Increasing Demand for Mental Health Services on College Campuses - North Carolina Health News
By Taylor Knopf
As students return to school, colleges and universities are looking for ways to support the increasing demand for mental health and counseling services on campus.
Across the nation, there has been a steady increase of high school and college students seeking mental health services, namely for depression and anxiety.
Schools are trying different approaches to meet the demand. Some are partnering with other foundations and obtaining grants to bolster their campuses’ behavioral health strategies.
At the University of North Carolina School of the Arts in Winston-Salem, the student wellness center implemented counseling session limits last year.
And North Carolina Central University in Durham is training faculty and staff in mental health first aid with hopes that staff can recognize problems before they escalate into something more severe.
It’s not entirely unexpected, as the Centers for Disease Control and Prevention has tracked the upward trend of various mental health conditions among high school students in the U.S.
Youth mental health trends
The CDC’s Youth Risk Behavior Surveillance System found that the number of high school students with persistent feelings of sadness and those who have suicidal thoughts has trended in the wrong direction over the past decade.
The percent of students who indicated in the biennial CDC survey that they “feel sad or hopeless almost every day for two weeks or more in a row in the past year” rose from 28.5 percent in 2007 to 31.5 percent in 2017.
“Poor mental health can result in serious negative outcomes for the health and development of
adolescents. It can lead to risky sexual behavior, illicit substance use, adolescent pregnancy, school absences/dropout, and other delinquent behaviors,” CDC researchers wrote in the latest YRBSS report.
A Center for Collegiate Mental Health report found that college students’ use of counseling center resources increased by an average of 35 percent over a five-year period, while the average enrollment increased by 5 percent during that time.
Meanwhile, the number of students receiving counseling for anxiety rose from 18 to 30 percent over the past four years, according to the 2017 CCMH annual report.
Depression is the second most common reason students seek mental health services on campus and that number rose from 15 percent to about 17 percent over the same four-year time frame.
The percentage of students who have had serious thoughts of suicide and those who have attempted suicide has risen over the past seven years. The number of students who have purposely injured themselves with behaviors such as cutting or burning has also steadily increased over the same time frame, according to the CCMH report.
Counseling session limits
At UNC School of the Arts, clinical case manager Laurel Banks said her students align with the national mental health services trends; most seek help for anxiety and depression.
Last year, she said the counseling center had to implement session limits because the demand was so high. Students can have up to eight sessions per semester, which is covered under the student health fee.
And if a student needs more than that, Banks said she can find additional services in the community.
About 25 percent of the student population seek mental health services through the wellness center, she said.
The School of the Arts counseling center employs three full-time licensed counselors. Additionally, there is a psychiatrist who comes to the school’s wellness center once a week to manage medications.
Banks said there has been such an increase in demand for mental health services, the school is working on ways to serve students better. This September, the school will begin creating a strategic behavioral health plan with the help of the JED Foundation, a national nonprofit dedicated to promoting good emotional health and preventing suicides among teenagers and young adults.
Banks said the rising demand for mental health services among young people could be related to many factors.
“Sometimes it’s the new demands on social media and how people think they have to keep up with others,” she said. “It could also be the state we are in as a country.”
She said some students deal with issues related to “not feeling as though they are understood.”
“Break the Stigma”
North Carolina Central University recently received funding from the Substance Abuse and Mental Health Services Administration (SAMHSA) for a suicide prevention program that has allowed the school to bring mental health specialists on campus to work with students, faculty and staff.
The goal is to teach them how to recognize the early signs of mental health issues, so people can hopefully get help before it’s a bigger problem.
NCCU has struggled to meet the increase in demand for services, said the university counseling center director Carolyn Moore.
She hopes that training the staff and students in mental health first aid will lead to students seeking help sooner.
“The more severe the problem is, the more intensive treatment they need. We’re trying to get staff to provide some support themselves and send students to us earlier.”
This summer, about 90 staff members were trained and certified in mental health first aid.
Moore said that trends with her students also follow national trends of dealing mostly with anxiety and depression.
“But the reasons why they are anxious and depressed varies,” she said. “Financial issues can cause students stress, which then leads to anxiety.”
It’s been an ongoing discussion at NCCU on whether or not there are resources available to hire more counseling staff, Moore said. The counseling center is also trying to do more group counseling. Some of these groups are held outside the center to avoid the stigma surrounding mental health.
For example, the center has hosted sessions with LGBTQ students at the LGBTQ center, or they’ve held a group session for injured athletes at the recreation center.
Moore said there has been a renewed focus on mental health across campus this year as the Student-Athlete Advisory Committee won a national contest with their video about breaking the stigma surrounding mental health.
Over five years, counseling center utilization increased by an average of 30-40%, while enrollment increased by only 5%.
The average length of treatment (individual counseling) continues to be approximately 4.5 sessions (Page 16) with the majority of students receiving 2-10 sessions (Page 7).The vast majority of students attended two to five appointments.
Treatment provided by counseling centers is effective and achieves the same level of symptom reduction as that reported in randomized clinical trials (RCT’s) for concerns such as depression and anxiety. A relationship exists between symptom reduction and length of treatment (Page 5-6).
Anxiety and depression are the most common presenting concerns (as assessed by clinicians) and are the only presenting concerns that have demonstrated a clear growth trend over the last 4 years (Page 9).
Anxiety is the top primary concern. Increase from about 18 percent to almost 30 percent over the past four years. Depression right behind it. Increase from about 15 percent to about 17 percent over the same time frame. Below those are relationships problems, stress and family concerns. Those concerns are flat lined of decreased through the years.
Rates of “threat-to-self” characteristics (non-suicidal self-injury, serious suicidal ideation, and suicide attempts) increased for the seventh year in a row among student seeking treatment (Page 13).
According to data provided by counselors at the end of treatment, a majority of students (61.2%) did not receive psychiatric medications during treatment.