Iowa State counseling director reports surging mental health needs

Mental health services across America's college campuses have been in growing demand for years - and that was before a pandemic hit the country, infecting more than 5.5 million Americans and killing more than 175,000.

It was before COVID-19 decimated the economy, leaving millions without jobs and steady income.

It was before social injustices this summer propelled weeks- and months-long protests, involving law enforcement clashes and deep-seated pain.

And it was before a hurricane-strength derecho earlier this month blasted Iowa - leaving hundreds of thousands with massive property damage and without power, internet, cellular service and access to food, water and other resources.

So as students return to Iowa's colleges and universities for an unprecedented and uncertain fall semester - with new health, finance and academic concerns, in addition to any they had previously - mental health supports are more important than ever, according to Iowa State University Student Counseling Services Director Christopher Hanes.

Q: What do you anticipate students might experience this fall that's the same and also different from what they experience any fall semester?

A: As a community we are facing an unprecedented challenge. We've been confronting a pandemic for several months that continues to impact us in unpredictable and significant ways. Students have likely faced prolonged periods of isolation, uncertainty, loss, financial stressors and disruption in their lives.

These circumstances are likely to contribute to increases in anxiety and other mental health concerns or further compound pre-existing concerns.

Q: How might first-year students be especially impacted?

A: Students often face challenges associated with transitions to campus, especially entering first-year students. It's a time of excitement and opportunity, as well as adjustment and finding new connections. Being in a prolonged period of uncertainty and stress can exacerbate these typical challenges, and they are having to adjust to new conditions and a new normal.

Students want to connect and find community in this new environment, and the way and norms on how they do this will certainly have to adjust.

Q: In what ways might COVID-19 play into students' mental health - via health issues, family issues, financial issues and isolation, for example?

A: According to recent publications, 80 percent of students report a negative impact on their mental health, with 20 percent saying their mental health has significantly worsened. The survey also found that common concerns include stress or anxiety (91 percent), disappointment or sadness (81 percent), loneliness or isolation (80 percent), financial setback (48 percent) and relocation (56 percent).

Q: What is ISU Counseling doing new or differently this year?

A: Student Counseling Services last fall implemented a stepped care model of services, and it's continued to expand and enhance those services.

This fall, we also have maximized use of telehealth to offer all routine and ongoing services through video-based technology. We have telehealth rooms at our center for students to receive services if they don't have access to a private space. We also have a care management team that provides intensive case management and clinical intervention for students who present at higher risk or confront complex challenges.

We implemented a new program called Therapist Assistance Online that provides accessible and evidence-based self-help resources for anxiety, depression, relationships and other mental health topics. This program is free for students, faculty and staff and is both web-based and app-based. It was funded through a partnership with ISU Student Government.

And we've used social media and YouTube for workshops addressing mental health and COVID-19 - promoting mental health awareness, skills development and connection to resources in response to COVID-19.

Q: Has ISU Counseling already been hearing from students?

A: During the remote period in spring and summer, we served more than 500 students with mental health counseling services.

Nationally, before COVID-19, college counseling service increases were six times the rate of enrollment increases over five years. That implies demand for counseling is not tied to enrollment increases and likely will continue to rise in response to COVID-19.

Q: What about demand so far this fall?

A: So far, 19 percent of students seen at Counseling Services report seeking services directly due to COVID-19, and 32 percent of students report COVID-19 has negatively impacted their mental health.

Q: Do you think the derecho and some of that fallout impacted student health in any way?

A: We have been in a significant period of uncertainty and prolonged stress. The storm serves as another reminder of the significant ways our lives have been impacted over the last few months. The storm further impacted residents' sense of security and safety, which are basic human needs.

A return to some consistency and predictability will be helpful, and a sense of personal and collective efficacy in repair efforts would be helpful too.

Q: With all the budget cuts this year, did ISU counseling have to trim any?

A: Student Counseling Services has had no reduction in clinical capacity and coverage. We've been able to maximize resources and promote program efficiencies in managing any budget changes.