David, a sophomore in pre-med at the University of Washington, used to juggle a busy schedule: He was a wrestler, swimmer, and runner in high school and worked 20 hours a week on top of a load full course.
Yet when he finally arrived on campus this school year — attending in-person labs for the first time after two years of working online — the stress was boiling over. Being on campus was challenging and exciting, but he felt higher expectations came with in-person learning.
“I felt like I had to hit the pedal hard 100% of the time or it was all going to fall apart,” said David, who asked that only his middle name be used for fear that talking about the issues mental health could disqualify him from future professional opportunities.
“It just got to this point where I couldn’t keep putting my foot down anymore,” he said.
In January, David had a manic episode – a period of extremely elated, irritable, or forceful behavior – and his fraternity brothers took him to the UW Medical Center on campus, where he was monitored overnight. He now sees a therapist weekly at the UW Counseling Center.
David and many other students now back on college campuses are not only dealing with the stresses of entering adulthood, but also the added burden of the COVID-19 pandemic against the backdrop. And though David was lucky to get mental health care, many students are experiencing long wait times to see a counselor as UW and other universities in Washington state struggle. to respond to demand.
Even before the pandemic, college and university advising systems could not provide enough services to students. COVID-19 exacerbated the problem, and it got worse as students returned to in-person classes.
Shortage of staff
In an average school year, the UW Counseling Center serves about 4,000 students — mostly undergraduates — out of a Seattle campus population of 46,000. At the start of the pandemic in 2020, demand for services plummeted as students were quarantined at home, center staff said. Out-of-state students were not eligible for college teletherapy, and some new students weren’t even aware that counseling services were available to them.
In 2021, with the return of in-person classes, demand for services has increased again. Especially as the final draws near, students ask for help in dealing with stress.
According to a 2020 report on student mental health at UW, about 28% of students coming for services reported depression, followed by anxiety and eating disorders. More than a quarter have been diagnosed with a mental disorder at some point, and 1 in 5 have reported acts of nonsuicidal self-harm. Young women and men use the center in equal numbers, though patrons are predominantly white and Asian.
Although it is home to one of the best psychiatric teaching hospitals in the region, the university does not have the staff to help all students who want or need services. Currently, the UW Counseling Center has 34 staff members, including licensed psychologists, social workers, and therapists.
“If we could serve everyone [our students]and we were able to serve them for as many sessions as they needed, we would need more than 200 counselors which honestly is not possible,” said Natacha Foo Kune, psychologist and director of the counseling center.
And that was before the pandemic stressed students and their families as people worried about health, finances, and political issues. With the virus, there were also moments of recalibration for mental health providers considering their future. The university has lost several of its employees, although it has since hired others.
Some realized they could open a private practice from home and be full with private practice clients within weeks – they didn’t have to deal with insurers and could work from their living room.
“They make more money working fewer hours. I can’t blame people for that,” Foo Kune said, noting that especially for families with children and care responsibilities, the flexible option was better suited.
To compensate, the center prioritizes students who need the highest levels of care immediately – students like David.
Other students, like Rachel McDonald, do not receive care. She waited two months before giving up.
A junior political science student, McDonald was diagnosed with anxiety and contacted the UW counseling center in January to settle down with a therapist and psychiatrist. She was seen once for a consultation and was told she might be able to see someone in March. She called a few more times to verify the cancellations, but eventually looked elsewhere for a private practitioner.
“I was really hoping to get [care at UW] because when you have a team like that at school, they can connect with a disability team,” McDonald said. “[A team] who can say, “She is dealing with very severe anxiety, so we can give her more time for the test or let her take it in a quiet environment.” It is all the more difficult to defend oneself because the resources are not so accessible.
It’s not just the University of Washington that faces this dilemma.
Central Washington University lost 2 1/2 positions (some people work part-time) on a staff of 11. Together, they see around 1,000 students a year, or 10% of the student population.
Cindy Bruns, director of student counseling services at Ellensburg University, said students don’t have many options outside of school. “CWU really exists in a medical wilderness, in terms of outside resources,” she said.
The city has a mental health agency in town; Bruns says some people wait up to about six months to see a practitioner. Although there are private therapists, many do not take out insurance. According to the American Medical Association’s Workforce Mapper, there were two psychiatrists in the county as of the 2010 census; Bruns says she doesn’t know any now.
Washington State University also faced staffing shortages, which resulted in longer wait times for students.
“Ideally, a student could be seen within two to three weeks,” said Jennifer Ellsworth, director of counseling and psychology services at the Pullman campus.
“Last semester, [the wait time] lasted up to six weeks which is so disheartening to see. We know that six weeks later is a huge part of the semester.
A broader shortage of mental health workers is well documented in Washington state and across the country, but for counselors who work with students, the problem predates the pandemic.
University Counseling Jobs, an online job site, has seen a steady increase in demand for providers over the past five years. Although COVID-19 caused many colleges and universities to implement hiring freezes in 2020, that changed in 2021 and job postings increased by 60% on the site.
According to another 2021 report According to the Association of University and College Counseling Center Directors, more than half of counseling centers reported turnover in one or more positions and 70% reported recruitment difficulties.
“The demand for care at college counseling centers has far exceeded enrollment,” said Meghann Gerber, former director of the UW Counseling Center who now works in private practice. “There’s just a much larger proportion of people who need help.”
The college experience is a time of transition; a place where young people learn, plan the start of their professional careers and explore their identities. But college also straddles a period when the adolescent brain is still developing. Three quarters mental illnesses begin at age 24and stress itself is a known factor in the development of mental health problems such as depression and anxiety.
From scholarship applications to competitive courses, campuses are challenging environments. Add student loans and part-time jobs, and it can create devastating stress. A 2012 report by the National Alliance on Mental Illness found that of students who dropped out, 64% said it was related to their mental health.
As McDonald said, “You can’t write an article if you’re too depressed or too anxious. You can try, but it won’t be as effective as your normal baseline.
That’s why early intervention is vital, experts point out. Students can learn healthy coping mechanisms and begin treatment, which can have a positive effect on the rest of their lives.
So how can colleges do this?
Foo Kune points to two key changes: more funding and an overall cultural shift on college campuses.
Federal money from the 2020 CARES Act meant an additional $1 million arrived to fund mental health at UW. The counseling center used it to contract with a service to provide counseling across the United States, and even overseas, to students who don’t live in Washington. Still, more is needed, Foo Kune said.
She also hopes that, rather than having a counseling center as the primary safety net for student mental health needs, UW and other campuses will ask faculty, students and staff to prioritize mental health.
This can mean accommodations for students like flexible deadlines and more preventative services like peer support groups and wellness programs for stress management. Students like David and McDonald agree that these changes could help students like them cope with the challenges of school in a world rebounding from a pandemic.
“Student mental health doesn’t just rest on the shoulders of mental health professionals,” Foo Kune said. “It actually rests on the shoulders of the entire campus.”