The fragmentation of mental health care for university students
Keywords:
mental health; students, university; mental health services; continuity of patient care; public healthAbstract
Introduction: The mental health of university students has become a matter of interest within the health sector due to the frequency of psychological problems during this stage and their potential effects across the life course.
Objective: To critically analyze the fragmentation of mental health care for university students from a public health perspective.
Opinion: Mental health care takes place in a context in which universities, health services, and policies targeting the youth population intervene simultaneously, with limited articulation among these levels. This fragmented organization is reflected in discontinuous care processes, referrals without institutional follow-up, and poorly defined responsibilities, which hinder continuity of care. As a result, the burden of sustaining care often falls on students themselves, affecting more strongly those in situations of social or economic vulnerability.
Conclusions: Analyzing the fragmentation of mental health care as a public health problem makes it possible to understand its effects beyond the individual academic sphere and to recognize how lack of continuity and inequalities in access limit the effectiveness of available responses.
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1. Paiva U, Cortese S, Flor M, Moncada-Parra A, Lecumberri A, Eudave L, et al. Prevalence of mental disorder symptoms among university students: An umbrella review [Internet]. Neurosci Biobehav Rev. 2025;175:106244. DOI:10.1016/j.neubiorev.2025.106244
2. Solmi M, Radua J, Olivola M, Croce E, Soardo L, Salazar de Pablo G, et al. Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies [Internet]. Mol Psychiatry. 2022;27(1):281-95. DOI:10.1038/s41380-021-01161-7
3. Read A, Lutgens D, Malla A. A descriptive overview of mental health services offered in post-secondary educational institutions across Canada [Internet]. Can J Psychiatry. 2023;68(2):101-8. DOI: 10.1177/07067437221128168
4. McGorry PD, Mei C, Chanen A, Hodges C, Alvarez-Jimenez M, Killackey E. Designing and scaling up integrated youth mental health care [Internet]. World Psychiatry. 2022;21(1):61–76. DOI: 10.1002/wps.20938
5. López-Gamboa GE, Pinto-Sosa JE. Public policies for the promotion of mental health in adolescents in Ibero-America: a systematic review [Internet]. Psychol Soc Educ. 2025;17(1):29-40. DOI: 10.21071/psye.v17i1.17390
6. Tafur S, Quispe MA, Ayala RE. La reforma de salud mental en el Perú, una actualización en el contexto pandémico [Internet]. Rev Cuidado Salud Pública. 2023;3(2):53–58. DOI: 10.53684/csp.v3i2.56
7. Ministerio de Salud. Resolución Ministerial N.° 686-2024-MINSA: Plan Nacional de Fortalecimiento de Servicios de Salud Mental Comunitaria 2024-2028 [Internet]. Lima: Ministerio de Salud; 2024 [acceso: 13/01/2026]. Disponible en: https://www.gob.pe/institucion/minsa/normas-legales/6094628-686-2024-minsa
8. Villarreal-Zegarra D, Al-kassab-Córdova A, Otazú-Alfaro S, Cabieses B. Socioeconomic and spatial distribution of depressive symptoms and access to treatment in Peru: a repeated nationwide cross-sectional study from 2014 to 2021 [Internet]. SSM Popul Health. 2025;29:101724. DOI: 10.1016/j.ssmph.2024.101724
9. Oha JT, Bridge G, Flood C, Jenkins CL, Taylor-Page C, Sykes S, et al. Gaps and opportunities in mental health support for young people: a process evaluation of a multi component intervention [Internet]. Front Public Health. 2025;13:1684562. DOI: 10.3389/fpubh.2025.1684562
10. Quinlan-Davidson M, Henderson JL, Szatmari P, Cheung A, Dixon M, Relihan J, et al. A qualitative study exploring youth’s experiences of hospital- and integrated community-based mental health services: the YouthCan IMPACT initiative [Internet]. BMC Psychiatry. 2025;25(1):07523. DOI: 10.1186/s12888-025-07523-7
11. McHugh C, Hu N, Georgiou G, Hodgins M, Leung S, Cadiri M, et al. Integrated care models for youth mental health: a systematic review and meta-analysis [Internet]. Aust N Z J Psychiatry. 2024;58(9):747-59. DOI: 10.1177/00048674241256759
12. Dar DR, Sobhana H. Bridging the gap and integrating youth mental health support in colleges: insights from policy to practice within a public health framework – a systematic narrative review [Internet]. Indian J Soc Psychiatry. 2025;41(4):342-53. DOI: 10.4103/ijsp.ijsp_219_24
13. Sawrikar V, Hodgins M, Leung S, Ardill-Young O, Curtis J, Lingam R. Evaluating youth mental health service integration in Australia using the youth integration project framework [Internet]. BMJ Open Qual. 2025;14(4):e003280. DOI: 10.1136/bmjoq-2024-003280
14. Lipson SK, Lattie EG, Eisenberg D. Increased rates of mental health service utilization by U.S. college students: 10-year population-level trends (2007–2017) [Internet]. Psychiatr Serv. 2019;70(1):60-3. DOI: 10.1176/appi.ps.201800332
15. Knaak S, Mantler E, Szeto A. Mental illness-related stigma in healthcare: barriers to access and care and evidence-based solutions [Internet]. Healthc Manage Forum. 2017;30(2):111-16. DOI: 10.1177/0840470416679413
16. Sontag-Padilla L, Williams D, Kosiewicz H, Daugherty L, Kane H, Gripshover S, et al. Supporting the mental health needs of community college students [Internet]. Rand Health Q. 2023 [acceso: 12/01/2026];10(4):6. Disponible en: https://www.rand.org/pubs/research_reports/RRA2552-1.html
17. Osborn TG, Town R, Bawendi M, Stapley E, Saunders R, Fonagy P. University students' access to mental health services: a qualitative study of the experiences of health service professionals through the lens of candidacy in England [Internet]. J Health Serv Res Policy. 2024;29(4):230-9. DOI: 10.1177/13558196241235877
18. King N, Pickett W, Pankow K, Dimitropoulos G, Cullen E, McNevin S, et al. Access to university mental health services: understanding the student experience [Internet]. Can J Psychiatry. 2024;69(12):841-51. DOI: 10.1177/07067437241295640
19. Salehi M, Hormozi F, Marvi A, Sedigh B, Zakeri AJ. Exploring implementation barriers of mental health programs in primary health care: a qualitative study from Iran [Internet]. BMC Health Serv Res. 2025;25(1):1555. DOI: 10.1186/s12913-025-13702-9
20. Cooper Z, Roberts B, Landery G, Woodland S, Collins KRL, Majda BT, et al. Exploring the perspectives of young adults on mental healthcare and systemic health, education, and social challenges in Australia: a qualitative study [Internet]. BMC Health Serv Res. 2025;25(1):1402. DOI: 10.1186/s12913-025-13580-1
21. Ayres JRCM, Mendes VM, Almeida IS, Devincenzi MU, Guimarães JS, Calazans GJ, et al. Atención integral a la salud de adolescentes y jóvenes desde la perspectiva de profesionales de atención primaria, San Pablo, Brasil [Internet]. Salud Colect. 2025;21:e5419. DOI: 10.18294/sc.2025.5419
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