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The Impact of Mental Health Provider Shortages on College Student Health

  • May 26, 2023
  • Dr. Bob Booth
College student looking outside

Table of Contents

  • Why are there challenges providing adequate mental health resources to students?
  • How the provider shortage impacts colleges and universities
    • Increase in waiting list
    • Difficulty providing services to students with severe mental illness
    • Liability risks increase
    • Support for academic success is decreased
    • Counseling centers are less available to support the campus community
  • How colleges and universities can overcome provider shortages
    • 1. Integrate mental health education into the curriculum
    • 2. Offer peer support
    • 3. Faculty training and support
    • 4. Access federal government aid
    • 5. Expand telehealth and virtual care options
  • Timely help to bridge the gap of provider shortages to support students

America is experiencing a physician shortage—and it’s expected to get worse. It not only impacts the general population, but also means many college students may not receive the care they need. According to the Association of American Medical Colleges (AAMC), the U.S. could be short anywhere from 54,100 to 139,000 physicians by 2033. Similarly, there is expected to be a shortage of between 14,280 and 31,109 psychiatrists within the next few years, which will leave psychologists, social workers, and others in the behavioral health field overextended and at risk of burnout.

As of April 17, 2023, the Health Resources and Services Administration (HRSA) reports that over 160 million people live in a designated mental health professional shortage area (HPSA). To remove the HPSA designation, more than 8,000 practitioners and healthcare workers are needed across the United States and its territories. Similarly, the Kaiser Family Foundation (KFF) found that almost 157 million people reside in a HPSA. The severity of this community health problem varies from specialty to specialty (e.g., Primary Care Physicians, Dental Health), but these stats highlight the significant shortage of mental health professionals in the healthcare workforce, impacting the general population along with college campuses.

Why are there challenges providing adequate mental health resources to students?

The American Psychological Association (APA) suggests the following reasons why higher education is struggling to keep up with the mental health needs of students.

  • Student mental health is worsening – During the 2020-21 school year, more than 60% of college students met the criteria for at least one mental health problem, according to a Healthy Minds Study. The pandemic and its long-lasting impact cannot be underestimated, with the CDC reporting in August 2020 that 25.5% of college-aged individuals (18 to 24) had experienced suicide ideation over the past 30 days. More recent findings from the KFF found that half (50%) of adults aged 18-24 reported anxiety and depression symptoms in 2023, in comparison to about a third of adults overall.
  • Traditional counseling center model is often not sufficient – Even before provider burnout from the COVID-19 pandemic, the number of students seeking mental health treatment was growing. The campus counseling center model alone may not be able to solve the clinician and behavioral health provider shortage and service disparities.
  • More students are seeking help – Progress has been made to de-stigmatize mental health issues and help-seeking behavior. This empowers those who were formerly silent sufferers, those who otherwise might not step forward and proactively seek support for mental health concerns. This signals progress, but it also means that colleges and universities need to be ready for additional students to seek help, with scale and bandwidth to meet more students’ needs.
  • College students face a variety of challenges – College students today balance an array of challenges and stressors, from coursework, relationships, and adjustment to campus life to economic strain, social injustice, mass violence, and various forms of loss in the wake of COVID-19.
  • Lack of funding – According to the APA, the rising demand for mental health services hasn’t been matched by a corresponding rise in public health funding for personnel, which has led to higher caseloads. The nationwide average annual caseload for a full-time college counselor is 120 students, with some centers averaging more than 300 students per counselor.

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How the provider shortage impacts colleges and universities

The shortage of mental health professionals in health centers at colleges and universities has a profound impact on the mental health of students. The International Accreditation of Counseling Services (IACS) sums up the impact succinctly.

Increase in waiting list

According to a recent report from the Association for University and College Counseling Center Directors (AUCCCD), the wait time for a first therapy appointment is between 1 and 2 weeks at most counseling centers, regardless of institution size. Students on a waiting list may not receive timely support for mental health conditions, resulting in some choosing not to seek counseling at all. Additionally, students put on a waitlist are more likely to leave the university, which directly impacts student retention rates. A study cited by IACS found that attrition rates increased by 14% for students put on a waitlist compared to those who received timely counseling.

Difficulty providing services to students with severe mental illness
Research confirms that as the severity of mental health challenges increases, the time required to manage each case also increases. So, the ratio of counselors to students should decrease as the severity of issues increases to appropriately meet student needs.
Liability risks increase
As there are fewer mental health care professionals to serve students, counseling centers have less time and resources to dedicate to prevention — particularly in underserved areas. This shortfall decreases support for the campus community and hinders efforts to prevent mental health crises. Additionally, counseling centers with higher ratios can be legally vulnerable due to an increase in the number and complexity of law cases that involve student mental health and higher education institutions.
Support for academic success is decreased

Counseling plays an important role in supporting the academic success of students. However, as staffing resources are stretched, fewer students experience this benefit.

