A national survey from the Hi, How Are You Project found that while 55% of college students reported receiving mental‑health care, only 18% accessed services on campus. Researchers say students broadly trust campus counseling but face barriers to utilization including scheduling, stigma, lack of culturally responsive care and limited capacity in campus clinics. The gap between trust and use leaves many institutions wrestling with how to scale services and ensure equitable access. Campus leaders cited workforce shortages, budget constraints and the growing complexity of student needs as obstacles. Experts recommend expanding low‑intensity supports, partnerships with community providers, telehealth, and targeted outreach to under‑represented groups to convert trust into uptake. The findings arrive amid rising attention from policymakers and trustees about student wellbeing and retention; institutions with limited counseling capacity risk both student welfare and enrollment stability.