Who is Caroline? One of our students.

Meet Caroline.

Caroline always struggled with her self-image. In middle school, she started obsessing over her appearance and weight. She never felt pretty as the other girls and turned to bulimia as a solution. When she was on her own for the first time in college the problem only got worse. She finally worked up the courage to visit the campus counseling center. Between one-on-one time with her psychiatrist and group therapy where she heard from other students coping with bulimia, Caroline started to feel the crippling thoughts in her head cease.

When she headed home to her rural Kansas family home for the summer, there were no licensed mental health providers. Even though she had good insurance that would help pay for treatment, the closest town where she could see a counselor was 90 miles away. Balancing a summer job and family commitments made the trip to therapy impossible. Caroline relapsed within just four weeks.

Caroline’s story is too common.

Per the American Psychological Association, 60 percent of rural Americans live in an area where there is a shortage of mental health professionals. Residents of those communities are less likely than their urban counterparts to report needing care, and are less likely to receive treatment for mental health problems.

For many students from rural communities, like Caroline, when they attend a university it is the first time they have access to counseling services.

As university leaders, how can we make a difference?

I worked for 30 years in college student mental health and have seen firsthand the need for newer treatment models to meet the growing mental health needs of today’s student population. Year after year, I’d see students, like Caroline, be placed on wait lists or have gaps in treatment because they’d head home for summer or winter break and have no access to care.

College students are mobile and on the go. They come from many different backgrounds and face pressures that no previous generations have faced. The higher education industry will never be able to hire our way out of the problem. We instead need to evolve the treatment model. 

Digital and online tools are at the forefront to increase access to mental health counseling on campus – and research has proven that digital solutions can be used to overcome barriers to treatment access. This kind of low-intensity, cognitive behavioral treatment (LI CBT) combines on-line educational materials and provides support via brief (5 to 30 minute) video conference or phone contact with a provider. Low intensity treatment can be delivered at a distance and provides students with practice tools and materials that can be used anytime and anywhere.  The model has been researched extensively in Europe, Australia, and other countries, with over 100 published studies verifying its effectiveness.

I created Therapist Assisted Online (TAO) as a solution for this need.  And, I created it to help higher education leaders address three challenges faced on every college campus: Retention, Risk Management and Staffing.

·      Retention: Studies have consistently demonstrated that counseling improves retention and helps students remain committed to their academic mission. In one study, an ROI calculator showed that improved counseling services on just one campus resulted in a 13 percent decrease of dropout rates.

·      Risk management: Around 30 percent of college and university students each year report feeling “so depressed it was difficult to function,” and 11 percent report contemplating suicide. Suicide is the second leading cause of death among students.

·      Staffing: The demand for counseling services is at an all-time high and our funding for additional counselors can’t keep up. The U.S. Department of Health and Human Services estimate that over 90 million people live in federally designated areas underserved for mental health care. It is estimated that one in five adults in the U.S. will experience an anxiety or mood disorder each year and one in four will experience depression in their lifetime.  This amounts to over 41 million people each year; however, only 15 million or 37% receive any treatment at all.

A recent study by the American Physiological Association showed this approach had greater reductions in student anxiety and greater improvement in mental health, life functioning, and sense of well-being than regular treatment.

If Caroline’s university had an online program she would have been able to continue her sessions remotely and would have not relapsed.

I am passionate about this issue and I encourage higher education leaders to think about all the tools and resources available today to connect students, like Caroline, to counselors who can help them. As we convene next month in San Antonio, I want to meet you and talk more about this issue and how we can solve it together.

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