Should Universities Have Mental Health Facilities

[mahagonny]

Just to clarify...

1) In both cases I cited, I was an adjunct. I had taken the time and trouble to learn about student healthcare options as soon as a student presented with possible issues because, when I was a student, those who recognized what I was going through in my abusive marriage had done so, and probably saved my life by helping me figure out the best, healthiest ways of dealing with things. (I didn't even know until much later that some of them knew, or did this; they let me take incompletes and were in touch with each other because they were concerned about me, let me counsel with them in their offices, etc.).

That's impossible. Adjunct faculty just drop in at the last minute, then get on the freeway the minute class ends. They're not sufficiently available to students and so shouldn't be compensated like regular faculty are.

The question you should be asking is what does the overall US healthcare system do about mental health? And the answer is nothing unless you have enough money to pay them in the same way as it is the case with physical health. In other words, universities can do everything in their power to help their employees and students with mental health, but the matter of fact is that  students will not always be affiliated with a university (the same applies to employees). Also, university populations are a small percentage of the overall population in the US. So, that's why the right question to ask is "does this healthcare system do anything about mental health?". And, of course, the answer is "no".

That doesn't seem to be correct.

As of 2014, most individual and small group health insurance plans, including plans sold on the Marketplace are required to cover mental health and substance use disorder services. Medicaid Alternative Benefit Plans also must cover mental health and substance use disorder services. These plans must have coverage of essential health benefits, which include 10 categories of benefits as defined under the health care law. One of those categories is mental health and substance use disorder services. Another is rehabilitative and habilitative services. Additionally, these plans must comply with mental health and substance use parity requirements, as set forth in MHPAEA, meaning coverage for mental health and substance abuse services generally cannot be more restrictive than coverage for medical and surgical services.

The government does treat mental illness, though you could argue, not enough. If you see a person who looks like they are homeless, walking the streets of the city talking to himself or to passersby, angrily, it's not pleasant. We've all seen it.

Whatever society collectively lacks in taking care of others, they don't do what colleges do, that is, hoard health care insurance for one segment of their workforce ('full-time') at the expense of another ('Part-time'). They don't intentionally grow the gig economy and then claim their employees are not affected by living in a society that has adopted the gig economy.

....this thread makes me sick.

Me too.

[mamselle]

Quote from: mamselle on Today at 10:28:15
Just to clarify...

1) In both cases I cited, I was an adjunct. I had taken the time and trouble to learn about student healthcare options as soon as a student presented with possible issues because, when I was a student, those who recognized what I was going through in my abusive marriage had done so, and probably saved my life by helping me figure out the best, healthiest ways of dealing with things. (I didn't even know until much later that some of them knew, or did this; they let me take incompletes and were in touch with each other because they were concerned about me, let me counsel with them in their offices, etc.).

That's impossible. Adjunct faculty just drop in at the last minute, then get on the freeway the minute class ends. They're not sufficiently available to students and so shouldn't be compensated like regular faculty are.

Not only impossible, but quite common.

There's no freeway between my house and the schools I was teaching at; I was (and am) on public transportation--have been since 1984.

And that's what I meant about meanness. Compensation for saving a student's life, potentially, or at least affording them a few moments of sanity?

Not all worlds are apparently the same. And some people are definitely different from you.... 

M.

[mahagonny]

I meant it ironically. Of course adjunct faculty save people's lives. I was giving you and your caring for people credit, for the second time.
The meanness and hypocrisy is higher education screaming in your face that everyone's life matters and casting themselves as champions of social justice when it excludes us from the health insurance pool. And that's why the thread makes me sick.

[mamselle]

Ok, my magnetomter apparently misfunctioned.

M.

[Hibush]

This article provides a glimpse into the visibility of a failed response, the incidence of mental health need among college students, and a professional's view on balancing the need for facilitating learning, providing discipline, and referring to mental health treatment.

It is hard to get it right, and a lot of people have to be on board.

[Stanford student's] Suicide Put the Spotlight on Student Discipline. Experts Say Mental Health Is the Larger Issue.   

