Suicide is the second-leading cause of death among college students, and it is estimated that 1,088 college students die by suicide each year (National Mental Health Association and the Jed Foundation, 2002). This chapter presents the context of college student mental health within which the problem of college student suicide is situated. Because it is estimated that 90 to 95 percent of those who die by suicide have some form of treatable mental disorder at the time of their deaths, frequently depression or substance abuse (Joiner, 2010; Moscicki, 2001), the state of college student mental health today is highly relevant to campus suicide prevention. Many campus suicide prevention efforts focus on the identification of students struggling with mental health concerns and the referral of those students to counseling resources available to them before their treatable problems reach the acute stage of suicide. This chapter presents highlights of the data on college student mental health and suicide risk and protective factors. Next, it explores college students' use of counseling services and patterns of help seeking among college students. Finally, the need for a comprehensive approach to campus suicide prevention is addressed.