The enrollment of individuals with psychiatric disabilities in American postsecondary institutions has grown substantially in recent years, and universities and colleges are struggling to meet the treatment and academic support needs of these students that will enable them to achieve their educational goals. In this article we examine (a) the in-college experiences (e.g., substance use, use of campus mental health services and classroom accommodations, academic integration, social integration) of these students, (b) the role that rehabilitation counselors can play to facilitate student achievement, and (c) emerging practices that have been implemented to better address their needs.