TOPLINE:

A 9-month integrated care program (ICP) led by nurse practitioners (NPs) significantly reduced the severity of depression and anxiety among students of a rural university.

METHODOLOGY:

• The ICP was implemented in a student health clinic of the rural university and enrolled 61 students (age, 18-25 years; 80.3% women) based on their positive scores on the nine-item Patient Health Questionnaire (PHQ-9) and seven-item Generalized Anxiety Disorder (GAD-7) screening tools.
• The ICP team consisted of two advanced-practice registered nurses in family practice, a dedicated integrated behavioral health provider, a psychiatric and mental health NP consultant, clinic director, and counseling center director.
• The team conducted weekly case-review meetings to ensure proper monitoring of patients, adjust care plans, and ensure coordinated care between primary care NPs and the behavioral health provider.
• Researchers evaluated student satisfaction using a seven-item survey specifically developed for the study.

TAKEAWAY:

• Average PHQ-9 scores decreased from 10.0 to 7.0, and average GAD-7 scores decreased from 9.8 to 6.3.
• The proportion of students with mild or minimal depression increased from 47.54% at baseline to 70.49% at the end of the academic year, whereas the proportion of those with severe depression decreased from 31.15% to 11.48%.
• The proportion of students with mild or minimal anxiety increased from 42.62% at baseline to 70.49% at the end of the academic year, whereas the proportion of those with severe anxiety decreased from 31.15% to 4.92%.
• Of the 32 students who completed the satisfaction survey, 97% reported being satisfied or very satisfied, and 91% reported having positive changes or significant improvements.

IN PRACTICE:

“Overall, the ICP effectively provided a systematic way of identifying and treating university students,” the authors wrote. This program “was able to effectively reduce rates of depression and anxiety among college-aged students,” they said.

SOURCE:

The study was led by Margaret R. Emerson, DNP, APRN, PMHNP-BC, University of Nebraska Medical Center and University of Nebraska-Kearney, Kearney, Nebraska. It was published online on July 17, 2025, in Journal of the American Association of Nurse Practitioners.

LIMITATIONS:

The ICP was developed with grant funding, which could impact its sustainability without continued financial support. The student and provider satisfaction surveys were specifically developed for this study without previous reliability or validity testing. Additionally, the behavioral health provider required more visits than desired to achieve the intended effects, indicating potential inefficiencies in the delivery model.

DISCLOSURES:

This study received funding from the American Rescue Plan Act, a comprehensive legislative package enacted by the US Congress in 2021. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.