June 14-16, 2023

Boston, MA

Like the rest of the higher education community, we share in Michigan State’s sadness and grief as it grapples with last week’s tragedy. After traumatic events like these, students report increased anxiety, tension, and insecurity—an impact the university will no doubt contend with in months and years to come.

Once again, the topic of mental health takes center stage—and on the heels of widespread challenges still lingering from the pandemic.

A Fall 2021 survey by the American Council of Education reported that student mental health was the most pressing concern of college presidents. Our research also points to long-standing shortages in the mental health counselor occupation, greatly diminishing our collective capacity to address these challenges effectively.

Ironically, while institutions are the sole “supplier” of this type of talent, they have also been challenged to increase capacity for counseling programs. Events like these cause us to question, what is the current state of this professional pipeline and how

The State of Mental Health

Campus mental health issues reflect those of the larger society. Between 2019 and 2021, the National Center for Health Statistics found an increase of adults (19.2% to 21.6%) who received treatment for mental health in the past 12 months. For adults aged 18 to 44, this was more pronounced, rising from 18.5% to 23.2% (see Figure 1).

Figure 1. (Source) Percentage of Adults Who Received Treatment for Mental Health in the Past 12 Months

The pandemic adversely affected people of all ages. An earlier survey conducted by the CDC in June 2020, at the height of the pandemic, showed that 75% of 18- to 24-year-old adults (a more granular sample) experienced at least one adverse mental or behavioral health symptom, the highest among all age groups (the next highest age group was 25- to 44-year-old adults at 52%). This survey asked about experiencing symptoms, whereas the content in Figure 1 displayed a receipt of treatment.

With mental health issues on the rise, institutions are positioned to make an impact not just on their campuses but in their communities. But shortages of mental health counselors have been a long-standing problem.

In 2016, the Department of Health Resources and Services Administration (HRSA) outlined a scenario where there would be nearly 27,000 fewer mental health counselors than needed by 2025. The HRSA identifies and designates primary care, dental health, and mental health as Health Professional Shortage Areas (HPSA). As of January 2023, the HRSA reported 6,599 mental health shortage areas nationally, which encompasses 158 million people or 47% of the total U.S. population.

While institutions recognize the rising mental health crisis across the country, there has been little conferral growth. Figure 2 compares the annual conferrals of master’s degrees in mental health counseling (supply) versus the annual mental health counselor job postings requiring a master’s degree (demand).

Figure 2. Mental Health Master’s Conferrals vs. Mental Health Job Postings Requiring a Master’s Degree

Figure 2 shows that there are now three times more job postings than new graduates, with nearly 50,000 total job postings in 2021. Conferrals, however, have hovered around 14,000 for the last six years. Projections conservatively estimate at least 40,000 job openings annually over the next 10 years.

This lack of “supply” of new mental health counselors is a tangled web. First, these programs are highly regulated and have not only state, but also discipline accreditation to account for. Accreditation standards can dictate student-to-faculty ratios for courses and supervision through a student’s fieldwork. Hiring faculty can also be problematic as mental health counseling suffers from the same chronic faculty shortages as many of the health and behavioral sciences.

Not all institutions are pausing growth, however. While there are nearly 500 total institutions with master’s in mental health counseling programs, the 10 largest programs are all delivered online, including a handful of for-profit institutions. These 10 programs confer about 25% of graduates nationally—a high concentration of providers that suggests room for other institutions that want to make an impact in this area using the online modality.

It is worth noting that the mental health counseling profession does not rest solely on this master’s credential. In addition to mental health counselors, there are licensed clinical social workers, marriage and family therapists, and even psychiatric/mental health nurse practitioners all trying to meet the need.

Many institutions faced with mental health professional shortages are finding ways to make an impact on campus mental health. Some have utilized federal funds to implement new initiatives. The Department of Education is encouraging institutions to use the pandemic-era Higher Education Emergency Relief Fund (HEERF) grants to address student, faculty, and staff mental health, and has extended the performance period through June 2023.

Here is a short list of mental health HEERF-funded initiatives:

• Using a telehealth mental health platform that provides 24/7 access to counselors for students and faculty
• Hiring social workers to assist students
• Pairing a crisis responder with campus police to better evaluate campus incidents
• Providing gatekeeper/suicide prevention training to faculty and staff
• Creating a call/text hotline for students to reach out if they are having issues

The Bottom Line

The current system in place for training, qualifying, and licensing mental health counselors is not meeting the need—a significant contributor to the mental health counselor shortage. At the same time, there is no doubt these positions require rigorous attention by accreditors and many fieldwork hours to ensure patient safety.

Positive well-being and emotional health are strong indicators of student persistence. Gallup-Lumina’s 2022 report, The State of Higher Education, found that currently enrolled bachelor’s students who considered stopping out reported “emotional stress” as the most common reason (76%)—a 34% increase from the previous year. Emotional stress was more commonly cited than “the pandemic” or “cost,” the next most common reasons.

Wrapping our collective arms around the emotional well-being of students is already seen as a top priority. Institutions are finding ways to support their students with new initiatives, and many have the funding (while it lasts) to make an impact on their campus communities.

Eduventures and Encoura send our condolences and sympathies to the families and communities impacted by the recent Michigan State University tragedy.

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