Brett E. Scofield and Ben Locke
Recent news stories have warned of a “mental health tsunami” and a “mental health crisis on campuses” as over the past two years, students and campus communities worked to master the new normal of masking, vaccines, and social distancing in a global pandemic. As we look toward the future, what should campuses do about the mental health of students? What can campuses expect now that the spring semester is in full swing? College counseling centers and the work at the Center for Collegiate Mental Health (CCMH) at The Pennsylvania State University provide some insight.
CCMH is a practice-research network of more than 650 college and university counseling centers that has been studying national trends in college student mental health since 2005. Detailed information about college students’ mental health can be referenced from dozens of peer-reviewed publications, annual reports, and interactive national data available to the public via the CCMH Data Navigator.
Whereas COVID-19’s negative impacts may be universal in some ways, CCMH data indicate that just one-third of students sought mental health services because of it, meaning that two-thirds of students were motivated for reasons other than the pandemic’s impacts. This important distinction confirms what was known before COVID-19: the demand for mental health services has been rising dramatically for more than a decade and the growth we are seeing now is not unique to COVID-19.
To further complicate the picture, the number of students seeking mental health services from counseling centers was down an average of 32 percent in fall 2020 due to a shift to remote instruction and a subsequent reduction in residential on-campus living, leading to many students receiving care in their home communities or not receiving treatment at all. The current return to campus is likely bringing another cycle of increased demand, however, given that the percentage of students seeking mental health services has increased annually for years.
Regardless of the specific motivation, 94 percent of students seeking mental healthcare reported that COVID-19 has negatively impacted at least one aspect of life, with mental health (72 percent), motivation or focus (68 percent), loneliness or isolation (67 percent), academics (66 percent), and missed experiences and opportunities (60 percent) as the most frequently affected areas. Notably, 36 of 38 demographic identities (e.g., race/ethnicity, gender, first-generation) reported mental health as the most negative impact of COVID-19, despite only one-third of students in this sample seeking mental health services because of COVID-19. This discrepancy suggests that there is a distinction between general negative effects and impacts that lead to help-seeking. African American/Black students and students who self-identified their race/ethnicity were the exception—they identified “motivation or focus” as the most common concern, followed by “mental health.”
Clearly, the impact of COVID-19 has been profound, and colleges and universities should be actively preparing to support student mental health needs in the coming years. Overall, it will be essential to be attentive, prepared, resourced, and creative in addressing the ongoing challenges as students reintegrate into campus life.
Interventions by colleges and universities should be targeted on giving students the tools they need to increase their overall wellness, which can include:
- Improving access to mental health treatment
- Supporting students’ ability to motivate/focus
- Fostering social connections
- Alleviating academic distress caused by COVID-19
- Helping compensate for missed experiences, opportunities, and developmental milestones
- Facilitating the transition back to pre-COVID-19 routines
- Attending to areas of basic need, including food and housing insecurities
Two other factors to consider: CCMH data suggest that the impact of COVID-19 varies by class year. First-year students appear to be coping with more significant impacts of missed experiences, while seniors report being most impacted by disruptions in career and employment opportunities. Seniors also reported elevated impacts in the areas of finances and food and housing insecurities. Institutions continuing with distance or hybrid learning should also know that the data show students are struggling with the remote academic environment, which is compounded by living at home as well as managing family dynamics and various forms of anxiety.
Of course, students weren’t the only population adapting to remote work. In response to COVID-19, 99 percent of counseling centers reported success in transitioning to telehealth, but they still struggled with finances and resources, reliable technologies, and the oversight of information security. As colleges and universities continue some hybrid operations and return to in-person learning, it will be critical to support counseling center operations, especially as they continue to shift between telehealth and in-person services.
It also will be important to identify the correct combination of service types (in person, telehealth, and hybrid) that work for the students and the institution, rather than simply adopting what was done in the midst of a national emergency. Importantly, these decisions will be informed by state and federal laws regarding service delivery and not just institutional or stakeholder preferences.
Finally, colleges and universities should attend to the treatment capacities of their counseling centers in the coming year. CCMH developed the Clinical Load Index (CLI ) to help institutions better understand the relationship between the existing supply of services (clinical capacity) and the demand for clinical care (annual utilization). In general, as counseling centers experience more demand for services relative to the supply of services available, annual caseloads of clinicians increase, which leads to less treatment and poorer outcomes for students who receive care. The Alignment Model was developed by CCMH to help centers use their CLI to inform staffing decisions and align current service capabilities with stakeholder expectations.
As higher education continues to navigate this new public health reality, colleges and universities will need to respond not only to increased demand for mental health services, but also to the broader negative impacts that might not require mental health treatment. During this time of increasing demand for mental health services, institutions should be rigorous in their efforts to understand their own campus’s needs and proactive in rising to the challenge. It is crucial to have an accurate and consistent metric, such as the CLI, for evaluating the clinical capacities of counseling centers.
Learn more about CCMH, its tools and services, and the benefits of being a member center.