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

Insufficient funding can impact an institution’s ability to expand mental health services, attract and retain clinical providers, and adequately prepare for peaks in demand. Learn how to maximize funding for the health and well-being of college students and leverage existing resources to improve the success of your on-campus mental health care.

Here are some ways you can advocate for mental health funding, stretch your current budget, and better support your existing counseling centers and mental health programs:

Utilize Grants to Improve Mental Health Across Campus

In addition to securing private grants, which can help expand student mental health resources, colleges and universities should be leveraging federal and state grants which can increase funding for student affairs and counseling services. 

As of May 19, 2022, the Biden administration released new guidance on how best to spend Higher Education Emergency Relief Funds (HEERF), which are extended through June 30, 2023. The administration strongly encourages colleges and universities to address student, faculty, and staff mental health and allocate the funds to “evidence-based best practices for meeting the growing and diverse mental health needs of students.” 

Some of the administrations suggested practices include:

Investing in Telehealth platforms offering therapy 

Offering wellness activities, such as skills-based workshops

Providing suicide prevention training to staff and faculty

Securing a crisis care hotline which offers 24/7 call/text options

Hiring additional in-person mental health professionals 

Hosting Screening, Brief Intervention, and Referral to Treatment (SBIRT) trainings

Luis Manzo, PhD, Executive Director of Student Wellness at St. John’s University, suggests looking into additional federal government reimbursements for COVID-related expenses, such as telehealth services. While you may be required to provide proof of use for COVID-specific activities, this source of funding should be utilized for campus mental health services before it runs out.

Reassess the Budget for Student Mental Health Services

While student health fees, donations, and tuition fees are often primary sources of funding for mental health services, this isn't enough to support the high demand for student mental health care. In many cases, only a small portion of these funds are available for mental health services, and administrators in charge of allocating these funds may not be aware of the difficulties facing their counseling center.

While higher education budgets are hard to change once established, you can reallocate and adjust your budget to better support counseling services.

Communicate regularly with counseling center directors to better understand student needs, care gaps, and pressing mental health resources. Present this information to relevant stakeholders with the hope of attaining more funding for mental health programs and raising awareness of the problems around student mental health.

Partner with Student and Community Organizations

Higher education leaders may overlook the benefits of partnering with student organizations and other local groups, but these offer additional sources of funding. These groups are likely already advocating for on-campus mental healthcare, but can generate funding through fundraising efforts and provide more mental health resources.

“Student organizations can advocate for additional resources for your center," says Dr. Manzo. "That’s how we’ve been able to get staffing approved as well as specific staffing for specific areas, whether in athletics, residence halls, or in certain colleges.”

Students advocate in addition to administrators and leverage their personal stories to coincide with relevant data; often this motivates higher education leaders to take mental health conditions more seriously.

Foster a Collaborative Environment for Clinical Providers

One of the primary concerns on college campuses is attracting, securing, and retaining college counseling professionals. The supply does not meet the demand and counselors face salary limitations, administrative burdens, and resource constraints. Attracting and retaining providers isn't easy in higher education, but offering a rewarding work environment is an important factor to consider.

Mental health counseling center directors and counselors should be given more flexibility, autonomy, resources, support, and mental health care so they can excel in their roles while maintaining a healthy work/life balance. This may require additional service offerings, such as off-campus therapy, psychiatry, and crisis care services, so on-campus providers can shift their focus to developing mental health resources, implementing programs for suicide prevention, and responding to widespread needs across the college campus.

Maximize Telehealth Services for Student Success

More and more students are demanding telehealth services, but most university counseling services don't have the bandwidth to offer this. Expanding your service offerings by securing a telehealth provider can lessen the strain on your counseling center, while simultaneously increasing access to college students.

At Mantra Health, we understand that most institutions face budgeting constraints, which is why we work directly with colleges and universities to fill gaps in care and provide additional support to on-campus providers. Our provider network can not only accommodate the growing need for more mental health care, but offer students more diverse and flexible care options. We work with our partners during and outside of the academic year to ensure that every student, regardless of their situation, can access therapy when needed. We want to ensure that students everywhere have equitable access to efficient and quality mental health services.

