High rates of burnout among college mental health counselors is compromising quality of care, survey says

Brooke Migdon

thehill.com

Originally posted 17 FEB 22

College counselors and clinicians are reporting increasingly high levels of burnout and stress as the pandemic enters its third year. Experts say it’s going to get worse before it gets better.

Just under 93 percent of clinicians on college campuses reported feeling burned out and stressed during the fall semester this year, according to a survey by Mantra Health, a digital mental health clinic geared at young adults. More than 65 percent of respondents reported a heavier workload and longer hours worked compared to the fall semester in 2020. 

Another 60 percent said their workload had compromised the quality of care they were able to provide to students in the fall.

Caseloads aren’t expected to fall anytime soon, as overworked clinicians are leaving the field at a rate similar to that of students asking for help, according to David Walden, the director of Hamilton College’s counseling center. Qualified candidates are also hard to come by.

“Over the last year college counseling centers have seen an uptick in professionals leaving the field and a smaller pool of applicants to refill their positions while the demand from students seeking treatment continues to rise,” he said Thursday in a statement.

Walden noted that, importantly, clinicians are also contending with their own pandemic anxieties that impact their ability to care for themselves, let alone others.

It is “increasingly difficult for directors and clinicians to avoid burnout while institutions of higher education are having increasing trouble hiring and retaining quality mental health staff,” he said.

With college-aged students reporting alarming rates of depression, anxiety and substance abuse, providing quality on- and off-campus care is critical.

The info is here.

State board punishes UO counseling center director

By Diane Dietz
The Register-Guard
Originally published July 23, 2016

The state psychology regulatory board voted Friday to punish Shelly Kerr, director of the University of Oregon counseling center, for giving a student’s therapy records to university lawyers without the student’s consent.

Kerr, a senior UO staff psychologist, will receive a letter of reprimand, pay a civil penalty of $2,500 and complete a six-hour course on professional ethics, the Board of Psychologist Examiners ruled.

(cut)

“Here, given the lack of a signed release from the student and the inherent conflict between the university’s interest and (the psychologist’s) ethical obligations to protect privacy of (counseling center) clients, (Kerr) should have taken additional precautions to protect the student’s counseling records.

The article is here.

Senate Unanimous in Bill Protecting Student Medical Records

By Chris Gray
The Lund Report
Originally posted February 16, 2016

Here is an excerpt:

Senate Bill 1558 allows university or college health centers, mental health centers and counseling centers to share patient medical information with someone at the university only if they have the right to access that information off-campus -- a high legal bar.

“Students will have the same expectation of privacy on-campus as off-campus,” said Sen. Sara Gelser, D-Corvallis, the bill’s chief sponsor.

She told The Lund Report that the bill was necessary because campus health records can sometimes be classified as student records under the Family Educational Rights and Privacy Act, and not protected under the more ironclad medical privacy law, the Health Information Portability and Accountability Act, or HIPAA. And whereas HIPAA medical records come with them a strong guarantee of privacy, FERPA student records can be viewed by university administrators in certain circumstances.

The article is here.

Mental health on college campuses: A look at the numbers

By Sarah Sabatke
USA Today
Originally published January 30, 2016

Approximately 42,773 Americans commit suicide every year, according to the American Foundation for Suicide Prevention, many of whom are college students.

The University of Pennsylvania, Tulane University, Appalachian State University and Yale University, among others, made national headlines in recent years after student suicides rocked their campus communities, highlighting a growing need for comprehensive mental healthcare on college campuses.

The page of statistics and infographics is here.

When Students Become Patients, Privacy Suffers

By Charles Ornstein
ProPublica
Originally published October 23, 2015

Here is an excerpt:

Yale Health’s website informs parents that they cannot access their child’s health information without a signed written consent form. Andrea said she does not recall signing that document. When she recently asked to see any such form, she said, she was told by the counseling center’s chief that there was none. “Most of what happened while I was in the hospital happened without my knowing it,” she said. “I got an update every day or two about where my life was going.”

Andrea’s case is a vivid demonstration of how weaknesses in state and federal laws — and the often-conflicting motives of students, parents, and college officials — have left patient privacy vulnerable when students receive medical treatment on campus.

Universities walk a fine line when providing that treatment or mental-health services to students. If campus officials don’t know what’s going on or disclose too little, they risk being blamed if a student harms himself, herself, or others. If they pry too deeply, they may be accused of invading privacy, thereby discouraging students from seeking treatment.

