Articles and research from our team on the future of mental healthcare for young adults.

Last year, Mantra published an inaugural provider burnout White Paper, which revealed a worrisome status quo: in college counseling centers, 9 in 10 clinicians reported experiencing burnout. This is 12% higher than the average burnout levels reported in a large-scale survey of North American psychiatrists.   

The COVID-19 pandemic marked a paradigm shift for mental health care needs. COVID-related challenges and anxieties across the population have contributed to severity of mental health issues. Beyond a taxing workload, the burnout clinicians experience is often compounded by the emotional strain that mental health providers are navigating themselves. 

Building on our 2020 provider burnout survey, we collected insights from college counseling center staff. In what follows, we review 2021 findings about the state of burnout amongst college mental health clinicians and directors. We then offer key takeaways to inform counseling center priorities in the coming year. 

The state of provider burnout in college counseling centers in 2021

NEW YORK, August 18, 2022 - Mantra Health, a pioneering digital mental health clinic for young adults, announced today that it has appointed Andrew Hermalyn as its first independent board director. Hermalyn, currently President of Partnerships with digital education leader 2U, will enable Mantra Health to better connect with key higher education leaders and understand the specialized needs universities face in delivering critical mental health care for students.

“Mantra Health has been a game changer for colleges and universities struggling to meet the growing mental health needs of their students,” Hermalyn said. “I’m excited to join the board to help Mantra lead in this critical field.”

Hermalyn has been with 2U since its inception, starting his career as the company’s first intern and being named President of Partnerships in 2017. In his current role, Hermalyn is responsible for cultivating and nurturing hundreds of university partner relationships around the world. 

“We are excited to welcome Andrew to Mantra’s board. He joins a very talented, experienced and knowledgeable team of professionals who are dedicated to pushing our platform forward and directly impacting the lives of many college students who need access to critical mental health services,” said Ed Gaussen, CEO and Co-Founder of Mantra Health. “We know the difficult challenges campus-based clinicians face day in and day out. By adding Andrew to our team, we can expand our knowledge of challenges and opportunities in higher education and devise improved solutions to help our university partners.” 

As a Board Director, Hermalyn joins sitting members Ed Gaussen, CEO and Co-Founder, Matthew Kennedy, COO and Co-Founder, Soheil Mirpour, Partner at Global Founders Capital, and Michael Mauze, Managing Partner at VMG Partners.

“Mantra is providing vital mental health services for young people whose need is greater than ever,” said Hermalyn. “Already, it has established itself as the number one mental health and wellness partner, well-positioned to serve 40 million young adults over the next decade, and I am excited to help the Mantra team achieve even greater success.”

Hermalyn graduated from Lehigh University and lives in Manhattan with his wife and two daughters.

Mantra Health is a digital mental health clinic on a mission to improve access to evidence-based mental healthcare for young adults. Through augmenting high-quality clinical services with software and design, we aim to improve the mental health of over 20 million university and college students through partnerships with higher education institutions and health insurance plans. The Mantra program has been deployed across 50+ campuses with over 500,000 students including Penn State, MIT, Cornell, and Miami Dade College.

Press Release: Mantra Names 2U’s Andrew Hermalyn as First Independent Board Director

Student engagement has drastically changed since the start of the COVID-19 pandemic, and colleges and universities are now in the difficult position of having to find new ways to reach students, make them aware of counseling services, and support their mental health needs.

A 2021 Student Voice survey showed that a startling 65% of students report having fair or poor mental health and 47% said they would have liked more support from their college during the pandemic. Yet, only 15% of students said they used campus counseling services. 

Up until the pandemic, events were the most prominent avenue for student engagement, but with COVID-19, Monkeypox, and other health concerns rising, many students no longer feel comfortable attending in-person events and many are fatigued by virtual ones. So what can counseling centers do to counteract this problem?

Most college counseling centers are under-resourced and understaffed, making it difficult to allocate time to student engagement and find new ways to conduct outreach. While events can still be utilized, college counseling centers should look to new ways to approach students and remind them of available resources and counseling services.

