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Reimagining the Role of the Counseling Center: How Hamilton College Approaches Student Mental Health

By Mantra Team

Posted: January 12, 2023

Students walking on campus. Copyright: Hamilton College

The Hamilton College Counseling Center wants to get the right treatment to the right students at the right time. To achieve this, David Walden, PhD, Counseling Center Director at Hamilton College, works on setting reasonable expectations around service offerings, session availability, and provider capabilities. 

“It doesn’t mean putting up boundaries. It doesn’t mean saying ‘No.’” says Dr. Walden, PhD. What it really means is being upfront about the role that the counseling center plays in the student journey.

Early on, students, along with their parents and guardians, are given messages that mental health support is available to all students at all times, no matter their situation. While free mental health services are offered on most campuses, not every center is equipped with the staff, resources, or clinical expertise to meet every student's mental health needs at all times, even if they wish that were true – and this can result in confusion, disappointment, and frustration.

While Hamilton College offers a wide range of services, including wellness and clinical offerings, Dr. Walden hopes that institutions, in general, will get real about higher education’s capacity to serve students in distress. This means being more open and honest with students upfront so they know what to expect when they walk into the campus counseling center. 

Prioritizing Transparency in College Counseling

“Wait lists are not meeting people's needs. They promise something that we may not be able to deliver or provide in a timeframe that is going to meet a students’ clinical needs,” Dr. Walden explains, which is why he prefers to focus on developing an intentional approach to services that other resources for mental health needs that can be fulfilled elsewhere.

Overrun with requests for appointments, many counseling centers are inundated with intakes and constantly adding new patients to their providers’ rotations. This increases a provider’s caseload, leads to long wait times, and inevitably lowers the quality of care provided. 

Dr. Walden believes there’s another way. 

Success to me is being transparent and honest, and just saying: ‘Here's what we can and can't do’. Instead of attempting to meet all needs with limited resources, our goal should be to be honest with the people we serve. That may mean a student doesn't get exactly what they are seeking, but that's a reality [that exists] in healthcare broadly, not just in higher education.

Rather than promising to meet every need, why can’t some students be directed to on-campus wellness programs? And others referred to more intensive clinical services off campus? Providers are working against [multiple] sets of expectations, Dr. Walden explains, and students have ideas of what they want, which are often at odds with what they really need. These young adults are in the early stages of understanding what the world around them can and cannot provide – and learning that the campus center isn’t fully equipped to fulfill a student’s every need can be hard to digest. 

This is hard for people who work in college settings. “We didn't get into this business to not respond to pain and suffering,” said Dr. Walden. “But there's a real opportunity for us just to embrace and admit that we can't be everything.”

Meeting Student Mental Health Needs with Diverse Offerings

Years before the pandemic, Hamilton College started exploring supplementary offerings and ways to provide a more comprehensive set of mental health services – and over time, the counseling center has learned that students’ preferences are wide-ranging. Using student feedback and suggestions, as well as formal methods of assessment, including satisfaction surveys and questionnaires, Hamilton College is able to take a more proactive approach to student mental health. 

“We recognize that students as human beings are holistic entities and need a more holistic approach to care,” Dr. Walden explains, which is why the counseling center provides both clinical services like individual therapy, group therapy, psychiatric care, dietitian care, and peer counselors and wellness offerings that are also effective and impactful. 

Some of Hamilton College’s wellness offerings include art therapy, acupuncture, movement and music programs, as well as a Wellness Room with weighted blankets, biofeedback, and massage chairs. The counseling center has also established the Community Pantry, a virtual cooking class with a registered dietitian, which has helped students with cooking and preparing healthy meals.

“College centers aren’t inpatient or intensive outpatient treatment centers,” Walden says, but they can function as a supportive place for students to access reliable resources, gain direction, and access a myriad of mental health offerings.

Expanding the Treatment Options

“By moving some students to wellness and virtual therapy options, our staff can focus on the quality of treatment provided to students assigned to an on-campus counselor,” says Dr. Walden, which has resulted in positive outcomes for Hamilton College students. 

While national symptom numbers are rising, as more and more students battle anxiety, depression, and other conditions, Hamilton College is seeing much lower numbers than peer institutions – and the rise in conditions is moving at much slower rates.

“I think it’s because we have a treatment focus,” says Dr. Walden. “We're giving the correct dose of medicine, so to speak, at the right time.”

That doesn’t mean Hamilton College isn’t facing its own set of challenges. Psychiatric providers are hard to find, specifically psychiatric providers who understand the college population and can serve the students well. This is, in part, why Hamilton College has turned to Mantra Health. 

Working with Mantra has been great for psychiatric care. It has met our needs in terms of basic additional hours, but also in terms of finding someone who is a good fit for our population, someone who could bring a different personality, approach, and a different set of demographic characteristics to the role and function… That feels really really wonderful.

While higher education continues to face challenges – including provider burnout – Dr. Walden hopes that institutions will consider a new approach to care and find ways to validate students and their mental health needs through a broader set of resources. 

Students are increasingly broadening their definition of mental health, so why not shift the way we approach mental health? The institution has an opportunity to legitimize, validate, and talk more about students as psychological, emotional, and physical beings who have needs that can (and should be) met with a wider range of services and resources. Instead of limiting the counseling center to clinical services, Dr. Walden believes that mental wellness exercises, coping strategies, and other therapeutic offerings can also support students, especially those that may not need traditional therapy or psychiatry. 

“We can’t keep doing what we’ve been doing and expect the outcomes to be different,” Dr. Walden says. “We really need to have a different approach if this is going to be a sustainable space.”

Photo copyright: Hamilton College