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IOWA CITY — Although University of Iowa enrollment has trended down in recent years — curtailing visits to UI Student Health in many categories — the center has seen more patients in one area: psychiatry.
Where total visits to UI Student Health in the most recent budget year dropped 12 percent to 25,106 from 28,661 in fiscal 2021 — and from 28,107 in 2019, before COVID-19 — psychiatry visits over that time swelled from fewer than 3,000 to more than 3,400 in fiscal 2022, which ended June 30.
Going back to fiscal 2018, UI Student Health psych visits are up 40 percent, even though total enrollment is down 8 percent over the same period. Meanwhile, having fewer students on campus has translated to a 26-percent drop in “family practice” visits and a 22 percent drop in gynecology visits.
The growth in demand for mental health services echoes concerns across Iowa’s public universities and all of higher education — with more than 60 percent of college students nationally meeting the criteria for at least one mental health problem during the 2020-21 school year, according to a Healthy Minds Study, as reported by the American Psychological Association.
The National College Health Assessment in 2021 found nearly three-quarters of students reported moderate or severe psychological distress — a finding matched in a UI version of the assessment. That UI survey also found 13 percent of undergrads had one mental health condition and 29 percent had two or more — topped by anxiety at 34 percent and depression at 27 percent.
‘We are not counselors’
“Just two or three nights ago, we got a call where one of the students literally had one leg out the window and wanted to jump, and he wasn't on the first floor,” University of Northern Iowa Police Chief Helen Haire told the Board of Regents this week about the rise in mental health needs.
“We take it very seriously,” she said, describing mental health-related training and education officers go through.
“We are not counselors, we don't pretend to be,” Haire said. “But we can do the exact same thing we do in a physical, medical situation. We can triage, get them to the resource that they need in that moment. If it's taking them to the hospital, getting on the phone with a counselor, that's what we do.”
Iowa State University police in September saw the highest mental health caseload in five years, prompting leaders to seek a better response that isn’t law-enforcement centered.
“We hired six public safety officers that are non-sworn, they don't carry weapons,” ISU Police Chief Michael Newton told regents. “They're taking over the calls that really don't need a police presence.”
That includes students experiencing mental health crises.
“A ride to the hospital doesn't have to be done by a police officer,” he said, reporting ISU police added a second mental health-specific advocate — so “we don't have to send a law enforcement officer.”
“Sometimes when we come dressed like I am today, that can exacerbate these calls for service,” Newton said. “So we're conscious of that.”
In response to a regent question about what qualifies as a “mental health call,” Newton said it runs a wide spectrum.
“These cases can range from Mom and Dad haven’t heard from the student in two hours, and they're freaking out — literally — and we go knock on the door and they're fine,” he said. “And then they range all the way up to attempted suicide cases.”
All three departments want to train officers to handle mental health situations while also getting students to the campus experts — like those in counseling and student health centers.
Student Health resources
The universities each have expanded their mental health resources — like UI’s new support and crisis line, allowing students to have a phone, virtual, or text conversation with a support person any time of the day, 365 days a year.
Psychiatric-specific appointments at UI Student Health can take longer, though.
“For the University of Iowa, we have a four-week lead time for non-urgent psychiatric care,” UI Student Health Associate Director of Operations Todd Patterson told regents when asked about wait times for mental health appointments.
In crisis situations, he said, “We have daily nurses’ visits available up until the last minute.”
Iowa State’s Thielen Student Health Center has three psychiatric providers tackling the campus’ thousands of mental health visits, according to Erin Baldwin, assistant vice president for Student Health Services.
“If you're looking for psychiatric services in the community, it can be weeks or months before you get it,” Baldwin said. “Typically we're able to get a student in within a week or two at the longest. And if they have an urgent need, we'll get them in same day or next day.”
UNI has a mental health case manager who works with its counseling and student health centers to arrange appointments and resources.
“We do safety plans with students,” UNI Executive Director of Student Health and Wellbeing Shelley O’Connell said. “We have an ASQ, which is an ‘ask suicide questionnaire.’ If the student scores positive on that, we create a safety plan, and the mental health case manager follows up on the safety plans with those students and provides them support.”
UNI, reporting an enrollment drop of 22 percent from 2018 to 2022, saw a corresponding decline in psychiatric visits — although UNI’s 2020 launch of telehealth services took some of those, serving 362 students that first year; 774 students in fiscal 2021; and 156 students in 2022.
“COVID has done some good things, and one of those is telehealth,” O’Connell said. “We do telehealth and we do telehealth psychiatry, which is very beneficial — especially during the summer months when students can continue to see their student health clinic psychiatric staff by doing it through telehealth.”
Vanessa Miller covers higher education for The Gazette.
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