How to Engage Students with Mental Health on Campus

With new technology and new ways of engaging, there are ever-increasing ways for students to engage with counseling services, and vice versa. We’ve compiled ten recommendations that can help college counseling centers better connect with students.

Build events around mental health: Offer free meditation classes for students during stressful times in the academic calendar. Set up a booth on campus during Mental Health Awareness Week, which includes free giveaways, food-to-go, and pamphlets on self-care strategies. Bring guest speakers to campus to talk about specific mental health issues. Host free mental health workshops. Dartmouth College Health Service, for example, has previously hosted an "Anxiety Toolbox Workshop" and an "Attention Please! Workshop” for students with ADHD.

Collaborate with students and key partners: Work with student-run organizations and groups, including diversity, equity, and inclusion organizations and LGBTQ+-friendly groups, to build strategic partnerships. Students running these groups can help inform outreach efforts and promote events, resources, and services to their members. 

Go beyond email to keep students informed: Many colleges and universities use text messaging to communicate with students. You can use this outreach method to remind students of counseling services, to encourage mental health breaks, or simply to invite them to attend campus-sponsored events, such as a free dinner, a Pride parade, or another event that fosters connection. You can also utilize apps to support students. Northwestern University, for example, created “Thought Challenger” and “Daily Feats” to support behavioral health. 

Post mental health resources and service offerings on Blackboard and other learning systems: Students are frequently engaging in these learning platforms. Posting or pinning an announcement across the platform is a great way to remind students of the counseling center and mental health resources available to them. 

Contribute to the student newspaper: While professional newspapers may be struggling to find readers, student-run publications are still highly read. Best of all, they are free and widely available on campus, both online and in print. If you want to connect with students directly, you can place an ad or contribute a piece addressing student mental health issues, providing coping strategies, or highlighting the importance of mental health care. 

Advertise in campus buildings and popular hangout spots: Put information in classrooms and buildings where students regularly pass through. In addition to advertising services in communal spaces, head to the local hot spots. Post information in public or private spaces not affiliated with the college where students are known to go, such as coffee shops or local libraries. If you’re not sure where to advertise your services, connect with student organizations and see what they recommend.

Add referral information to your website: Referrals should be easy to make and even easier to fulfill. Colleges and universities should have this information on the school’s website. Ideally it would go on the home page, but if not, it should at least be accessible on the counseling services page.

Develop strategic partnerships: If you’re not already working closely with faculty, staff, and other members of campus, now is the time to start. Establish mental health committees. Bring in student-run organizations, campus police, and others, to discuss mental health on a macro and micro level. These relationships are vital to maintaining campus mental wellness and preventing or managing mental health crises. You can also partner with other departments and outside organizations to address specific issues. Seattle Pacific University, for instance, 

Incorporate on-campus resources into class materials: Encourage professors to share campus mental health resources as part of their syllabus and remind students of the services that are available to them, especially during high-stress times like midterms and finals. See if professors will bring you in as a guest speaker. This can be especially valuable in graduate classes, as many graduate students are balancing work obligations or parenting responsibilities. 

Utilize social media: Not every student is on every platform, but many college students are online. Building social media platforms for your counseling center is a great way to connect with students. Check out Texas A&M University’s Counseling & Psychological Services (CAPS)’s Instagram and Twitter accounts. You can share campus resources, highlight events, recommend mental health tools, and encourage students to engage with your staff in a fun, innovative way. Host online giveaways or share student success stories, when possible. Students should also be encouraged to reach out directly if they’re feeling stressed or overwhelmed. 

Use focus groups or surveys to find out what students need: The best way to engage with college students is to ask what they want. If possible, send a survey to all students. You can also ask current patients what resources they’d like, what ways they prefer to engage.

Diversify your offerings: Keep students front of mind. If students are requesting telehealth services or weekend availability, you may want to consider working with a telehealth provider. You can also consider adding psychiatry services, crisis care, or wellness workshops. 