Counseling centers are less available to support the campus community
With a decreased ratio of mental health professionals to students, less time is available to train faculty and staff, provide preventive outreach to student groups, and provide consultations for difficult student situations.

How colleges and universities can overcome provider shortages

With the demand for mental health care skyrocketing, it’s challenging for colleges and universities to keep up. Even so, consider these five solutions to to help meet the growing demand.

1. Integrate mental health education into the curriculum

Incorporating mental health education into courses could be a proactive step in supporting student well-being. By providing students with tools to manage stress and overcome challenges early on, colleges and universities may be able to alleviate the burden on mental health and healthcare services. Some high schools and colleges are beginning to recognize the importance of mental health education initiatives, with some requiring health classes and even incorporating mental health curricula into writing courses for incoming students.

2. Offer peer support

Peer-to-peer support programs offer cost-effective one-to-one support to increase student success, health, and well-being. They also help destigmatize mental health services and expand the network of student support, which is particularly helpful in rural communities. Of course, peer support systems can’t replace professional mental health care for complex challenges. Rather, higher education leaders must assess where peer support has a distinct advantage and where professional mental health care is necessary.

3. Faculty training and support

Implementing training programs such as Mental Health First Aid can help faculty recognize and respond to students in distress. Workshops teaching faculty to “recognize, respond, and refer” can also be beneficial. These programs enable faculty and staff to recognize changes in behavior that could indicate a student is struggling and allow for staff across campus, including athletic coaches and academic advisers, to monitor students for signs of distress.

4. Access federal government aid

The Bipartisan Safer Communities Act (BSCA) provides over $188 million in grants to 170 grantees in more than 30 states to increase access to school-based mental health services and to strengthen the pipeline of mental health professionals in high-needs educational institutions. These healthcare system funds enable communities to hire 5,400 school-based mental health professionals and train around 5,500 more to build a diverse pipeline of mental health providers in schools. With these grants, colleges and universities can overcome workforce shortages and broaden access to critical mental health support by increasing the number of healthcare providers in schools.

5. Expand telehealth and virtual care options

As I shared with MedCityNews, the best approach to addressing this shortage of behavioral health professionals is more widespread adoption of virtual mental healthcare, a method of care delivery that’s particularly appealing to college students. Virtual care offers several advantages, such as flexibility for when students can seek care, multimodal care beyond face-to-face counseling, peer support options, and increased diversity of providers. Virtual care services, including health coaching, on-demand emotional support, on-demand urgent medical care, peer support, and psychiatry, can help mitigate the expected impact of physician supply and demand.

Timely help to bridge the gap of provider shortages to support students

TimelyCare is the market leader in providing medical and mental health services to college students, serving more than 1.5 million students. As the prevalence of college students experiencing at least one mental health issue grows, the need for mental health support on campuses becomes more pronounced. TimelyCare is addressing the need by working with over 250 colleges and universities, providing much-needed mental health support and suicide prevention resources to campus communities across the U.S.

TimelyCare’s 24/7 virtual health and well-being services are particularly useful in reaching students who may not want or be able to seek care through in-person campus resources, with 40% of student visits occurring after hours or on weekends. The platform’s diverse mental health counselors ensure inclusive and culturally appropriate care for underserved populations and in underserved communities, which is especially important for community college students, more than half of whom are members of minority groups.

By collaborating with TimelyCare, colleges and universities can expand their services while saving on the costs of hiring additional medical and mental health staff, especially in rural areas. TimelyCare’s virtual platform meets students’ needs and ensures timely and effective mental health support, leading to higher student retention rates, degree completion, and academic success.

Learn how TimelyCare can help your campus cover provider shortages. Contact us today.

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Dr. Bob Booth

Dr. Bob Booth

Chief Care Officer

Dr. Bob Booth brings extensive expertise in clinical administration and a unique combination of medical, mental health and higher education experiences that make him perfectly suited to lead the dynamic and innovative care team at TimelyCare.

Most recently, Bob served as Regional Chief Medical Officer, VP of Physician Services at NorthStar Anesthesia, where he provided clinical and operational leadership across 43 hospital contracts from Texas to Montana. In this role, he led enterprise-wide strategy around developing and guiding clinical leaders to foster wellness in healthcare workers. He also played an integral role in shaping NorthStar’s approach to leadership development by addressing burnout, promoting well-being and building resiliency among providers.

Prior to attending medical school at Texas Tech and completing his residency in Anesthesiology at Baylor Scott and White in Temple, Texas, he worked in student affairs. After earning his B.S. at Abilene Christian University, he worked as the Director of Living and Learning Communities for four years at ACU while pursuing his master’s degree in Counseling Psychology.

Between his residence life and housing experience and completing practicum hours at the university’s on-campus counseling center, Bob has a deep and first-hand understanding of what college students are going through – from the continuum of homesickness to suicidal ideation.

Bob’s heart for helping college and university students flourish physically, mentally, and spiritually aligns perfectly with TimelyCare’s vision to help students be well and thrive in all aspects of their lives.

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