Virginia College Mental Health Study
Prepared for the Joint Commission on Health Care
General Assembly of the Commonwealth of Virginia
By Richard J. Bonnie
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 (including the 23 community colleges). It is well known that young adulthood is the period of onset for major mental disorders and is often characterized by intensive use of alcohol and other drugs. Based on national data as well as the data available in Virginia, it is likely that at least 46,000 of Virginia's college students are experiencing significant mental health concerns and are in need of psychological assistance at any given time. According to the Virginia College Mental Health Survey (VCMHS), at least 11 Virginia college students committed suicide and at least 86 more attempted suicide during 2008-09. However, based on national data, we estimate that there were approximately 2300 attempted suicides and approximately 30 completed suicides among college students during that year.
Each college and university that has not already done so should establish a planning group for involving and guiding students in clinically, culturally, ethically and legally appropriate roles in campus-based mental health awareness and suicide prevention.
Access to Services in Residential Colleges
The best way of preventing mental health crises is to assure that people experiencing mental or emotional stresses or disturbances have expeditious access to mental health services before events spiral out of control. This challenge is no less important in a college environment than it is in the community at large. Research shows that participation in college counseling services increases student retention and graduation rates.
All of the 15 four-year public colleges and 22 of the 25 private colleges offered mental health counseling services to enrolled students (generally full-time students). Using the International Association of Counseling Services standards as a guide, the majority of private colleges in Virginia meet the minimum requirement of one counselor per 1,500 students while the majority of counseling centers in the public colleges do not meet the requirement. Most counseling center directors report that they lack adequate psychiatric coverage. The percentage of the student body served by Virginia's college counseling centers parallels the staffing pattern. In the public colleges and universities, 6.3% of the student body utilized services in the counseling center during academic year 2008-09, compared with 11.1% of the student body in the private colleges and universities.
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 the VCMHS, most private colleges (about 60%) and about one-quarter of 4-year public colleges require all of their students to have health insurance. As a result, counseling centers at the four-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 mainly on the services provided by the Commonwealth's community services boards (CSBs) to assist troubled students.
Access to Services for Community College Students
One of the most important issues considered in our deliberations concerned the mental health needs of students enrolled in the Commonwealth's 23 community colleges. …