Students’ needs and preferences are constantly evolving, which is why it’s so important to be creative in your approach. College counseling centers are vital to the health of a campus, but students can’t access the care they need if they don’t know what services are available or how to access them. 

At Mantra Health, we work closely with college counseling centers to expand students’ access to mental health care. We provide teletherapy, telepsychiatry, and 24/7 crisis care services to colleges and universities, tailoring our care to the individual needs of the campus. Learn about our solutions here.

Strategies to Increase Student Engagement and Improve Student Mental Health

Want to reduce the wait time in your college counseling center, widen access and availability to mental health services, and track the progress of students in care? Working with a telehealth provider can help reduce clinical burden, support high demand, and enable greater flexibility for students, many of whom are working part-time, parenting, or playing a sport, which prevents them from utilizing counseling services during regular business hours. 

The best telehealth provider will act as an extension to your college counseling center, working closely with your clinical staff to identify pain points, fill gaps in care, and meet students where they are in their mental health journey. When working with a telehealth provider, you want to make sure your campus and student needs are met, you maintain regular communication with the telehealth providers, and you’re receiving real-time updates so you can close the loop on referrals and monitor the outcomes of students in care.

Here’s what you can do to establish a mutually-beneficial, collaborative relationship with telehealth providers:

Align on a Shared Vision: Before choosing a telehealth provider, have a conversation around your short- and long-term goals, what you hope to achieve with this partnership, and how you will work together to make this happen. What does success look like to you? How will you track student mental health outcomes? How will you respond in a crisis situation? When it comes to student mental health, you have to follow the same protocols, no matter if you’re providing in-person or telehealth care.

Set Clear Expectations: Before onboarding telehealth providers, consider how you plan to work with them and how you’d like them to work with your students. Will you refer students with minor forms of anxiety or depression? Will you refer students with higher acuity? Once you have a good idea of what you expect, then you can move forward with defining the roles and responsibilities of each stakeholder

“As a former counseling services director, I found that having clear expectations and guidelines surrounding the referral process to your telehealth provider helped increase the confidence in the referral for the student, and ensured that the student would remain in care versus being referred once more.” – Liz Jodoin, PhD, LPC, LCMHCS, former counseling services director

Imbed Telehealth Providers into the Campus Environment: A telehealth provider should be onboarded in much the same way as a counseling center employee. Introduce the  telehealth provider to fellow clinicians. Keep them informed of campus happenings. Share staff meeting minutes, annual reports, student satisfaction survey results, policies and procedures, and campus calendars. Trust is critical to building a successful partnership and you want to feel confident referring your students and to these providers.

Prioritize Student Needs: How does a telehealth provider approach student mental health? Do they understand the value of whole person care? Are they aware of the issues facing young adults today? Can they work with diverse student populations? College counseling centers are responsible for the health and safety of students, so they must take student needs into account when working with telehealth providers. One of the benefits of working with a telehealth provider is that they can track student satisfaction, showing how satisfied a student is with their virtual care. 

Maintain Up-to-Date Mental Health Resources: Ensuring students can access relevant mental health resources on campus will help promote success among those receiving telehealth care. While your telehealth provider does offer robust counseling, students still need a dependable community support network as they work toward maintenance and/or recovery. 

Establish Open Lines of Communication: When building a successful working relationship with your telehealth provider, communication is key. You need to ensure that a telehealth provider can provide real-time reporting so your on-campus counseling team is  informed of any changes, updates, or concerns around patient conditions.. In addition to working in a shared platform – with shared note-taking – you can also plan routine calls with your telehealth provider to ask questions, share concerns, and brainstorm solutions. 

"I'm a big believer in redundancy and having a Plan B,” says Dr. Jodoin. “Many times, counseling staff at leadership levels are granted administrative access to Electronic Health Record systems. While managing permissions is very important for the safety of patient data, consider what your center's plan is when leadership is on vacation or away from the office. How will staff collaborate and communicate with your telehealth providers?"

