Campus Mental Health Campaigns Are Working: So Where Are All the Counselors?

| TBS Staff

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Colleges are more expensive than ever. Students are under greater pressure than ever. And we’re learning more every day about the mental health needs of young learners. So why are campuses struggling to keep up?

The short answer is that guidance counselors are in limited supply. The long answer is a bit more complex. On one hand, colleges are doing a better job than ever of acknowledging, providing information for, and offering outreach to students with mental health needs. On the other hand, countless schools lack, or have failed to invest, the resources necessary to provide adequate mental health support to their student bodies.

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So what’s the reason for this counseling shortage, what does it mean to today’s college students, and what can be done about it?

It Starts in High School

This shortage begins at the high school level. According to an article in The Atlantic, as of 2012, the national public school counselor-to-student ratio was 491:1. The American School Counselor Association recommends a ratio of 250:1, which still seems like a heavy caseload for one counselor. This means public school students receive scant personal access to counseling for either mental health support or the college admissions process.

This inadequate access is often tied directly to socioeconomic factors. Schools with fewer resources are at once more likely to be populated by at-risk students and less likely to offer sufficient counseling options. In fact, says a study by the Department of Education [PDF], roughly 850,000 students at 21% of high schools in the U.S. don’t have access to a guidance counselor at all.

This absence of access is also loaded with socioeconomic, geographical, and racial inequality. In fact, schools populated with at-risk and minority students are more likely to staff a greater number of school resource officers (a school-based law enforcement officer) than guidance counselors. Read about the school-to-prison pipeline to learn more about how this impacts at-risk student populations.

The Department of Education report finds that black students are 1.2 times more likely than white students to attend a school with a school resource officer but not a school counselor; Asian students are 1.3 times more likely; and Latino students are 1.4 times more likely.

In reality, school counselors carry irrationally heavy caseloads nationwide. A startling 2005 report from the National Association of College Admission Counseling (NACAC) revealed that the average public school student received roughly 38 minutes of college-admissions-related counseling throughout the entire course of high school.

Just 38 minutes?! The Allman Brothers have individual songs longer than the amount of time your counselor spent advising you on the college admissions process.

Going It Alone

Shortages at the high school level have direct implications to the counseling equation on college campuses. Countless students make critical admissions decisions without meaningful support. This can lead poorly advised students to institutions ill-suited for their needs, expectations, or social disposition. It also deprives students of a frank and realistic discussion about academic abilities, professional expectations, and the financial burdens that come with college enrollment.

Students who arrive at college without this support can find themselves unprepared for the academic rigors, geographic realities, cultural peculiarities, and even the individual freedoms of campus life. Just as the counseling shortage at the high school level disproportionately impacts low-income, minority, and at-risk students, so too are these demographics more likely to arrive at college in need of critical support.

Even as colleges try valiantly to create opportunities for at-risk and first-generation students, many of these same colleges struggle to fully understand and keep up with mental health needs. This is true even as we gain an increased understanding for and appreciation of the unique cross-section of mental health risks facing college students.

The Good News

This is not a doom and gloom report on the state of mental health on college campuses. It may instead be a reflection of something positive. In many ways, the growing demand for counselors is as much a result of improved outreach as it is a shortage of resources.

A 2016 report from the Center for Collegiate Mental Health (CCMH) found on-campus mental health awareness campaigns make a real and observable impact on student populations. As these campaigns expand their outreach, a growing number of students seek the support of campus mental health services.

An article from Inside Higher Education suggests the current generation of students doesn’t necessarily have a greater set of needs than previous generations. Many of the same groups — low-income, minority and at-risk students — arrive at college with the same needs as did previous generations. What largely characterizes younger generations is the effort required to make them aware of their need for support.

The same is true of students who arrive at college with preexisting mental health concerns. Inside Higher Ed reports that during 2011–17, one in two students had sought some mental health treatment prior to on-campus counseling, one in three had taken medication before enrolling, and one in 10 had previously been hospitalized for a mental health condition. Even as the number of students seeking support grows, the number of students with previously identified mental health needs remains constant.

This is a good thing. Colleges and students now better understand the mental health challenges unique to this demographic, including bullying, hazing, substance abuse, sexual assault, depression, suicide, gun violence, and even just the anxiety that comes with adjusting to college life, academic demands, and family pressures.

Now it’s up to colleges to demonstrate a preparedness for this increase.

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Growing Demand (As Opposed to Growing Need)

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Growing awareness may be a good thing, but the remaining gaps are serious. During 2010–17, average institutional enrollment grew by 5%. In that same scope of time, counseling center use grew by 30%.

