The university system strives to ensure equal access to mental health care at all campuses

An uplifting banner at Keene State College. Photo/KSC

DURHAM, NH – Shari Robinson, associate vice president for student life at the University of New Hampshire, has a perspective on the mental health crisis facing educators that stems from years on the front lines.

She has been an active therapist for two decades and has been counseling students since 2004. “We’ve always experienced stress, anxiety and depression,” she says. “But now we’re seeing more major depression, bipolar disorder and psychosis, and more developmental disorders like autism. These students can do well in college, but they need more support.”

The university system board of trustees heard a clear call for these services in late August, when a group of students and administrators presented a report on “Mental Health and Campus Life,” calling for equal access to mental health services across the university system.

Representatives from the University System Student Board along with the Chief Student Life Officers from UNH, Plymouth State, Keene State and Online Granite State College reported research that was initiated because of a common theme they heard among students and student officials: a significant decline in relation to the well-being and mental health of students compared to previous years.

No wonder, because the alarm bells are ringing across the country. That healthy minds The annual web-based survey of college students across the country found that 41 percent of respondents tested positive for depression and 34 percent for anxiety in the 2021-22 academic year. The survey reached 450 colleges and universities with over half a million respondents. Perhaps most troubling, one in four had serious suicidal thoughts.

The UNH investigation showed that the number of students seeking counseling and the number of counseling sessions at the four campuses has not increased significantly over the past three years, but much of this is due to a lack of capacity to significant increase and school closures due to COVID.

“The number of students who seek support has not increased significantly in comparison. However, due to ongoing staff shortages, demand for services feels tightened amid the ongoing pandemic,” the report said.

As Robinson puts it, “At UNH, we started the semester with a longer wait than ever. In the first few weeks, our waiting times were up to nine or ten days, and we never started the free semester like this. There is usually no waiting time and definitely no longer than a week. It was truly unprecedented here at UNH.”

The backlog is primarily due to a 50 percent reduction in the number of counselors and therapists available for student consultations.

“Most counseling centers are understaffed,” says Robinson. “As a result of COVID, there has been such a high turnover that we have started this academic year at 50 percent staffing, with six vacancies out of 12 full-time positions. This is not unique to UNH. Therapists and counselors realized they could do private practices from the comfort of their own homes and make more money. We can’t keep up with that.”

Anyone who needs treatment from a licensed psychiatrist has to wait in a longer line. “Psychiatry is such a scarcity in our state,” Robinson said. “It can take months to get a psychiatric appointment.”

Keene State College campus. Courtesy photo

No quick fix

According to data in the Mental Health and Campus Life Report, students in the USNH system who sought counseling primarily did so because of family or school hardships, eating disorders, adjustment to college life, and family or interpersonal challenges. The most common problems were anxiety, stress, depression, lack of motivation, separation, isolation and loneliness or grief/loss.

It all sounds pretty predictable, but Robinson says something deeper is going on. The increased demand for mental health services is a trend that dates back at least 20 years and was not caused by, but exacerbated by, COVID.

“We’ve always had youth who suffered from bipolar disorder or even psychosis, but these students are now able to do well in high school and get accepted into competitive institutions thanks to IEPs (Individualized Education Programs) and the like,” she said. “That’s good. But I’m not sure our institutions have kept up with the amount of all-round services these students really need.”

With no immediate solution to the staff shortage in sight, UNH has turned to more online services, launching an awareness campaign on mental health and emotional wellbeing in the fall. The related websiteHow Are You Really? includes self-assessment tools and links to resources.

Graphic of UNH’s How Are You? self-assessment tool Landing page.

The UNH Psychological and Counseling Center offers a personal suicide prevention training called QPR (Question, Persuade, Refer) for all faculty, staff and students. “We have 20 QPR trainers here who have been teaching 60- or 90-minute training sessions for the past seven years,” Robinson said.

UNH has contracts with online services that provide 24/7 crisis counseling, including protocol and its subsidiary, Welltrack Connect (formerly known as The Shrink Space). Keene, Plymouth and Granite State hire similar services from a mix of providers that includes companies like UWill, Protocol, Kepro, WellTrack and BetterHelp. According to the report, students would be better served with a system-wide contract.

“At UNH, we now have a 24-hour hotline for advisors if you need them,” said Wayne Jones Jr., provost and vice president of academic affairs at UNH. “These are resources that didn’t exist five or 10 years ago and we had to add them.”

The problem, according to student representatives from the USNH student board, is that these investments have not been made in the same proportion at the other two residential campuses, nor are the same services available to online students enrolled through Granite State College.

“The problem is that not all campuses are created equal,” said Robinson. “It’s a great campaign (How are you – really?). We have to do that at all of our system schools.”

“Not where we need to be”

According to Robinson, UNH is not where it should be when it comes to psychological counseling compared to other institutions of a similar size, but Keene and Plymouth are even worse off.

“I’ve worked at three other counseling centers, so if I evaluate where UNH stands, we could do a lot better. But within our system, we’re doing so much better than Keene and Plymouth. So the student point was a call for justice…an expectation that there would be a baseline offered at all institutions. It shouldn’t be a cookie cutter, but there should be a baseline. All of our students in our system deserve timely and responsive access to quality mental health.”

These types of services are funded through tuition. With a student population at least four times that of its smaller peers, UNH has a distinct advantage that some say should now be shared through a consolidation of services across campuses.

At a minimum, Robinson says, each campus should have its own in-house counseling center, with contracts for additional services like protocall centralized throughout the system.

“It’s a way to start centralizing,” she said. “But this is an investment in the system. I ran the numbers. The system would have to invest $350,000.”

Robinson studied the costs of consolidating services as part of her role on a USNH planning committee called The Behavior Roundtable. “It’s a committee of the system that meets at least once a semester or a few times a year,” she said. “I’m in and we’re having these talks. If we could get a buy-in and support from the system that would be a good place to start. It doesn’t answer everything, but it’s a low-hanging fruit.”

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