How Florida’s universities seek to keep up with rising demand for mental health services

Editor’s note: This is the second of two news articles exploring the challenges that Florida’s colleges face this year as demand rises for mental health counseling services. The first article can be read here.

As enrollment increases, Florida universities are trying to find ways to bridge the widening gap between the number of students in need of mental health services and the ability to respond.

With students fully back on campus this year, universities recognize this could be a year that the demand soars past pre-pandemic levels. Some counseling centers are directing students into group therapy. Others are limiting the number of sessions per student or referring them to off-campus therapists.

“University administrators know there is a problem with staffing levels,” said Brett Scofield at the Center for Collegiate Mental Health. He believes universities are in the “neophyte stages” of coming up with solutions.

In Florida, there are no state requirements that a university must provide its students with mental health services, nor are there baseline requirements for how it should provide support.

Each institution takes a different approach to meet the increasing demand for mental health services, said Dr. Jon Brunner, chair of the Florida College Counseling Directors Association and director of the counseling center at Florida Gulf Coast University. However, they do share information on what works. In June, staff from each university came together for a “health and wellness summit” in Orlando to exchange ideas.

At Florida Gulf Coast University, Brunner’s center offers group therapy and online courses teaching mindfulness/meditation for students “with less severe needs.” This frees up counselors’ time for those students with more intensive problems, he said. And this year his center will rely on trainees from a graduate program who need clinical hours to fill in for therapists who have left.

Putting a plan together

The University of Central Florida, which has the largest student body in the state, says it will rely heavily on using social media to provide mental health information, and do more outreach presentations, offer single-session appointments and offer wellness workshops.

Rebecca Lockwood, a University of Central Florida clinical psychologist, remains optimistic. “It’s a large group of freshmen but the biggest piece is getting students connected to all the different resources.”

Kathryn Kominars, director of the Counseling and Psychological Services Center at Florida Atlantic University, said her school’s focus is on prevention as well as intervention. “We are working on increasing people’s mental health literacy, so they know more about how to identify, signs and symptoms of serious problems for themselves and others on campus,” she said.

Kominars said students who are doing well in individual sessions are encouraged to move on to group sessions, freeing up time slots for others. Students, she said, need to be realistic in their expectations of counseling centers: “Our ability to provide long-term counseling has really gone down in the last decade because of the pressure of more students seeking services.”

Florida A&M University has hired part-time counselors and is paying an outside vendor for 24/7 virtual crisis counseling. But the counseling is meant to be a last resort for students who need help when there are no counselors available, not an alternative to regular therapy.

“Hopefully you will not have that many crises, hopefully, you will not be calling that number a lot,” said Dr. Anika Fields, the director of the counseling center at FAMU.

Turning to teletherapy

Since the pandemic, many counseling centers have begun paying outside vendors for tele-mental health counseling, where students video chat with therapists or talk to them on the phone.

Florida International University started a contract with one such vendor, BetterMynd, four months ago to try to reduce weekslong wait times.

Teletherapy, made more accessible during the pandemic, will continue to play a big role in how Florida’s college students now receive mental health support.

Lockwood said some staff at her counseling center want to continue offering teletherapy from their homes after providing that service during the pandemic.

“I will say a lot of the universities are definitely trying to accommodate that,” she said.

Center directors say they have found many students prefer telehealth.

“We’ve been providing a lot of services by telehealth because it really works,” said Kominars at FAU. “We are likely going to continue a hybrid delivery of services because of the convenience and also different things are better dealt with in person versus via telehealth.”

Nick Allen, a psychology professor at the University of Oregon, said universities need to think about the problem differently if they are going to retain students. “I think it’s a question of not just doing more of the same but also thinking about different ways of interacting with young people who are seeking services,” he said. “Young people expect their experience of mental health support to be much more integrated, particularly with digital spaces.”

Florida’s universities have begun using technology to supplement and perhaps even replace traditional therapy. In addition to BetterMynd, FIU began to provide Togetherall last January, an anonymous peer support forum like “Reddit for mental health,” said Brenezza Garcia, FIU’s associate vice president for student health and wellness.

In 2018, the school bought Cognito, a computer program that has students undergo simulated scenarios with an avatar, like helping a friend in crisis. Other schools have added crisis text lines.

Nance Roy, clinical director at The Jed Foundation, a nonprofit aimed at suicide prevention among young adults, said counseling centers alone can’t be responsible for the mental health of all students.

“Not everyone needs direct care,” she said. “Why not train all employees to identify students who might be struggling. Sometimes, it’s a warm hand or gentle outreach across campus that can avert a student from spinning into a situation where they need critical care.”

The consequences of inadequate mental health support could be severe. Suicide is one of the most common causes of death among college students, according to the American College Health Association. However, the consequences extend beyond the students. At least two universities are facing lawsuits by parents of students who died by suicide. In both, the parents allege the university did not do enough to prevent their child’s death.

Looking ahead

So what happens if the demand for services continues to exceed supply at the rate counselors are seeing?

Some counseling center directors say increasing their own staff won’t be the solution, or will only form a piece of a much bigger puzzle.

Dr. Scott Strader, the director of the University of South Florida’s counseling center, thinks the answer lies in improving on little things: more group therapy, more digital technology, and more help from people who aren’t necessarily licensed mental health counselors, like peers and faculty.

Lockwood at UCF said her university, one of the largest in the country, knows it cannot provide ongoing mental health to every one of its 70,000 students.

“It would be overwhelming to provide individual counseling to the entire university. We can do an initial assessment and offer resources, help them find clinicians in the community,” she said.

Even though he wants more counselors, Todd Lengnick, the director of the counseling center at Florida International University, feels that there will never be enough staff to meet demand. Change will have to come in other ways.

“On one hand, it would be cool to have 100 clinicians here and be able to really spend time with students long term,” Lengnick said. “The amount of growth a student could go through if they really had that professional there to walk them through all the challenges, maybe they get bullied, hazed, get into a relationship and it doesn’t work out and they think it’s the end and they’ll never find love again, that to me would be ideal, I’d love that.”

“But what do I think is going to happen?” he said. “I think society goes through waves of interest and all this intensity around mental health is going to wane a little bit, and I don’t know that the budget for 100 clinicians on a campus is going to ever happen.”

Within days, dorms will fill up and dining halls will become busy again. Students will pull all-nighters, go to parties, make new friends.

Some will take on the weeks and months that lie ahead with ease. But others will find that a battle awaits them.

“We have to understand that even though it’s a return to normal, there’s going to be a lot of variability in how people experience that,” said Allen at the University of Oregon. “For some people, it may not necessarily be as positive as it would be for others.”

He believes that it will be the university’s responsibility to help them. “If they want the income from a student’s tuition, then I think they really need to make sure that student is successful,” he said.

Sun Sentinel health reporter Cindy Goodman can be reached at cgoodman@sunsentinel.com. Sun Sentinel reporter Shira Moolten can be reached at smoolten@sunsentinel.com.

©2022 South Florida Sun-Sentinel. Visit sun-sentinel.com. Distributed by Tribune Content Agency, LLC.