Available information about college student mental health has largely been anecdotal or based on information drawn from a single institution. This review examines ten studies published within the past 20 years that focused on college student mental health using data collected from multisite college or university counseling center clients or staff. This subset of research on college student mental health is important in view of the increased demands on counseling centers and the increased emphasis on evidence-based practice. Collectively, these studies suggest that the presenting concerns of college students are changing, that those in treatment are more distressed than those who are not, that clients who identify as ethnic minorities appear to evidence slightly more distress than their white counterparts, that matching client and counselors relative to ethnicity does not appear to improve outcome, and that counseling services seem to improve outcome. While each study makes a unique contribution to the literature, this body of literature suffers from a common set of limitations that stem from the difficulties associated with multisite research, research taking place in active clinical work, and the time-limited nature of data sets. Through our review and critique of these studies, we discuss the importance of establishing an infrastructure that helps researchers to elucidate trends, effective treatments, and risk factors that will be useful to clinicians treating this population. The Center for Collegiate Mental Health, a practice-research network focused on college student mental health, is described and preliminary findings from this entity are presented.