“(College counseling centers)…can't be everything to everyone.” A valuable observation from the president of the AUCCCD

“(College counseling centers)…can't be everything to everyone.” A valuable observation from the president of the AUCCCD

Robert Meenan, MD, MPH, MBA


Dr. Marcus Hotaling is president of the Association of University and College Counseling Center Directors(AUCCCD). He also serves as director of the Eppler-Wolff Counseling Center at Union College. This makes him a well-informed observer of recent trends in college mental health. 

Dr. Hotaling was a recent guest on The Quadcast, the Mary Christie Institute’s interview series that focuses on the mental health and wellness of young people, especially college students. Christie Campus Health is the proud leading sponsor of the Mary Christie Institute.

During the interview, Dr. Hotaling was asked what piece of advice he would give to colleges and universities that are looking to address the growing gap between demand and supply that their counseling centers are grappling with. His insightful response was that college counseling centers “can no longer be everything to everyone.” He observed that while college counseling centers have long prided themselves in being able to deal with the mental health needs of all students, that is no longer a viable approach, in part because the prevalence and severity of student mental health issues continue to grow, and in part because staffing challenges have become an increasingly serious issue for counseling centers. These entwined trends have been exacerbated by the COVID pandemic, and they will persist for years to come.

Dr. Hotaling went on to propose three key approaches that college counseling centers need to embrace in today’s evolving and challenging environment:

Promote a campus community of care

Counseling centers need to engage other campus resources in their schools’ efforts to help students deal with mental health issues. This will require them to resist the tendency to silo themselves off over concerns about confidentiality. It will also require them to move beyond a focus on encouraging faculty and staff to refer students to the counseling center and instead focus on getting them to engage students in supportive conversations that may well avoid the need for a counseling center visit. Dr. Hotaling advised that counseling centers should also advocate strongly for mental health days in the academic calendar.

Diversify the model of care

College counseling centers can no longer employ the traditional models of care that typically involve one-hour visits, full intake assessments, follow-ups with the same counselor, and a weekly pattern of ongoing care. They need to move toward a problem-solving approach that incorporates triage appointments, stepped care models, group sessions/workshops, and referrals out of the counseling center. The key is to be flexible, offer a mix of approaches, and focus on what students want.

Expand student access

Rising student demand tends to mask the fact that there are many college students who could use mental health support but do not, for various reasons, engage with their campus counseling center. This means that the centers must take steps to increase student access by making efforts to reach the underserved elements of their student body. These efforts should include promoting self-care, providing 24/7 access to mental health services, eliminating financial barriers to care, and providing access to a diverse group of counselors.


About Dr. Robert Meenan 

Dr. Meenan served as Dean at Boston University School of Public Health from 1992 to 2014 and retired from BU in 2016 as Professor of Health Policy and Management in the School of Public Health and Professor of Medicine in the School of Medicine. He holds a BA in government from Harvard College, an MD from Boston University School of Medicine, an MPH in Health Administration and Planning from the University of California Berkeley, and an MBA in Health Care Administration from Boston University School of Management. 

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