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Over the past year, academic, financial, emotional, and family stressors have all piled up for college students. These stressors often manifest in mental health issues. While some students have found ways to thrive with a renewed focus on academics, taking a gap year, or bonding with a close circle of friends, some students had difficulty making social connections or navigating the shift to an online learning environment. As schools prepare for post-pandemic campus life, many students will return to campus in a state of depression or with feelings of stress or anxiety.
During a panel discussion on how colleges and universities can support student mental health, over 60% of the higher education attendees said that they felt less than prepared to support student mental health this fall. For higher education to support student health and well-being moving forward, schools need to take an approach that supports students before counseling is needed.
Just trying to meet counseling demand isn’t enough
Before the coronavirus impacted college campuses, many college counseling centers struggled to meet the demand for care. In 2019, the Association for University and College Counseling Center Directors (AUCCCD) found that nearly 90% of counseling center directors reported an increase in students seeking services. Claytie Davis III, Ph.D., ABPP, chair of the Association of Psychology Postdoctoral and Internship Centers (APPIC) board of directors, told the American Psychological Association in July 2020 that most counseling centers had two- to three-week waitlists for students seeking care before the pandemic.
As students, faculty, and staff prepare to return to campus, some have called for a closer look at the root of why higher education and mental health are at such odds with one another. Simply asking for faculty or staff to do more won’t be enough. Faculty and staff can’t take the place of a counselor. But hiring more counselors only serves as a band-aid.
Adopt a reopening strategy that responds to the collective trauma of the past year
At The Claremont Colleges, classes went remote when the coronavirus pandemic started, so no residential students have been on campus in the last year. Janet Smith Dickerson, vice president for student affairs for The Claremont Colleges Services, shared how the students at her consortium, which is about 55% students of color, have experienced a challenging year.
“We’re all recovering from this global pandemic, which has created a collective trauma for all of us,” said Dickerson. “It intersects with a variety of other traumas that we’re all experiencing – ranging from political, to economic, to social.
“What we’re trying to do is to create a culture of care where we acknowledge that students need support in a variety of areas.”
Dickerson mentioned several ways The Claremont Colleges are working to support students and make sure they feel safe and secure as they return to campus, including:
- Requiring all students to receive the COVID-19 vaccine.
- Making arrangements for international students and others who may have not had access to the COVID-19 vaccine.
- Creating housing policies to make sure students feel safe and comfortable.
- A hybrid model of teaching where not all classes will be in the classroom.
- Preparing outdoor activities.
An extensive list of support services is available to make sure there is a network of health and wellness services for students in post-pandemic campus life, including:
- Mental health care and resources.
- Physical health care and resources.
- Disability and accommodation services.
- Occupational health and support.
From trauma-informed pedagogy used by faculty to preparations by chaplains in the consortium’s spiritual life area, Dickerson said that everyone is preparing to help students be healthy in all eight dimensions of their health so that mental health is not seen as something separate from other needs.
Why a comprehensive approach is needed for student mental health
Nance Roy, Ed.D., chief clinical officer for The JED Foundation (JED), said the results from the American Council on Education’s (ACE) higher education president survey show a promising trajectory that opinions are changing on student mental health and well-being.
“Mental health and student well-being are top of mind for college and university presidents,” said Roy. “This has not been the case prior to the past five years. Senior leaders on campus are waking up to the fact that emotional well-being is not only something that colleges have a responsibility to help develop and is the mission of the university as much as academics, but it also speaks to the bottom line in terms of retention.
“Colleges need to be taking a comprehensive, public-health approach to promoting student well-being on campus. And everyone on campus has a role to play in promoting student mental health … So that there’s no wrong door for a student to walk through for support.”
How students evaluate a campus’ mental health resources
Roy said that’s what students are looking for — schools that create a culture of caring on campus. But there isn’t an easy way for students to evaluate schools on that criteria. When looking at colleges that do this work well, Roy said that students should evaluate if the school is doing the following things well:
Social connectedness programs
Promotion of help-seeking
Mental health services
Policies on identifying students who are struggling
“What are [the school’s] policies, programs, and systems that support mental health? Those need to be broad-based,” said Roy. “If we want to affect any long-term, systemic change, we really need to take a holistic approach that looks at the students from all elements of their development — not just academics, and not just psychopathology.”
She said that not every student may need direct clinical service, but all students can benefit from support and developing life skills when those types of resources are readily available and easily accessible.
Similarly, Rob Buelow, MS, senior vice president for EVERFI, discussed how higher education is in a moment of reflection and change, in light of decreased enrollment at many schools, as it reckons with how to provide the value that Generation Z is looking for. This generation is socially conscious and values-based, said Buelow, and those traits bleed into how these students select the colleges they will attend.
A recent study by EVERFI found that 82% of graduating high school seniors who were planning to go to college said that safety, well-being, and inclusion were as important to them as academic rigor when deciding on colleges. But over 40% of those students said they were having a hard time finding out how the colleges they were considering were aligned with their interests in these areas — the policies, procedures, and programs in place to support students.
The prevalence of depression on higher education campuses
Sarah Ketchen Lipson, Ph.D., M.Ed., associate director for the Healthy Minds Network and principal investigator for the Healthy Minds Study, shared during the Gen Zstressed: Student Mental Health in the New Now panel discussion how it isn’t that the COVID-19 pandemic made student mental health issues dramatically worse, but that negative trends have continued during the pandemic.
