Depression, anxiety and other mental health concerns have been on the rise for college-age students for some time.

Many of these concerns were intensified by feelings of isolation, fear and loss of personal connections at school, work and in social circles throughout the pandemic, and further exacerbated by economic instability, political unrest and racial injustice over the past year.

The CSU Health Network has responded to both the ongoing increase in mental health needs and the pandemic by moving traditional services into a virtual environment and introducing innovative tools to provide mental health support.

As the pandemic began impacting Colorado State University operations last spring, the Health Network responded quickly.

“We moved our entire Counseling Services operations, including on call, individual and group counseling, to telehealth delivery in March of 2020 to provide continuity of care for students,” said Lisa Miller, director of Specialty Counseling Services. “Our staff was committed to providing services at a time when anxiety, confusion and stress were significantly on the rise for students, while also doing our part to follow community health guidelines”

Psychiatry Services also rapidly shifted to seeing clients remotely through secure video conferencing, according to Director Irena Danczik.

“Psychiatry has continued to see students at a steady pace during the pandemic,” Danczik said. “Students have expressed how they appreciate being able to engage with their provider remotely and that it can save time.”

Miller added that students responded cautiously in the first few weeks but quickly adapted. As the technology became more familiar, the number of students continuing services and those seeking new services steadily grew.

Connecting through telehealth

You@CSU website

YOU@CSU is an online, self-paced portal that allows students to explore topics like depression, difficulty sleeping, stress and anxiety. 

In the past year, individual Counseling Services has conducted 93.5% of the appointments conducted during the same time period last year. Miller noted that some students have missed being in the same room as their provider and have struggled to find private space to conduct telehealth appointments with roommates and family members in shared living spaces.

Telehealth was a direct response to the pandemic and was introduced as a temporary solution, said Reid Trotter, director of Counseling Services. Other innovative approaches — such as online platforms and apps — were introduced in partnership with Health Education and Prevention Services as long-term solutions to meet students wherever they are located.

YOU@CSU is an online, self-paced portal that allows students to explore topics like depression, difficulty sleeping, stress and anxiety. Self-assessments, exercises and workshops allow students to identify and work through resources that appeal to them. Launched in 2016, YOU@CSU has seen steady growth since its introduction with more than 48,000 logins last year. During the pandemic, students spent more time on the site, conducted more searches, and completed more self-assessments.

“YOU@CSU delivered skills and tools relevant to users in response to COVID-19. Fifty-plus COVID-related pieces of content were added with high engagement,” said Christina Berg, director of Health Education and Prevention Services. “Past evaluation results show the portal is working to connect students to important resources to support their well-being and academic success.”

A new online resource available for students, faculty and staff, called SilverCloud, was introduced in September 2019, just a few months before the pandemic hit. It offers several different programs based on cognitive behavioral therapy principles to help users increase their well-being. Self-guided programs are focused on education and skill-building on topics such as managing depression and anxiety, sleep, positive body image and more. Some programs include virtual coaching to offer support and guidance. While the coaches are not counselors, the model has been successful in boosting user engagement.

“Users who had a coach versus those engaged in self-help had a higher number of sessions (85% higher), more than double the total time using the tool (135%), and their average time per session was 30% higher,” Berg said. “The benefits of having a supporter appear to be significant and successfully driving engagement with the tool.”

Planning for the future

Moving forward, this hybrid approach of personalized coaching within self-paced online platforms could be a successful balance between in-person and virtual services.

Individual engagement — such as one-on-one services, self-paced online resources, or the new Nod app the Health Network introduced in April 2020 to help students build social connections — are one part of the solution. Another more community-based approach is therapy groups, which allow individuals who share common experiences, identities and concerns to come together.

CSUHN theme therapy groups include a wide range of groups students can join, from an international group to a group dedicated to making changes in substance use and a group for students coming out.

One such approach that has been well-received by students is Multicultural Counseling Services, designed for students with historically marginalized identities to help reduce barriers to access and support. In addition to identity-based group counseling, resources also include multicultural counseling drop-in hours and peer support.

“My sessions with Dr. Wright gave me new ways to deal with my anxiety and stress surrounding academic performance at CSU. It also allowed me to be more open to talking with others about my experiences with mental health,” said Helen Obuna, a first-year student who utilized Multicultural Counseling Services in Fall 2020. “It’s important for the Health Network to provide multicultural counseling because marginalized students deserve to work with counselors who understand and can relate to their lived experiences.”

Obuna noted that as a first-generation Black student at a predominantly white institution, multicultural counseling was critical in engaging her.

“I don’t think that I would have decided to work with a counselor [otherwise],” she said, adding that her counseling sessions were covered by her student fees and that removed a significant financial barrier for her.

Tips for initiating a mental health conversation with a student

Normalize stress and feeling overwhelmed at times. We all experience times that are difficult to navigate, and it’s OK to not be OK.

Discuss healthy coping.

Be willing to listen and offer a supportive ear.

Share your story about help seeking and encourage reaching out for support.

Be familiar with student mental health and well-being support resources to share.

If you are concerned about a student, friend or peer, Tell Someone by calling (970) 491-1350 or visiting to share concerns with a professional who can discreetly connect the distressed individual with the proper resources.

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