How Much To College Mental Health Counseling Services Cost

Overview of Mental Wellness Services
for College Students

In this mail, nosotros provide an overview of the mental health services available to students at the Academy of California (UC), the California State University (CSU), and the California Customs Colleges (CCC). Nosotros first depict the mental wellness services provided by campuses, and then describe the mental health services provided by customs mental health agencies. Next, nosotros highlight contempo developments in student mental wellness since the start of the coronavirus illness 2019 (COVID-nineteen) pandemic. Nosotros conclude past assessing the data currently available on pupil mental health problems and making an associated recommendation.

Campus-Provided Services

Almost Campuses Provide Student Mental Health Services. All 10 UC campuses, all 23 CSU campuses, and at least 90 out of 116 CCC campuses provide student mental health services. Campuses primarily provide brusque-term counseling in individual and sometimes group settings. Campus policies vary on the exact number of counseling sessions students may receive, with some campuses setting a limit (commonly betwixt vi to twelve sessions per twelvemonth) and others leaving this to the discretion of counselors. Beyond counseling, other typical campus-provided services include crisis intervention (such as a hotline) for students experiencing urgent mental health concerns, as well as instance direction to connect students to other campus and community resources. In addition, campuses often provide various kinds of outreach on mental health issues, including trainings and workshops, peer support programs, and online resources. The verbal types and levels of mental health services provided vary by segment and campus. Whereas UC campuses tend to offer the broadest assortment of services, including psychiatry services provided past medical doctors who are authorized to prescribe medications, CCC campuses typically offer the narrowest array of services.

Campuses Employ Mental Health Professionals to Provide Services. Campuses commonly rent various types of licensed mental health professionals, including psychologists, clinical social workers, clinical counselors, marriage and family unit therapists, and psychiatrists. Some campuses also accept graduate- and postgraduate-level trainees, who provide mental wellness services nether supervision. In addition, some campuses contract with third parties, including telehealth vendors, to provide or augment mental health services. Less commonly, campuses have agreements with community providers to deliver services on campus.

Campus-Provided Mental Health Services Are Largely Supported Through Educatee Fees. These fees are charged to the general pupil body, rather than to individual students utilizing the services. (Campuses typically do not charge user fees for counseling visits.) Fee levels vary by segment and campus. UC charges all students a systemwide Student Services Fee of $1,128 per bookish year, which supports a broad range of services including mental wellness. Six UC campuses also charge additional fees for health services (including concrete and mental health), ranging from $85 to $549 per academic yr. CSU does not take a systemwide student services fee, but all CSU campuses charge health services fees, which range from $150 to $740 per bookish twelvemonth. Similarly, CCC does non have a systemwide educatee services fee, but districts are permitted nether state constabulary to charge health services fees of upwardly to $44 per academic twelvemonth. Most districts charge such fees, with many of them charging at or nigh the maximum charge per unit.

State Has Begun Supplementing Funding for Campus Mental Health Services. As Figure one shows, the state has provided funding to UC, CSU, and CCC specifically for student mental health services since 2017-eighteen. While the initial appropriations were i time, the country began providing ongoing General Fund for mental health services at UC in 2019-20 and at CSU and CCC in 2021-22. Each segment has discretion over how to classify these ongoing funds among its campuses. The allocation methods vary by segment, merely they mostly business relationship for differences among campuses in their pupil enrollment and demographics.

Effigy ane

State Has Significantly Increased Funding for
Campus‑Provided Student Mental Health Services

General Fund, Unless Otherwise Noted (In Millions)

	2017‑18	2018‑nineteen	2019‑20	2020‑21	2021‑22
UC	—	—a	$v.three	$5.3	$xx.3
CSU	—	—	3.0b	—	15.0
CCCc	$4.5	$10.0	vii.0b	—	30.0
Full	$4.5	$ten.0	$15.3	$5.3	$65.3
aUC indicates it spent $5.iii million on student mental wellness services in 2018‑19 using part of a one‑time land allotment for general university needs. bMental Health Services Fund (MHSF). cUnless otherwise noted, reflects Proposition 98 General Fund. Nautical chart excludes about $100,000 ongoing MHSF to CCC for state operations provided since 2008‑09.

At a Small Number of Colleges, Medi-Cal Reimbursements Encompass Some Costs. Eleven community colleges currently participate in the Local Education Bureau Medi-Cal Billing Option Program (LEA BOP), which allows public Thou-12 and higher education institutions to receive federal reimbursement through Medi-Cal, the state's Medicaid program. (Though eligible, no CSU or UC campus currently participates in the program.) Under LEA BOP, institutions are reimbursed for providing sure health services to sure Medi-Cal eligible students (those nether age 22 and receiving services nether an individualized care plan developed by the campus). The federal reimbursements cover at least fifty pct of the cost of providing the service, with the establishment roofing the remaining toll. Based on data from the Department of Health Intendance Services (DHCS), participating community colleges in California collectively received an estimated $23 one thousand thousand in federal reimbursements specifically for student mental health services in 2019-20.

