Defunding Student Mental Health

When Harrisburg Area Community College, the largest community college in Pennsylvania, announced Thursday that it had stopped providing on-campus clinical counseling services to students, it was perhaps a sign of things to come.

University and college administrators across the country have been increasingly saying that student mental health issues are one of the most pressing, and costly, challenges on campuses today.

Four-year institutions are allocating larger portions of their budgets to mental health services for students, and they are feeling some financial strain. But community colleges -- largely underfunded and facing declining enrollment -- are seriously struggling to cover, much less keep up with, the high costs of providing those services.

HACC, as the Pennsylvania college is known, seemed to have little choice.

"Over the past decade, HACC, like other colleges and universities across the commonwealth and nation, has seen a decline in our student enrollment, having a profound impact on its financial operations," said a statement released by the university Thursday. "During the same time period, for example, HACC has experienced a reduction in enrollment, a significant reduction in financial support from sponsoring school districts and very modest increases in state funding."

Enrollment at the college dropped from 20,000 students to 17,400 between 2014 and 2019. What's more, the college is facing a $9.7 million budget deficit for 2019-20 fiscal year. As a result, "the HACC Board of Trustees approved several measures to address the shortfall; remain fiscally sound; and continue to offer a high-quality, accessible education to its students," the statement said.

Among those measures, the college will eliminate 20 staff counseling positions by October of next year and will refer students to local mental health providers instead, the statement said.

"With limited resources, HACC is focusing on providing an excellent education for students and allowing other organizations that can provide specialized clinical mental health services to do so," it said.

“At HACC, our first priority is our students,” the system’s president, John J. Sygielski, said in the statement. “We know that they overcome challenges every day to make their dream of a college education a reality. Our primary job is to help them succeed academically.”

Although addressing mental health needs is an important part of that student success equation, community colleges will be the first among struggling postsecondary institutions to eliminate on-campus counseling services, said Kevin Kruger, president of Student Affairs Administrators in Higher Education, known as NASPA.

No matter how important mental health may be to university leaders, institutions “on the margins” have to make difficult choices about the resources they provide to students, he said.

Student mental health was ranked the No. 1 issue by 750 chief student affairs officers at both private and public, two-year and four-year institutions in NASPA’s 2019 Vice President for Student Affairs Census. Twenty-eight percent of student affairs professionals said mental health concerns outweighed other pressing issues, including declines in enrollment and completion, according to the census, which will be released Dec. 1.

Administrators are trying to address fiscal challenges “in a time when students’ needs are greater than ever,” Kruger said. He added that students’ use of college counseling centers has increased over the last five years and institutions feel they can never have enough counselors.

HACC's mental health counselors previously had one to two clinical sessions with students seeking help and then referred them to an off-campus professional. HACC reported that from 2018 to 2019, only 1 percent of its more than 17,000 students across five campuses received this service, which could explain why administrators decided to eliminate it.

With the looming loss of mental health counselors at the college, student affairs staff will now be tasked with picking up the slack and will focus on supporting students by working more closely with them on goal setting, career planning, time management and achieving college work-life balance, the HACC statement said.

Pennsylvania ranks 49th in the country in higher education funding, and community colleges in the state especially are suffering from “chronic disinvestment,” Elizabeth A. Bolden, president and CEO of the Pennsylvania Commission for Community Colleges, said in a statement.

Spotlight PA reported that the community colleges have had a “nearly stagnant” state budget for years.

“Community colleges are often forced to review what programs and services need to be reduced, redesigned or -- in some cases -- eliminated,” Bolden said. “The recent redesign of the provision of on-campus clinical mental health counseling at one college is an example of one of those decisions.”

Despite the diminished state funding, Pennsylvania governor Tom Wolf "encourages leaders at the Commonwealth’s post-secondary institutions to continue exploring all available options for providing their students with access to mental health services within their budgetary constraints," Eric Levis, press secretary for the Pennsylvania Department of Education, said in a statement.

He noted that the Wolf administration recommended last year that school districts expand student access to mental health services. Postsecondary institutions were not included in this recommendation, however.

"The administration recognizes the importance of providing access to mental health services to students of all ages, including those attending post-secondary institutions," Levis wrote.

College administrators will have to weigh the long-term consequences of reducing mental health services and how to alleviate the outcomes.

“Where the conversation is evolving is … how can institutions build the capacity to address some of the normal psychological issues that are common for the typical college student,” Kruger said. “How do you engage other faculty in this process, so that not all the weight is on the counseling center? More colleges are looking into how faculty can play a role. Not a therapeutic role, but with conversations.”

Outsourcing counseling services to community health networks is not a new strategy and could even provide a level of support on-campus counseling centers are unable to deliver, Kruger said. A 2015 American Association of Community Colleges survey of campus counselors found that of two-year colleges that do not provide on-campus mental health services, 21 percent refer students to outside organizations, 20 percent have contracts with community-based programs and 10 percent handle student concerns through behavioral intervention or threat assessment.

The responsibility of community colleges to provide commuter students with mental health resources is different from that of four-year institutions that have students living on campus, Kruger said.

The Community College of Allegheny County, which enrolls about 15,000 students across four campuses in Pittsburgh and surrounding areas, already refers students to off-campus mental health providers, Spotlight PA reported. CCAC’s counseling department provides services aligned with what HACC has begun -- career services and academic development -- with 12 staff members who are not required to be licensed therapists, Elizabeth Johnston, the college's executive director of public relations, wrote in an email.

CCAC’s services do include “personal counseling,” but counselors do not directly handle mental health issues, Johnston wrote.

“If a counselor sees a student who is in crisis and who requires mental health treatment, the counselor will make a referral and arrange for ongoing treatment with an outside agency,” Johnston wrote. “If the student is already in treatment, the counselor will refer the student back to his or her mental health professional.”

Community mental health programs have extended hours and 24-hour suicide prevention services, which many colleges or universities are unable to provide, Kruger said. HACC will continue to provide students in crisis with immediate help from security and student affairs officials, a protocol that has been in place for “several years,” the college's statement said.

Some higher education advocates are concerned that low-income and nontraditional students will have reduced access to outside counseling services as a result of reduced services on campus, said Lauren Walizer, a senior policy analyst for postsecondary education at the Center for Law and Social Policy, known as CLASP.

“In making referrals for clinical mental health needs, HACC employees take into account a student’s financial situation, as well as insurance coverage, and then make the appropriate referral based on the student’s circumstances,” a college spokesperson wrote in a statement. “Referrals are made to local professionals or community resources based on the student’s needs.”

Beyond whether students have insurance that covers mental health services, students in community college face barriers with transportation, Walizer said.

“The less you offer, the more you are putting the burden on students,” Walizer said. “They have to figure out how to get there … it’s a mental burden. They could be spending time studying or focusing academically, but they’re searching for services instead.”

Walizer said the ideal option for colleges that decide to stop providing mental health services is to build partnerships with specific community organizations that can send therapists to the campus. HACC said it “hopes to partner” with a third-party organization that would provide affordable counseling options. But community organizations, like community colleges, are also struggling due to inadequate state and county funding, Walizer said.

“I’m sure they do the best they can, but what we’re seeing is that states are underfunding their mental health services -- things that students need and what adults need,” Walizer said. “There’s no guarantee that the county or nonprofit organization that the student would be referred to is going to have the resources they need, either.”