On Campus Counseling Services Are Unable to Support Students with Long-term Mental Health Concerns
Last semester, Olivia Robertson, ’19, was having trouble sleeping and, as she put it, “things weren’t going well” with her mental health. She couldn’t remember the details of her appointment with the counseling center because it was “a hazy, emotional time,” but she remembered being told that by the center that they couldn’t help her because her situation sounded like a more serious, long term issue. She recalled a counselor telling her something like “we don’t think that we can really treat you here.”
Goucher’s counseling center, like almost all college counseling centers, operates on a short term treatment model, which ranges from 8-12 sessions. There is no “hard” limit on sessions, and they often see students for the duration of a semester, but they do typically recommend that students with needs for specialized services and/or persistent counseling, seek services off-campus. The center is only open ten months out of the year and it doesn’t have the capacity to serve students with long term or specialized needs.
A high percentage of Goucher students suffer from mental health conditions that are more long term and serious than coming-to-college anxiety or anything that a few trips to the counseling center might fix. According to the 2016-17 Healthy Minds Study, 14% of Goucher students screened positive for severe anxiety and 20% for major depression, 15% reported suicidal ideation, and 38% reported self-injury. 38% of Goucher’s undergraduate population means about 560 students.
Nationwide, mental health demands in institutions of higher education are increasing, and it is typical for students to come in for one or two counseling sessions. However, it is less typical at the national level for students to come in for more than ten sessions. In contrast, at Goucher many students use the counseling center for the length of a semester, and others are in need of even more prolonged services. “Pragmatically, I just don’t know that there’s a way we can manage that,” said Monica Neel, the Director of Counseling Services.
The counselors at the center are also “generalists,” Neel explained. “We need to be able to treat anything that walks in the door,” she said. For students with long term or more serious mental health concerns, it is important that they have access to more specialized care.
When students are advised to go off-campus, however, they might not seek services elsewhere. Through a Google search, Robertson found a therapist that she consulted with for a while, but she didn’t follow up with the off-campus resource list provided by the counseling center.
Robertson was also discouraged by the services she did receive from the center. They provided her with a list of local service providers and asked her to fill out a plan for suicide prevention. “[It was] a very DIY [Do-it-Yourself] kind of sheet, like ‘instead of trying to kill myself, I’ll call my mom,’ which is not…super useful? It was just a lot of information that I could’ve just googled…It serves the purpose but is not the same level of usefulness as actually having counseling available.”
Robertson didn’t schedule a follow-up on-campus appointment, and she hasn’t returned to the Goucher counseling center since. “I think it was discouraging because they were sort of saying that there weren’t really the resources here to treat me, and I guess I would extend that to say probably any real sort of mental health issues, compared to like, short-term, adjusting to college issues,” she said. And she’s right. The counseling center isn’t able to treat students with severe or serious mental health issues. Like almost all campus counseling centers nationwide, they must operate on a short-term model.
The counseling center is “tremendously well-staffed for a school our size,” according to Monica Neel. The nationally recommended number of counselors is 1 per 1400 students enrolled, and at Goucher there are 3.5 staff for an undergraduate student body of 1,473.
The counseling center is reaching maximum capacity simply because so many students need and use the center’s services. In the past school year, the counseling center completed 354 individual intakes and there were 97 crisis walk-in sessions, for average of three a week.
This semester, the counseling center did not reach a wait list level, but it has had one for the past three semesters. The counselors do their best to manage it; the average wait time is 7-12 days. The counselors assess students over the phone for safety before putting them on the wait list. While there is an assessment of immediate need made within 1-3 days of a request for an appointment, simply knowing that there is a wait list can discourage students from seeking on-campus help. “It’s unacceptable,” said Olivia Siegel, ’18, who works as a Resident Assistant and Peer Mentor. “No student should ever have to wait to speak with a mental health profession in person.”
This wait list may also soon improve with the new counseling center space in Mary Fisher. However, even with the new larger facilities, increased counseling staff, and longer clinical hours, the on-campus counseling center won’t be able to treat students with long term or specialized mental health concerns.
The counseling center hopes the short term restrictions will not deter students from at least making an appointment and completing an intake form. In situations in which counselors recommend off-campus resources, they typically provide a minimum of three clinicians, taking into consideration the student’s clinical needs, transportation situation, and insurance type.
There are also additional resources available like the after-hours mental health hotline that provides phone support by licensed clinicians. “They are there for students who need some support, and it can be something more benign all the way up to suicidal ideation,” said Monica Neel. These clinicians are familiar with Goucher and Goucher’s campus. They have a map of campus and can provide students with information on where to go to get help. Goucher also has a communication agreement with St. Joe’s Medical Center to ensure a smoother process if students need to be hospitalized.
Alexandra Graves and Cameron Cox are Goucher’s case managers, and they can collaborate with students to create individualized plans of support.
Faculty have some basic training in mental health through the counseling center, and Residential Life and Public Safety staff complete their own training.
Goucher also offers access to psychiatry, through health services, although it is limited. The psychiatrist is only on campus six hours a week.
Other on-campus resources that may be helpful for students include Peer Listeners, the Student Bereavement Group, the Academic Center for Excellence (ACE), the Center for Race, Equity, and Identity (CREI), and the Office of Accessibility Services.
Addendum: [This information was published in a earlier article but it was deemed beneficial to include it on the same page on the website to create a more holistic picture of mental health services at Goucher]
Many Goucher students are taking action regarding their mental health, and those that use the counseling services generally have positive things to say. According to internal statistics, in 2016-2017, the Goucher counseling services completed intakes with 354 individuals, which is roughly 25% of the student body. 1,349 individual counseling sessions occurred, and there were 97 crisis walk-in sessions, for an average of three a week while classes were in session. Of the 2017 graduating class, 45% of graduating seniors used counseling services at some point during their enrollment at Goucher.
“I’ve personally had a really good experience with counseling center,” said Monthie. “They technically say that they do have a policy you’re not supposed to go back-to-back semesters but I’ve done it. You just fill out a new form.” Director of Counseling Services Monica Neel confirms that there is no hard limit to the number of sessions that students can have, although the center does operate from a short-term treatment model.
In the Healthy Minds Study, students also reported high satisfaction with the counseling services. 87% of students reported having knowledge of mental health services on campus, 37% thought counseling was “very helpful” for mental health, compared to a national average of 31%. Student satisfaction with hours, scheduling and quality of therapists at the campus counseling center was all in the high 80% range.
The stigma surrounding mental health and mental health services is also relatively low at Goucher. In the Healthy Minds Study, only 38% of students reported perceived stigma, considerably less than the 47% nationally, and only 4% of students reported that they would think less of someone who received mental health treatment, compared with 6% nationally. “[At Goucher,] it’s pretty accepted to take a mental health day,” said Adina Karten, ’18.
Correction: An earlier version of this article included the phrase “turn away” which does not accurately represent the services provided by the Goucher counseling center.