In the fall-2021 American College Health Association National College Health Assessment, which surveyed 33,204 students at 41 institutions on their health and well-being, 21.7 percent reported being diagnosed with depression at some point in their lives, and 27.4 reported an anxiety diagnosis. More than 17 percent had been diagnosed with both.

Kevin Kruger, the president of Student Affairs Administrators in Higher Education, said that focusing on student conduct instead of mental health "nudges in the wrong direction about how to solve this problem ... We can't knock off student conduct. It's just not possible to have a community where these things aren't a part of the learning process." Instead, it's important that more faculty and staff members are trained on identifying "signs of distress" in college students so that they can get the help they need.

[research_prof]

The question you should be asking is what does the overall US healthcare system do about mental health? And the answer is nothing unless you have enough money to pay them in the same way as it is the case with physical health. In other words, universities can do everything in their power to help their employees and students with mental health, but the matter of fact is that  students will not always be affiliated with a university (the same applies to employees). Also, university populations are a small percentage of the overall population in the US. So, that's why the right question to ask is "does this healthcare system do anything about mental health?". And, of course, the answer is "no".

That doesn't seem to be correct.

As of 2014, most individual and small group health insurance plans, including plans sold on the Marketplace are required to cover mental health and substance use disorder services. Medicaid Alternative Benefit Plans also must cover mental health and substance use disorder services. These plans must have coverage of essential health benefits, which include 10 categories of benefits as defined under the health care law. One of those categories is mental health and substance use disorder services. Another is rehabilitative and habilitative services. Additionally, these plans must comply with mental health and substance use parity requirements, as set forth in MHPAEA, meaning coverage for mental health and substance abuse services generally cannot be more restrictive than coverage for medical and surgical services.

You said it yourself: "most individual and small group health insurance plans, including plans sold on the Marketplace". This does not seem to cover employer-sponsored insurance programs and that justifies why many colleagues have paid $500 (or more) out of their own pockets for a visit to a psychiatrist in order to be prescribed antidepressants, while in EU countries or Canada, even uninsured individuals can be prescribed antidepressants for free and also get the actual pills for free..... What you are saying does not seem to be correct and also looking a bit further away than our own city, state, or country could actually help us understand how others do it better than us. It is not a coincidence that the average life expectancy in the US is 78 years, while in Canada and most EU countries is 82 years and beyond.

[dismalist]

The question you should be asking is what does the overall US healthcare system do about mental health? And the answer is nothing unless you have enough money to pay them in the same way as it is the case with physical health. In other words, universities can do everything in their power to help their employees and students with mental health, but the matter of fact is that  students will not always be affiliated with a university (the same applies to employees). Also, university populations are a small percentage of the overall population in the US. So, that's why the right question to ask is "does this healthcare system do anything about mental health?". And, of course, the answer is "no".

That doesn't seem to be correct.

As of 2014, most individual and small group health insurance plans, including plans sold on the Marketplace are required to cover mental health and substance use disorder services. Medicaid Alternative Benefit Plans also must cover mental health and substance use disorder services. These plans must have coverage of essential health benefits, which include 10 categories of benefits as defined under the health care law. One of those categories is mental health and substance use disorder services. Another is rehabilitative and habilitative services. Additionally, these plans must comply with mental health and substance use parity requirements, as set forth in MHPAEA, meaning coverage for mental health and substance abuse services generally cannot be more restrictive than coverage for medical and surgical services.

You said it yourself: "most individual and small group health insurance plans, including plans sold on the Marketplace". This does not seem to cover employer-sponsored insurance programs and that justifies why many colleagues have paid $500 (or more) out of their own pockets for a visit to a psychiatrist in order to be prescribed antidepressants, while in EU countries or Canada, even uninsured individuals can be prescribed antidepressants for free and also get the actual pills for free..... What you are saying does not seem to be correct and also looking a bit further away than our own city, state, or country could actually help us understand how others do it better than us. It is not a coincidence that the average life expectancy in the US is 78 years, while in Canada and most EU countries is 82 years and beyond.

Yes, "small" means individual or employer sponsored plans who have 50 employees or fewer. Larger plans are subject to State regulation. The majority of employer-sponsored health insurance plans cover mental health and substance use services. However, the specific services, providers, and medications covered by each plan vary. Employers are not always required to cover mental health services, but most do.

