Tamia Sanders’ voice trembled as she looked out on a large rally crowd from the steps of UNC-Chapel Hill’s Wilson Library.
She was there in April to talk about the ongoing opposition to “Silent Sam” and the alleged mistreatment of student activists by campus police.
But she decided to share a personal perspective on it.
Sanders — a rising senior and co-chair of the UNC-Chapel Hill Black Congress — talked about the anxiety and depression that hospitalized her twice last semester.
In the last year, two of UNC’s most powerful female leaders stepped down amid political power struggles, both replaced, in the interim, by white men more in line with the UNC Board of Governors’ conservative majority.
She heard members of the UNC Board of Governors call for the return of a statue honoring those who fought to preserve a white supremacist system.
And she watched armed white supremacists treated with civility as they marched on campus following Sam’s toppling last August, even as police pinned and cuffed unarmed student activists.
White students can ignore all that if they wish, she said. Black students don’t have that luxury. What may be an academic discussion for some is, for her, a crisis. It is, she said, “its own kind of torture.”
“I am tired of having to fight for my humanity,” Sanders said.
Overwhelmed by emotion, she paused to collect her thoughts. That’s when the large crowd of students gave her a roaring ovation.
Many could relate.
In April, a task force summoned by university leaders delivered a report* on student mental health to the UNC-Chapel Hill Board of Trustees. It detailed significant increases in anxiety and depression among undergraduate and graduate students, a contributing political and social environment on campus, and understaffed, on-campus mental health services.
While the statistics on increased mental health needs at Chapel Hill follow a national trend, the task force pointed to national, state and campus political environments as destabilizing for UNC students.
“Recent campus events and related discourse at Carolina and across the nation have intensified the University’s politically — and emotionally — charged environment,” the task force concluded. “Challenging topics include the confederate monument known as ‘Silent Sam,’ and related discussions of race and racial disparities throughout the University’s history, and the impact of sexual assault and misconduct. The tense climate on our campus and beyond, and the significant administrative transitions at our own campus and throughout the wider University system, have directly affected the perspectives of students, staff and faculty, as well as shaped the process of creating this report.”
Christi Hurt, UNC-Chapel Hill’s interim vice chancellor for student affairs, helped to produce the report.
“We wanted to acknowledge the time period in which we wrote the report, what was going on on campus,” Hurt said. “It’s a part of the backdrop of the work we did.”
The political turmoil might have impacted what students told those preparing the report, Hurt said, or it could have deterred certain students — especially from marginalized groups — from participating.
The report cites results from the National College Health Assessment Survey in 2017.
In the 12 months leading up to the survey, more than 90 percent of undergraduates reported “feeling overw
helmed.” Seventy-one percent said they felt “very sad” and 60 percent said they felt “overwhelming anxiety.” Thirty-seven percent said they felt so depressed it was difficult to function, and 38 percent reported “overwhelming anger.” Meanwhile, a staggering 11 percent said they seriously considered suicide.
While those numbers were slightly lower in most categories for graduate students, one category — overwhelming anxiety — was slightly higher at 62 percent.
UNC’s Counseling and Psychological Services (CAPS) simply doesn’t have the resources to effectively meet students’ growing needs, the report found.
“While approximately 30% of students seen at CAPS are then referred into the community for ongoing psychotherapy because their condition or circumstances exceeds the parameters of brief psychotherapy, UNC-Chapel Hill serves 5.5% of students with brief counseling, slightly above the national average of 5.2%,” the task force wrote in its report.
“Additionally, rates of clinical utilization for CAPS and their permanent staff to student ratio are meeting or exceeding standards set by the International Association of Counseling Services (IACS),” the report reads. “Further, while the IACS recommends that clinical utilization not exceed 65% (or 60% for larger centers) of staff time, it is of concern that counselors at CAPS are maintaining 65-70% in direct service clinical utilization, thereby increasing risk of staff burnout.”
CAPS treatment numbers show the massive increase.
From the 2012-2013 academic year to the 2016-2017 academic year, the number of visits for “triage” — or to assess the urgency of mental health related care — surged by 102 percent. “Urgent crisis” visits increased by 105 percent. The number of visits requiring academic intervention were up by 113 percent.