“We’ve been seeing a consistent increase in the prevalence of depression, anxiety, suicidality, and eating disorders, for the past 10 years — in particular, in the past 5 years,” said Lipson.
The national Healthy Minds study has shown a steady increase in students who screened positive for clinical symptoms of major depression.
36% fall 2019
37% spring 2020
39% fall 2020
Lipson said these trends have also continued during the pandemic for other serious issues like anxiety, suicidality, and eating disorders.
Lipson said what the pandemic has significantly impacted are the key risk and protective factors for these mental health issues, including:
- Sense of belonging is much lower on campus.
- High rates of loneliness due to social isolation
- High rates of discrimination, particularly among AAPI students
- Those who have experienced discrimination have a significantly higher prevalence of screening positive for a mental health problem.
In the fall 2020 Healthy Minds Study, students were asked how their mental health has affected their academics. “In the pandemic, we’ve seen the highest rates of students indicating their mental health has negatively affected their academics,” said Lipson. “As a faculty member myself that really resonates. It has been very hard for students to perform and succeed in their coursework throughout the pandemic. And I think mental health has become even more closely tied to that.”
In the study, 28% of students said that, over the past four weeks, their academic performance had been negatively impacted six days or more because of mental health issues.
Discover how telehealth improves student retention
The intersection of faculty, staff, and student mental health support on campus
In many ways, higher education faculty and staff have been on the frontlines of student mental health over the past year. Faculty have seen a decline in student mental health, with nearly nine out of 10 faculty members saying they believe students’ mental-health struggles worsened during the pandemic.
The study, also conducted by the Healthy Minds Network and Sarah Ketchen Lipson, Ph.D., M.Ed., found that almost 70% of faculty indicated that they would like to better understand student mental health and have more training. And 61% of faculty said basic training on how to respond and help students in a mental health crisis should be mandatory.
Faculty stepped up in the past year. This is exemplified by the fact that 20% of faculty members said they had 10 or more conversations with students about mental or emotional health during the spring. Unfortunately, approximately 20% of faculty said their mental health had suffered because of the help they extended to students.
Colleges and universities can’t be blind to the fact that faculty and staff are facing the same challenges as students, said Roy. They have faced trauma as well, as some lost jobs and others may have lost a friend or family member to COVID-19.
Rob Buelow, MS, senior vice president for EVERFI, noted that, while students are changemakers on the campuses of most four-year institutions, faculty play a vital role for community colleges.
“In the more transient environment of community colleges, where you might have people popping on and off-campus, if there even is an on-campus environment, you change culture by empowering staff and faculty,” said Buelow. “They are the culture bearers of the institution.”
The role of technology in supporting college student health and well-being
If there’s one thing that was learned during the pandemic, it’s that technology is vital in providing services and meeting needs. Whether it’s ordering food, getting a car ride, staying connected with friends, or even accessing healthcare services, technology has become a staple for many as a way to get what’s needed. This fact is particularly true for Generation Z — a generation of digital natives that are always looking for touch-of-a-button convenience.
“The shift to virtual in the pandemic — that’s not just a point-in-time change,” said Buelow. “We’re going to continue to see technology-enabled higher education, certainly on the academics side but on the student support and services side as well.”
“The value that technology brings to this question of supporting student well-being primarily hinges on its ability to scale to meet and reach universal populations of students. And in the mental well-being space, it’s providing an accessible continuum of care that is personalized for all students on campus.”
Buelow said what that looks like is upstream, proactive, and preventative education that addresses students who might not be struggling with mental well-being challenges. This enables institutions to make sure those students stay well. But there must also be adaptive and responsive experiences for students who might be in the middle of a crisis.
That’s why EVERFI recently formed a strategic partnership with TimelyMD — the leading telehealth provider specializing in higher education. TimelyMD’s teletherapy platform will be directly integrated into EVERFI’s technology-based education to meet students wherever they are in their mental health journeys.
During the pandemic, telehealth usage rose significantly, and “telehealth is here to stay,” said Buelow. This technology fills in the gaps of care, when a clinic or counseling center can’t meet demand, care is needed outside of office hours, or when a student may not feel comfortable seeking in-person care.
Buelow said that the conversation about in-person care or care delivered through technology like telehealth shouldn’t be an “either-or” conversation. It should be a “yes and” conversation.
“The best case for campuses in technology usage is leveraging it for its ability to reach everyone in your community to establish a foundation of knowledge, awareness, attitudes, and skills around these issues — to collect data from the full campus community to understand their unique needs and strengths,” said Buelow. “And then, use that data to inform all of the other touchpoints that you’re going to build throughout their experience on campus.”
That all starts with orientation, said Buelow. It is a process. It can’t just be done once and then never again.
“Prevention is a process. Social impact is a process,” said Buelow. “It has to be an investment that an institution makes throughout the life course of a student.”
Preparing for the semester ahead
Coming out of a year unlike any other, higher education needs to prepare unlike it ever has before for the health and well-being needs of students. It’s impossible to ignore the data that says the prevalence of student depression and other mental health concerns is at an all-time high. But only focusing on treatment and care will leave holes in the education, awareness, and preventative measures that a campus needs. And only focusing on preparing faculty and staff to try and help students will lead to burnout. A comprehensive approach from the top down puts a strategy in place to ensure that every student has the resources they need to succeed.
If your campus is looking at ways to fill gaps in care and provide a more comprehensive approach to student health and well-being in post-pandemic campus life, TimelyMD can help. Contact TimelyMD to learn how a customized telehealth solution can help your students thrive.
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