Mental Health Support Systems at U.S. Universities: a Comparative Analysis of Institutional Architectures and Societal Engagement

Mental health is increasingly treated as an institutional challenge in higher education, yet the presence of individual services does not show how universities organize responsibility, coordination, and evidence use. This study compares the institutional architectures of mental health support at five U.S. universities, examines whether strategic coordination corresponds to integrated support, and explores societal engagement. A qualitative multiple-case study was conducted at the University of Michigan, Pennsylvania State University, The Ohio State University, the University of California, Los Angeles, and Stanford University, with the university as the unit of analysis. The empirical corpus comprised 24 official institutional and network-based web resources, examined through qualitative document analysis. The Framework Method organized the evidence into case summaries, structured focused comparison examined them across universities, and ideal-type analysis produced four profiles: ecosystem-integrative, service-distributed, multilevel navigational, and organizational-professional hybrid. The main finding is that shared strategic coordination does not equal integrated support: even at universities with a shared strategic agenda (Michigan, Ohio State), student and staff pathways remain separate. At all five universities, student support was documented more fully than support for faculty, researchers, and other staff. Data use ranged from descriptive monitoring to strategic decision-making, but for tools operating at the service, network, or component level, a link to university-wide decisions was not traceable. An exploratory analysis of additional sources identified six mechanisms of societal engagement, documented within the sample and not exhaustive. The study’s novelty lies in distinguishing strategic coordination from integration of support within university cases, which a shared commitment to mental health or a similar service portfolio does not reveal. CCMH analytics are treated as a network resource, and Stanford’s organizational-professional component is confined to Stanford Medicine. Limitations: a purposive sample and reliance on public documents. This is an empirical study.