Meanwhile, says an article in Scientific American, large campuses report an average of one licensed mental health professional for every 3,500 students. Mental health experts recommend a ratio of 1,500:1 on college campus, at the very worst.

The need for mental health services hasn’t grown though. The demand has. Students with mental health needs increasingly recognize their needs and seek support accordingly. This isn’t a growing mental health crisis, even if it looks like one at first glance. On the down side, this is perhaps why the counseling profession has been slow to grow in its ranks.

Funding for college counseling has remained flat.

As demand for counseling grows, the focus has shifted rather than expanded. In a January 2017 article, Inside Higher Education found, over the previous six years, campus counseling personnel shifted their focus toward crisis counseling and away from ongoing counseling. Counseling centers reportedly provided 28% more “rapid-access” service hours per student, while providing 7.6% fewer hours to routine counseling services.

As a result, wait lists for access to non-crisis counseling services have grown inexcusably long. Directors at colleges with total enrollment of 1,501–2,500 students reported wait list use of roughly eight weeks out of the year. For schools with enrollments greater than 15,000, the average number of students on wait lists for counseling was over 50. The wait list line was as long as 70 students for schools with more than 30,000 students.

Simply stated, the bigger the school, the easier it is to get lost.

And these wait times aren’t just inconvenient. For students facing mental health struggles, long counseling wait times may be a matter of life-and-death.

Automatic Analyst?

To handle the personnel shortage, some colleges now resort to technology for help. An article from Inside Higher Ed points to the advent of the virtual advisor. Large schools such as Colorado State University and the State University of New York already employ online applications that provide immediate access to automated advisors. This strategy, sometimes referred to as telepsychology, uses media such as web chat, text messaging, and smartphone applications to provide students with immediate access to support.

Note this support comes from a computerized program designed to ask pertinent questions related to your mental health and well-being. If it sounds far-fetched, realize that 9.1% percent of college counseling centers used some form of this strategy during the 2014-15 school year.

Some argue this level of access is better than nothing. And perhaps it is, particularly for those students who might not otherwise reach out, or who might be too afraid or embarrassed to ask for direct human support. Of course, the notion of telepsychology invites obvious concerns about the efficacy of the experience. If you’ve ever tried paying your insurance provider using their stupid automated system, you’ve experienced the risks of relying on automated processes to help students in emotional crisis.

A number of nonprofit groups have also emerged to confront the service gap. Among them, the College Advising Corps and College Possible hire recent grads, many with backgrounds similar to students in need, to help staff counseling jobs.

Other groups, including CollegePoint and Strive for College, use virtual advising to reach remote and isolated students.

Inside Higher Ed also points to schools like Oregon’s Williamette University and Amherst College, which offset the shortage by implementing 24-hour mental health hotlines.

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Counselors Wanted!

These measures help fill gaps. Each has the potential to provide access and encouragement to students who might not otherwise reach out. And the use of automated services and hotlines can at least ensure that students in immediate crisis have somewhere to turn. In reality though, the counselor shortage in higher education has one solution: more counselors.

Some revelation, right? But the reality is that we now understand so much more about the mental health needs of the student population. We’ve also learned much more about shaping effective public health messages and reaching students with critical information.

Some campuses have taken steps to confront the problem. Among them, the University of Iowa announced it would hire eight new counselors to handle growing demand. At Penn State, students took matters into their own hands. The graduating class of 2016 imparted, as its senior gift to the school, an endowment that placed a counselor directly in a residence hall.

Though an innovative approach, the solution to the demand doesn’t fall on colleges alone. This is an issue connected directly to policy priorities. The Atlantic argues, “Public policy and funding play a crucial role in improving the advising and, consequently, the future of millions of students. As it stands, some states and districts are making a serious commitment to redressing the advising gap, but the majority have demonstrated little sense of urgency on this issue.”

And this is truly where the shortfall exists: urgency. For students in emotional distress or crisis, the consequences can be dire. The effort by the Department of Education and individual states must be equally urgent in providing financial support to colleges commensurate to the growing demand for mental health support.

Again, what we see today on college campuses isn’t a mental health crisis. It’s evidence we’ve taken a half-step toward progress.

Now colleges must take the other half-step by providing enough counselors and resources to meet the needs of every student — both those in crisis and those in need of long-term support.

Our knowledge, understanding, and capacity to treat mental health have grown considerably. It’s time for the counseling community to catch up.

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