Psychiatric prescribing: an increasingly important component of campus mental health services

Psychiatric prescribing: an increasingly important component of campus mental health services

Dr. Kaitlin Gallo
Chief Clinical Officer, CCH

The demand for mental health services on college campuses has continued to grow as students struggle with many dislocations caused by the COVID-19 pandemic.  The number of students prescribed or needing psychiatric medications has also been rising in concert with the demand for other services. Colleges can help to ensure that more of their students can access high-quality psychiatric prescribing services by including such services as part of their counseling center’s offerings. 

According to the Center for Collegiate Mental Health’s most recent Annual Report, 35 percent of college students have previously taken or are currently taking a prescribed medication for mental health reasons, with about two thirds of those students reporting that they have taken that medication during their time in college. Antidepressants are the most common psychiatric medication in the college population, followed by anti-anxiety medications, psychostimulants (often prescribed for ADHD), sleep medications, mood stabilizers, and antipsychotic medications. 

Despite the growing rates of college students being prescribed psychotropic medications,  according to the most recent survey of counseling center directors conducted by the Association for University and College Counseling Center Directors, a third of campuses have no on-campus psychiatric services (including prescribing services). Of those that do offer on-campus psychiatric services, an average of only 218 students per campus accessed those services across the entire most recent academic year, with an average of 891 total psychiatric sessions taking place. Even if all psychiatric sessions offered on college campuses were for medication management, that number would pale in comparison with the 35 percent of college students estimated to be taking psychiatric medications. 

Not all students who are prescribed psychiatric medications or need evaluation for a possible prescription require on-campus services. Many of these students have existing providers through their own health insurance or that of their parents, and many others receive prescriptions for psychotropic medication and subsequent medication management follow-up appointments from their primary care physicians. But for many others without those arrangements, having to go off-campus to receive a psychiatric evaluation or psychiatric medications during their time in college presents insurmountable barriers—financial, insurance, stigma, or logistical. These barriers are magnified by the psychiatric prescriber shortages that affect many parts of the country.  There are only about 9 psychiatrists in the United States for every 100,000 people, and 6 out of 10 counties have no psychiatrists. Even in places with high proportions of psychiatric prescribers, practices are often full, wait times are long, and many providers may operate outside of insurance panels, requiring patients to pay fully out of pocket, costs that may or may not be reimbursable. The rising number of Advanced Practice Psychiatric Nurses helps to some extent with access issues but does not come close to fully mitigating the problem. Ultimately, these barriers often result in students not seeing a psychiatric prescriber and not being prescribed the medication they need.

Christie Campus Health offers virtual psychiatric prescribing services as an add-on to the CONNECT@College services. Both schools that already have psychiatric prescribers on campus and those that do not have these services can benefit from these virtual services, which allow for a predetermined number of hours of psychiatric prescribing services per week, which are conducted by psychiatrists, Advanced Practice Psychiatric Nurses, or both. Information from these appointments is shared with counseling centers, allowing for schools to ensure that students are getting the care they need. The virtual appointments can be conveniently scheduled by the counseling or health center staff and can then take place in either the health center or the students’ homes or dorm rooms.

It is challenging for students to access high quality psychiatric care. Providing psychiatric prescribing service on campus shows students that their school is committed to their mental health and wellbeing. Contact Christie Campus Health to learn about how CONNECT@College and our virtual psychiatric prescribing services can help your students.

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