Abstract
Community colleges now account for over 40% of all undergraduate students (Bumpas, 2021). With a focused mission to provide access and completion to all students, these institutions continue to be critical importance to the local communities they typically serve. The heterogeneous nature of the student population provides each institution with both a rich resource and a plethora of issues
The Need for Mental Health Services
Student mental health is related to academic success, completion and over-all wellness across all higher education settings. Common mental health issues (e.g., anxiety, depression) have been highly related to lower GPAs and dropping out (Eisenberg et al., 2009), and such issues tend to be more pronounced with first-year students than upper-class students (Fruehwirth et al., 2021; Wyatt et al., 2017). Mental health differences were also found between traditional and nontraditional students (Trenz et al., 2015).
During 2013, teams from The American Council on Education, National Association Student Personnel Administrators and the American Psychological Association partnered to conduct a yearlong project to illuminate the need for heightened attention to college student mental health. The teams examined trends in college student mental health and examples of approaches that contribute to student wellbeing. The study documented the impact of mental health on student learning and campus engagement and stressed that supervising major mental health challenges (e.g., admission to treatment facilities, sexual assault and relationship problems, withdrawal from school, and/or unexplained swings in GPA) is important and recommended for all higher education institutions (Douce & Keeling, 2014).
In a study of over 4,000 students across ten community colleges, students reported high level of student mental health problems coupled with low availability of services (Eisenberg et al., 2016; Potter et al., 2020). Almost 50% of those students reported at least one mental health challenge. Depression, anxiety, and eating disorders were the most frequently cited. Students at community colleges reported use of any available mental health services at a much lower rate than 4-year college students (Kalkbrenner et al., 2021). They also reported less access to mental health services on community college campuses simply due to much lower numbers of mental health providers employed by community colleges (Kalkbrenner et al., 2021).
Lipson et al. (2021) described the prevalence of mental health issues and use of available resources across a large sample of college students. The total pool in their study was disaggregated to include over 10,000 students from 23 community colleges and over 95,000 from 133 4-year institutions. An analysis reported a significantly higher mental health issue prevalence rate among community college students as compared with students at 4-year institutions. Students at community colleges from lower socioeconomic backgrounds reported a lower rate of access to any mental health services than similar 4-year students (Kalkbrenner et al., 2020), and financial stress was found to be a barrier to access, especially for community college students
The need for additional mental health staffing on college campuses is a matter of long standing. For example, the Council for Collegiate Mental Health (2021) annual report (2020) stated that over the previous 6 years there was a 28% increase in services used by students at post-secondary counseling centers coupled with 7.6% fewer hours devoted to providing ongoing counseling services. Similarly, the American Counseling Association of Community/2-year College Counseling Services reported a history of understaffing and under-resourced counseling centers or programs (Edwards, 2011). The National Council on Disability (2017) study noted that, “Community colleges are the least equipped to deal with college mental health issues when compared with state college and universities, even though they serve the most at-risk populations” (p. 16). The arrival of the global pandemic only exacerbated these issues for community colleges.
Impact of the Pandemic on Community Colleges
The COVID-19 pandemic produced significant and challenging changes across higher education world-wide (Salmi, 2020). All sectors of American higher education institutions have been confronted with short term issues of enrollment, financial, and program delivery in a climate of changing demographics, technology, and political pressures. Concurrently, they face the need to plan for an institutional future postulated to be different from the past (Kelly & Columbus, 2020; TIAA, 2020).
The immediate impact of the pandemic for all institutions was the total shutdown of campus functions. Courses went on-line, student services (including mental health related services) became virtual, on-campus activities were suspended or canceled, and administrative functions shifted to technology for delivery. In fact, enrollment rates across post-secondary institutions have largely fallen during the duration of the COVID-19 pandemic (Kyaw, 2021; Taylor et al., 2021a, 2021b).
Impact on Students
In the fall 2020 the Center for Community College Student Engagement survey of 5,193 entering students across 38 community colleges reported increased pressures on personal finances, childcare needs, and access to internet and other instructional tools. Basic needs insecurities, such as food and housing, increased during the pandemic, especially for the marginalized student population (Center for Community College Student Engagement, 2021; Hope Center, 2021).
Research findings about the impact of COVID-19 on college student mental health have been considerable. Batra et al. (2021) conducted a meta-analysis of twenty-seven studies constituting over 90,000 students. This analysis illustrated “collective evidence of the negative psychological burden of the COVID-19 on the mental health of college students” (Batra et al., 2021, p. 8). Additional studies present data supporting the influence of the pandemic on college students’ mental health and the demand for adequate institutional services (Pownall et al., 2021). Lederer et al. (2020) cited 75% of community colleges reporting an increase in anxiety and loneliness across their student population. Williams June (2020) reported that depression among students increased from Fall 2019 to March-May 2020. Students also indicated an increase in impaired academic performance due to mental health struggles over the course of the pandemic.