A Few Other Fund Sources Support Campus Mental Wellness Services. Other fund sources for student mental health vary past campus and may include core campus operating funds, certain categorical programs (such equally the CCC Pupil Equity and Achievement Plan), external competitive grants, and federal COVID-19 relief funds. At UC, university-sponsored health insurance also is showtime to encompass more pupil mental health costs. Nearly half of UC students are enrolled in the UC Student Wellness Insurance Programme (Send). (CSU and CCC do non have comparable student wellness insurance plans.) UC SHIP historically has been limited to psychiatry and other medical services, but ii campuses recently started billing UC Send for student counseling services.

Systemwide Data on Mental Health Spending Is Express. Of the three segments, only CSU has collected systemwide data on full educatee mental health spending. In 2020-21, CSU reports spending $45 million systemwide on mental health services, of which $30 1000000 came from campus fees. CSU projects educatee mental health spending volition increment to $62 meg in 2021-22, primarily reflecting a $15 million General Fund augmentation.

Mental Health Staffing Levels Vary Across the Segments. Staffing ratios are 1 indication of the level of mental wellness resources, with fewer students per staff fellow member associated with greater availability of services. The International Accreditation of Counseling Services has a commonly cited recommendation that campuses maintain a ratio of one,000 to 1,500 students per mental health professional person (commonly referred to as a "counselor"). As of autumn 2020, UC'south systemwide ratio was inside this range at 1,138 students per counselor. CSU's systemwide ratio was exterior this range at 1,958 students per counselor. CCC does not rail this ratio, but the Chancellor's Part indicates most colleges apply ane to 3 mental health counselors, suggesting considerably more students per advisor than at the universities. Variations in staffing ratios among the segments and campuses may reflect differences in funding, the availability of providers, the types of services provided, and other campus characteristics (such as whether the campus primarily serves commuter or residential students).

Express Data Is Bachelor on Mental Health Utilization and Outcomes. Historically, only UC has tracked systemwide utilization of campus mental health services. In 2019-20, UC campuses collectively provided counseling services to about 34,000 students (12 percent of total UC enrollment) and psychiatry services to about vi,400 students (2 percent of total UC enrollment). CCC recently began collecting utilization data, reporting that most 59,000 students (ii percent of full CCC enrollment) received any mental health services in 2019-20. Across the segments, information is non available on the impact of mental health services on students' bookish or clinical outcomes. Measuring the outcomes of mental health services remains a claiming among all providers, non only college campuses. The main claiming is that bookish and health practitioners have not yet adult an agreed-upon set of measurable mental health outcomes that are consistently reported.

Students Besides Can Receive Mental Health Services From Community Providers. Community providers (such as clinics and hospitals) offer mental health services to the full general population, including college students. These community providers often offer similar types of clinical services equally campuses, including counseling and psychiatry. County mental wellness departments too have a major role in the delivery of customs mental health services. In particular, counties provide services for low-income individuals with the highest service needs, including Medi-Cal beneficiaries with severe mental illness. Comprehensive data is not available on (i) the full amount of community-provided mental wellness services for college students or (2) the amount of services provided specifically by counties for college students. Some related information, all the same, is bachelor. Specifically, in 2019-twenty, counties provided over $400 million (across all fund sources) in Medi-Cal mental wellness services to Medi-Cal beneficiaries with severe mental illness who were historic period eighteen to 24, including but not limited to higher students.

Students Are Frequently Referred to Community Providers for Long-Term or Specialized Treatment. While some students straight seek out community providers, other students are referred by their campus. Considering campus mental health services are by and large intended to be short term, with the number of counseling sessions limited at some campuses, students seeking or requiring long-term treatment tend to be referred to community providers. Students are besides typically referred to customs providers if they have a condition that is severe or requires specialized treatment (such as an eating disorder, attention deficit hyperactivity disorder, or substance abuse). Campuses ordinarily maintain directories of community providers for referral purposes. Some campuses as well provide additional support to students with the referral process, such as helping students brand phone calls to providers or navigate their health insurance coverage. Campuses vary in terms of the availability of providers in their local community and the strength of their relationships with those providers. None of the segments collect comprehensive data on the volume of referrals to customs providers.

Students Typically Use Health Insurance for Community-Provided Services. Unlike campus providers, customs providers typically charge for services. As Figure 2 shows, most students in California attending public or private higher teaching institutions have health insurance to help cover these costs. Students typically receive health insurance through their or their parent's employer, Medi-Cal, or the individual market. (The individual marketplace is where people purchase coverage direct from insurers, including through the Covered California wellness benefits exchange.) Although students commonly take insurance coverage, they may nevertheless face barriers to accessing community providers—including finding a local provider that accepts their insurance, covering the cost of co-pays, and getting transportation to appointments.

