Almost half a million students attend Virginia's colleges and universities. About 45% attend one of the 15 four-year public colleges, 17% attend one of the 25 four-year private colleges, and 38% attend one of the 24 public two-year colleges.
Last October, the Joint Commission on Health Care agreed to undertake a study of mental health issues in the Commonwealth's colleges and universities. The study is being conducted by two task forces - one to assess students' access to mental health services and the other to analyze legal issues surrounding colleges' responses to students' mental health needs. In the spring of 2010, the Joint Commission, in coordination with the Commission on Mental Health Law Reform, conducted a survey of Virginia's public and private colleges to collect relevant data bearing on these issues. Data was requested for the 2008-09 academic year.. The survey response rate was a remarkable 98%. The study's task forces are now reviewing and analyzing the data and will report their conclusions and recommendations to the Joint Commission next spring. However, key findings of the survey are summarized in this article.
Access to Services
The survey indicates that counseling centers in the private colleges have about 70% more staff capacity than counseling centers in the 4-year public colleges. Similarly, about 70% more students are served by counseling centers in the private colleges than in the 4-year public colleges. While these findings may not be surprising, they highlight the challenge of addressing mental health needs of students in the 4-year public universities.
One of the most important issues being considered in our deliberations concerns the mental health needs of students enrolled in the Commonwealth's 23 community colleges.
While access to on-campus mental health services may seem less important in nonresidential colleges than in residential ones, students attending community colleges often face mental and emotional challenges equivalent to those faced by students in traditional 4-year colleges, and may be even less able to cope with them without professional assistance. Nonetheless, Virginia's community colleges are prevented by official policy from providing mental health services on their campuses.
Health insurance, including adequate behavioral health benefits, is an important part of the equation for assuring adequate access to mental health services for college students. Although the proportion of students covered by insurance could not be ascertained in this survey, most private colleges (about 60%) and about one- quarter of 4year public colleges require all of their students to have health insurance. As a result, counseling centers at the 4-year colleges customarily refer their students to private providers when they are unable to meet the students' mental health needs. By contrast, none of the community colleges requires its students to have health insurance; instead, community colleges rely heavily on the services provided by the Commonwealth's community services boards (CSBs) to assist troubled students.
Frequency of Hospitalization and Withdrawal for Mental Health Problems
The survey data indicate that four-year colleges rarely initiated either an Emergency Custody Order ("ECO") or a Temporary Detention Order ("TDO") to detain students for emergency mental health evaluation in 2008-09, doing so for only 2 out of every 10,000 students. However, the initiation of involuntary commitment proceedings is meant to be a last resort. Better indications of the frequency of severe distress experienced by Virginia's college students are the rates of medical withdrawal for mental health reasons and psychiatric hospitalization. An average of 56 students per 4- year public college and 6 students per private college withdrew from school in 2008- 09 for mental health reasons. The average number of students admitted to a psychiatric hospital in 2008-09, regardless of legal status, was about 10 per 4-year public college and 3 per private college. …