MHW: New Federal Report Addresses Mental Health Crisis on College Campuses

New Federal Report Addresses Mental Health Crisis on College Campuses
Mental Health Weekly July 31, 2017

Bottom Line…
If colleges and universities are unable to provide the expertise needed to care for students’ mental health needs, they should provide community referrals, the NCD suggests.

College administrators have been unable to meet the demand of increasing numbers of students seeking help for mental health disabilities, and are experiencing a lack of financial resources, contributing to a mental health crisis, according to the first report on campus mental health conducted by the National Council on Disability (NCD) and released July 21.

Strong mental and behavioral health supports on campus can improve the academic performance of students and increase their resilience and ability to handle stress, with reduced suicide rates, substance abuse and eating disorders, according to the NCD.

According to the study, “Mental Health on College Campuses: Investments, Accommodations Needed to Address Student Needs,” students with mental health disabilities continue to face barriers to accessing counseling services on campus and in receiving disability-related accommodations that are necessary to help them participate in their education on an equal footing with students without disabilities.

To understand challenges, best practices and emerging trends of supporting students with mental health disabilities, the NCD interviewed mental health providers, students, college administrators, advocates and other stakeholders.

“This is the first time that the NCD has looked at college mental health,” Ana Torres-Davis, attorney advisor for the National Council on Disability, told MHW. The NCD decided to prepare a report on college mental health more than a year ago following a council meeting where various stakeholders (i.e., students, administrators) shared information about what’s happening on college campuses. “From there, NCD decided the topic was of great importance. We wanted to take a very deep dive,” Torres-Davis said.

The current situation involving mental health services on college campuses has been referred to as a mental health crisis, she said. What’s fueling the crisis is that more students are coming to campus with mental health issues than ever before, Torres-Davis said.

Torres-Davis added, “Other issues might include funding, although some students beg to differ, particularly students going to schools with large endowments. If colleges had more money, they could hire full- or part-time staff and more qualified staff.”

Provider partnerships
Colleges are becoming very good at recognizing when they do not have the capacity to support students and, when this is the case, developing partnerships with community providers, according to the report. Colleges and universities generally provide short-term services to students and, if they have connections with community-based clinics, refer students for assistance with long-term needs. If there is a fee for service, it is helpful if colleges offer a voucher system for off-campus mental health services, according to the NCD.

In colleges that use the case management model, case managers are often responsible for managing relationships with community-based providers. Case managers also help students transition to off-campus services, which is especially necessary for students who are not from the community and lack a way to determine which provider would be best for them.

“Having a system in place when you refer students is an excellent best practice for all colleges to have,” said Torres-Davis. “Most community colleges do not have services onsite, so they have to rely on community mental health providers so that they can continue to see the student. If they’re understaffed for whatever reason, they can refer them out.”

Mental health case managers that can act as community liaisons and maintain relationships with community providers are good resources, she said. “Say a student comes in and needs a referral, you have a community liaison — they know what counselors in the community are accepting clients, and what insurance is accepted,” Torres- Davis said.

She added, “You don’t want a referral where someone says they’re not seeing new clients right now. Somebody will walk kids through the service access process. They make sure students don’t get lost in the hole when they walk through the door.” Sometimes referrals are more challenging in rural areas because there are fewer counselors in the surrounding communities, said Torres-Davis.

“If students need mental health services and the college can’t handle those numbers in a short time, they’re going to need to have a referral system to community mental health providers,” she said.

Student protections
It’s important to distinguish between mental health challenges not diagnosed versus students diagnosed with a mental health disability, said Torres-Davis. “When a student with a diagnosed mental health disability makes it known to the colleges, the student has certain protections under civil rights laws, such as the Americans with Disabilities Act and Section 504 of the Rehabilitation Act,” she said.

The law requires that if a person is diagnosed with a mental illness and needs accommodations, the school has to provide that unless it’s an undue burden, she noted. The school needs to work with the student to provide reasonable accommodations. “That’s the layer of information we provide,” she said. “That’s the level of protection that other reports don’t delve into.”

Key findings, recommendations
The report found that concern over stigma prevents students from disclosing their disabilities and results in students not receiving accommodations and possibly dropping out of school.

Treating mental health as part of wellness for the entire campus would improve academic success and promote safety, according to the report.

Students with mental health disabilities are often placed on lengthy waiting lists for mental health services — sometimes waiting over a month. Many schools do not screen for emergencies when students need help, the report found. “There are issues with wait lists for mental health services on campuses all over the country,” Torres-Davis said. “When you have students in crisis, they need help today — not in two weeks.”

Among its recommendations, the report noted that:
• The Substance Abuse and Mental Health Services Administration should require colleges that apply for mental health–related grant funding to hire mental health staff, describe how they will recruit and hire culturally competent and diverse counselors, and have a system in place to ensure that colleges that receive grant funds comply with these requirements.
• Colleges should examine the service structure within campus health centers to ensure that parity exists between mental and physical health services. Policies should be adjusted to adhere to parity regulations if needed.
• The Suicide Prevention Resource Center’s guidebook to promoting mental health and preventing suicide in college and university settings argues that college campuses with a comprehensive wellness system in place to assist in early intervention have a greater chance at reducing student suicide rates.
• Offer life skills and resilience classes as part of a comprehensive health promotion effort along with the integration of mental health curricula in regular classes.
• “We are promoting better mental health services for all students whether they have been diagnosed or not with a mental health disability,” Torres- Davis said. “Schools have to invest in better mental health services for students with disabilities and be aware of their responsibility to provide reasonable accommodations to students with disabilities.”• For a copy of the report, visit