Objective: College students who receive an acute care visit (ACV) from an emergency or inpatient unit require mental health follow-up (MHF) to improve long-term outcomes. This study describes tracking ACVs and MHF, while identifying characteristics of multiple vs. single ACVs. Participants: 191 students who received an ACV (N = 231) at one public university -- enrollment approximately 39,000. Methods: For two academic years (AYs), students were tracked and offered timely MHF. Demographics, clinical information, utilization patterns, and rates of MHF were analyzed. Results: Primary reasons for an ACV were suicidal thinking (60.6%) and psychosis (13.9%). MHF improved between AYs (65.8% to 93.3%, X[superscript 2] = 27.48, p < 0.01). Multiple vs. single visits were more likely to present with self-injurious behavior and psychosis and received more intensive follow-up yet, had similar rates of MHF. Conclusions: The primary reasons for an ACV -- suicidal thinking and psychosis -- underscore the importance of campus suicide prevention and psychosis-specific services.