Campus health and well-being: New ways forward

Effective solutions must be broad in scope

• Colleges and universities are facing increased demand and heightened risk when it comes to providing student health services.
• A variety of internal and external factors are complicating efforts to positively impact student health and well-being.
• In response, leading institutions are improving healthcare and services and addressing student well-being at a systems level.

Campus health professionals support the academic, research, and service missions of the nation’s colleges and universities by optimizing conditions that enable students to be well, a prerequisite for success on campus and in life.

Today, a variety of internal and external factors complicate the efforts of colleges and universities to positively impact student health and well-being. These include:

Increased demand and risks. More than ever, students and their families are evaluating comprehensive healthcare, especially mental health services, when making enrollment decisions. Simply put, demand for campus health services is outpacing supply, creating reputational and legal risks.

Mental health crisis. Depression, anxiety, self-harm, and suicide among adolescents and young adults have increased dramatically since 2007. Suicide is now the second leading cause of death among 15–24-year-olds.

Changing needs. The Americans with Disabilities Act of 1990 (ADA) has opened the doors of campus life to students with serious medical and mental health conditions, requiring campus health centers to provide higher complexity care and services than in the past.

A siloed approach. Student mental health and medical care and services are not often operationally integrated or collaborative, leading to significant inefficiencies in care and cost.

Rising costs and decreased funding. Like the U.S. healthcare system, campus health faces skyrocketing costs. Colleges and universities are increasingly grappling with how to fund campus health and well-being services amidst declining enrollment and tightening budgets — all while increasing students’ access to care.

Organizational alignment challenges. Student affairs or business affairs administrators often oversee campus health services, with insufficient collaboration and oversight by senior healthcare executives. Many institutions lack the healthcare operations, quality outcomes management, and technology, including electronic health records and data warehousing, critical to modern healthcare practices.

Staffing and talent. A long-standing and worsening national shortage of health providers, particularly mental health professionals, makes it challenging to recruit and retain the right talent mix.

In response to these challenges, colleges and universities have implemented a variety of approaches, many of which emphasize clinical services. These approaches include outsourcing to other healthcare providers and rapidly expanding on-site staffing — especially in mental health — with insufficient investment in prevention and public health.

Emerging technologies, such as mental health apps and telehealth providers, have also become common institutional responses to the student mental health crisis, but often without standardized or consistent assessment. Given the market's rapid growth, colleges and universities have seen varying levels of expectations being met by these products, further exposing institutions to potential risk.

While these approaches are driven by a shared concern for advancing campus health, they may miss opportunities to improve campus well-being more strategically. While individual-level services are necessary, they are insufficient to address well-being at the systems level. Effective solutions for campus health must be broad in scope — involving the whole of campus — and grounded in wellness theory and healthcare best practices.

Leading institutions are making positive steps forward by transforming multiple areas of campus health delivery to advance conditions that foster well-being. The following are four examples.

Organizational alignment. Colleges and universities increasingly recognize the value of integrating health-related efforts across the enterprise. As a result, institutions have begun to elevate campus health leaders to chief wellness officer roles, including cabinet-level positions.

Health records. Electronic health records (EHR) support the sophisticated levels of care that colleges and universities must provide to today’s students. They can also lead to better healthcare outcomes. A private R1 institution on the East Coast started its transformative journey to improved care by adopting a single, shared EHR that will enable integrated services, consolidated medical records, and enhanced reporting capabilities.

Primary care. Meeting student needs requires more than offering clinical services. A private R1 institution assessed its student primary care practice to enhance service quality and patient access, top-of-licensure practice, staff satisfaction, and other critical elements of campus health delivery.

Counseling services. Inter-institutional and external partnerships can be valuable mechanisms for improving access to counseling services. To ensure the best and highest quality care for its students, an academic medical center in the Midwest evaluated different partnership models for student counseling and mental health services.

To discuss the factors unique to your institution’s campus health and well-being strategy and begin creating a new path forward, contact our team.