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Nurse-Led Mental Health Interventions for College Students: A Systematic Review

Nancy G. Russell, DNP, MSN, FNP-BC, CNE^1,2; Tamar Rodney, PhD, MSN, PMHNP-BC, CNE²; Jennifer K. Peterson, PhD, APRN-CNS, CNE²; Andreea Baker, RN, MSN³; Lucine Francis, PhD, RN, CNE^2,4 (View author affiliations)

Suggested citation for this article: Russell NG, Rodney T, Peterson JK, Baker A, Francis L. Nurse-Led Mental Health Interventions for College Students: A Systematic Review. Prev Chronic Dis 2025;22:240200. DOI: .

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Abstract

Introduction

Mental health conditions such as anxiety, depression, and suicidal ideation or suicide are prevalent among college students and are a growing public health concern. The COVID-19 pandemic exacerbated this crisis. Nurses are a vital component of college health services and may be the first or only health care provider to evaluate college students experiencing a mental health condition. However, the literature has limited evidence on the nurse’s role and its impact on college mental health. Our systematic review examines nurse-led mental health interventions for college students.

Methods

We conducted a comprehensive search for nurse-led interventions in college mental health by using PubMed, Embase, CINAHL, PsycInfo, and ERIC databases. A total of 2,814 articles were identified, and 2,290 were screened after removal of 524 duplicates. Thirty-five studies were reviewed for eligibility, and 16 were included in this review. The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Hierarchy of Evidence Guide and Appraisal Tools were used to rate the strength and quality of the evidence, and the selected articles were generally of good quality.

Results

The 16 articles came from institutions in North America (n = 5), southeastern Europe (n = 3), and Asia (n = 8). The studies focused on samples with a pre-existing mental health diagnosis or on mental health symptoms and interventions aimed at addressing mental health concerns. The interventions were facilitated by nurses and included various approaches, including experimental, quality improvement, and educational strategies.

Conclusion

This review underscores the crucial role of nurses in addressing mental health issues among college students. Despite variability in approaches, nurse-led interventions offer promise in enhancing student well-being. Further studies are essential to gauge effectiveness and shape policies for supporting the nurse’s unique role in higher education. Integrating these findings into practice and policy will equip college health services to meet students’ evolving needs. Leveraging the expertise of nurses can enhance student mental well-being, leading to improved academic outcomes and overall quality of life.

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Introduction

Mental health conditions, including anxiety, depression, suicidal ideation, and suicide are global public health concerns and are highly prevalent among the college-aged population (1–4). Early adulthood and late adolescence are the periods in which 75% of mental health conditions begin, coinciding with the traditional college age for most students (5). Mental health symptoms are individual experiences or signs, such as persistent sadness or anxiety, that indicate a potential issue. A formal diagnosis, on the other hand, is a professional assessment made by a clinician based on a comprehensive evaluation of these symptoms and other criteria, leading to classification of a specific mental health condition, such as generalized anxiety disorder (6,7). Additionally, symptoms of different mental health diagnoses overlap. For example, symptoms such as sleep disturbances, irritability, and difficulty concentrating can appear in both depressive and anxiety disorders (6,7).

Suicide is the fourth leading cause of death worldwide among people aged 15 to 29 years (8). Over the last 3 decades, rates have been increasing among those aged 10 to 24 years in Central Europe, the US, the United Kingdom, Latin America, and Australasia (9). In the US, suicide is the second leading cause of death for people in the 10- to 24-year-old age group (3). US males have the highest age-standardized suicide rates globally (8,9). People who are adversely affected by social determinants of health, those from sexual minority communities, and those from tribal or indigenous groups have the highest rates of suicide (3,8). According to the American College Health Association (ACHA) National College Health Assessment (NCHA), which included more than 54,000 undergraduate student respondents, approximately 35% reported having anxiety, 27% reported having depression, 23% reported having both anxiety and depression, 8% reported having posttraumatic stress disorder (PTSD), 12% reported intentional self-harm, and 30% reported positive suicidal behavior, with 3% reporting a suicide attempt within the previous 12 months (4). The 2022 ACHA NCHA found that some students experience higher rates of anxiety, depression, PTSD, intentional self-harm, suicidal behavior, and suicide attempts compared to others (4). Mental health conditions affect academic performance (10,11) and potentially overall progression and outcomes (10,12) and are associated with other adverse health and social effects (12). College student mental health concerns are increasing in prevalence, and the COVID-19 pandemic has further exacerbated this mental health crisis, particularly with disruptions to lifestyle, loss of social support, risk of illness, and isolation (13). The prevalence of mental health conditions among college students and the lifelong impact of these conditions make mental health a crucially important aspect of college health.

