Even before COVID-19 hit, colleges and universities across the country were seeing increases in students reporting depression, anxiety, suicidal thoughts and other mental health challenges.
In response, many schools are working to address the increased demand for services on their campuses by adding staff, expanding community partnerships, establishing on-demand programs and more, all the while working to ensure that services reach those who are most at risk.
In many ways, colleges demonstrate “what really good community-based mental health care can look like, in that communities and other organizations outside of the education setting have a lot to learn from what’s happening in higher ed,” said John MacPhee, CEO of the Jed Foundation, a nonprofit organization that works with high schools and colleges to support student mental health, during a recent webinar hosted by U.S. News & World Report.
Like many organizations, lots of colleges adopted more robust virtual and hybrid services to reach students during the pandemic. “For many, the tele-mental health and digital platforms were more comfortable and more culturally competent in many cases, and so [they] actually created more connections to care than actually existed prior to the pandemic,” MacPhee said.
“Even two years, three years leading up to the pandemic, we had seen an increased utilization of behavioral health services,” said Dr. Wendy Shanahan-Richards, chief medical officer of Aetna Student Health, which works to meet the needs of colleges, universities and students. Her organization began increasing school partnerships in order “to ensure that the programs that we have and the offerings that we have are in alignment with their student population,” she said.
In many ways, the pandemic helped institutions focus and reevaluate their missions, said Dr. David Walden, director of the Counseling Center at Hamilton College in Clinton, New York, as well as a lecturer in the college’s psychology department. “Any crisis provides that opportunity to really tune into ‘What do I really need? Who am I really,’” he said.
That includes reexamining approaches to overall health, said Dr. Shawnté Elbert, associate vice president of health and well-being at Ohio State University. When done well, such efforts include “actually sitting down, talking with students and bringing them to the table, which is a population and public health approach,” she said. “That means looking at how we approach the work that we do from a very health equity-focused lens.”
Staffing issues are a top-of-mind concern. In addition to concerning data about overall higher ed retention and turnover, “there’s also data that says some 90-plus percent of college counselors are burned out,” Walden said.
That has forced some creative solutions. For example, “at Hamilton, we created something called a quarantine pantry,” Walden said, to provide farm-fresh ingredients to students to cook along at home in a virtual, community-oriented way. “We created a songwriting therapy outlet and a number of different virtual offerings that met the needs of the moment,” he said.
Even though the utilization of telehealth services has decreased since the early part of the pandemic, “we don’t believe it’s going to go away,” Shanahan-Richards said. To meet student needs, Aetna has developed a well-being web portal that can be used by any student and includes resources and self-screening tools. “We listen to our schools and our students,” she said. “We want to make sure that we are doing what we can.”
For colleges, MacPhee recommended creating an interdisciplinary leadership team that oversees mental health planning and engages faculty and different key campus offices, “so that you’re sending this message that this belongs to everybody, and it’s everyone’s responsibility, even if mental health services is not in their role description.” He also stressed the importance of suicide prevention, which includes “systematically making sure that the potential means for suicide are hard to access.”
Hamilton has support specialists “that work through various offices on our campus that are focused on specific populations,” such as the LGBTQ community, Walden said. “This person can answer very specific questions about that life journey. … That partnership allows our office to provide good treatment and good therapy.”
Ohio State brings in community partners for daylong educational and professional development training, Elbert said, which can also sometimes help the university recruit new practitioners.
Caring for staff is important as well. Burnout has “arguably never had a higher profile, and institutions are not remaining competitive with the other opportunities for specifically mental health providers,” Walden said. Providers and staff want and need connection and cohesion, he said, and want more flexibility in their work options.
The panelists agreed that tele-mental health and digital mental health have enormous promise in alleviating some of the challenges they discussed. These platforms give universities a competitive edge, MacPhee said, and they help with student retention and graduation rates, which in turn can boost the bottom line. “From an investment perspective, I think that that needs to be part of the argument, or just part of the case, about these investments. They really do pay dividends, and they really do support student success,” he said, “in addition to the extraordinarily important primary benefit of supporting the mental health of the students and the faculty and the staff.”
Public health, Elbert said to close the webinar, is a team sport, and so colleges must embrace a collaborative approach when it comes to meeting mental health needs. “We can’t do this work in silos,” she said. “We can’t do this work from one specific lens or area of expertise. We have to have an interdisciplinary approach to looking at this comprehensively.”