Figure 2 - Students Receive Health Insurance Through Various Sources

Recent Developments

Educatee Mental Health Concerns Have Continued to Increase During Pandemic. Historical data suggests the prevalence of mental wellness issues amidst college students nationally has increased over the long term. More recent data suggests the COVID-19 pandemic exacerbated this trend. Since the onset of the pandemic, several studies accept plant further increases in a variety of student mental health issues. For example, a written report from the Healthy Minds Network (a research organization focused on the mental health of young adults) indicates that the prevalence of depression among college students nationally increased from 36 percent in fall 2019 to 41 pct in bound 2021, while the prevalence of anxiety increased from 31 percent to 34 percent.

Campus Mental Health Utilization Decreased at Start of Pandemic, but Could Abound as Campuses Reopen. Despite the increase in the prevalence of mental health bug amid college students, national information suggests the use of campus mental health services declined at the onset of the pandemic. As Effigy 3 shows, this turn down similarly occurred at UC, the just segment that systematically reports utilization data. The decline probable was related to campus closures first in March 2020, which required campuses to chop-chop transition to providing mental health services through telehealth. In discussions with our office, stakeholders noted that while some students prefer the convenience of telehealth services, others face up barriers to accessing telehealth or prefer the face-to-face interactions of in-person visits. Some students may also have sought community-provided services during their time off campus. With campuses delivering more teaching and other activities in person in 2021-22, many campuses anticipate an increase in utilization of campus mental wellness services. Systemwide utilization data for 2021-22 is non all the same bachelor, but anecdotally some campuses indicate an unusually high influx of students seeking counseling early on in the fall 2021 term.

Figure 3 - Use of UC Student Mental Health Services Declined at Onset of Pandemic

2021-22 Upkeep Provided Meaning Augmentations for Student Mental Wellness. The 2021-22 land upkeep included the post-obit actions:

Ongoing Funding to CCC, CSU, and UC. The budget provided $xxx million ongoing Proposition 98 General Fund to CCC, $15 million ongoing General Fund to CSU, and $15 meg ongoing General Fund to UC for student mental wellness services. Conditional linguistic communication requires CCC to report every 3 years and CSU and UC to study annually on these funds, including how the funds were distributed among and used by campuses.
Partnership, Capacity, and Infrastructure Grants. The upkeep provides $xxx million onetime Full general Fund in 2021-22 and $120 million i-time General Fund in 2022-23 to DHCS for grants to build partnerships, chapters, and infrastructure supporting behavioral wellness services for CCC, CSU, and UC students. DHCS is to award the grants through a competitive process to higher education institutions and other eligible entities (such equally counties, community-based organizations, and wellness insurance plans). As of this writing, the process and time line for application these grants had not withal been determined. These grants are part of the broader Children and Youth Behavioral Wellness Initiative.
Other Behavioral Health Back up for Young Adults. Beyond the grants targeted toward college students, the Children and Youth Behavioral Wellness Initiative provides an additional $four.ii billion in total funds beyond v years for numerous other efforts supporting the broader population of individuals age 25 and under. These efforts include creating more than online behavioral health resource, expanding the behavioral health workforce, implementing evidence-based interventions, and launching a public education campaign to heighten awareness of behavioral health bug.
New Requirement for Health Insurance Plans. Trailer legislation to the budget requires health insurance plans to begin covering medically necessary behavioral health services provided at school sites—including CCC, CSU, and UC campuses—effective Jan 1, 2024. State law defines "medically necessary" to refer to services that address the specific needs of the patient and meet certain conditions, including being clinically appropriate and in accordance with generally accustomed standards of care. Many services that campuses provide probable meet this definition.

Decision

Country Lacks Adequate Data to Guide Futurity Decisions. Given contempo state augmentations and continued involvement in this area, the Legislature will likely desire to monitor student mental health services more closely in the coming years. Consequent reporting, however, is lacking in several key areas. For case, only UC systematically tracks information on the utilization of campus mental health services, whereas merely CSU tracks total spending on these services. Recently, CCC has collected some utilization information, but information technology has non yet collected data on spending or staffing. Moving forward, the Legislature will need more comprehensive, consistent information to assess whether the recent augmentations are improving access to mental health services, whether future augmentations are warranted, and how those futurity augmentations should exist targeted.

Recommend Expanding Mental Health Reporting Requirements at UC, CSU, and CCC. The 2021-22 budget contains provisional language outlining new reporting requirements, which we believe serves as a promising starting point. This conditional language is linked with ongoing country funding for student mental health services at UC, CSU, and CCC, and it requires all three segments to submit recurring reports on the use of these funds. Nosotros recommend the Legislature expand on these reporting requirements to collect a more comprehensive, consistent set up of information on student mental health services supported by all fund sources. Specifically, we recommend requiring the segments report the data listed below. Near all of the data elements listed already are collected by some campuses, and many are collected systemwide by at least one of the segments.

Unduplicated number of students receiving campus mental health services, disaggregated by race/ethnicity, gender, age group, source of insurance coverage, and type of service received.
Average look time for initial routine counseling appointments.
Average number of campus mental health counseling appointments per pupil.
Number of students referred to community providers for mental health services.
Total spending on student mental health services, by fund source.
Number of pupil mental health staff by provider type and counselor-to-student ratio.