Emphasis on college health and associated programming has expanded substantially since its development in the US in the late nineteenth century (14). Today, college health programs vary widely, with some institutions providing only nursing services and others providing a full array of integrated well- and sick-care services (15). College health is a focus on advancing the health, wellness, and well-being of college students and campus communities (16). However, “college health” is not consistently defined, which highlights its understudied aspects and the roles of college health providers globally. Furthermore, the demand for mental health services on college campuses, already high before the COVID-19 pandemic, is even higher postpandemic, due in part to increased levels of need for student mental health support (17).

Nurses are a substantial portion of a college health center’s clinician staff. According to ACHA (18), of the 62 US institutions that completed the Institutional Profile Survey data survey for the academic year 2022–2023, these institutions employed approximately 80 psychiatric nurse practitioners, 443 primary care nurse practitioners, 862 registered nurses, 158 licensed practical nurses and licensed vocational nurses, and 33 certified nursing assistants. College health centers may also be nurse-directed, where the primary administrative director is a registered nurse or an advanced practice nurse (19). ACHA found that among US college health centers that merged or integrated counseling and health services, nearly 30% reported the professional affiliation of the center director as a nurse (20).

Nurses play an important role in student well-being and academic success (19,21). Nurses may serve as the first or only health care professional that students seek out for support and care, including for a mental health crisis or mental health evaluation, on a college campus (19,20). Nurses can also play a key role in developing and implementing interventions to improve the mental health of college students (22), including mental health screenings and surveillance. By offering mental health screenings and interventions through college health services, students can obtain timely assessment, evaluation, and treatment of their mental health conditions, including referrals to other campus or community partners (eg, counselors, psychiatrists) or other campus resources (eg, academic support services).

The role of nurses in providing mental health assessment and care in college settings is understudied, despite the mental health crisis affecting this population. This systematic review examines nurse-led mental health interventions for college students.

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Methods

Data sources

We used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) standards for reporting the results of this systematic review (23). In collaboration with an experienced clinical informationist and librarian, we built a search strategy and retrieved citations from the following databases: PubMed, Embase, CINAHL, APA PsycInfo, and ERIC (Appendix). We did not include reviews. The search was completed on January 5, 2024. As an example, we included MeSH (Medical Subject Headings) terms and key words that included “student health services” OR “universities,” OR “college student” and “anxiety” OR “depression” and “nurses”” OR “nurse led.” The search results were imported into Covidence (Veritas Health Innovation), an online software, to facilitate the conduct of the systematic review. We included studies from settings across the globe that were published in English from 2015 to 2024 in peer-reviewed journals. The college student population was not defined by age because of variation in college student demographics. Exclusion criteria included no full text available in English, gray literature, or non–peer-reviewed publications. We defined “nurse-led” as nurse participation in authorship or the design, implementation, or evaluation of the intervention to capture information on various degrees of nurse involvement. This criterion was used during full-text review. We defined “mental health conditions” as a diagnosis or symptoms of mood disorders that are prevalent in the college-aged population, such as anxiety, depression, or suicidal ideation.

Study selection

Two independent reviewers (N.G.R., J.K.P.) screened titles and abstracts to determine eligibility for full-text review. Differences between the 2 reviewers were resolved through discussion. Articles eligible for full-text review were retrieved in PDF format and imported into Covidence, and 2 authors (N.G.R.,T.R.) conducted full-text review to identify articles for inclusion in the review. Disagreements were resolved through group discussion. A PRISMA flow diagram was constructed to describe study screening and selection (Figure).

Figure.
PRISMA flow chart: nurse-led mental health interventions for college students. From: The PRISMA 2020 statement: an updated guideline for reporting systematic reviews (23). [A text version of this figure is available.]

Data extraction

Two reviewers (N.G.R., T.R.) abstracted the remaining articles independently. The group met weekly to discuss progress and resolve questions about articles. The abstracted data included citation information, setting, study demographic characteristics, intervention description, role of nursing, and results. The articles were also categorized as to whether participants in the described studies had an active mental health diagnosis or were symptomatic without a formal diagnosis. After the results were discussed, the data were synthesized. We developed an a priori organizing framework which included the study’s purpose statement, study design, intervention description, participant demographic characteristics, and outcomes.

