Over the past few years, college counselors have struggled to serve a rising number of students with mental health issues. “Trends in College Student Mental Health and Help-Seeking by Race/Ethnicity: Findings from the National Healthy Minds Study 2013–2021,” a report by Boston University and other institutions, found that in 2020 and 2021, more than 60 percent of college students dealt with one or more mental health concerns — a greater than 50 percent increase from 2013.
To fortify in-person and their own online counseling, many institutions are turning to virtual therapy companies. One such provider, TimelyMD, was founded in 2017 with an emphasis on physical health. Before the onset of COVID-19, only 10 percent of its clients sought help for mental health concerns. That percentage has now risen to 80 percent.
TimelyMD offers a variety of services, including a 24/7 on-demand option called TalkNow that puts students in contact with a counselor in just a few minutes for a brief interaction. Students can also schedule longer TimelyCare virtual appointments with wait times of between a few days to a week. Psychiatric services are also included.
Tony Spann, TimelyMD’s executive director of mental health, says changes wrought by the pandemic — including school disruption followed by an uneasy return to classrooms — escalated issues already troubling many students.
“We’re seeing more depression, anxiety, and general stress,” Spann says. “If mental health was the fire, COVID was the gasoline being added to that.”
Need for Counseling Surges
Asian, Black, and Latinx students were less likely to obtain treatment than White students, according to the study. Yet students of color often experience a greater need, says Tierra Parsons, director of counseling services at Johnson C. Smith University (JCSU), a historically Black college and university in Charlotte, N.C. The mental health concerns of many Black students were exacerbated only months into the pandemic following the May 2020 murder of George Floyd and the resulting racial unrest.
“Having to process the injustice and maybe also be fearful of the social climate around them can be a contributing factor in their mental health,” Parsons says.
At the University of Kentucky (UK), students who are Black, Indigenous, and other people of color sometimes struggle with being a minority on campus, says Corinne Williams, acting associate vice president for student wellbeing. Starting in 2020, the need for services in connection with these and other concerns created a logjam, and a triage system was created to prioritize those with more serious issues.
“For others, there could be a wait of about two to three weeks to get in for that first appointment,” Williams says. “We told them to let us know if things got worse.”
Burnout Among Counselors
Along with serving more students, college counselors face in their own lives the same societal upheaval students are dealing with. Nearly 93 percent of counseling staff in the United States say they’ve experienced burnout, with 60 percent reporting their increased workload has compromised their care, according to a Mantra Health survey, “The State of Provider Burnout in College Counseling Centers.”
At UK, some counselors worried that feeling overwhelmed might hamper their efforts to properly care for students.
“There was a real concern that they would miss something,” Williams says. “And then when those students are out on their own, is something bad going to happen?”
At the University of California, Irvine (UCI), counselor stress created higher-than-normal turnover, according to UCI Counseling Center Director Frances Diaz. UCI tries to maintain 37 counselors, about one for every 1,000 students. They currently have 30.
“Burnout? A thousand percent. Mental health providers are exhausted,” Diaz says. “And you can’t hire your way out of the demand.”
Virtual Services Getting High Ratings
In late September, UCI added a service called Welltrack, formerly Shrink Space. For $8,150 a year, Welltrack provides the university with a database of providers students can use to connect with counselors in the community. Students contact these providers to set up appointments as they would with any off-campus counselor.
Soon UCI students will also be able to receive virtual counseling through Lyra Health, a service contracted by the University of California system for all of its campuses. Lyra offers in-person and online appointments as well as a texting option. It will also allow students to work on their issues beyond the six visits UCI’s on-campus staff typically provide.
“Those who want more ongoing care, or longer-term or open-ended treatment, will be able to get that,” Diaz says.
In the past five years, UK has added eight counselors to its staff for a total of 22 for its 32,955 students. This fall, UK also partnered with a virtual therapy company called Talkspace. Through Talkspace, students can comb through counselor bios and set up appointments with little wait time. They can also text or send videos to providers for a quick response of just a few hours.
The bottom line is that the contracted services are working: “Students who use them report a 70 percent reduction in stress.”
Tierra Parsons
Talkspace represents a significant financial investment. The university is paying close to $1 million dollars for the service, says Williams. It’s worth it, she says. In the first eight weeks of school this term, the campus counseling center had 462 initial consultations. During the same period, another 475 students registered with Talkspace.
“So that’s essentially doubled the number of students who are able to receive therapy,” Williams says.
Like UK, JCSU began ramping up its counseling efforts before the pandemic. In early 2020, JCSU contracted with TimelyMD to better serve its 1,093 students.
The diversity of the service’s counselors is impressive, Parsons says, and while not every student wants to see a provider who identifies in a specific way, many do. Black, biracial, Latinx, LGBTQ+, and other students at JCSU all have an easy time finding counselors with a matching identity through TimelyMD, she says.
“Although we are a historically Black college and university, we have a diverse campus,” Parsons says. “And so we want to be inclusive.”
Students who participate in online therapy enjoy the easy access from their laptop or phone, Parsons says. A virtual platform also eliminates any discomfort regarding walking into a counseling office or sitting in a waiting room. There’s no commute time for busy students running from class to class or juggling numerous extracurriculars. The bottom line is that the contracted services are working, Parsons says.