When fostering a relationship with telehealth providers, make sure the partnership fits the needs of your center. Let your telehealth provider know how often you’d like to connect, what expectations you have, and what adjustments need to be made. You may decide upon weekly reports and monthly check-in calls, but feel this cadence isn’t working – let the telehealth provider know so you can make adjustments to better suit your center’s needs.

At Mantra Health, we are dedicated to supporting college counseling centers through expanded service offerings. Our team of highly trained, in-house providers come alongside counseling center directors to provide students with therapy, psychiatry, and crisis support via telehealth. We give on-campus providers easy access to patient notes and histories through our collaborative platform, ensuring they are fully aware of student diagnoses, treatments, and outcomes.

We encourage you to check out our services here or follow us on LinkedIn, Twitter, or Facebook to stay updated on events and resources. 

Building a Collaborative Partnership with Telehealth Providers

College is a time of big life transitions for students who are juggling multiple different demands. In addition to managing their academic responsibilities, students are also dealing with relationship stressors, questions of identity, financial responsibilities, living away from home for the first time, among other factors.

These challenges and transitions make it all the more important that students get access to quality mental health care. Ironically, some of these challenges can create barriers for students to access the mental health care services they need.

Barriers to care are especially prevalent among marginalized student populations. International students, first-generation students, LGBTQ+ students, BIPOC students, students with disabilities, and students with intersectional identities may be more likely to face barriers to care and, at the same time, have a higher need for mental health services.

Common barriers faced by college students

When addressing student mental health, it’s important to recognize the many barriers preventing students from accessing mental health services. These are some of the most common ones:

Insurance and financial concerns - Nearly one in five students have reported that financial or insurance barriers prevent them from seeking care for mental health issues. The high cost of care or not having therapy covered fully by health insurance is often a concern for students.

Low socioeconomic status – When college students are battling food insecurity, financial strain, and other socioeconomic stressors, they may experience a higher need for mental healthcare services and increased barriers to accessing them.

Physical Access - Lack of reliable transportation is often a barrier for college students and it has risen during the COVID-19 pandemic. 

Stigma - Mental health stigma still exists and is more prevalent among certain student populations, including male students, international students, students who are more religious, and students from lower socioeconomic status families. Student-athletes, students of color, and other students may also be hesitant to engage in help-seeking behaviors. They may be discouraged from seeking care or they may feel the available service offerings are not reflective of their need.

Scheduling conflicts - Many students juggle multiple commitments during the day, including classes, work, and extracurricular activities. Many campus counseling centers have limited staffing and availability and aren’t open in the evenings and on weekends. This can create substantial barriers for students who want to access the services but can’t get an appointment in a reasonable timeframe or at a time when they’re available.

Privacy concerns - Some students refrain from accessing mental health services because of concerns about their privacy. They might have concerns about sharing intimate, vulnerable details about themselves with a relative stranger, or might fear how their mental health information will be used at the college level.

How to improve access to mental health care 

College campuses can make mental health services more accessible for students. First, college campuses need to acknowledge the importance of mental health. Second, they need to recognize the barriers that prevent so many students from utilizing services. Third, they need to invest more into mental health offerings, so all students, regardless of background, ability, identity, and socioeconomic status, can access the same high quality of care. 

Here are some strategies for improving the mental health care access for your students.

Telehealth services can improve access to mental health care and are perceived positively by college students. When you add on telehealth services, you increase the number of clinicians available and thus reduce the burdens experienced by campus counseling centers. By incorporating therapy and psychiatry via telehealth into your range of services offerings, you give student-athletes, students who work, students with disabilities, and other students who prefer not to visit an in-person counseling center the opportunity to talk with a mental health professional on their own terms and within their own busy schedules.

Mental health crises can occur at any time during the school year, which is why you need to offer students access to 24/7 crisis care. Many college counseling centers operate on a standard work schedule and while counselors may be willing to take after-office calls, it’s much harder to implement an emergency response plan without a support team in place. Providing 24/7 behavioral health support, which can be made available through texts and video chats, is essential to meeting the mental health needs of students. 