Reducing the workload for on-campus providers and expanding mental health services via telehealth is critical now more than ever. Since attracting and retaining providers with limited funding is a significant concern among higher education administrators, we encourage you to read our white paper on provider burnout to better understand the challenges facing your college counseling services. 

Maximize Your Funding Resources for Student Mental Health Services

Mental health inequities have disproportionately impacted historically marginalized populations for decades – and this is true on college campuses all across the country. Among the most vulnerable are students with disabilities, low-income students, BIPOC students, students in the LGBTQ+ community, and students living in remote areas. 

Students identifying as LGBTQIA+, for example, are experiencing more stress, feelings of loneliness or isolation, difficulty with schoolwork, and depression compared to their non-LGBTQIA+ counterparts – and 42% seriously considered attempting suicide in 2020. Likewise, students of color are facing higher rates of depression compared to their white counterparts, and among those with intersectional identities, the barriers are even more aggravated. 

In addition to witnessing ongoing pandemic, changing political climate, rising social justice movement, and uncertain economic climate, students are facing numerous personal hardships, including financial strain, cultural differences, academic pressures, trauma, discrimination or racial microaggressions, all which is leading to worsening student mental health outcomes and a greater need for mental health support on campus.

Barriers Preventing Students from Accessing Mental Health Services

When faced with high levels of stress, anxiety, depression, or other mental health issues, students should be turning to on-campus mental health services, but many students of color and those in minority populations will not – and it’s not because they’re busy balancing school assignments, family obligations, sports, work schedules, or other aspects of college life, though that is often the case. In addition to facing numerous social determinants of health, these student populations face the very real possibility of inappropriate, ineffective, or lower quality care. 

“Research suggests that although there's a great need for mental health services among historically marginalized college and university students, there are significant barriers to accessing and actually using quality-affirming care,” says Farah Gilani, LPC-S, a clinical solutions consultant at Mantra Health.

On-campus counseling centers provide tremendous value to students, but clinicians aren’t always trained in cultural competence and may not have expertise in working with BIPOC, LGBTQ+, or other minority populations – and this can, unfortunately, lessen the effectiveness of a student’s treatment or care. Understanding a college student’s cultural background, linguistic need, or identity challenges can not only enhance a student’s care experience, but can improve their overall mental health. 

Studies on microaggressions and cultural competence in mental healthcare have shown that minority clients are 50% more likely to prematurely terminate their relationship with a counselor or mental health professional after the initial meeting – and this has a direct impact on the individual’s mental health. 

To achieve greater student health equity on campus, colleges and universities must revitalize their mental health offerings and recognize the unique behavioral and mental health needs of minority populations. In doing so, student mental health will improve – and so, too, will student success. Here’s what you can do to improve your mental health care on campus:

Colleges should be collecting information on students’ backgrounds, identities, and preferences in order to develop and offer more tailored resources, programs, and service offerings. The more accurate the numbers, the easier it is to build proposals for funding, develop comprehensive student support services, and implement training sessions. Leverage your campus climate surveys and other screening tools to better understand your student body and what they need to succeed on campus.

Is your existing structure conducive to all students, regardless of their background, identity, or lifestyle? If not, consider adjusting your policies or procedures to better account for student preferences. A gender non-conforming student, for example, may not want to choose a gender on forms, or they may wish to use a chosen name as opposed to a birth name in their student email or on their student ID. Changes to the existing structure may require cross-campus collaboration, but would make a significant difference to the individual student. 

Train providers and campus staff in cultural competence and humility

Clinical providers, as well as staff, professors, and other higher education leaders should be engaging in the most culturally-responsive practices. It’s not enough to simply understand cultural barriers; colleges and universities should strive for cultural competence and humility. Beyond providing written materials, you can host webinars, training sessions, or workshops for providers, as well as faculty, staff, and students. Make sure everyone on campus is given the opportunity to learn and grow.

