When Demand Rises and Supply Falls: New Challenges in Meeting Student Mental Health Needs

When Demand Rises and Supply Falls: New Challenges in Meeting Student Mental Health Needs

Robert F. Meenan, MD, MPH, MBA
President, Christie Campus Health

College counseling centers are dealing with a steadily worsening imbalance of rising student demand and declining staff morale and supply. We addressed this issue in a CCH blog post at the start of the fall semester, but the imbalance has turned out to be even greater than we predicted. College counseling centers are striving mightily to keep up with the demand for services, but staff are being further stretched by the effort.

On the demand side, the COVID-19 pandemic has greatly exacerbated a decade-long trend in depression, anxiety, and other mental health issues among college students. The most recent report from the Healthy Minds Study, released at the start of the 2021 Fall semester, documented that this trend is continuing. The prevalence findings included: lifetime history of mental illness 40%, major depression 22%, all depression 41%, anxiety 34%, and eating disorder 12%. Students reported the following experiences in the prior year: self-injury 23%, suicidal ideation 13%, psychiatric medication use 25%, and engagement in counseling 25%. This increase in prevalence and severity has led to a significant increase in student demand for mental health services.

The pandemic is also having an increasingly negative impact on the morale and supply of campus counselors, many of whom have joined in the “great resignation”. The title of a recent report from Mad in America gets right to the point: Crisis on Campus: Mental Health Counselors Are Feeling the Crush. The key paragraph of the report states: “College and university counseling services are swamped. At some schools, the wait time for a session can be as much as six weeks. Mental health staffers are taking on a flood of appointments, sapping their energy and strapping them for time. Many counselors are exhausted, their own mental equilibrium disrupted by the constant demand. Many directors are, too, juggling the needs of students and employees along with administrative concerns.”

Addressing mental health needs in an increasingly challenging scenario of rising student demand and decreasing staff supply and morale requires a multi-faceted approach. Counseling centers need to utilize a range of services and lessen their emphasis on individual counseling. Their new ethos should be that many students need help, but not all of them need counseling.

The Chronicle of Higher Education recently released a major report on college student resilience and mental health. The first section of the report, appropriately entitled Counseling Supply and Demand, documents the COVID-fueled increase in student demand. It also reinforces the severity of declining counseling staff morale and supply. One counseling center director states that he and his fellow directors are seeing an unprecedented number of college counseling center clinicians leaving the field, including many center directors. Staff that remain are feeling increasingly over-worked and burnt out. Candidate pools to fill vacancies are smaller than anyone has ever seen.

The recommendations in the Mad in America and CHE reports include:

  • It’s time to move away from a focus on counseling to a broader and more holistic approach. A continued commitment to the standard model won’t solve the problem.
  • It’s time to shift from just providing individual therapy and frontline treatment to providing a comprehensive array of integrated services to students.
  •  Counseling centers should offer a mix of direct clinical service, wellness support that helps students with milder issues, and crisis services that ensure students in distress or crisis have resources at any time of day or night.
  • Colleges should continue their wellness programs, which are helping many students be resilient.
  • Counseling centers have severe staffing problems, so it is important to distinguish between students in crisis and those for whom more modest interventions could help.
  • Colleges are increasingly working with outside telehealth services to increase capacity, provide off-hours coverage, and broaden the diversity of caregivers.

Christie Campus Health’s CONNECT@College offerings can help college counseling centers that are looking to respond to the increasing demand for more services of more types. We strive to complement and expand the work already being done by campus counseling centers. We offer a multi-modal platform of best in class services, ranging from resilience app to psychiatric prescribing, that is designed to meet a broad range of student mental health needs. While serving students is the core of the CCH approach, we also strive to partner with and support counseling center staff through special benefits like quarterly webinars with continuing education credit.

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