Quality appraisal

The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Hierarchy of Evidence Guide and Appraisal Tools were used to rate the strength and quality of the evidence (24). Developed by nurses initially for nurses (24), the JHNEBP model is a commonly used EBP model (25) that uniquely incorporates the evaluation of research and nonresearch evidence by level (levels I through III are research evidence, levels IV and V are nonresearch evidence) and quality (grades A through C, where A is high, B is good, and C is low) for an overall assessment of strength (24). This model was a strong fit for this review, which explored nurse-led mental health interventions for college students.

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Results

The final synthesis incorporated 16 studies conducted at institutions across the globe, including in North America, southeastern Europe, and Asia (26–41). These studies used diverse interventions aimed at addressing mental health concerns, encompassing a blend of quality improvement, intervention, and educational strategies. Each study included met our definition of nurse-led, with nurses implementing the intervention in most studies. An intriguing observation was that some studies included participants with pre-existing confirmed diagnoses, while others concentrated on symptoms (Table).

Strength and quality rating

Of the 16 articles, 10 were rated as Level I evidence (27,28,30–32,35,36,38,40,41), 3 were rated as Level II evidence (33,34,39), 1 was rated as Level III evidence (37), and 2 were rated as Level V evidence (26,29). Most of the articles were rated as Level A High Quality Evidence (26–30,32,33,35,38–41), and 4 were rated as Level B Good Quality Evidence (31,34,36,37) (Table).

Articles that focused on a mental health diagnosis

Six articles in our review included a sample of college students with a suspected or established mental health diagnosis, including major depressive disorder (30), depressive phase of bipolar disorder (30), depression (28,35,38,39), PTSD (38), and irritable bowel syndrome (IBS)–related mental health symptoms (27). Patients with IBS have a high prevalence and risk of psychiatric disturbance (42).

Four studies were conducted at institutions in Japan (30), China (35), and South Korea (38,39), and 2 studies were conducted at US institutions in Connecticut (27) and North Carolina (28). Four of these 6 studies included 1 college or university site (27,28,30,39), 1 included 3 sites (35), and 1 included 8 sites (38). Most articles included a broad sample of college and university students with a known mental health diagnosis (27,28,30,38,39), and 1 included only nursing students with a known mental health diagnosis (35).

Intervention type. The interventions used in the 6 studies in Japan, China, and South Korea exhibited a wide range of approaches. These included a shared decision-making program (30), an 8-week group positive psychotherapy (PPT) program (35), an eight-session online mental health program delivered through blog posts (38), a group cognitive behavioral program (39), an 8-week comparison of mindfulness and yoga intervention practices (28), and 10 video modules in a nurse-led online program, complemented by nurse-led one-to-one consultations as part of a nurse-led self-management program (27).

Measurement tools. Various measurement tools were used in the 6 studies, with the Beck Depression Inventory (BDI) being the most common (28,39), including the BDI-II (35). Other tools used to measure depression included the Quick Inventory of Depressive Symptomatology (QIDS-SR) (30) and the Center for Epidemiological Studies Depression Scale (35,38). Self-efficacy was measured with the General Self-Efficacy Scale (35) and the Self-Efficacy for Managing Chronic Disease tool (27). The Stressful Life Events Screening Questionnaire (38), Impact of Event Scale–Revised (38), Student Adjustment to College Questionnaire (38), and the Student Life Stress Inventory (28) were used to measure stress. Anxiety, mindfulness, self-compassion (28), self-esteem (39), relationship change (39), coping strategies (27), patient-perceived involvement in medical decisions (30), and functional health (38) were also measured. Chen and colleagues (27) used the brief pain inventory, the IBS quality of life scale, and the National Institutes of Health Patient-Reported Outcomes Measurement Information System for IBS-related symptoms, including anxiety, depression, fatigue, and sleep disturbance. Descriptive statistics and participant self-report were included as measurement tools (30).

Outcomes. Overall, significant improvements in mental health were noted in the 6 studies that included college student samples with a known mental health disorder. Four studies found a significant reduction in depression post-intervention (28,35,38,39), and 3 studies found a significant decrease in anxiety (27,28), stress (28), PTSD (38), and/or dysphoria (27). Significant improvements were also noted in self-efficacy (35), self-esteem (39), self-compassion and mindfulness (28), patient-perceived involvement in medical decision-making (30), and pain (27). Nonsignificant findings included improved functional health and adjustment to college life (38), and self-efficacy (27).