Provide more personalized offerings to minority students

Navigating mental health as a minority student is challenging, especially when resources are tailored to white cisgendered students. Ensure that all intersectional identities are reflected in campus offerings, including in mental health resources, workshops, clubs, peer support groups, community spaces, and clinical providers. If you’re unsure what students want or need, simply ask. 

Extending your school’s mental health services to include telemental health providers is an important step in removing barriers to care, but isn’t enough to meet minority students’ needs. Colleges and universities should ensure that their provider network is full of diverse providers who have unique specialities and can meet students where they are. Hiring BIPOC providers is important, but so is hiring providers who have expertise in working with students with disabilities or students who are parents or international students who face language and cultural barriers. 

Closing the student mental health equity gap won’t happen overnight, but colleges and universities can take many steps to improve their diversity and inclusion efforts across all aspects of student life. Expanding counseling center offerings to include more diverse care is just one aspect of the solution, but it can make a big difference to the minority students who don’t currently have access to quality mental health services. 

Mantra Health can work with higher education leaders to address student mental health needs. Our 50-state provider group is trained in cultural competence (and humility). Fifty-percent of our providers identify as BIPOC and have lived experiences. To learn more about our mental health service offerings and how we can work with your campus, contact our partnerships team today. 

How to Address Student Mental Health Equity on Campus

It’s the end of the school year and college students are preparing for summer break or life post-graduation. Some are looking forward to this time away, while others face new living situations, unhealthy home environments, new jobs, cross-country moves, or other stressful life events, which can heighten stress levels and worsen mental health conditions. 

When students leave campus, they often leave behind social support systems, which may include mentors, friends, therapists, and on-campus advocates. It’s not enough to bid them farewell and wish them a happy summer. Administrators, counseling center directors, and other higher education leaders need to prepare students for this transitional time, with the understanding that summer breaks – and time away from campus – can be harmful to students’ mental health. 

How Can Colleges Support Student Mental Health When the School Year Ends?

Mental health needs don’t cease to exist at the end of the academic calendar. In some cases, this is when care is needed most. As higher education leaders, athletic directors, counseling center directors, clinicians, and other on-campus staff members prepare for the summer break, now is the time to consider students’ needs.

Here’s what you can do to better support students through summer break and beyond:

This should include online and on-campus resources, such as peer support groups, online screening tools, mental health workshops, counseling and behavioral health services, crisis care, and comprehensive lists of recommended organizations, associations, or providers which can be accessed outside of the calendar year, such as during breaks or summer months. Ideally, these resources are diverse and comprehensive to accommodate a diverse student body.

Students may have moved back home, taken on an internship, or started a new job, but they can still be reached by email, phone, or address. Colleges and universities should utilize these methods of communication to stay connected to the student body over breaks, summer, and other times throughout the year. This is, especially, important for students who’ve sought help through the counseling center and need ongoing mental health support. Send them reminders of available services, programs, and tools; give them tips to protect their mental health throughout the year. 

Advise parents on the mental health issues facing college students today

Parents and guardians are often emergency contacts – and the first line of support for students. Colleges and universities can inform parents and guardians of the signs and symptoms of mental health problems, share on-campus offerings, and encourage active listening and advocacy. 

Extend telemental health service offerings 

Some students have secured a therapist who understands them, their condition, and their treatment plan. Rather than pausing their care for the summer, consider extending telemental health hours through the summer so students can maintain ongoing sessions with their preferred providers. If they leave the state, provide them with alternative options, such as local community health centers or therapists in their area.  

How Mantra Health’s Care Navigation Team Ensures Continuity of Care

A 2022 College Pulse study found that 20% of students would like their school to expand telecounseling services, 21% want more diversity in their on-campus staff, and 18% want more off-campus wellness programs. Demand may reach its peak in the fall and winter months when students face high-stress events like midterms and finals, but it doesn’t cease to exist in the summer. In fact, many students need more care in this transitional period – and that’s why Mantra Health’s care navigators work directly with counseling centers to assess each patients’ specific needs. 