Those left out in the cold can purchase individual plans through the Affordable Care Act.

I was objecting to the idea that nothing is done for mental health.

Anyway, sticking to the subject of the thread, universities have the authority to require insurance. As long as it's clear who pays for what, I have no problem.

[Wahoo Redux]

The question you should be asking is what does the overall US healthcare system do about mental health? And the answer is nothing unless you have enough money to pay them in the same way as it is the case with physical health. In other words, universities can do everything in their power to help their employees and students with mental health, but the matter of fact is that  students will not always be affiliated with a university (the same applies to employees). Also, university populations are a small percentage of the overall population in the US. So, that's why the right question to ask is "does this healthcare system do anything about mental health?". And, of course, the answer is "no".

That doesn't seem to be correct.

As of 2014, most individual and small group health insurance plans, including plans sold on the Marketplace are required to cover mental health and substance use disorder services. Medicaid Alternative Benefit Plans also must cover mental health and substance use disorder services. These plans must have coverage of essential health benefits, which include 10 categories of benefits as defined under the health care law. One of those categories is mental health and substance use disorder services. Another is rehabilitative and habilitative services. Additionally, these plans must comply with mental health and substance use parity requirements, as set forth in MHPAEA, meaning coverage for mental health and substance abuse services generally cannot be more restrictive than coverage for medical and surgical services.

Most employer-contributed insurance includes mental health coverage.

The societal problem is that once a person falls through the cracks and is in need of intensive, in-house treatment we have very little to offer unless you or your family has a boat-load of money.

Any chance to intervene before that person falls into the morass we should give them.  It is very expensive, literally and metaphorically, not to help.

[dismalist]

The question you should be asking is what does the overall US healthcare system do about mental health? And the answer is nothing unless you have enough money to pay them in the same way as it is the case with physical health. In other words, universities can do everything in their power to help their employees and students with mental health, but the matter of fact is that  students will not always be affiliated with a university (the same applies to employees). Also, university populations are a small percentage of the overall population in the US. So, that's why the right question to ask is "does this healthcare system do anything about mental health?". And, of course, the answer is "no".

That doesn't seem to be correct.

As of 2014, most individual and small group health insurance plans, including plans sold on the Marketplace are required to cover mental health and substance use disorder services. Medicaid Alternative Benefit Plans also must cover mental health and substance use disorder services. These plans must have coverage of essential health benefits, which include 10 categories of benefits as defined under the health care law. One of those categories is mental health and substance use disorder services. Another is rehabilitative and habilitative services. Additionally, these plans must comply with mental health and substance use parity requirements, as set forth in MHPAEA, meaning coverage for mental health and substance abuse services generally cannot be more restrictive than coverage for medical and surgical services.

Most employer-contributed insurance includes mental health coverage.

The societal problem is that once a person falls through the cracks and is in need of intensive, in-house treatment we have very little to offer unless you or your family has a boat-load of money.

Any chance to intervene before that person falls into the morass we should give them.  It is very expensive, literally and metaphorically, not to help.

There is Medicaid, too, which encompasses mental health, and is the largest health insurance program in the US of A, covering about a fifth of the population. This is for poor people, a group more needful of our attention than college students.

Once again, universities are in a position to require health insurance  by their students. That could pay for anything any university saw fit.

There cannot possibly be a concentrated mental health problem in academia. As I reported upthread, 3% of dropouts suffered from mental health problems, not 60%.

Anything above and beyond requiring health insurance, paid for by students, sounds like special pleading to me.

[mahagonny]

There is Medicaid, too, which encompasses mental health, and is the largest health insurance program in the US of A, covering about a fifth of the population. This is for poor people, a group more needful of our attention than college students.

Once again, universities are in a position to require health insurance  by their students. That could pay for anything any university saw fit.

There cannot possibly be a concentrated mental health problem in academia. As I reported upthread, 3% of dropouts suffered from mental health problems, not 60%.

Anything above and beyond requiring health insurance, paid for by students, sounds like special pleading to me.

