Since March of 2020, there has been little respite for college counseling center leaders as isolation, academic worries and health concerns have led to huge increases in care needs from students. However, as COVID-19 case counts have waned recently, the centers have had a small window to devote more critical resources to them.
That is critical because, according to several studies, between 80-90% of college students have sustained some mental health strains during the pandemic, and leaders and administrators have labeled the crisis a top priority in 2022.
“When you look at trends, even within the pandemic, anxiety is up, depression is holding steady and suicide ideations are down, although still at an unacceptable number for this age group,” said Dr. Nora Feldpausch, Medical Director at Mantra Health. “One of the biggest difficulties from a mental health perspective is uncertainty. The constant change [with the pandemic] continues to wear on students. I’m not sure until we have an extended period of time where we can say we’ve beat this, that you’re going to see a huge shift in the mental health perspective with students.”
Telehealth has been an important part of many institutions’ strategies to help students, and Mantra has been a key provider, offering a foundation of support through its unique portal for students and 24/7 service. Mantra also recently forged an exclusive partnership with Didi Hirsch, the preeminent organization that helps care for those with suicidal ideations, an issue that has affected between 15-25% of all college students. The goal is to install “a mental health-care pathway for students from the day they walk on campus to a time where they might be considering suicide,” says Ed Gaussen, Mantra’s co-founder and CEO.
More from UB: How college can provide strong mental health supports in five steps
Despite the further reopening of campuses, there are many unknowns, including whether new variants will disrupt students’ lives. And mental health is an issue that long preceded the pandemic. So how can colleges better prepare for the coming months? University Business sat down with Feldpausch to get her perspective on the crisis and potential solutions.
What have been the aftershocks of the pandemic on students?
There’s a constant need to adapt and change. There’s a nerviness when folks open, and there’s a nerviness when folks close. Students are often trying to catch up from more than a year now of uncertainty, being online and having campuses shut down. Even if we get back to normal, there’s some catching up that needs to be done from an academic perspective, from a social perspective. That is weighing on students. This has specifically hit students of color and students who are socioeconomically disadvantaged. The pandemic has further emphasized those differences in resources.
How do you think students would react if another stronger variant came along and they had to isolate again?
It would probably be the same thing that happened the last time around. Maybe they’re a little bit more well-versed in how to stay connected or more understanding of what this might feel like. But it’s incredibly disruptive, especially for students that don’t have an easy home to go back to. One of the biggest disruptions for students that are struggling with mental health is that they lose access to their care team at the time when they’re most stressed. The more that schools invest in a model that’s flexible and that can accommodate students’ need, regardless of where they’re located, the more likely you are to be able to at least support them as they navigate whatever difficulty comes along.
What is the current lull in COVID cases allowing counseling center leaders and administrators to consider?
This break is giving us a little bit more time to be thoughtful. We have the perspective of not ever wanting to be unprepared for that again. It also highlights hybrid models right now, because those models have been able to demonstrate success. I was at Michigan State when this first hit, and we had about a week to transition from a clinic that was just beginning to consider the possibilities of telehealth to a clinic that was entirely virtual. We’re in a different space now. That conversation has shifted to, what should it look like?
What are the best colleges and counseling centers doing in terms of care for students?
The ones that are doing it right are the ones that are basing their decisions on how they structure their clinics around evidence-based, consistent protocols that have been shown to be standard of care. Good care isn’t provided in a vacuum. It’s provided within the context of a team, especially when you’re talking about high-risk, or students having complicated presentations. Trying to have one provider separated from the resources on campus, separated from the rest of the clinical team, is not a good idea. The places that are doing it right are thinking about how they build collaboration into the system to make it seamless and easy.
How different should that care be at, say, a large campus community compared with a smaller one?
The system should reflect the personalized needs of each campus. I don’t think you can provide the highest level of care when you’re just dumping them into a black-box third party. You want to work with a partner that works seamlessly and follows what’s going on with students. Many folks on campus have been there for years. They understand the day-to-day and know students much better than someone who’s coming in from the outside. There has to be a way to share that understanding and to build a relationship that honors that.
We’ve gotten reports through the past year or more about shortages of staff at counseling centers. Do those still exist and have prevalent are they?
Of all the counseling center directors I’ve spoken to last year, I can think of only one that’s been able to successfully recruit and fill their staff to where it needs to be. We’re approaching a crisis within college mental-health centers nationally with providers leaving and having trouble recruiting and retaining providers. Some places are resorting to bringing in folks that may not be specialized in college mental health. Primary care is carrying a huge burden, and they just don’t have the background and training. That’s why they’re starting to look at companies like Mantra. Can we find a really high-quality partner that can help us with this? I think we need to make this somewhat of a cooperative effort.
What are some of the considerations for improving mental health care for students and what needs to happen to make them a reality?
We’re starting to come together and say, what should the standard of care look like? What should the ratios be? What does an excellent hybrid program model need to have in order to be considered at your university?
[Colleges] need to allocate funding to get the services in place that their students need. They have to prioritize mental health. There’s also going to be a role for providing a spectrum of care. What are the various pieces to support the long-term wellness of students as opposed to just coming in when the wound is gushing blood and trying to get a tourniquet on it?
