Anxiety, Depression, Relationships

The findings of this year’s survey of college counseling directors about the state of their students and the centers where they treat them look a whole lot like last year’s (in some ways good, in some ways bad).

The percentage of students seeking help for various problems continues to creep up in many areas, and nearly all respondents to the Association for University and College Counseling Center Directors’ annual survey said the number of students with “significant psychological problems” is a growing concern for them. Also still on the slow but (mostly) steady rise are counseling centers’ budgets and staffing levels.

Four hundred directors -- about half the association’s membership -- completed the survey during the 2011-12 academic year. Together, they account for 319,634 students who sought mental health services during that time. The colleges are about split between public and private, mostly four-year, and vary in size and location.

About two-thirds of directors also said they perceived an increase last year in the number of students coming in with “severe psychological problems” (21 percent of students overall) and already taking psychotropic medications (24 percent of students).

Directors also, as has been the case in the past, are unsure whether those students’ needs are being met. About six in 10 directors have psychological services available on their campuses, but 19 percent say what’s available is inadequate.

However, Victor W. Barr, a co-author of the survey report and director of the University of Tennessee at Knoxville counseling center, suggested the years-long rise in students coming into college with issues may be peaking. For instance, 82 percent of directors last year said more students who sought counseling were already on psychotropic medications. That figure dropped 12 percentage points this year.

“We’re dealing with a change that has already occurred,” Barr said. “I think they’re here and I think we’re figuring out how to deal with them…. It’s much more of a system for us now.”

In terms of what students received counseling for, anxiety, depression and relationship issues still top the list.

About 42 percent of those who sought counseling had anxiety (up one percentage point from last year and two points from the year before), which for the third year in a row was the most common issue among students. That was followed by depression, exhibited by 36.4 percent of students (a percentage point down from last year), with relationship issues close behind, at 35.8 percent (about the same as last year).

Percent of Students Going to Counseling Centers With These Conditions/Experiences

Rates of alcohol abuse also dropped slightly, falling from 10.8 percent in 2011 to 9.9 percent in 2012.

And most directors – granted, 51.25 percent is a slight majority – actually saw their total budgets increase last year (most by only 1 to 3 percent). Another 38.5 percent said their budgets stayed stagnant. Operating budgets, on the other hand, only increased at 22 percent of centers, and most only rose by 1 to 2 percent. Another 55 percent said they didn’t change.

Most directors also got paid more last year, with 53 percent reporting a salary increase. About a fifth of centers also added staff last year, in most cases, one or two positions. Even still, on average, there is only one clinician for every 1,673 students.

“That’s half-a-counselor at a school of a little over 7,000,” Barr said.

Most centers (68 percent) did not see a change in staffing levels.

And they may be getting paid more, but these days, they’re also expected to do more. Outreach, stigma reduction and faculty consults are all commonplace, newer responsibilities that take up time and bodies.

Nearly a third of centers have a waitlist during the year. About half of centers have session limits, most of 8 to 12 per year (though the AUCCCD notes its research has found that limits do not “significantly” change the average number of sessions per student).

Despite counseling centers reporting direct targeting of specific campus populations, many of those students are still underserved, directors say. Nearly 60 percent of directors believe gay men are underserved, more than for any other campus subgroup. However, lesbian and bisexual students are close behind, with about 56 and 48 percent of directors, respectively, saying they are underserved.

The stigma surrounding mental health issues has long been blamed for the underrepresentation of men and minority students among those seeking counseling, and while experts say that stigma is fading -- albeit slowly -- directors are still concerned about its effects. Almost 54 percent of directors said black students are underserved, 52 percent said Latino students are, 45 percent said Asian students are, and 53 percent said male students are.

But more concerning for directors than domestic minority students are international students, as 56 percent said they are underserved.

For the most part, as institution size increases, the proportion of students served decreases. That is because the larger universities simply don’t have the staff to serve all the students in need, Barr said.

“They also tend to have a lower utilization, but it’s the staffing that drives the utilization,” he said. “It’s a tremendous challenge for them because you’ve got to figure out how to provide the services for the ones coming in.”