Apart from the question how many are dropping out or will soon, our school seems to think people are in dreadful shape psychologically. They have scheduled a whole bunch of something called 'healing sessions'. These are pitched as meant to help people get cope with the toxic effects of social aggression visited on them because they are are some variation of BIPOC or LGBTQ etc.*   Growing the fear of depression/psychological trauma aggrandizes the DEI department and its offerings which makes the college appear more cutting-edge. Which I suppose is believed to boost enrollment. Or maybe it's just keeping up with the Joneses.

* Naturally, the folks for whom these healing sessions are not intended are presumed to be the ones who've been dishing out the abuse.

[dismalist]

There is Medicaid, too, which encompasses mental health, and is the largest health insurance program in the US of A, covering about a fifth of the population. This is for poor people, a group more needful of our attention than college students.

Once again, universities are in a position to require health insurance  by their students. That could pay for anything any university saw fit.

There cannot possibly be a concentrated mental health problem in academia. As I reported upthread, 3% of dropouts suffered from mental health problems, not 60%.

Anything above and beyond requiring health insurance, paid for by students, sounds like special pleading to me.

Apart from the question how many are dropping out or will soon, our school seems to think people are in dreadful shape psychologically. They have scheduled a whole bunch of something called 'healing sessions'. These are pitched as meant to help people get cope with the toxic effects of social aggression visited on them because they are are some variation of BIPOC or LGBTQ etc.*   Growing the fear of depression aggrandizes the DEI department and its offerings which makes the college appear more cutting-edge. Which I suppose is believed to boost enrollment. Or maybe it's just keeping up with the Joneses.

* Naturally, the folks for whom these healing sessions are not intended are presumed to be the ones who've been dishing out the abuse.

Iatrogenic.

[mleok]

I'd like to hear from people who voted "yes" to the survey. Is this level of on-campus mental health services sufficient, or should treatment for more serious issues be provided on campus (other than through a medical school)?

I voted yes, but I don't think it's realistic to expect every university to have a full-blown mental health facility, so I was really only expecting something with basic services akin to a student health clinic or urgent care.

It's different when the university's enrollment is substantial relative to the size of the host city (think Texas A&M in College Station), in which case the university should reasonably be expected to take greater responsibility for offering such mental health services, as offloading it to the community would overwhelm the community level resources.

[mleok]

Universities are like small towns-- they need to do the emergency services and routine care, they transfer out for everything else.

I think that's the right analogy, universities are like small towns, often small cities, and we should have services commensurate to the size of the community.

[marshwiggle]

Universities are like small towns-- they need to do the emergency services and routine care, they transfer out for everything else.

I think that's the right analogy, universities are like small towns, often small cities, and we should have services commensurate to the size of the community.

That's a reasonable rule, and it also gives a decent guideline for how reasonable it is to go "outside the community" for care. In a small town, if there's a bigger town/small city 20 minutes away, people have realistic expectations of what is OK to require a 20 minute drive. If a campus is in or near a city that is larger, then a 20 minute drive to off-campus services in the city should be viewed in a similar way.

[mahagonny]

Universities are like small towns-- they need to do the emergency services and routine care, they transfer out for everything else.

I think that's the right analogy, universities are like small towns, often small cities, and we should have services commensurate to the size of the community.

That's a reasonable rule, and it also gives a decent guideline for how reasonable it is to go "outside the community" for care. In a small town, if there's a bigger town/small city 20 minutes away, people have realistic expectations of what is OK to require a 20 minute drive. If a campus is in or near a city that is larger, then a 20 minute drive to off-campus services in the city should be viewed in a similar way.

Sorry, no.
That may be a reasonable thought process for calculating how much health support students deserve, but again I reiterate: if there is anything colleges and universities are distinctly not, it is a community, as in a group of people frequently interacting who have some sense of looking out for one another.[/i] A community would not externalize a large segment (nor even a small segment) of its population in order to avoid the obligations that normally go with community-hood, as higher education does, prolifically, with (part-time) teaching faculty. For those who still don't get it, I have sat at a meeting and listened to a universally chancellor state flatly 'adjunct faculty in the university will never get health insurance here.'