The mental health and well-being of students in postsecondary institutions of education has been explored in the last decade in an effort to provide better services to students and support their academic success. The pandemic of 2020 has significantly changed access to education for many, but the impact of this pivotal change on mental health and well-being is not yet known. We present a case study of 1752 surveyed students at a liberal arts institution and their need for and access to mental health services.
While the world population seems to be moving on past COVID-19, many continue to be significantly impacted by A study of 502 college students across the US indicates that a majority (85%) of college students say they continue to experience increased stress and/or anxiety as a result of COVID-19, with women reporting higher rates of coronavirus-related stress than men (93% vs. 78%). The top three causes of stress and anxiety of students are related to academics: 72% feel uncertainty about the future of their education, 61% fear falling behind in their coursework, and 60% have experienced struggles with remote learning. Worries about future career and job prospects (50%) and fears about their health and/or the health of loved ones (49%) rounded out students’ five most common concerns (Dennington, 2020). The National Association of Student Personnel Administrators and Course Hero conducted a study in fall of 2020 with a sample of 3,500 full-time students currently enrolled in four-year degree programs. In this study, one in five students are constantly “anxious” about the pandemic and are spending more time on their coursework and less time sleeping and exercising. All of this data would seem to imply a greater need for mental health services on campus. Current research also indicates however, that despite this increasing need for mental health care services at institutions of higher education, very few students will seek support or counseling services on campus (Tian, Li, Yang, Tian, Shao, Tian, 2020). Research indicates that a negative stigma associated with counseling or mental health services has decreased student adherence to treatment and possibly even a discontinuation of treatment (Eisenberg, Down, Golberstein and Zivins, 2009; Kaiser, Sattler, Bellack and Dersin, 1996).
The COVID-19 pandemic has impacted a variety of populations mentally and physically. Epidemics can create stressors such as fear and worry for oneself or loved ones, constraints on physical movement and social activities due to quarantine, and sudden and radical lifestyle changes. A recent study confirmed pandemic stressors such as infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma (Anderson, 2020: Brooks Webster et al, 2020).
Symptoms of mental health conditions were reported to be significant in college student populations even before the COVID-19 pandemic (Center for Collegiate Mental Health, 2019). Another national study indicates that the prevalence of depression increased from fall 2019 to spring 2020, while substance use decreased in spring 2020. Students also reported lower levels of psychological well-being in spring 2020 and stated that their mental health negatively impacted their academic performance (Anderson, 2020).
Methodology
This is a case study of a private liberal arts institution which transitioned to completely online programming in 2020. The total number of students in the traditional undergraduate liberal arts program is approximately 1752. Participation in this study was voluntary and students completed an online survey. Students were invited to enter in to a drawing for $50 Amazon gift cards as incentive. No particular hypotheses are proposed as the research is exploratory. All data is analyzed with SPSS.
Survey Instrument
The survey was delivered to students online in Qualtrics. The survey is a Likert scaled questionnaire with 20 questions regarding students’ sense of well-being, how they may have or have not utilized mental health services, the origins of their anxiety during the pandemic, and whether or not their academic program has changed as a result of the pandemic. Students are also asked an open ended question regarding ideas they have relative to strategies to better support overall student well-being during the semester. Students are asked about the types of mental health services they would like to have available.
Results
Six hundred and thirty-eight students responded to the survey distributed online. While 44% of students said they would take advantage of virtual counseling services, 30% were unsure, and 26% of students said they would not pursue virtual counseling services. Only 27% said they actually used traditional counseling services via campus. Additionally, when asked why they have not accessed services, the most frequent response was students are “too busy.” Also, students believed they did not need the services. Eighteen percent said they weren’t sure how to access services and 16% said they were nervous about using the services. Thirty-nine percent of students said they would use virtual counseling services via the campus counseling center.
Females are more likely than men to utilize counseling services χ2 (4, N = 601) =9.487, p < .025 and general telehealth services χ2 (3, N = 597) = 10.53, p < .02. Freshmen are also more likely than upperclassmen to have used telehealth services χ2 (4, N = 598) = 13.04, p < .01. Students who had previously used telehealth (25% ) are more likely to have accessed campus counseling services χ2 (1, N = 601) = 36.68, p < .000 than those students who have not used the services.
Students also included open ended responses. The most popular suggestion from students as to how the institution might improve services to students was: better and more frequent communication about services. Students noted things like “The school needs to communicate better with students; I didn’t even know mental health services were available. I must’ve missed an email.” Others said things like “I need time to decompress from all the stress,” and “I need to understand how I can recover from the stress.”
One of the more popular suggestions was more “mental health days.” Students’ comments included “A day off in the middle of the week would help” or “A four day week might make it easier to manage school and work.” Some students commented on workload: “Online and hybrid doesn’t mean you overwhelm students with work.” Many commented on faculty: “Faculty need to be more understanding,” “Explain to professors that mental health is a real thing.” “Have counselors available in online classes to speak so students know more about services,” and “make mental health services part of a course syllabus.” Students also advocated for virtual sessions (such as videos or other online offerings). “Students need services available to them when it’s convenient for them; online services make this easier.” There are opportunities to improve communication to the students who may be unsure about services and to provide training to faculty via the counseling center.
Implications and Discussion
During the session we will present additional results from the study and conduct a poll with our audience members regarding mental health support services provided by their institutions. We will discuss possible models for successful online mental health support as well as the challenges presented with supporting mental health for online students.
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