UNC wants to make sure students who need to take time off from their studies to tend to their mental health can do so, Hurt said. But what they heard from students while preparing the report is that coming back can be difficult for students. Some of the task force’s recommendations would make that process easier, she said.
CAPS has revised its triage process, Hurt said, so that students who feel they need help can get it on the day they are first seen. But that does require appropriate staffing.
“It is also of significant concern that the current permanent staff to student ratio at CAPS is one permanent staff member for every 2,248 students,” the task force wrote. “This ratio falls significantly short of the IACS recommended ratio of one permanent staff member for every 1,000 to 1,500 students. Taken together, these data suggest that CAPS staff is currently functioning at or beyond recommended clinical capacity and is understaffed by recommended norms for the size of our student body.”
But is an increase in staffing levels realistic as the UNC system mulls budget cuts?
“That is quite literally the million dollar question,” Hurt said. “I hope so.”
Adding therapists isn’t going to solve the problem by itself, Hurt said, but lowering the ratio of staff to students is important. That means working with off-campus partners and allies, Hurt said. Making sure students have access to off campus therapists when they need it is part of the equation as well, she said.
Last month, members of the UNC Board of Governors expressed deep concerns following another troubling report on student mental health from CAPS Director Allen O’Barr.
O’Barr shared information from a number of national studies, including the 2018 Center for Collegiate Mental Health report, to demonstrate a national trend of increased anxiety and depression among American college students.
Examining data from more than 100 university and college counseling centers, the Center for Collegiate Mental Health found average rates of students’ self-reported anxiety and depression continuing to increase, while other areas of self-reported distress remained flat or even began to decrease.
Between Fall 2009 and Spring 2015, according to the report, counseling center utilization increased by an average of 30 – 40 percent. Over the same period, enrollment only increased 5 percent. The report also found a growing number of students with “threat-to-self indicators.” Those students use between 20 and 30 percent more on-campus counseling services, the report found.
“I was told that 80 percent of our infirmary business now is mental health,” said Harry Smith, chairman of the board. “That’s obviously a dynamic change and I think an alarming change.”
“It was incredibly enlightening to all of us on all the challenges our students face today — which are much different than the challenges that were some time ago,” Smith said. “I’ve talked to a lot of the membership and I think you will see the board move swiftly with the president to try to start working to address what is no doubt a significant and challenging issue for our 235,000 students.”
Interim UNC System President Bill Roper agreed, calling O’Barr’s report “sobering.”
“It described what appears to be worsening levels of anxiety and depression among college students, including within our universities,” Roper said. “I think there’s a desire on everybody’s part to figure out how best to deal with the needs that these young people have and to do it most effectively. It’s an ongoing issue.”
Virginia Rodillas is already working to be sure college students understand their mental health needs and have access to care. She’s with the on-campus support staff for the National Alliance on Mental Illness of North Carolina (NAMI NC).
NAMI has been working to reach young people through its “Ending the Silence” program, which seeks to erase the stigma of mental health issues with middle school and high school students. It also has seven “NAMI on Campus” groups, student-led organizations that raise awareness about mental health and wellness. Current chapters include UNC-Chapel Hill, Duke, N.C. State, Meredith, UNC-Wilmington, Western Carolina University and Greensboro College. The program is growing, with three more campuses soon to announce new chapters.
“A lot of people experience mental health issues for the first time at this age, when they go to college,” Rodillas said.
While there is clearly a growing demand for mental health care, Rodillas cautioned against viewing it strictly as a surge in people having problems. The numbers could also reflect a clearer sense of the scope of the problem, Rodillas said, one that’s always existed.
“We have people who seem more open to talking about mental health and mental wellness these days,” Rodillas said. “We have celebrities who are talking about it. We’re squashing that stigma. So it could be that more young people are asking for help and realizing there’s nothing wrong with that.”
Hurt said that fighting mental health stigma is important for everyone, which is why UNC is asking students, staff and faculty to undergo training, aimed at reducing stigma and connecting individuals with help when they need it.
“This isn’t a matter for only a few people to solve.”
*Read the report here starting on page 35: http://www.ncpolicywatch.com/wp-content/uploads/2019/06/meeting-book-university-affairs-committee-may-29-2019-public.pdf