"Continuity of care is essential to ensuring all students are supported and able to choose their ideal plan of action on what steps they would like to pursue in their mental health care journey throughout the break,” says Ashley Jordan, Lead Care Navigator at Mantra Health. 

"At Mantra Health, we take the added initiative to ensure that no student feels left behind or abandoned when the school year ends," Jordan explains. "We provide various options, including sponsored care, private pay to continue care, or recommended referrals based on the student’s location, health plan, and identified preferences."

At Mantra Health, we are committed to providing the highest quality care and that doesn’t stop when the academic calendar ends. To learn more about continuity of care and how you can sponsor students’ mental health services through the summer, check out our approach to telemental health. 

Together, We Can Provide Continuity of Care: How to Support Student Mental Health Through the Summer Months

When students are in serious mental distress, they need immediate care. Partnering with the right crisis care provider is a necessity as more and more students face mental health emergencies. Results from a 2020 Active Minds survey found that crises among college students are not just a possibility, but an expectation. Among the more than 2,000 students surveyed, 39% reported experiencing a significant mental health issue. 

If mental health crises go unaddressed, there may be grave consequences. According to a 2020 CDC report, one in four college-age youth have contemplated suicide. Crisis care providers – and 24/7 crisis lines – can provide students with the care they need, whenever and wherever they need it. 

On college campuses, mental health crises occur all the time – and administrators need to be prepared. Investing in a crisis care provider can save lives.

Key Considerations When Selecting a Crisis Provider 

Mental health crisis services are just as essential as medical emergency care centers. When choosing a provider for your campus, the goal is to connect students with the highest quality of care available. As you compare crisis care providers and the value they provide, here are four domains to consider:

If a crisis isn’t mitigated, it can become dangerous and deadly. To ensure your students receive the highest quality care, make sure you assess the expertise of a provider. How long have they been providing crisis care? What is their experience working with students with diverse backgrounds? All staff members and crisis counselors should be trained in culturally competent care, as outlined by the Centers for Disease Control and Prevention (CDC), to ensure responsiveness to the unique and intersectional identities of patients. They should also receive comprehensive and ongoing training in crisis support and suicide intervention strategies. 

Peer support workers with lived experience of mental health or substance abuse disorders are often the most helpful counselors on crisis lines, as they can relate without judgment and act as models for recovery, but they should have the round-the-clock support of mental health professionals should an emergency escalate. 

Sustained and stable funding is important to ensure consistent, widespread access to services. Be aware of the nuances of your financial investment. Calling and messaging rates—hang-ups, wrong numbers, unused call time, etc.—can incur unexpected costs. When reviewing a crisis line provider, ask about roll-over calls, hang-ups, and how your hours are utilized. Will extra hours roll-over month to month or do you lose them?

A crisis line creates an opportunity to increase awareness of available services. Providers can tap into the power of the college community by holding informational mental health sessions with coaches, administrators, professors and others who may have opportunities to recognize signs of a student in crisis. 

Crisis care providers can support continued learning. Best practices and additional data-backed mental health resources can be shared with college administration and staff workers to bolster their capabilities in recognizing crises. 

It can be impactful for students to feel like their mental health support is coming directly from the college or university. When securing a provider, you should inquire about the option to personalize the call line. 

You should also consider the language needs of your student body. You may have deaf or hard of hearing students, or students who speak English as a second language. Of the millions of U.S. residents with limited English proficiency, about 64% are Spanish speakers. Providers should be able to offer bilingual crisis support. Didi Hirsch, for example, has Spanish-speaking and Korean-speaking counselors, in addition to translation services.

The adoption of crisis lines by institutions of higher education comes at a time of such high demand as people all around the country face a rising mental health crisis. No longer do people in crisis have to call 911 for emergency mental health care. Congress has mandated 988 as the new national suicide hotline, which will be implemented in July 2022. The hotline will connect callers to local crisis counselors who can provide emotional support and immediate assistance for mental health crisis and suicide prevention services. 