Articles that focused on mental health symptoms

Ten articles in our review addressed symptoms experienced by college students, including depression (26,29,31–34,40), stress (33,37), sleep difficulty, which is associated with psychological distress (43), and anxiety (34,36), and premenstrual symptoms (41), which commonly include behavioral and mood disturbances that may exist alone or in conjunction with somatic symptoms (41,44,45).

Eight studies addressing symptoms in this review were conducted at colleges or universities in the following countries: Canada (37), Korea (33), Singapore (40), Turkey (31,36,41) and Taiwan (32,34). Two studies addressing symptoms were conducted at US institutions in Minnesota (26) and Pennsylvania (29). Seven studies were conducted at a single college or university site (26,29,32,34,36,40,41), 2 studies included 2 colleges or universities (31,37), and 1 study included 4 colleges or universities (33). Nursing students constituted the sample in 4 of these studies (31,32,34,36), and the other 6 studies included a broader sample of college and university student types (26,29,33,37,40,41).

Intervention type. Various interventions were used in these 10 studies, with some commonalities noted (26,29,31–34,36,37,40,41). Two studies implemented depression screening and referral protocols in college health centers (26,29). Educational interventions were used in 2 studies (37,40), and 2 other studies employed interpersonal relational role analysis (IRRA) interventions (31,36). Other interventions included Chinese 5-element music therapy (32), logo-autobiography for college students (33), auricular acupressure (34), and mindfulness-based stress reduction (41).

Measurement tools. The most common measurement tools used in the studies addressing symptoms included the BDI (31) and the BDI-II (34), the Beck Anxiety Inventory (BAI) (34,36), self-report surveys (37,40), and descriptive statistics (26,29). Other measurement tools included the Coping Styles Inventory (31), the Depression Mood Self-Report Inventory for Adolescence (32), salivary cortisol levels (33), the Pittsburgh Sleep Quality Index (34), the Interpersonal Problem-Solving Inventory (36), and the Premenstrual Syndrome Scale (PMSS) (41).

Outcomes. Among the studies included that addressed symptoms, significant improvements were noted post-intervention for depressive symptoms (31–34), stress level (33,37), meaning of life (33), sleep quality (34), anxiety symptoms (34,36,37), PMS symptoms (except swelling) (41), help-seeking for a mental health issue (37,40), and accessing school resources (37). Increases in screening for depression (26,29) amongcollege students were also noted. Chen and colleagues (32) found nonsignificant decreases in salivary cortisol levels, and Tay found no significant differences between the control and intervention groups for barriers to help-seeking behavior (40).

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Discussion

Our literature review underscores substantial differences in the focus of studies in institutions across North America, southeastern Europe, and Asia. Understanding these differences is essential for comprehending the nuanced health care delivery contexts, particularly regarding mental health support for college students. In the US, nurses assume a multifaceted role in collegiate health care settings, acting as primary caregivers, educators, and advocates for students’ well-being (19,21). Their duties include direct care, health promotion, and facilitating access to resources (19,21). Conversely, in global contexts, the role of nurses may fluctuate considerably depending on legislative definitions of nursing practice, educational preparation of nurses, health care systems, cultural norms, and resource availability (46). Nurses may have varying scopes of practice across the globe, where nurses in one country may only be able to practice under the supervision of a physician. In contrast, other countries may recognize the role of advanced practice nursing and a more autonomous role for nurses in patient care, though the scope of practice for advanced practice nurses may also vary (47,48). Recognizing these differences is essential for crafting tailored interventions that meet the distinct needs and resources of diverse college communities worldwide.

Variability of interventions

We found various intervention modalities for addressing the mental health concerns of college students. A stepwise approach was implemented by Aoki and colleagues in a shared decision-making program comprising 3 steps: initial consultation, decision coaching with a nurse, and a decision-making consultation (30). Longer-term interventions included one focused on IRRA, involving 21 sessions lasting 90 minutes each (31). Similarly, Chen and colleagues used the Chinese 5-element music therapy, consisting of 40-minute sessions twice weekly over 10 weeks (32). Another long-term intervention approach was the use of logo-autobiography for college students, where students engaged in autobiographical writing, explored common topics, shared writings with group members, exchanged feedback, and discovered meaning in their lives through 90-minute sessions held weekly for 6 weeks (34).

A unique intervention using auricular acupressure was implemented over 4 weeks and involved the application of a magnetic pellet on the shenmen acupoint of participants (34). The use of technology to implement interventions was another unique feature. These interventions included a mindfulness-based stress reduction program consisting of 8 weekly sessions, including a 6-hour silence retreat conducted via Zoom (41). Similarly, an online mental health promotion program, consisting of 8 individual sessions held twice a week, was supplemented by one-on-one feedback sessions via SMS or messaging applications (38).

