College students experience mental health problems (MHPs) at high rates, presenting challenges to students, families, and campus officials. As one response, student mental health groups – often student-led campus chapters of national organizations – have emerged and multiplied. Because extant research regarding student mental health groups is limited, this qualitative study explored the goals, processes, and members of one university chapter of the national organization To Write Love On Her Arms. Semi-structured interviews (N = 9) were conducted with current and former college students who participated or expressed interest in the group, as well as with the group’s advisor. Interviews were transcribed and analyzed via iterative, constant comparative analysis. Findings indicated that participants often joined the group due to a personal experience with MHPs, and that, at its best, the group provided camaraderie, understanding, and a link to the counseling center. However, findings also underscored the challenges facing such groups. The group discontinued due to low membership, with potential contributing factors at multiple levels, including: lack of clarity regarding the group’s goals, purposes, and activities; the departure of a founding leader; insufficient campus outreach; stigma regarding MHPs; and limited support from the national organization. Implications from this study include the importance of a clear theory of change for mission-driven organizations (from the national organization to its local affiliates), such groups’ potential for positive impact, and the need for further research on and evaluation of such groups.