When institutions evaluate the success of their student mental health strategies, the conversation often centers on treatment outcomes: Did symptoms improve? Did students complete counseling? Did demand for clinical services decrease?

These measures matter, but they begin too far downstream.

For many students, particularly those who are struggling but not in crisis, the first meaningful outcome is simply being able to access mental health support when they need it. Expanding access to support can lead to increased retention and improved overall wellbeing within a student population.

That makes access more than a pathway to an outcome. Access should be considered a key metric in university student mental health outcomes and an essential component in evaluating who’s getting help.

“Access doesn’t mean every student should be able to walk into the counseling center whenever they want. It means diversifying the ways students can get to the support they need, when they need it.”

– Carl Dindo, Director of Counseling Services, Northern Arizona University

Measuring access, not just treatment

While rates of student depression, anxiety, and suicidal thoughts have improved slightly over the past few years, significant barriers still remain for those who need support. These barriers include timing and scheduling, readiness to seek 1:1 care, or fear of stigma around seeking mental health support.

AUCCCD found that only 11% of students received therapy or counseling on campus in the past year, while the latest Healthy Minds Study indicated that 50% of students reported a mental health disorder within their lifetime. When we also factor in the loneliness epidemic and the absence of flourishing, it is undeniable that a large percentage of students are not getting the support they need and deserve.

Institutions therefore need to ask a broader question: Can students access the right level of support, at the right time, in a way that works for them?

Expanding support beyond the counseling center

Not every student requiring mental health support needs 1:1 counseling.

There is a broad population of students experiencing loneliness, stress, anxiety, or other challenges who may not seek professional treatment, or may not need that level of care. They may may simply want to talk to someone who understands what they are experiencing.

This is where complementary population-level mental health support can expand a university’s approach and reduce counseling center burden. 92% of students using Togetherall’s service are not actively seeking help elsewhere, meaning the digital peer support community is reaching an entire sub-population of students who aren’t accessing campus clinical care.

Stepped-care models offer multiple levels of support, from self-guided resources, to peer support, to counseling and crisis intervention. Emerging evidence suggests these models can improve access, reduce wait times, and help match support to students’ needs.

For universities, this creates an opportunity for increasing access to mental health support while reducing counseling center burden, rather than expecting counseling services alone to meet population-level demand.

Meeting students’ mental health needs whenever and wherever they are

Access also means support availability beyond traditional office hours.

Students’ mental health challenges do not only occur between 9 and 5. A student might feel overwhelmed late at night, experience loneliness on a weekend, or need to talk through something immediately after an upsetting experience.

Togetherall provides instant access to support, any hour of any day. 55% of students using Togetherall access the platform outside office hours. Its anonymous, digital community combines peer support with clinical moderation, creating a clinically safe mental health solution for entire campus populations.

Clinical oversight is an important distinction in peer support services. A study with Harvard University examined moderation within Togetherall and found that licensed clinicians play a critical role in facilitating peer support while minimizing potential harm.

Togetherall helps universities support more and different students in a safe environment, without positioning peer support as a replacement for professional care.

Access can support retention

Expanding access is not only about meeting today’s demand. It can also contribute to longer-term student success.

The 2026 State of Higher Education report from Gallup and Lumina Foundation identifies emotional stress and personal mental health issues among the leading reasons students consider dropping out. Earlier Gallup-Lumina research found that among bachelor’s students who had considered pausing their studies, 67% cited emotional stress and 56% cited personal mental health reasons.

This is indicative of the need to offer a range of mental health supports to meet students where they are, including population-level digital peer support.

Of the 92% of students using Togetherall and not any other campus mental health services, 1 in 5 (20%) reported that the platform helped them remain enrolled. For institutions, this translates into improved student outcomes, significant financial returns, and the potential to offset the full cost of investing in Togetherall.

A broader measure of mental health success

Universities cannot measure the success of their mental health strategy solely by the number of counseling appointments delivered. A more complete picture should consider whether students can reach support before a point of crisis and whether alternate pathways exist for different needs and preferences.

That means measuring time-to-support, barriers to access, engagement with early support, and students’ ability to find help when they need it.

It also means connecting mental health access to institutional priorities such as retention, resource allocation, and sustainability. Universities increasingly need mental health solutions that improve retention and ROI, while ensuring students can access safe, clinically supported care.

For institutions focused on demonstrating ROI from scalable student mental health programs, access itself can be an important metric. Key questions to consider include:

• How many students can the institution reach?
• How quickly can they access support?
• How many engage outside traditional counseling pathways?
• How can we provide a truly safe environment for students to connect with others?
• And can additional support help counseling centers focus clinical capacity where it is most needed?

A study with Togetherall and the University of Edinburgh collected a range of stakeholder perspectives on the platform and its benefits to help inform and accelerate the development of the digital peer support landscape for mental health. Ultimately, a mental health service can only improve outcomes for the students who can access it.

About Togetherall    

To date, Togetherall is available to 4.5 million students worldwide at more than 350 colleges and universities. Togetherall is the leading clinically managed, peer-to-peer, online support community where students can share what’s on their minds, anonymously, safely, and in-the-moment, 24/7/365. Students can connect through shared lived experiences with a global network of peers, backed by the safeguarding of real, live, licensed clinicians overseeing the community around-the-clock. These clinicians empower individuals in peer support and foster and maintain a safe, vibrant environment.     

If you are interested in offering safe and scalable ways to support your students’ mental health, contact us to find out more about Togetherall’s online community.