Some studies used traditional mental health therapeutic approaches, including cognitive behavioral group (39), group positive psychotherapy (35), mindfulness and yoga (28), and group IRRA (36). Other interventions created education-based programs, including the HOPE intervention, a web-based program consisting of 4 sessions focusing on mental health education (40). Chen and colleagues introduced a nurse-led one-to-one consultation, supplemented by online self-management education modules, over a 12-week period (27). A health education intervention comprising 2 structured visits 2 weeks apart involved structured teachings on various health topics (37). A combination approach was used for a depression screening and referral protocol at a state university health clinic, including education on depression and suicide prevention for all students (26).

The variety of interventions in our review offers valuable insights into the multifaceted strategies employed to overcome mental health issues among college students, highlighting the importance of diverse approaches tailored to individual needs and circumstances.

Differences in college student populations

Another observation is the diversity in college student populations, both in terms of demographic and clinical characteristics. Studies have indicated differences in the prevalence of mental health disorders among college students across different regions and cultures including Korea (33), Singapore (40), Turkey (31,36,41), and Taiwan (32,34). Additionally, there may be differences between students diagnosed with mental health conditions and those experiencing symptoms without a formal diagnosis. These differences underscore the importance of implementing flexible and inclusive strategies to address the spectrum of mental health needs of college populations. Recognizing these variations enables nurses who care for college students to adopt a holistic approach that encompasses early intervention, symptom management, and support for students at various stages of their academic journey and health care needs. This recognition further highlights the critical role of screening and care coordination in facilitating early detection and intervention for mental health concerns among college students. General health care providers, including nurses, play a pivotal role in implementing systematic screening protocols and identifying students who may be at risk or experiencing mental health symptoms (22,26,29). These clinicians can facilitate timely referrals to mental health professionals, ensuring that students receive appropriate assessment, diagnosis, and treatment, thereby mitigating the potential escalation of mental health challenges. Furthermore, proactive screening and early intervention efforts contribute to destigmatizing mental health issues and fostering a campus culture that prioritizes emotional well-being.

Depression and anxiety

Rates of depression and anxiety among college students are increasing at an alarming rate (4). An importantfinding of the reviewed studies is the potential for expanding the role of college health nurses in addressing depression and anxiety symptoms among students. Although some interventions focus on students with diagnosed mental health conditions (27,28,30,35,38,39), recognition of the value in extending care to those experiencing symptoms without a formal diagnosis is growing (26,29,31,33,36,37,40,41). Nurse-led interventions, such as counseling, psycho-education, and support groups, have shown promise in providing accessible and stigma-free mental health support (38) with similar findings reported by Amsalem and colleagues and Castillo and colleagues (49,50), and can be replicated in college settings. By broadening the scope of care to encompass symptom management and preventive strategies, college health nurse providers can effectively reach a larger segment of the student population and promote overall psychological resilience. Additionally, state and country regulations may limit the scope of practice for nurses, including advanced practice nurses, which could affect timely access to critical mental health services for college students. Nurses should be able to practice to the full scope of their educational preparation, licensure, and certification.

Effect of nurse-led interventions on college students’ mental health

A recurring theme in the literature is the positive effect of nurse-led interventions on the mental health outcomes of college students. From providing counseling and psychotherapy to promoting wellness and resilience, nurses play a vital role in delivering holistic care that addresses the diverse needs of students. The evidence suggests that nurse-led interventions contribute to improved access to mental health services, reduced stigma (38), and enhanced student engagement in self-care practices (37,38). Moreover, the collaborative nature of nurse-led initiatives can foster a sense of trust and rapport between students and clinicians, facilitating open communication and help-seeking behavior (51).

Clarification of college versus university terminology

Terminology such as “college” and “university” are often used interchangeably in the US (52), but these terms can have different meanings in educational contexts in other countries. Although in some regions, “college” refers to postsecondary institutions offering undergraduate degrees, “university” usually encompasses broader academic programs, including graduate studies and research. For example, in the United Kingdom, the term “college” refers to either 2-year programs to prepare for university examinations or to vocational programs, whereas “university” or “uni” refers to bachelor’s degree or higher programs (53). Understanding these terminological distinctions is crucial for ensuring clarity and precision in cross-cultural research and intervention efforts to support student mental health globally.

