leaders, the report calls on the higher education and philanthropic communities to lead new research into what ideal peer support models should look like. .
Peer support can take many forms, including peer education programs such as tabulation (making charts of mental health information); confidential sessions with a trained peer counselor; peer coaching; mental health helplines; and anonymous online connections such as those offered by TimelyMD and Togetherall.
The report follows an institute survey this year that found one in five college students had used some form of peer support in the past year. Nearly 60 percent of respondents said it was helpful, and rates of use were higher among black, LGBTQ and first-generation students.
A new report presents the results of a July 2022 survey that asked college counseling directors about their views on peer support models. The survey was distributed to members of the Association of Directors of University and College Counseling Centers, and although the response rate was low, 95 percent of the 57 respondents were interested in some form of peer support.
However, counseling directors’ interest in different types of grant programs differed significantly. Campus officials indicated that they are most interested in and likely to support peer education programs that they believe are the easiest to implement. There was also strong interest in peer listening programs, short-term mental health coaching and support groups.
There was less interest — 30 percent — in peer counseling, defined as “confidential counseling by trained peers” to help students navigate mental and emotional concerns, including depression, anxiety and suicidal thoughts.
Marcus Hotaling, director of the Counseling Center at Union College in New York and president of the Counseling Leaders Group, was one of the experts interviewed for the report. Hotaling spoke Chronicle that he is concerned about peer support models that are more akin to traditional counselling, particularly coaching, training and support for students leading sessions.
“I’m much more comfortable sitting at a desk or in a mindfulness meditation group than students sitting and counseling,” she said. “Potential ethical issues are not only possible, but students are already under a lot of stress.”
But Hotaling thinks it’s possible to do such programs well with the right training and supervision. He cited the University at Albany’s decades-long Middle Earth Mutual Aid Program, which includes a hotline, peer tutoring and health workshops, as an example. The State University of New York campus program is student-led but professionally supervised.
Zoe Ragouzeos, clinical director of the Mary Christie Institute and author of the report, said it underscores the need for standardized protocols and training for peer support. Ragouzeos is also the executive director of Counseling and Wellbeing Services at New York University.
She hopes the report will prompt research into the effectiveness of different forms of peer support and which programs work best for specific students.
Although peer support cannot replace professional counseling, the report concludes that it should be pursued as a valuable part of public health for student well-being. Peer support can help students cope with temporary problems, such as loneliness or homesickness, that are not the result of a mental health diagnosis. In some cases, it can be a bridge to intensive care. And it can be especially helpful for students from certain identity groups who want to connect with peers they can relate to.
“But again, without data, you don’t know which students it’s really working for,” Ragouzeos said.