A developing crisis has formed on America’s campuses. Recent studies have shown upticks in feelings of anxiety, depression and stress among students, both incoming and returning. More students than ever before are expressing mental health support. As increased numbers of students struggle with issues, more turn to the universities they attend for mental health services. The real heart of the crisis lies in the gap between available resources and the demand for counseling, which continues to persist and undercut the potential for helpful treatment.
Limited manpower and strapped budgets at universities have led to long wait times and a lack of face time in mental health services. Understanding how to connect with this young demographic and to successfully serve its counseling needs can be another challenge, especially in a world of 24-hour screens. While diminishing stigma has opened the door to counseling for more students, many barriers still exist for others, which affects schools’ ability to optimize allocation of their resources. This confluence of factors has negatively impacted colleges across the nation, but strategies for meeting these needs are becoming clearer.
Universities are tapping into creative and online-based outlets to deliver mental health services. Counseling over text and email, though not a substitute for face-to-face appointments and interactions, has enabled counselors to reach students in convenient, immediate ways at minimal cost. The emerging new normal will force colleges to adapt to increased student demand for mental health services and modest resources. A supply of certified mental health counselors would also help abate the gap.
Greater demand places strain on resources
Compared to previous generations, students today are more prone to extreme emotions and mental health trouble. A 2016 report from the Center for Collegiate Mental Health (CCMH) at Pennsylvania State University detailed increases in self-reported instances of depression, generalized anxiety, social anxiety and academic distress for each year since 2010. A little more than one-third of respondents said they seriously considered attempting suicide, an almost 10 percent increase in five years. Nearly one in 10 of those respondents had been hospitalized in relation to mental health.
As concerning as these trends may be, more students have sought help from counseling services. However, the high rate of utilization has strained available resources. CCMH noted in its 2016 report that data from its 2015 study showed that while institutional enrollment between the 2009–10 and 2014–15 academic years had increased 5 percent, counseling utilization spiked 30 percent and appointments grew 38 percent. Counseling centers, unprepared for the increase, have also had to deal with complex utilization tendencies. Although the most common number of appointments per year across 132,597 students was one, clients averaged 5.84 visits per year and 20 percent of students accounted for more than half (56 percent) of appointments. Students with a history of self-harm or threat-to-self behavior utilize counseling services 20 to 30 percent more on average.
Colleges have not been ignorant of these changes. In fact, more than 50 percent of counseling centers reported budget increases in a 2014 Association for University and College Counseling Center Directors survey; however, the surging demand has outpaced staff growth and resource allocation. “The plight of every counseling center on every campus is that they’re way overworked,” Thomas C. Shandley, dean of students for Davidson College in North Carolina, told The New York Times.
A primary consequence of the strain on counseling resources is extended wait times. STAT News collected wait time information from universities across the country and found counseling centers at schools large and small under pressure. One school with a ratio of more than 1,200 undergraduates for every counselor had wait times of 12.5 days, while one with a 443:1 ratio had wait times that exceeded two weeks. STAT News found the resourcing crunch to be felt especially during midterms and finals, meaning counseling resources are at their most strained when students need services the most.
Understanding college students’ unique stresses
In order to devise ways that more effectively serve mental health needs, counselors need a better grasp of what unique stresses and pressures burden the modern college student. That understanding can be particularly challenging. “College students, by their nature, are a transient population,” Sarah Lipson, professor at the University of Michigan, told USA Today. “Their needs change — we can’t be assuming that today’s college students have the same needs as college students 10 years ago.”
Generation Z has much in common with the millennial demographic, which both helps and hurts how the public and professionals view mental health needs of the group. The notion that the problems of today’s youth can be traced to being coddled, as The New York Times reports, can be demeaning and may obstruct a true appraisal of the underlying causes for depression or anxiety. These reasons can be as complex as they are disparate between different classes of students. Consider how different the scenarios are for an international student, a freshman who is hundreds of miles away from family for the first time and a graduate student with immense academic demands and a close family member who is dying. The diverse mental health conditions presented by students pull counselors in all different ways, illustrating one of the challenges even sufficiently staffed centers have when addressing increased appointments and utilization.
A topic that causes stress for students — from recent graduates to first years — is student debt. Not a new phenomenon but one that has exponentially multiplied, student debt demonstrates again the specific problems confronting younger generations. Stress related to debt also illuminates opportunities for counselors to meaningfully interact with and serve student clients. Putting students in touch with literature on loan deferments, payment plans or credit score maintenance is a simple yet powerful act that shows how counseling has adapted to meeting mental health needs of modern student populations.
Flexibility, responsiveness, long-term thinking highlight new approaches
Given the current state of budgets and staffing, counseling centers in all states have had to make do with what they can and develop new ways to maximize available resources. One strategy that is gaining popularity among counseling centers is the use of flexible time. CCMH detailed the growth in rapid-access hours among clients seen in 2016. Defined as “services that are typically available within one to five days year round and include appointments such as crisis, walk-in, on-call or triage/screening services,” rapid-access hours per client grew 28 percent in six years, to 0.51 hours average in 2016. On the other hand, routine hours (general individual appointments) per client decreased almost 8 percent. This hours shift is indicative of the overall change in counseling centers’ operational attitude in recent years — that is, being more flexible in meeting needs and thus more responsive. CCMH determined these approaches are especially helpful for centers whose funds don’t automatically increase with demand.
Taking a long-term perspective of mental health has also helped colleges more effectively address the needs of student populations. More students are entering college with existing mental health problems or conditions, meaning not only are counseling centers pressed to treat students when they arrive but are also responsible for looking down the road at what supports such students may need. The New York Times reported on a collective of four higher education institutions in North Carolina and South Carolina that created a program to track the freshman class of 2018 through its four years in school. Students are required to complete a 400-question survey four times in their first year and two times each subsequent year. Though just getting started, the intake responses are already proving enlightening to counseling services at the schools. One executive student administrator for a participating college said so many students reported a loss early in their lives that it “raised an alert.”
Leveraging technology is yet another way for counseling centers to offer students modern treatment, which is also cost effective. Deseret News in Salt Lake City reported on the trend of students seeking help online and how one fraternity partnered with a texting app to provide an outlet for students feeling stressed. While not an official counseling avenue, testing shows how professionals can incorporate modern technology and networks into counseling approaches. The Deseret News also said numerous large universities have invested in online programs to help service students’ mental health needs. An extension of this strategy is using social media to engage with clients or connect them with other students or groups that may be able to offer support or help. Though it can be a tricky medium to operate in, social media can be a highly effective environment in which to interact with 21st-century students.
Fill the gap by getting a Masters of Arts in Counseling from Bradley University
As the mental health needs of college students continue to grow, counseling centers will have to rise to meet demand. This situation is a reality of American campus life. Adopting new strategies that improve flexibility and responsiveness are steps in the right direction for centers but can only go so far in solving the imposing math of student-to-counselor ratios and the pains of long wait times. The more counselors are trained, educated and certified, the more able schools will be to help their students.
Individuals interested in the counseling profession and aspiring to help close the resources gap can inquire with Bradley University about its online Master of Arts in Counseling graduate program. Contact an admission officer today to learn more.
The positive impact school counselors can have on students