“Students who use them report a 70 percent reduction in stress,” she says.
Nearly three years after the onset of the pandemic, Parsons sees the number of students seeking counseling beginning to return to pre-pandemic levels. As she and her team start to catch their breath, taking steps to avoid burnout remains a focus.
“Our administration supports us in making time for our own mental health, for example, taking a walk during the workday,” Parsons says. “Whatever we need to do to meet the needs of our students.”●
Nancy Fowler is a contributing writer to INSIGHT Into Diversity.
This article was published in our December 2022 issue.
![One day after the mass shooting incident at Michigan State University in February, a University of Florida (UF) student called the UF Police Department (UFPD) concerned about a classmate who was researching guns and ammunition. Instead of just police responding to the call, a trained behavioral health specialist was also dispatched. “Our clinicians and officers spent three hours with that person to really flesh out why he was searching what he was searching,” says Meggen Sixbey, PhD, assistant director of the Behavioral Services Division of UFPD and a co-responder. “Do we have evidence to be concerned? In those three hours with him, they learned that he was in fear of his own safety [due to] things that were going on in his own life.” Without UF’s co-responder approach, Sixbey says, the situation could have escalated quickly or ended differently, and the student may not have received appropriate help. Due to widespread concern around mental health and fears of escalation caused by law enforcement response, partnerships between police and behavioral health specialists are growing across higher education campuses. Experts see this collaboration as a way to aid the most vulnerable by connecting them with needed resources and support. Collaborations differ campus to campus based on institutional needs. While some new programs, like the one at UF, dispatch counselors directly to the scene with police officers, others do not involve immediate on-site clinician response to dispatch situations. The University of Colorado Anschutz Medical Campus, for example, works with both municipal and campus police to provide mental health support services to students, all of whom live off campus. University case managers help officers on the scene when there is no perceived imminent danger. Additional support is provided by the Campus Assessment, Response & Evaluation (CARE) Team, which is a common type of program at colleges and universities. The goal is to reach students before their situation becomes critical. The CARE Team reviews referrals for urgent mental health support among students and connects them to campus resources such as case management and additional counseling services. When assessing a threat, each situation is evaluated based on the NABITA Risk Rubric, a tool used in triaging mental health concerns with an interdisciplinary team approach, says Jan Gascoigne, PhD, associate vice chancellor for student affairs, and associate clinical professor. “Often the situation is determined not to be a threat but really just someone who is struggling and needs help,” she says. “We’d rather try to work with that person, figure out what’s going on, and get them the help they need without having to escalate to a police intervention. Our campus police have the same philosophy.” New programs expand mental health services in dispatch situations, with projects being introduced at Johns Hopkins University, The University of Texas at Austin, the University of Oregon, Colorado State University, and California State University, Long Beach. During a six-month trial in the city of Denver, in which mental health specialists were paired with police to respond to calls involving trespassing and other nonviolent events, a 34 percent drop in crimes was reported, or approximately 1,400 fewer criminal offenses, according to the Stanford University report “A Community Response Approach to Mental Health and Substance Abuse Crises Reduced Crime,” published last year. UF’s program launched in July and is the first in the nation led by a campus police department, Sixbey says. Calls are answered by UFPD, which contacts clinicians when there is a mental health component. Situations might include, for example, a student who threatens suicide, someone who was just fired from their job, or an individual whose property was stolen. It’s essential to decriminalize mental health, or mitigate criminal offenses in such calls, Sixbey says. It’s also important to de-escalate situations with clinically trained professionals to help reduce hospitalizations, which are often traumatic, she says. The UF team is looking for more effective ways to enhance efforts to assist underrepresented individuals because the relationship between these communities and law enforcement has historically been strained, a circumstance highlighted by recent social justice activism and political attention paid to policing. In addition to a campus climate survey, UF is conducting focus groups to see how underrepresented communities on campus view the program. Preliminary feedback points to possible changes in police uniforms, where officers would wear a pin or patch to identify themselves as Crisis Intervention Team trained, which means they have received mental health instruction to guide interactions. Individuals surveyed also showed interest in making the clinician the lead responder instead of an officer. This model was used successfully a couple of months ago, Sixbey says. A faculty member of color called regarding a Black student who made a concerning statement about suicide and left the classroom abruptly. The caller didn’t want police to go to the student’s home because they were aware he had experienced past interactions with law enforcement, but the caller still felt a wellness check was warranted. Based on the information provided, the clinician was able to strategize and lead the interaction. They found that the fears the instructor had regarding the student’s mental health were not present and that he was thankful for the tailored response. “Why a program like this is so beneficial, especially to underrepresented populations, is simply because it provides an additional resource which is an alternative to law enforcement response,” Sixbey says. “Even the best law enforcement officer with an abundance of mental health and crisis intervention team training is still an officer. When you can bring a mental health worker to the scene, it can shift the dynamic and allow for a noncriminal approach to a noncriminal matter.”](https://www.insightintodiversity.com/wp-content/uploads/2023/03/Crisis-Response-1-218x150.png "Counselor-Police Response Partnerships Benefit Students in Crisis")
