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Crisis care strains college campus counseling services

Higher ed copes with a mental health resources shift
University Business, April 2017
Keeping college students emotionally healthy comes down to the resources campuses are willing to provide. (GettyImages.com: Solstock)
Keeping college students emotionally healthy comes down to the resources campuses are willing to provide. (GettyImages.com: Solstock)

The growing demand for mental health treatment on campuses resulted in part from a national effort, mounted over the last decade or so, to eliminate stigmas and get more students to seek help when grappling with emotional distress.

At the same time, a heightened need for crisis care has forced colleges and universities to shift resources to urgent services, such as 24-hour help lines, and away from the long-term counseling that can best treat a student’s underlying problems.

Experts compare the situation to putting a broken leg in a cast at the emergency room, but not providing the follow-up physical therapy that leads to full recovery.

“You’re treating the symptom and not necessarily the cause,” says Christopher Corbett, president of the American College Counseling Association and director of counseling and student support services at the Savannah College of Art and Design. “You get stuck in a potential loop with a person accessing care when there’s a crisis, rather than accessing care until the whole thing is resolved.”

Creating capacity

Many institutions, especially larger ones, have taken new approaches to expand their abilities to provide counseling, including:

  • Group therapy sessions sometimes based on specific topics or focused on demographic groups
  • Daily drop-in workshops on yoga and other relaxation techniques
  • Online therapy connecting students to counselors and trained listeners 
  • Embedded counselors who hold office hours in residence halls, graduate schools and other buildings

A student who doesn’t get sufficient treatment after a bout with depression or anxiety is more likely to relapse, with every recurrence potentially growing more severe, says Ben Locke, executive director of the Center for Collegiate Mental Health at Penn State University.

“Counseling services are very good at rapidly responding and performing initial assessments. Then there’s a waiting list and they can’t see a student for three weeks. That’s where the problem is.”

Offering group counseling services to augment individual treatment is one way colleges are working to expand counseling capacity.

The Ohio State University accommodates, in a semester, more than 30 groups of five to 10 students who meet regularly with a therapist, for example.

Some of the groups support a specific demographic, such as women of color, while others focus on grief, relationships or another topic, says Micky Sharma, director of the Counseling and Consultation Service in Ohio State’s Office of Student Life, and president of the Association for University and College Counseling Center Directors.

Ohio State—as well as other Big Ten universities—also embeds counselors across campus. One clinician spends four days per week in a residence hall office where students can be treated. Other clinicians are stationed at graduate schools.

The university also hosts daily drop-in workshops—one is called “Relaxation Station”—where students can learn yoga and other techniques for managing general stress or anxiety. These services can prevent students from falling into emotional crisis, Sharma says.

Elsewhere, a handful of third-party services—such as Therapist Assisted Online, WEBeMED and 7 Cups of Tea—are connecting students with online therapists and trained listeners. Morneau Shepell, a new service based in Toronto, provides international students with counseling in their native languages.

Institutions will refer students to off-campus counseling services as well, but that’s not always effective. Research indicates that around half the students sent for outside treatment never go, says Locke at Penn State.

Studies conducted at the University of Michigan show clear economic benefits—to schools, students and society—when institutions provide treatment that prevents someone from dropping out.

Students who stay in school, of course, are more likely to graduate and lead productive lives, says professor Daniel Eisenberg, a researcher at the School of Public Health.

“From institutions’ budget perspective, there’s a solid economic case for supporting student mental health if it’s an institution where, if you lose a student, you can’t replace them,” Eisenberg says.

Ultimately, keeping students emotionally healthy comes down to the resources campuses are willing to provide. “If you have 30 students who need a math course, you will find someone to teach it because, for better or worse, it’s a requirement for graduation,” Corbett says.

“Mental health services don’t hold the same priority—even though, when you have a person in better a mental health state, they’re a lot more likely to stay enrolled.”

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