After two years of COVID-19, data guides university support for mental health

College advisory services rely on data to guide support as student needs and campus operations continue to drastically change amid the coronavirus pandemic.

To find the best way to support students who are facing unprecedented challenges throughout their studies, colleges are drawing on robust data from electronic medical records and drawing on a national research infrastructure to support requests for resources. However, counseling agencies cannot rely on data from previous years to guide current services as students have faced dramatic changes both on and off campus during the pandemic, experts told EdScoop.

Data helps college counseling centers allocate resources appropriately each year and avoid a “one-size-fits-all approach to a variety of problems and concerns,” said Barry Schreier, director of counseling services at the University of Iowa.

“There seems to be an endless need, and counseling centers are always a limited resource,” Schreier told EdScoop. “Counseling centers are often left in a position to decide how the demand is viewed.”

When students return to campus, many counseling centers offer both in-person and virtual services to test student preferences. Counseling centers also have to decide which workshops or self-help groups to offer and whether support should be provided in person or online.

These decisions are also supported by data. For example, if students seeking mental health treatment report high levels of anxiety, a campus may offer workshops that teach coping strategies.

“It’s looking at what the students are asking for and then finding out if we’re offering that, if they’re actually going to come,” said Schreier, who is also committee chair for the Association for University and College Counseling Center Directors. “If we offer it and nobody comes, then it’s an employee who doesn’t offer one-on-one counseling, who then did something that nobody used, and so it becomes a resource thing.”

identify needs

Even before the pandemic, there was a decade-long trend in which demand for mental health counseling and support outstripped supply, said Brett Scofield, who directs Penn State’s Collegiate Center for Mental Health. This has led to clinicians taking on higher caseloads.

The pandemic has put the spotlight on mental health issues on college campuses and elsewhere. President Joe Biden described mental health as a “national crisis” in his State of the Union address last week. Millions of dollars in coronavirus relief funds have been poured into universities, with one possible use being mental health care.

But counseling centers must continue to work to obtain these resources from university leadership. Administrators have long relied on data such as appointment wait times and the number of students using services to advertise resources. This data comes from admission forms and, more recently, from electronic medical records.

“We really pay attention to things like the number of appointments scheduled, how many appointments attended, as there are also no-shows and cancellations,” said Vanessa Stein, associate director of public relations and prevention at the University of Central Florida. “[We look at] how customers are served, what the nature of the concerns – is it fear, is it grief, is it trauma – and that helps us determine our staffing needs.”

Nationally, the Collegiate Center for Mental Health publishes annual reports with aggregated data for more than 600 counseling centers. That can help universities amplify their resource needs by showing national trends, Scofield said.

The center is also developing tools such as the Clinical Load Index, which examines correlations between clinical caseloads and counseling outcomes.

“It can [help] better understand the realism of the services [a center] can create and contribute to a match between what their stakeholders expect from their service and what they can realistically deliver,” said Scofield.

“We need more of this”

Some counseling centers turned to teletherapy providers to expand their counseling capacity even before the pandemic accelerated this process for some schools due to increased demand. These companies may also provide data on what students are looking for and the level of interest in certain services. For example, TimelyCare, a telemedicine app, reported on it last year 40% of its virtual mental health exams with students over three months took place outside normal business hours.

UWill, a company that connects students with consultants, launched in 2020. UWill founder and CEO Michael London told EdScoop that these searches automatically produce data that the company can provide to universities, including information on why students were looking for assistance, whether the session was an emergency service acted and what types of services and counselors the students sought .

UWill provides dashboards for some of that data, and then customers can choose to have anonymized, aggregated data sent to them on a regular basis, London said.

“There are ways to get specific information, but it’s a process,” London said. “If it’s a consultation and they want the actual notes as an example, they have to request them. That doesn’t happen very often. I think they’re really looking for aggregate data to back up the fact that we need more of that.”

There is evidence that students are struggling. An Annual Report of the Collegiate Center for Mental Health — with 1.1 million mental health visits across 180 sites — shows the number of students reporting anxiety and depression has steadily increased over the past 11 years.

academic distress

But college counseling agencies have yet to figure out how to support their campus.

Each campus participating in the CCMH survey submits information from student self-reports and information entered by healthcare professionals. Each campus individually submits data that is typically collected via an electronic health record, meaning campuses can compare their own data to national figures.

And the data shows that college students suffer from more than just anxiety and depression.

“The academic load in particular has increased significantly compared to the previous year,” says the report. “It is possible that the increase in academic distress is related to the abrupt shift to distance learning, which may have negatively impacted many students’ learning styles, motivation and attention levels, and access to academic resources on campus.”

Clinical descriptions also showed an increase in concerns about stress and academic performance, both of which were in decline before the pandemic, according to the report.

Students also said they seek help with family issues, which the report says may be because many lived with family rather than on campus during the first waves of the pandemic.

Reviewing the reasons students seek therapy or support can help centers develop more specific services, said Schreier, director of the University of Iowa. He said that doesn’t always mean offering more one-on-one therapy — it could mean offering workshops on managing emotions, specialized support groups, or online training.

“There are many different offers from the counseling centers, which often meet the needs of the students and it doesn’t necessarily have to be the highest level of care from the counseling center,” says Schreier.

stigma

The Center for Collegiate Mental Health collected data on session methods for just one year, but out of 322,000 appointments, only 2.3% were in-person and about 83% were completed via video.

Therapists at the University of Central Florida completed remote therapy training in 2019, just before the pandemic, Stein said.

“We knew this was going to be part of our field, we just didn’t know how soon,” she said.

Remote counseling, even when in-person services are available, can provide flexibility for students living off campus or out of state, Stein said.

More data is needed to understand how students are using these services over the long term, but UWill is expanding its options for virtual events and services to see how students and centers are responding, said London, the company’s CEO.

And virtual or group services can help bring together students who might not otherwise have sought support, he said. Only about 6% of the students surveyed for the 2021 Healthy Minds Study said they would think less of someone seeking psychiatric treatment, but 45% said they thought “most people” would look down on people seeking help.

“I think there are people who will just never seek therapy, not even teletherapy, but they could just go to an event,” London said. “You might want to go to an event about how to get better sleep – it doesn’t feel like therapy. It doesn’t feel like it has a stigma.”

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