ADHD News & Research

Study: ADHD Treatment Less Likely for College Students Using Campus Clinics

Seventy-eight percent of college students received ADHD treatment, including medication and therapy, from off-campus providers compared to 70% of students who used campus clinics.

June 17, 2023

U.S. college students with ADHD who saw a mental health professional on campus were less likely to receive medication or therapy for the condition than students who saw a mental health professional off campus, according to a new study published in the Journal of Attention Disorders.1

Researchers from Johns Hopkins University and Syracuse University found that a higher percentage of students with ADHD using off-campus mental healthcare received medication (68% vs. 60%), therapy (46% vs. 41%), or either of the two (78% vs.70%) than students with ADHD receiving on-campus mental healthcare. Ten percent of students with ADHD who saw a mental health professional on campus had appointments or discussions about attention deficit but did not receive ADHD treatment compared to 8% of students with ADHD who saw a mental health professional off campus.

Even when the analysis compared students with the same severity of self-reported ADHD symptoms, those who saw a mental health professional on campus still had lower odds of being treated for ADHD on campus, James Aluri, M.D., lead author of the study, told ADDitude. He said the study’s findings raise questions about the considerable variability between the evaluation and treatment of on-campus and off-campus clinics.

“Is the difference in treatment related to policies at the on-campus clinics that limit access to prescription stimulants? Is this related to student preferences? Are on-campus clinicians too strict with their diagnoses and treatments? Or are off-campus clinicians too lax with their diagnoses and treatments?” Aluri asked.

“Our work cannot differentiate between these possibilities,” Aluri told ADDitude. “However, I am concerned — based on talking to other clinicians and reviewing college ADHD policies across the country — that many campus-based clinics are overly strict with access to assessment and treatment for ADHD. Our study’s findings are consistent with this hypothesis but do not confirm it. The strictness is understandable; resources are limited, and colleges want to avoid contributing to stimulant misuse. But it also means that students with ADHD have limited access to treatment.”

The study examined data collected between Fall 2019 and Spring 2022 from the National College Health Assessment (NCHA) regarding the type and location of mental healthcare among 11,404 U.S. college students diagnosed with ADHD between the ages of 18 to 25.

More students receiving on-campus care lived in university housing (52% vs. 39%) and were on student health insurance plans (13% vs. 7%) compared to students with access to off-campus care. Most students (82%) who received mental healthcare off campus were on their parent’s insurance plans, while 76% of students receiving on-campus care had coverage through their parent’s plans.

The study also found that a higher percentage of those receiving mental healthcare on campus identified as LGBTQ+ (54% vs. 50%), Black (5% vs. 4%), Asian (9% vs. 6%), and international students (6% vs. 4%), and student-athletes (6% vs. 4%)  compared to students who accessed off-campus mental healthcare.

Why ADHD Treatment Lacks Uniformity

David Goodman, M.D., an assistant professor in psychiatry and behavioral sciences at the Johns Hopkins School of Medicine and a co-author of the study, told ADDitude that the lack of uniformity in diagnosing and treating college students seeking ADHD evaluations at college campus mental healthcare services nationwide was concerning. He said some college clinics have psychiatrists on staff, some have psychiatrists on a contract basis, some clinics are run by psychologists, and some have providers who may not have expertise in evaluating ADHD. This is particularly troublesome, he said, for students who have ADHD and go untreated.

“If college students are not receiving ADHD treatment, their academic and social performance is compromised. We know that students with ADHD who are not treated tend to drop out of college or take longer to complete their coursework — and this compromises their ability to move forward in life at the same pace as their peers,” Goodman told ADDitude.

Goodman said that researchers intend to use the study, which was called the largest of its kind, to spur college campuses to review their standards of care, and ultimately, to establish uniformity across campus mental healthcare clinics nationally.

View Article Sources

1Aluri, J., Goodman, D., Antshel, K., & Mojtabai, R. (2023). Variation in ADHD Treatment by Mental Health Care Setting Among US College Students from 2019 to 2022. Journal of Attention Disorders0(0).