Most of us can recall our college days and experiences as being some of the best times of our lives. Many college graduates can reflect on the time as the introduction of “adulthood”; freedom, or if you were like me, it was a time of self-expression and self-discovery. Overall, college is a time for all of those things… freedom, self-exploration/identity, adulthood, challenges, responsibility, friendships, career exploration and planning for the future. While college can be a positive experience for many students, there is a darker side that has been neglected in the discussion. For some students, college can be challenging. Students often struggle with adjusting to college, trying to manage finances, balancing work and academics, fear of failing, the imposter syndrome, establishing friendships and the list goes on. While many people would see those issues as a small obstacle, imagine that list being coupled by the fact that the student has a mental health condition such as anxiety, depression, bipolar, schizophrenia or a personality disorder. Seventy-five percent of mental illnesses are onset by age 24 and 43.8 million adults, about one in five, experienced a mental illness in 2012, according to Substance Abuse and Mental Health Services Administration. According to the Association for University and College Counseling Center Directors survey of counseling center directors, 95% of college counseling centers directors surveyed said the number of students with significant psychological problems is a growing concern in their center or on campus. According to the 2013 American Freshman survey of college students, 57% of women and 40% of men reported experiencing episodes of “overwhelming anxiety” in the past year, and 33% of women and 27% of men reported a period in the last year of feeling depressed it was difficult to function. Along with the increase of depression and anxiety, more students are meeting the criteria for a learning disability. As a result of the ongoing mental health crisis, the suicide rate has tripled and is the second most common cause of death among college students. Why is this problem now an epidemic and what can we do to change it? Unfortunately, mental illness is still considered a source of stigma among certain groups of people, organizations etc. Historically, society has frowned upon mental illness which has left a long-lasting effect on how it is addressed. Often when we think about college, we think that students attend who are academically strong, motivated and seeking to make a productive mark in the world. We never think those who suffer from high functioning illness, where the illness is hidden because it may not cause disruption in their everyday life. We also never think about those who struggle because they are afraid of being exposed or seen negatively (hence social stigma of mental illness). I recall during my college years we had classes to support incoming freshmen with the adjustment to college life, yet there was little to no discussion of mental illness. Often these said students struggled silently and when it was too unbearable, they quit or were forced out of school. In twenty years, much of what we know about college students and mental illness has changed but much as not. The challenges of college life including being away from home, managing coursework, making friends, getting along with roommates or choosing classes for a specific semester are some factors that ca lead to intense feelings of inadequacy, which if left unaddressed can lead to feelings of depression. College can be a stressful time and a major transition. Students are under high amounts of stress and often exposed to a culture that they may have been sheltered from of drinking and drug use. The social and academic pressures can be overwhelming for most students. More students are seeking supportive services to help them to cope with the stress and demands of college. What can we do to address this issue? The first and most important step is to bring awareness to this topic. This would include colleges sharing information on their websites about where to find counseling services on campus or off campus. Some community colleges in Maryland have adopted an outreach program for students to connect with a staff member called Success Navigators. These individuals are responsible for assessing the students’ need and help secure appropriate referrals through the college and/or community resources. Additionally, NAMI has a program called NAMI on Campus. This is a student led mental health club that helps raise mental health awareness through fairs, candlelight vigils and walks. This program also provides mental health education through presentations, guest speakers, and student panels. The American Psychological Association developed the Campus Suicide Prevention (2004) as an initiative to provide education and outreach to suicide prevention on college campuses. Active Minds is a non-profit, student mental health advocacy organization that advocates for college campuses to provide mental health services and programs to students. Without the proper psychological services, students with emotional and behavioral problems have the potential to affect many other people on campus, including roommates, classmates, faculty, and staff with disruptive and dangerous behavior. However, when students receive help for their psychological problems, counseling can have a positive impact on academic success, retention and student well-being.