Ah, college. So many great memories. Sports!* Beautiful, dusty libraries! The opportunity to learn how to do your own laundry and feed yourself with some kind of regularity! In addition to actual Book Learning, college can serve as an integral opportunity for kids to explore new facets of themselves. It’s also a beacon for mental healthcare for a lot of students, especially those who didn’t come from touchy-feely households where seeing a shrink wasn’t the norm.
Often, college students can just sort of walk right into a cozy office and not pay a cent (until you’re paying off your debt). Or you could, if there were enough qualified therapists on your campus, which there may not be.
A 2015 industry report found that while college enrollment had increased only about 6% in the previous six years, demand for mental health services increased by 30%.
Its role as a place where young people who are still very much emotionally evolving have greater access to care options is an often-unspoken benefit of higher education. I mean, anyone who’s ever attempted to get into to therapy as an adult knows that it can take a tremendous effort to even find a therapist, let alone figure out how to schedule and pay for the sessions.
Which means that the conversation around student debt must also include an understanding that enrollment in college is a critical way to increase access to mental healthcare. If the cost of education over time - because it’s the interest that kills you - continues to be a barrier to college, it will also continue to create a two-tiered community wherein some people are receiving critical care and others are not.
Increasing inequity in mental health
In a perfect world, anyone who wanted mental healthcare could both get it and afford it. But of course, that’s now our world - as the cost of education goes up and the professional support for mental health withers, it’s getting harder and harder to even get into a therapist’s office.
Companies like BetterHelp are cleaning up as a result - which a lot of therapists say is decidedly not a good thing.
College, then, presents a unique path toward mental healthcare. Often, therapists are right there on campus, so students can schedule around classes and work. These professionals are used to dealing with college students, making it easier for patients to slip right in and start working out their problems. Plus, when mental healthcare is combined with the cost of an education, there’s no monthly sticker shock like there might be for those paying for therapy out of pocket or even with insurance.
The importance of college mental healthcare was evident during the height of the COVID-19 pandemic, where students were made to leave campus and go back to their respective hometowns. Once there, they found that therapy was a lot harder to find. One student told The Washington Post that her nearest provider while staying home during COVID was several hours away.
The absence of mental healthcare used to mean suffering in silence. Now, it’s more likely to mean a potential patient seeks advice from Dr. TikTok, self-assessing and diagnosing without the guidance of a trained professional. And it means that college students are getting one more leg up as they head into the world - they’re not only getting an education, they’re also finding tools to help them manage their emotions and have healthy relationships. By encouraging poorer students to skip college, we’re also short-changing them on emotional development if we’re not also working to make therapy more easily available.
But we can’t make therapy more available without minting more therapists. And we can’t mint more therapists if prospective therapists can’t afford to go to college.
Someone has to go to college and it can’t just be rich kids
More and more colleges are hiring more and more therapists - but from what school are these therapists graduating? The cost of becoming a licensed therapist is pretty steep; it requires a Master’s, as well as potential licensing and continued education.
The cost of college is one of the biggest hurdles for students who are considering becoming therapists. Even though there is enormous demand, the Mental Health Economy doesn’t really function like others. Most therapists aren’t going to radically increase their prices in order to subdue demand, and insurers aren’t going to agree to pay more, anyway. So unlike other businesses, which can scale when there’s that much need, mental healthcare is a specified skill set that is costly and time-intensive to meet.
Therapists can earn a decent living - somewhere in the six figures - but many don’t. Which means, unless they had a spare quarter-million lying around, they probably have debt to pay off. And if that debt is like most college debt, it will actually grow before it gets any bigger. During the time when a therapist is first getting started (i.e. not earning a lot), they are also strapped with big loan payments and a lack of institutional support.
So you really have two choices: Only students from wealthy families can become therapists (furthering the therapist shortage, especially on campus and ensuring that therapy is super-costly and hard to access) or we loan/grant people the money and financially/emotionally support them in their first few years to ensure that they don’t burn out and everyone gets a therapist.
The issue of college funding and student debt is truly a two-way street. We will all do better when higher ed and mental health are both fully and amply funded. Unfortunately, we’ll never be able to manage those lofty goals as long as we see other people as a burden.
*JK, my college got rid of football which was honestly the right call so mostly we played Ultimate.
Here’s a piece I wrote about the ways that we all pay for each other.