College students all around the country are experiencing long wait times to get an appointment with a clinical provider. Extending provider availability to nights and weekends can help increase access to care, especially for students who work during the day, student-athletes who are busy practicing, and other students who can’t carve out time to visit the center during the typical 9-5 hours. However, many campus counseling centers are currently understaffed, and asking providers to work nights and weekends on top of their daytime hours is unreasonable. Colleges and universities should consider investing in a third-party provider, like Mantra Health, so existing counselors are supported and students are given greater availability.

Offer on-campus spaces for telehealth visits

The majority of students live in a parent or guardian’s home or in a campus residence hall with roommates. Finding a private space for telehealth visits can be challenging for college students. They may be concerned that someone could overhear their session or they might feel uncomfortable discussing sensitive topics in public spaces. This is why colleges and universities should offer private spaces on campus for students to take telehealth visits. This widens access, while protecting student privacy.

Supporting student mental health goes beyond providing individual therapy. In order to provide the most comprehensive care, you must diversify your care offerings. This could include psychiatric care, group therapy, coaching, peer support, and other mental health services. Colleges and universities can also work to diversify their provider group. Students from traditionally disenfranchised groups are widely underserved by campus counseling centers. Campuses can tackle this issue by training existing providers in culture competency and diversifying their providers by including BIPOC providers, providers who specialize in LGBTQ+ mental health care, and those who have experience working with students with disabilities, international students, students with children, among other populations.

At Mantra Health, our mission is to increase access to mental health services for college students by expanding the offerings of campus counseling centers. We partner with colleges and universities to provide therapy, psychiatry, and 24/7 behavioral health services, which inevitably helps to increase access to life-saving mental health care.

Breaking Down the Barriers to Care: How to Improve Access to Student Mental Health Services

Over 36% of college counseling center directors say they have no psychiatric provider on campus, which is a problem considering 75% of all lifetime cases of mental illness present by age 24. College counseling centers are often equipped with high-quality clinical providers who are trained in young adult mental health care, but how many are qualified to oversee medication management plans? How many have been trained in neurology and biochemistry?

Equipping your college counseling center with psychiatric specialists is a necessity if you want to build a robust offering of mental health services. Psychiatry involves so much more than mental health; it dives into medical, behavioral, and lifestyle factors, all of which contribute to holistic care. 

Psychiatrists are medical doctors who specialize in mental health. They have received significantly more training than counselors or psychologists and have a more specialized understanding of mental illness. Unlike psychologists, therapists, or counselors, psychiatrists are licensed to prescribe medication, if needed, to treat a mental health condition. Specialized treatment can be imperative to students battling severe mental illness, especially those needing antidepressants or anti-anxiety medication as part of their treatment plan. 

Prompt psychiatric intervention is also paramount for students at risk of suicide ideation or behavior. Psychiatrists can help students manage a variety of mental health conditions that require medication, such as bipolar disorder, schizophrenia, mood disorder, or severe depression.

Because of their extensive medical training, psychiatrists can also align with medical doctors to determine the correlation between physical symptoms and conditions. Thyroid problems, for example, can cause mental health symptoms like mood swings, nervousness, and anxiety. Mental health conditions, like severe depression, can also affect a student’s physical health. 

Psychiatrists understand the science behind mental illness and are uniquely positioned to work as the go-between for mental health and medical professionals. The challenge is finding a psychiatrist, let alone a psychiatrist who specializes in young adult mental health care. 

When evaluating psychiatry, it’s important to consider the different types of psychiatric specialists who are trained to work on college campuses. The most common types are psychiatrists and psychiatric nurse mental health practitioners (PMHNP). We explain the differences between these roles and the benefits of each.

Psychiatrists complete four years of medical school after college to get their Doctor of Medicine (MD) degree and then another four years of residency specializing in neurology and psychiatry. Psychiatry training includes a general intern year which allows them to rotate through all areas of medicine beyond mental health. Many will continue their training further in fellowships and spend three or more years studying and treating mental illness before receiving their board certification. 

