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A New Perspective: How College Clinics Work

Colleges have been struggling to keep up with the growing demand for mental health services. From 2009 to 2015, the national average use of counseling centers has increased by nearly 30%, while enrollment only increased by 5%. The number will likely continue to rise as we further into the digital age. Fortunately, with the rise of technology and access to computers, counseling centers will be able to implement new ways to reach the student body.

Despite their best efforts, however, counseling centers can come under much scrutiny. With such demand for mental health help, long waitlists and infrequent meeting times can place much of the blame for the mental health crisis on the counselors and the clinics themselves.

For example, in a recent survey with Yale, only a third of students claimed they were “satisfied” or “very satisfied” with the counseling services received. Another third of students claimed they were “dissatisfied” or “very dissatisfied,” while the last third reported feeling neutral.  

At Michigan State University, the counseling and psychological services underwent a drastic remake after intense criticism. As one student quoted, “When the psychology and psychiatry departments weren’t integrated together, not only were wait times for seeing someone in the Counseling Center long, but then, if you needed that actual medicinal help, you would have to wait for another three to four weeks to get an appointment from the psychiatry department to get that medication,” Stephens said.

Just this past week, a student at the University of Virginia posted an opinion article calling for a reform of CAPS, citing long wait lists and outdated technology, and an overall need for an improved system.

There is no doubt that these concerns are vastly important – they are proof that demand is rising and that more drastic action needs to be taken. If things do not change, students will continue to suffer.

On the other hand, it is equally important to understand the context of clinics and how they operate – so that we can understand both sides of the equation.

The rising demand for mental health clinics is in part due to years of research and intervention programs through the U.S. government and related agencies. For example, following the implementation of the Garrett Lee Smith Memorial Act, colleges and counties saw drastic decreases in youth suicide rates.

Efforts like these encouraged students to seek help if they were faced with a problem. The overall goal was to identify someone at risk, and then refer them to a professional.

Thus, the rising demand for help is in part due to efforts to reduce stigma, with messaging stating it’s okay to reach out for help.

Furthermore, colleges have a weekly cap – meaning that they can only devote a certain amount of hours to student appointments. For most schools, this is about 65% percent of work hours per week, which equates to about 26 hours.

Schools implement weekly caps so that clinicians themselves don’t burn out, as their jobs are incredibly taxing on their mental health as well.

Overall, clinics have limited resources. The recommended clinic to student ratio is 1000:1, which may seem high. However, many clinics don’t even meet this requirement. It can be difficult to properly distribute time and resources when faced with few options.

This, combined with the growing demand, means schools are often faced with situations that are not anticipated, such as waitlists. Clinics have to invent novel ways to give every student quality care as quickly as possible.

Some schools implement session limits, meaning they refer a student to outside resources after a certain amount of appointments. Most schools are forced to give priority to those who need it immediately. They then provide online resources to those that they cannot see right away.

Every clinic wants every student to be mental illness-free, and to live fulfilling lives. However, when faced with limited resources, they are often put in tough positions. It’s important that counseling centers have enough funding and support from the community so that they can deliver the most quality care possible.

In the meantime, we can continue to practice preventive self-care techniques so that mental illness does not have the opportunity to arise and afflict us in the first place. For example, using techniques such as meditation or proper coping skills will keep us resilient and may reduce our need for outside help.

We know that clinics aren’t perfect, but we must also understand that they are working to get better each day.

The UniWellness team hopes that you’ll continue to support your counseling center and encourage others to seek help and practice self-care.

If you are part of a counseling center, reach out to us to see how we can help enhance your reach and resources.


Our goal is to reduce barriers by connecting students to mental health care whenever and wherever because every person matters and every illness hurts

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