According to the New York State 988 Implementation Plan Report, “Crisis counselors will thoroughly assess the risk of each caller and assist with the development of a personalized safety plan. Statistics show that 80% of crises are resolved at the call center level, demonstrating the effectiveness of crisis counselors’ ability to defuse mental health crises and suicidal ideations without the need for in- person intervention.” 

Mantra Health has partnered with Didi Hirsch, the nation’s first suicide prevention center, that has been around for more than 80 years. Together, we are working with universities to provide a 24/7 bilingual crisis line counseling to students. Didi Hirsch specializes in suicide prevention, mental health, and substance use, and is California’s partner in the national 988 crisis line launch. You can learn more about this vital partnership and how you can benefit from it here.

If you or someone you know is in a mental health emergency, call the National Suicide Prevention Lifeline at 800-273-TALK (8255) or call 911 immediately.

Crisis Care is a Vital Campus Service, but How Do You Choose the Right Provider?

College students are facing unprecedented levels of stress, as they endure heavy workloads, crippling student loan debt, environmental crises, academic pressures, social barriers, and other serious concerns, so it comes as no surprise that 34% percent have anxiety and 41% suffer from depression. 

Campus counseling centers know the rising concerns and are working overtime to support students, but are, far too often, short-staffed, under-resourced, underfunded, and unable to meet the growing demand. They also have limited networks and few psychiatrists on staff, if any, who have the expertise and credentials needed to address more complex psychiatric issues.

While the majority of college presidents have recognized mental health as the most pressing issue on their campus, few employ psychiatrists – or invest in comprehensive psychiatric care, which is often needed to address severe mental illnesses like severe depression, psychotic disorders, and schizophrenia, among others. This gap has a crippling effect on students’ health, well-being, and success on campus – and could be a contributing factor to the 43-86% dropout rate among students with mental illness.

Nora Feldpausch, M.D., Medical Director of the Wellround Provider Network at Mantra Health, believes that every college campus should take a holistic approach to address student mental health and include telepsychiatry in their service offerings. Doing so is no longer simply a benefit, but a necessity. 

The importance of psychiatry in college mental health care

Long before the COVID-19 pandemic, students were facing high levels of severe mental health conditions. According to a Healthy Minds Study, which included 10 years of population-level data, lifetime mental health diagnoses among students rose from 22% to 36% – and 88% of counseling centers reported an increase in treatment seeking behaviors over a five-year period.

There’s no question that mental health services are needed, but college leaders need to think beyond this to account for students’ complex mental health concerns. By adding psychiatric services to a counseling center’s offerings, colleges can actually work across departments and specialties to meet the personalized needs of students, many of whom are arriving on campus with pre-existing conditions, severe disorders, and comprehensive treatment plans. 

Psychiatrists are highly trained in complex mental health disorders and can work closely with on-campus providers and clinicians to co-manage mental health disorders and provide a holistic, cognitive behavioral approach to care, Dr. Feldpausch says. Psychiatrists should not replace current clinicians, but act as consultants, so on-campus providers and clinicians are supported rather than overburdened with issues they can’t solve on their own. 

Adding telepsychiatry to on-campus offerings and supporting continuity of care

With college students living off campus, in remote locations, without transportation access, and with significant personal obligations, college leaders need to consider alternative options to care. Not every student has the time, ability, or desire to visit their on-campus counseling center, especially when wait-lines are preventing them from accessing services quickly. This is where teletherapy and telepsychiatry come in – and offer a more sustainable, long-term solution.

In addition to providing virtual therapy sessions, colleges can work with psychiatrists to offer medication management support to students battling severe mental health disorders. Adding on teletherapy and telepsychiatry to current offerings allows students to access mental health care outside of counseling center hours, connect with more diverse providers who have unique specialties, and engage in sessions from anywhere, including their home or workplace. 

“We’ve had students join sessions at private locations from their workplace,” says Dr. Feldpausch – and she says more and more students are now requesting teletherapy and telepsychiatry services as they live in remote areas, can’t access transportation, or wish to continue their care virtually over the summer months or on breaks. 