To become board-certified, psychiatrists must show expertise in individual, group, and couples counseling, as well general neurology, and medical management of mental and physical illnesses which affect mental function.

Psychiatric Mental Health Nurse Practitioners (PMHNP)

A psychiatric mental health nurse practitioner (PMHNP) completes their general nurse practitioner (NP) training before spending an additional two or more years specializing in treating illnesses that affect the way people think and feel. PMHNPs are able to treat and manage mental health conditions such as depression, anxiety, schizophrenia, and bipolar disorder.

Like psychiatrists, PMHNPs can prescribe medication, but in many states, a PMHNP must work with a physician who oversees and signs off on their practice. One of the benefits to working with a PMHNP on a college campus is that they can work closely between health centers and college counseling centers to close gaps in care.

“If I was dealing with a new onset of psychosis in a young person with a really tricky presentation, I would absolutely want to make sure that person is working with a psychiatrist,” says Leigh White, MD, a psychiatrist at Mantra Health. “But I think psychiatric nurse practitioners are very well equipped to work with depression and anxiety, especially when they are paired with a supervising psychiatrist [or MD].”

The collaboration between PMHNPs and physicians can vary depending on the state. Some require basic collaboration, offering PMHNPs the opportunity to ask questions or it may mean that a physician must be physically present and available to cosign on all of a PMHNP’s notes and scripts. Texas and Missouri, for example, require the physical presence of a physician within a certain number of miles of the PMHNP. 

Working with a psychiatric mental health nurse practitioner (PMHNP) is extremely valuable. When choosing a psychiatrist, it’s important to consult your state’s healthcare laws before determining which type of psychiatric specialist is right for your campus. 

Addressing Student Mental Health with Psychiatry 

“To meet the medical and mental health needs of our nation, we have to have all of these resources and we have to have our PAs and NPs working as a team with physicians to provide a range of medical care,” says Dr. White. 

There’s no one-size-fits-all approach to psychiatric care, because every college campus has a different set of health and counseling services. If you’re in a rural area, you may not have reliable access to psychiatry and you may need telepsychiatry to fill gaps. If your campus has a reliable, communicative medical center, with available physicians, you may not need a psychiatrist; you may benefit more from a PMHNP who can work with your existing staff to offer additional care. 

At Mantra Health, we work with colleges and universities to better understand care gaps, so we can equip college counseling centers with the most comprehensive, highest quality care possible. You may have psychiatrists on staff or you may not be able to afford a full-time psychiatrist. Regardless of your existing situation, you can benefit from more diverse care – and that’s why we encourage all colleges and universities to consider additional care options.

We know how hard it is to build a reliable team of clinical providers who are specialized in young adult mental healthcare. Rather than replacing your existing mental health professionals, we offer extended services and collaboration tools to make the most of your existing resources and ensure that your providers are given the time and support they need to thrive. 

Learn about our telepsychiatry services here or download our ebook Telepsychiatry: Transforming College Mental Health to learn more about the benefits of telepsychiatry. 

Identifying the Right Psychiatric Expert for Your College Campus

Before partnering with Mantra Health, Alfred State College had a dedicated counseling center, but few psychiatric services. A SUNY college located in the rural town of Alfred, New York, Alfred State needed more offerings to reduce waitlists and improve the quality of care offered to students. 

Since adding on Mantra, the college has helped fill gaps in care by offering assessments and treatment plans for conditions such as autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), generalized anxiety disorder, and other mental health conditions.

"Patients love the services. We have not had one bad or negative review,” said Libby Tsibulsky, MSEd, LMHC, Alfred State Counselor.

Since launching the program, 90% of students felt their Mantra provider was a good match for their mental health treatment and 100% felt their Mantra provider helped them accomplish their goals in therapy and psychiatry.

Improving Student Mental Health at Alfred State College with Psychiatry Services

Food for Thought