Impact on Institutions
Campus response to increased student mental health issues was a matter of national concern before COVID-19 arrived. In June 2019, the National Academies of Science, Engineering, and Medicine launched an extensive study to explore the extent post-secondary campus programming was responding to the growing incidents of student mental health issues. The report (National Academies of Science, Engineering and Medicine, 2021) called for immediate institution-wide priority, attention, and programming to respond to student mental health issues. Increased campus-wide data to inform programming needs, alternative strategies, and increased financial support were recommended. Two recurring themes were prominent in the recommendations: the differential impact of mental health concerns among students from marginalized populations and resistance to the ‘one size fits all’ approach.
In addition, the American Council on Education surveyed presidents during the pandemic (Taylor et al., 2021a, 2021b). Student mental health was identified as the most pressing issue across the respondents, increasing from 68% in the August 2019 survey to 73% in the final survey in April 2021 across all post-secondary institutions. Community college presidents surveyed indicated student mental health was a greater pressing issue than did the overall survey respondents (79% versus 73%). In response to the COVID-19 environment, community college presidents reported increased efforts to attend to student food and housing needs as well academic and mental health needs. To this end, community college presidents reported a greater interest in contracting for external mental health services (68%) (Taylor et al., 2021a, 2021b).
Mental Health Staffing in the Pandemic Community College
Presidents from both community colleges and 4-year institutions indicated that as the pandemic recedes, staffing will be different (Taylor et al., 2021a, 2021b). Community colleges arguably have an urgent need to reimagine staffing to meet the pandemic world. The National Institute for Staff and Organizational Development (NISOD) challenged community colleges to make such timely changes to meet their mission of access and success. More on-campus accessibility and availability of mental health professionals to the mental health needs of students is one of the central suggested changes (NISOD, 2021). Students cut off from critical campus-based student services with online learning has been challenging and some argue intensify current mental health issues (Perkins, 2021). To complicate matters, the preference among community college students for taking at least some of their courses online or in hybrid formats has increased over the course of the pandemic and will likely continue. Declines in enrollment, stressed state fiscal budgets, diminished resources from auxiliary services combined with pressures for expanded technology, and revisions to physical facilities suggest a challenging environment ahead generally. Funds to significantly increase staffing for mental health services most likely are limited and face competing institutional needs and priorities (NISOD, 2021; Taylor et al., 2021a, 2021b).
A return to the pre-pandemic practices regarding mental health services is problematic at best given the current intense need. In the 2021 Survey of Community College and University Presidents, only 20% suggested their institutional operations will return to normal within 21 to 18 months. In addition, forty-four percent of the presidents were planning on institutional transformation, including prioritizing mental health support (INSIDE higher ed, 2021). How this shift will influence more mental health services at community colleges is unknown.
Planning for the uncertain future is particularly vexing for small/rural community colleges that constitute 41% of all community colleges. These small/rural community colleges typically do not enjoy the size and geographic advantage that strengthens enrollment and supports expanded services of their larger/urban counterparts. Also, they have on average experienced a greater than l0% decline in enrollment during the pandemic (Slepyan, 2021). This results in increased fiscal pressures to meet the mental health needs of community college students previously indicated via resources and qualified personnel. A National Council on Disability study found “many rural community colleges lack on-campus mental health services and access to community mental health services due to geographic limitations” (National Council on Disability, 2017, p. 16). Rush-Marlowe (2021) found the three most critical issues facing rural community colleges going forward are access to broadband internet, funding, and student basic needs-mental health. An environmental scan suggests that demands for additional student mental health services, especially at community colleges, will not abate (Education Policy & State Higher Education Executive Officers Association, 2021; U.S. Department of Education, Office of Planning, Evaluation and Policy Development, 2021), while available additional institutional resources will be hard to come by. This future calls for innovative strategies to meet these mental health needs.
Given the breakthrough of tele-health mental health services, one such innovative strategy is for a rural and metropolitan community colleges to partner with a local university mental health training program and have master’s level internship students provide mental health services. To illuminate a strategy to respond to this expanded need for additional community college mental health professionals, two case studies were conducted to show initial efforts to build such arrangements in different geographic settings. The two case studies (one from an urban community college and one from a rural community college) utilized a partnership model to address new staffing arrangements, and mental health professionals in each location who conducted the review provided the description for each setting. While both case studies piloted this generic strategy, matters of location, program design, and student demographics illuminate issues going forward.