Reaching more students with Mantra Health

Every student is unique. When colleges and universities limit their mental health options to in-person care, they miss an opportunity to address personal preferences and more severe mental health conditions. Not every student wants to visit a mental health professional and many feel their needs aren’t being met by the limited on-campus staff members whose specialities or backgrounds don’t align with their concerns. 

While working with Colgate University in Madison County, New York, we have found that telepsychiatry services could drive a major shift in the college’s quality of mental health care. When providers work together on a consistent basis, they can leverage each other’s skills, expertise, and training to provide the best, most holistic care to their student patients. This includes reviewing student medical records, conducting symptom severity screenings to monitor improvement in treatment, and recognizing physical symptoms to identify and treat existing and developing conditions. 

Our psychiatric services at Moravian College in Bethlehem, Pennsylvania, also resulted in significant mental health improvements. Among the students requesting services in 2021, 95% attended their scheduled intake appointment and 89% attended a follow-up appointment. In addition, 66% saw improvements in anxiety symptoms and 45% saw improvements in depression symptoms.

At Mantra Health, we have developed our own provider network to accommodate the comprehensive, personalized needs of students and we work closely with counseling centers to connect them to diverse providers who are trained in specialty areas. For many students, this is a non-negotiable. If a provider doesn’t understand or can’t speak to their racial, gender, identity, or socioeconomic concern, then mental health conditions can worsen – and students may be discouraged from seeking services in the future.

We have the fastest-growing, clinically-backed digital mental health solution for college students and we’re on a mission to increase access and improve the quality of care for college students, while relieving the strains put on health centers. 

If you want to learn more about our offerings and how we’re changing youth mental health care for the better, please get in touch with us today! 

The Rising Need for Telepsychiatry on College Campuses

With responsibilities, expectations, and demands rising, student-athletes are facing a growing number of mental health issues that aren’t going away anytime soon. According to the American College of Sports Medicine,  approximately 30% of women and 25% of men who are student-athletes report feelings of anxiety, but only 10% of all college athletes with known mental health conditions seek care from a mental health professional.

The reasons are wide-ranging – stigma, inaccessibility, embarrassment, lack of representation – but the harsh reality is that many coaches, athletic directors, and other leaders are put in the difficult position of acting as counselors to athletes. From implementing one-on-one walks around campus to setting aside time for journaling, there are a number of ways in which leaders are working beyond their job description to support the mental health of collegiate athletes. 

At NAIA’s 2022 National Convention, Mantra Health’s Clinical Solutions Consultant Farah Gilani, MS, LPC-S, NCC joined the NAIA Governance Academy, the ASA Student-Athlete Leadership Summit, and led the Student-Athlete Mental Health session titled Preparing for the Future of Addressing Athlete Mental Health, which is available to view here.

Leaders in the field, including coaches and athletic directors, face the unique challenge of listening to athletes’ issues, reassuring their feelings, and addressing their anxiety, stress, and other mental health concerns, often without clinical support or guidance on what language to use and how to encourage help-seeking behaviors. 

During Gilani’s session, we learned that some leaders take one-on-one walks with athletes, offering a supportive voice. Others use journaling to help athletes process their feelings and emotions in real-time. While there’s no simple solution – and there’s no one-size-fits-all approach to mental health – Mantra Health is working with colleges and universities to ensure that student-athletes are given access to professional digital mental health services, which will not only improve mental health outcomes for student-athletes but ease the burden on leaders. 

We understand the challenges facing student-athletes and their coaches, athletic directors, and other key stakeholders. As NAIA’s official mental health provider, we are thrilled to bring student-athletes the mental health care they need to thrive. We offer colleges and universities access to our integrated provider network, full of virtual therapists and psychiatrists. 

Watch Mantra Health’s NAIA Governance Academy session here or schedule a call with our partnerships team today to learn more about our services.

Advocating for the Mental Health of Student-Athletes at the NAIA National Convention

Food for Thought