Limitations

Several studies shared common limitations, including small sample sizes (26,27,29,31,35,38), reliance on self-report data (29,35,41), and the use of convenience sampling methods (28,32,33,38). Furthermore, some studies were limited by their study design, such as being single-center or single-site studies (29,30,33,34,40,41), lacking control groups (33,36), and lacking long-term follow-up (26–29,33,34). Additionally, participant characteristics are sometimes poorly described, such as not specifying the student type (eg, undergraduate, graduate) or the student’s major (39). Moreover, studies often feature predominantly female samples, overlooking the mental health issues in college-aged males. Additionally, the ties to college health centers are noted in a few studies (26,29,30,37), but are not adequately described in others. Furthermore, the small number of countries in which our included studies were conducted does not include most of the world’s geography and may highlight the understudied nature of the nurse’s role in mental health interventions for college students. In addition, because terms such as “college” and “university” have different meanings across the globe, the ability to fully and accurately compare studies is limited. Lastly, our search may not have yielded all articles on nurse-led mental health interventions for college students, particularly if “nurse” or another variation of nurse as noted in our search terms was not included as a key term, indexed as a MeSH term, or in the title or abstract of the article. For example, the Creating Opportunities for Personal Empowerment Program is an evidence-based cognitive–behavioral therapy-based intervention that has been shown to improve symptoms of depression and anxiety among college students in a pilot study but did not appear in our search results because “nurse” was not in the title, abstract, or keywords and was not used in the indexing process (54). Addressing these shared limitations calls for enhanced research methodologies and broader participant inclusion to bolster the generalizability and validity of findings.

Strengths

Despite these limitations, our findings represent a substantial contribution to the understanding of mental health issues among college students. The reviewed publications offer valuable insights by allowing an examination of mental health challenges in the college/university environment in several areas of the world. This broader outlook enhances the relevance and applicability of the findings to a wide range of college populations worldwide. There is also an opportunity to identify important areas for improvement in campus health practices, particularly in addressing mental health concerns. It is crucial to involve all health care providers, not just mental health specialists, in the school health system in screening and identifying mental health concerns. This comprehensive approach ensures that students receive timely and holistic care, leveraging the expertise of various health care professionals to address their needs effectively. By highlighting common limitations and gaps in the existing literature, our review lays the groundwork for future research and intervention efforts aimed at enhancing mental health support on college campuses.

Conclusion

Our systematic review highlights the importance and heterogeneity of the nurse’s role in supporting mental health among college students. From mental health screening and care coordination, to delivering targeted and creative mental health interventions, nurses at all levels of practice play a key role in reducing the burden of poor mental health and related symptoms on the college campus. Further research to validate nurse-led mental health intervention effectiveness and policy development are needed to support nursing practice in this understudied role.

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Acknowledgments

The authors acknowledge Stella M. Seal, MLS, lead informationist at Johns Hopkins University for her assistance in the literature search. The authors declare no potential conflicts of interest with respect to the research, authorship or publication of this article. The authors received no external financial support for the research, authorship or publication of this article. No copyrighted material, surveys, instruments or tools were used in the research described in this article.

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Author Information

Corresponding Author: Nancy G. Russell, Johns Hopkins School of Nursing, 525 N Wolfe St, Baltimore, MD 21205 ([email protected]).

Author Affiliations: ¹Johns Hopkins University Student Health & Well-Being, Baltimore, Maryland . ²Johns Hopkins University School of Nursing, Baltimore, Maryland. ³Doane University College Health & Wellness, Crete, Nebraska. ⁴Johns Hopkins University Center for School Health, Baltimore, Maryland.

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Table

Abbreviations: BAI, Beck Anxiety Inventory; BDI, Beck Depression Inventory; CAMS–R, Cognitive and Affective Mindfulness Scale–Revised; CSI, Coping Styles Inventory; DMSRIA, Depression Mood Self-Report Inventory for Adolescence; IBS, irritable bowel syndrome; IRRA; interpersonal relational role analysis; PHQ, Patient Health Questionnaire; PROMIS, Patient-Reported Outcomes Measurement Information System; NIH, National Institutes of Health; PMS, premenstrual syndrome; PMSS, Premenstrual Syndrome Scale; PTSD, posttraumatic stress disorder; QIDS-SR, Quick Inventory of Depressive Symptomatology–Self-Report; RCT, randomized controlled trial.

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Appendix. Search Strategy

Abbreviations: RCT, Randomized Controlled Trial; QI, Quality Improvement.

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