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This article is intended to show the value, limitations, and major concerns in providing psychotherapy and counseling for college and university students. The challenges of the college years, the evolution of campus services, cultural changes affecting postsecondary education, and types of services are noted. Critical issues affecting college mental-health care are discussed, with an emphasis on ethics, effectiveness, and legal issues with suicidal and homicidal threats to life, mandatory treatment, and illicit and prescribed psychotropic drug use.