College mental health and the digital care transition: national trends in distress, help-seeking, and technology-mediated access, 2020-2025.

BACKGROUND

College mental health burden increased during the COVID-19 era while university mental health services rapidly adopted remote and digital modes of care. The population-level co-occurrence of these changes has rarely been described across the pandemic and post-pandemic period.

METHODS

We performed a secondary ecological trend analysis of seven publicly available, weighted Healthy Minds Study national reports based on successive independent cross-sectional samples from Winter/Spring 2020 through 2024-2025. The reports contained a nominal 553,785 response records across waves; they were not pooled as a single cohort. Harmonized outcomes included depression, anxiety, suicidal ideation, nonsuicidal self-injury, self-reported academic impairment, treatment use, stigma, resource awareness, and selected digital-care indicators. Changes were summarized descriptively as percentage-point and relative differences; no across-wave significance tests or individual-level associations were estimated.

RESULTS

Depression increased from 37% in Winter/Spring 2020 to 44% in 2021-2022 and was 37% in 2024-2025; anxiety increased from 31% to 37% and was 33% in 2024-2025. Self-reported academic impairment of at least 6 days in the prior 4 weeks declined from a Fall 2020 peak of 28% to 16% in 2024-2025. Therapy use increased from 27% to 38%, treatment among students with positive depression/anxiety screens from 51% to 61%, resource awareness from 72% to 83%, and perceived public stigma declined from 51% to 36%. Among therapy users, remote-only care increased from 29% in Fall 2020 to 42% in Winter/Spring 2021, while in-person-only care declined from 35% to 22%; remote-capable care (remote-only plus hybrid) increased from 65% to 77%. In 2024-2025, 7% of the weighted national sample reported a mobile app, online platform, or other digital mental health resource as a provider/resource category.

CONCLUSIONS

The observed national estimates show post-peak improvement in several mental health and functional indicators alongside an early-pandemic shift toward remote and hybrid care. Because the analysis used aggregate reports with changing institutional composition, these findings describe population-level trends rather than causal effects or individual recovery.