The entire article is here.

Feds oppose UO for releasing alleged gang-rape victim's therapy records

By Richard Read
The Oregonian
Originally published August 20, 2015

A federal official advised universities this week to not share a student's medical records without written consent, contradicting the University of Oregon's release of an alleged gang-rape victim's therapy records to the school's lawyers.

The six-page draft letter from Kathleen Styles, the U.S. Education Department's chief privacy officer, was issued this week after repeated inquiries by The Oregonian/Oregonlive and members of Oregon's congressional delegation.

In effect, the letter steamrolls a UO Counseling Center confidentiality policy weakened in March by center director Shelly Kerr, clinical director Joseph DeWitz and university associate general counsel Samantha Hill. The Oregon Board of Psychologist Examiners is investigating four UO psychologists, including the two center managers, after Kerr secretly gave the woman's records to university attorneys in December without seeking her permission or notifying her therapist, Jennifer Morlok.

The entire article is here.

UO whistleblowers: giving student's confidential therapy records to campus lawyers felt wrong

By Richard Read
The Oregonian
Originally posted June 4, 2015

The executive assistant to the director of the University of Oregon's Counseling Center disobeyed instructions last December and showed a therapist a confidential email from their boss.

The email's directions horrified both Karen Stokes, the director's assistant, and Jennifer Morlok, the clinician.

Shelly Kerr, the center's director, told Stokes in the Dec. 8, 2014, message to give the university's legal office a client's entire case file -- including notes taken by Morlok during private therapy sessions.

The client was a UO freshman who says she was gang raped multiple times on March 8, 2014, by three members of the men's basketball team.

Normally mental-health professionals go to great lengths, even in the face of court orders, to release as little information about clients as possible. Clinicians want patients to feel safe expressing their most intimate thoughts and feelings during therapy.

The entire article is here.

University of Oregon Employees Under Investigation for Misconduct in Rape Case

By Richard Read
The Oregonian
Originally posted May 8, 2015

Six University of Oregon employees, including a vice president and the school's interim top lawyer, are under investigation for alleged misconduct in the handling of therapy records of a student who says she was gang-raped by three Ducks basketball players.

The Oregon State Bar is investigating complaints against interim general counsel Douglas Park and associate general counsel Samantha Hill. The Oregon Board of Psychologist Examiners is investigating complaints against four people, including Robin Holmes, the university's vice president for student life, who is a licensed psychologist.

Jennifer Morlok, a senior staff therapist identified in legal correspondence as the clinician who counseled the woman, filed all the complaints.

The entire article is here.

Mental-Health Crunch on Campus

By Melissa Korn and  Angela Chen
The Wall Street Journal
Originally published April 28, 2015

Universities are hiring more social workers, psychologists and psychiatrists as demand for campus mental-health services rises. But persistent budget gaps mean that students in some cases foot much of the cost of the positions.

Students at George Washington University will be charged an additional $1,667 in tuition next year, a jump of 3.4%. More than $830,000 of the resulting new revenue will pay for mental-health services.

(cut)

“The demand [by students] so outpaces the supply of appointments that it’s very hard to get a weekly appointment, even for students having pretty serious symptoms that interfere with their academic function,” said Elizabeth Gong-Guy, executive director of counseling and psychological services at UCLA and president of the Association for University and College Counseling Center Directors.

The entire article is here.

Controversy Continues at University of Oregon Counseling Center

By Richard Read
The Oregonian
Originally published April 8, 2015

Here is an excerpt:

Bronet assured students in a March 20 memo that UO's counseling center would keep records confidential barring extraordinary circumstances. She urged them to use university mental-health services without fear.

Meanwhile, The Oregonian/OregonLive has learned, the head of the University Counseling and Testing Center significantly weakened confidentiality safeguards in a policy statement she wrote with UO's legal department.

Director Shelly Kerr wrote in an internal April 3 email obtained by the news organization that she worked with university attorneys to draft the new confidentiality policy. "I want to be sure that the information on our web and printed materials are as clear and accurate as possible," she wrote.

But the new policy, already in effect, contradicts promises Bronet made and greatly expands the number of exceptions that could be cited as justification to break confidentiality.

The entire article is here.

College Counseling Centers Turn to Teletherapy to Treat Students for Anxiety

By Jared Misner
Sunoikisis via the Chronicle of Higher Education
Posted September 26, 2014

At the University of Florida, students struggling with anxiety can visit its counseling center and, after an initial, in-person consultation with a counselor, can elect to start a seven-week program called Therapist Assisted Online. The program works like an online course, complete with videos and online activities. Once a week, students meet with their specific counselor, one on one, through a videoconference for 10 to 15 minutes to discuss their anxiety.

