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College and university presidents reported in a national survey last spring that the most pressing issue on their campuses was student mental health. At Georgia State University, where I serve as director of counseling services, we have been working to develop an inclusive and accessible program for student mental health and have developed some successful strategies.
One particularly effective strategy has been to incorporate a 24-7 online peer-to-peer support platform into our arsenal of student resources. While every campus is distinct, colleges and universities might want to integrate a similar platform into their own mental health programs as they work toward serving a diverse group of students.
First, some history: a decade ago, we began evolving our counseling center operation. Like our peers, we realized that we needed to better recognize the individuality of our students and address the distinct challenges of some of the groups to which they belonged, especially when it came to the population who were Black, Indigenous and people of color. With about three-quarters of our students being BIPOC, becoming a more equitable resource meant building a staff from a variety of races, genders and socioeconomic backgrounds so every student in need of support could say, “Someone is ready to help who will see me for who I am, who will understand where I’m coming from.”
In my experience, the overwhelming reason that people avoid seeking mental health support is the fear and discomfort of being vulnerable. Moreover, among many barriers that people in BIPOC communities confront concerning mental health care is the stigma surrounding it. One study found that 63 percent of Black people believe a mental health condition is a sign of personal weakness. Many BIPOC students come from families that don’t believe in mental health treatment. The prevailing attitude is to pray about it or “push through it” but never seek help and risk showing vulnerability.
Knowing that students, especially those of color, typically come to the counseling center as a last resort, we added drop-in services so a student could see a counselor right at that critical moment they gathered the courage to ask for help. We implemented a stepped-care model that allowed students and counselors to assess progress and adjust session frequency, thereby opening up appointment slots for other students. And we undertook a robust communications program to reduce the stigma around mental health.
Over the next six years, from 2014 to 2020, we saw an 80 percent increase in the number of students seeking counseling. We also saw the number of people of color asking for services increase: the percentage of all students who accessed counseling services who were Black increased from 33 percent to 46 percent, while the percentage of all students who accessed counseling services who were Asian increased from 7 to 14 percent. As it was, we handled that growth within our existing limited budget, meeting significantly greater demand for our services with limited resources.
Then COVID-19 hit in 2020, bringing unprecedented challenges. Counselors filled their days with virtual sessions to address heightened student concerns stemming from COVID-related isolation, anxiety and safety worries, social unrest, and political turmoil. One of our primary focuses was addressing the growing financial insecurity brought on by the pandemic and how it affected not only physical and academic well-being but also the mental health of a student community that was already nearly 60 percent Pell eligible.
Our counselors provided nearly 1,500 students with more than 15,000 telehealth appointments during a very challenging year. Yet our staff members, already stretched thin, were at risk of burning out. We were also keenly aware that lockdowns placed many students in challenging living conditions that, to varying degrees, threatened their physical health, mental well-being and academic achievements. Due to the changes involved with adjusting to the pandemic, students were feeling alone, isolated and overwhelmed with uncertainty. So we decided to harness students’ comfort with technology and online platforms in an attempt to help students who might need support but might also be hesitant to seek counseling services from the university counseling center by contracting with Togetherall.
Togetherall is an online community where students from various participating campuses—including, among others, the University of Michigan, Bucknell University and the University of Central Florida, as well as Georgia State—can anonymously seek support from one another in a safe and inclusive environment. Togetherall harnesses the power of vulnerability and supports students in their drive to connect with others. Licensed mental health professionals moderate the platform 24 hours a day, seven days a week, to intervene when a student’s chat indicates crisis.
We’ve found no disadvantages in using an outside company to provide this type of service. Due to our contract with Togetherall, students now have access to an additional service without the university having to absorb the costs, labor and administrative load involved with developing, maintaining and tracking such a complex system. Also, although a number of students prefer to work with more traditional counselors on campus, many other students report that they feel more comfortable seeking support that is not generated by or directly managed and monitored by the university. They report feeling freer to express themselves when they are anonymous.
Togetherall removes much of the fear BIPOC and other students generally have about coming forward due to its anonymous and judgment-free environment, encouraging that important first step and subsequent sharing. Its round-the-clock accessibility enables users to seize that most vulnerable moment and get immediate support. And once they make a connection, the peer-to-peer community normalizes mental health issues and creates a powerful sense of unity.
Hundreds of Georgia State students have signed up for Togetherall since September 2020, with the average student logging in more than five times. Moreover, we’re advancing toward our goal of greater equity in our mental health resources. User profiles for the platform closely reflect our student community, with more than 70 percent identifying as BIPOC.
A recent national survey suggests our experience of peer counseling benefiting BIPOC students in particular is not unusual. Almost half of the students reported that they were more likely to seek out peer counseling due to disruptions the pandemic created. Yet an even greater percentage of the students surveyed who said they were more likely to see out such counseling were Black (58 percent) and Latinx (54 percent).
College students often report feeling alone in their experiences, but that singularity is imagined. Along my journey as a counselor at Georgia State, I’ve focused on giving students multiple touch points to access social support through shared lived experiences. In that way, we can help eliminate the stigma around mental health and establish the use of trusted services that will significantly strengthen student mental wellness.
When I hear of a student who feels completely alone in their suffering of anxiety, trauma or depression, it breaks my spirit, because we all walk around with our own vulnerability. Yet the online peer-to-peer community works to normalize experiences and help students feel OK in reaching out. In this shared experience lies the power to unite us. It is a very powerful factor in achieving greater diversity, equity and inclusion in a college or university’s mental health program.