Case Studies
Metropolitan Community Colleges
This public metropolitan community college is located in the western U.S. The college enrolls 13,000 students and offers applied and transfer programs with certificates and degrees in over 50 programs. The metro area in which the college is located has become a new major U.S. technological area and has a Metropolitan Statistical Area (MSA) combined population of over 425,000 in the latest census. Since the onset of the global pandemic, it has become clear via student expressed concerns at this metro community college that student mental health is an urgent concern that needs immediate attention. Unfortunately, there are few low-cost options available to these students.
A potential solution for the college is to invest in expanding its counseling center. Although it has a staff of six counselors, their duties (i.e., academic advising, student orientation, crisis response, career related counseling) for over 13,000 students are such that they do not have the resources to deal with on-going mental health issues beyond crisis response. An alternative and virtually no-cost strategy is to partner with a local master’s level mental health clinician training program. Developing a formal and ongoing arrangement where experienced third year licensed eligible Professional Counselor or Marriage and Family Therapist master’s level interns deliver mental health services on-site at the community college greatly expands accessibility, availability and affordability. These advanced license-eligible graduate students are qualified to provide the services before completing their degrees with proper clinical supervision.
The benefits to the university training program are also distinct. Often, one of the challenges for university academic departments is to deliver integrated and coordinated internship training that successfully meshes academic preparation with practical work. This model offers motivated clients in need of help with an on-going counseling experience addressing counselor training and community needs at the same time.
Rural Community College
The Rural Community College (RCC) highlighted is a 2-year comprehensive college with a total enrollment of slightly over 2,000. It is in a farming community in the Midwest. The college is in a community of about 7,000 to 80,000, a county of about 12,000 and close to a Native-American Reservation. RCC offers associate degrees in applied sciences, diplomas, and certificates in business, trade, and technical programs. It also offers associate in arts degrees in Liberal Arts or Science and Business Administration. On-campus enrollment was 526 degree-seeking, full-time and part-time students, most of whom come from the region around the college. Additionally, online, off- campus, and dual credit courses are delivered to approximately 1,500 part-time or non-degree seeking students.
Before the onset of COVID, RCC already saw an increase in the need for mental health services. Over the period 2014 to 2020, the college experienced a doubling in students seeking mental health counseling services (from 43 students in 2016, 94 students in 2019). These trends taxed an already under-resourced service. The arrival of the pandemic served to further exacerbate this situation. In recent years, RCC employed one counselor. This position is not full-time and has additional responsibilities. The limited mental health resources in the county make referral of students facing significant mental health challenges problematic.
To enhance the available mental health staffing, RCC joined with two other rural community colleges and the state university in establishing a Mental Health Consortium. The state university with its counselor education program provides part-time internships 3 to 4 days on the community college campus. Students are expected to function autonomously and conduct individual counseling sessions. The RCC counselor provides on-site supervision, with additional support through the other Consortium institutions. The Consortium has obtained an annual line-item appropriation in the system budget which covers a stipend and travel reimbursement for interns. RCC provides housing for the interns. Differing each year, the consortium has provided RCC with one or two interns annually. While not sufficient, the interns were able to serve significantly more students seeking mental health services than one counselor is able to do alone.
Recommendations: Lessons Learned to-Date From Collaborations at Both Sites
Using the organizational development lens of enabling an organization to better respond and adapt to industry/market changes, and to assist organizations’ systemic change in the beliefs, attitudes and values of employees for individual and organizational growth, the following suggestions and potential challenges are considered (Education Policy & State Higher Education Executive Officers Association, 2021; NISOD, 2021)
Identifying a champion at each partner community college and university counselor training program with organizational decision-making power is key (Heifetz et al., 1997), as is the adaptive challenge of developing a community college campus strategy for early available mental health counseling interventions (Phelan, 2014). Community college counselors, interns, and instructors should be oriented and intentional about the kinds of counseling services that can be provided by interns under clinical supervision, such as crisis response, therapy, appropriate identification and referral to longer-term counseling services. University graduate level counselor training programs should provide ongoing training and professional development opportunities to on-site clinical supervisor(s) at the community colleges. Partners should also work out a clear [organizational] contracting agreement between the entities to codify the partner relationship so it is on-going and sustainable. Amey et al., (2010) specify that community college partnerships with other colleges and universities are strategic ways to meet their students’ educational needs and maximizing resources. Understanding what is required for effective partnerships is important in determining when and how to engage in these collaborations (Amey et al., 2010).
Summary
There are many mental health challenges facing community college students, especially since the onset of the COVID-19 pandemic. Two case studies, one from a metropolitan serving institution and the second serving rural populations, illuminate how partnership models with university counselor training programs can effectively expand mental health resources at a low cost. It is the hope that such programming described herein is useful for other institutions to adopt.
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