That means students visit the counseling center only once and can do the rest from the comfort of their dormitory room. “They like the idea of being at home,” Brian C. Ess, a counselor at Florida’s Counseling and Wellness Center, says.

The entire article is here.

Please visit the Ethics and Psychology podcasts for Episodes 15 and 16, which addresses Ethics and Telepsychology.

Anxiety, Depression, Relationships

By Allie Grasgreen
Inside Higher Ed
Originally published April 12, 2013

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.

The entire story is here.

Students Rate Mental Health Services

By Allie Grasgreen
Inside Higher Ed
Originally published October 30, 2012


More than 62 percent of students who withdrew from college with mental health problems did so for that reason, a new national survey shows.

The survey, released today by the National Alliance on Mental Illness, aims to gauge, based on student perceptions, whether colleges are meeting students' mental health needs and how they can better support those students' academic experience. The results are mixed.

From August to November 2011, the NAMI surveyed 765 people diagnosed with a mental health condition who are currently enrolled in college (68 percent were) or were enrolled within the past five years. The vast majority -- 71 percent -- attended public or private four-year colleges, while 19 percent attended community colleges (the others were online, trade or technical and specialty colleges). Eighty-two percent of respondents were white and the same percentage were female (women are much more likely than men to seek counseling on campus), and more than 60 percent were between the ages of 18 and 27 (with 37 percent in the traditional college ages of 18-22). Nearly eight in 10 identified as straight.

Consistent with other national surveys, depression is one of the most common problems for students, with 27 percent reporting it as their primary diagnosis.

Read more here.

Court Upholds Counseling Program's Requirement That Students Accept Gay Clients

By Peter Schmidt
Chronicle of Higher Education
Originally published June 26, 2012

Jennifer Keeton

A federal district court has thrown out a civil-rights lawsuit challenging the Augusta State University school-counseling program's dismissal of a student who said her Christian beliefs preclude her from affirmatively counseling homosexual students.

Judge J. Randal Hall of the U.S. District Court in Augusta, Ga., dismissed the lawsuit last week, rejecting its claims that the graduate counseling program had violated the student's rights under the U.S. Constitution by demanding that she demonstrate a willingness to counsel homosexual students in a nonjudgmental manner.

In upholding the counseling program's decision to kick out the student, Jennifer Keeton, for refusing to complete a remediation plan intended to change her position, Judge Hall said the plan was based on a "a legitimate pedagogical interest in cultivating a professional demeanor" and concern that Ms. Keeton "might prove unreceptive to certain issues and openly judge her clients."

Ms. Keeton was motivated by her religious beliefs, but those she sued were not, Judge Hall concluded in rejecting her claims that professors and administrators at Augusta State, and officials of the University System of Georgia, had violated her rights under the Constitution's First Amendment and Equal Protection Clause.

Rejecting the idea that the case represented "a public contest of values," Judge Hall said the facts it had presented "amount to no more than this: a student enrolled in a professional graduate program was required to complete a course of remediation after being cited for purported professional deficiencies by educators in her chosen field of study; she refused to do so and was dismissed from the program."

The entire story is here.

Thanks to Ken Pope for this story.

Counseling Conflict

By Allie Grasgreen
Inside Higher Ed
Originally published March 26, 2012

Georgia State University’s decision this month to replace its counseling center staff with outsourced employees is worrying those in the field, who say such moves are extremely rare and will likely prove detrimental to the mental health services available to students.

The shift is doubly troubling because a number of former staff members (as well as others in the field) are accusing the university of outsourcing services as a retaliation for their complaints that some university policies involving the counseling center had the potential to hurt students. While the outsourcing was announced shortly after the complaints were made, the university says there was no relationship between the two developments. The director and two associate directors will stay on as full-time employees of Georgia State, spokeswoman Andrea Jones said.

The university says it replaced its nine counseling center clinical positions (three of which were vacant) with contracted employees “in order to increase institutional effectiveness in delivering mental health services to students.”

Because the staff were eliminated through a “reduction in force” process, which is done without regard to an employee’s performance, the change could not have been retaliatory, Jones said. The new model will mimic that of Georgia State’s psychiatry services and health center (both of which commonly use independent contractors).

The entire story is here.