The purpose of this article is to provide an overview of mental health issues and counseling services on college campuses in the USA. The findings from several national surveys are reviewed to estimate the prevalence of anxiety and depression, suicide and suicidal ideation, and violence among college students. Common prevention and treatment programs are then described with particular attention to innovative campus-wide programs. Student outcomes research is examined to determine whether receiving counseling services is associated with academic performance and the likelihood of graduation. The article concludes with a set of recommended practices to improve the effectiveness of counseling services on campus.