The COVID-19 pandemic has transformed the way that colleges address the mental health needs of their students — and at many schools, has left some students behind.

Research from the American College Health Association’s COVID-19 Survey found that 60 percent of college students report increased difficulty in accessing mental health care at college during the pandemic. The survey also found that two-thirds of students reported increased financial insecurity, which contributes to anxiety and stress.

For out-of-state Oberlin students, accessing therapy while engaged in remote learning from their home state is especially challenging. These students cannot legally schedule virtual mental-health appointments with any of Oberlin’s Counseling Center staff, which includes practitioners licensed in family therapy, counseling, psychology, and psychiatry. These Obies — many of whom may have insufficient mental health coverage or live in small towns with few practitioners — are hard-pressed to find mental health professionals in their own state.  

Further, many students may live in homes where mental health stigma abounds. Because the vast majority of students are still on one or more parent’s health insurance plans, reaching out to therapists on their own would mean acknowledging to their parents that they want to work on their mental health, which can be a challenging conversation to navigate in some homes.

The lack of access to continuous, uninterrupted therapy disrupts the continuity of mental health care that Oberlin students deserve. Many students seek out counseling for the first time while in college, and the relationship that they build with a therapist here cannot be instantly replicated with a therapist that they meet at home for the first time. While the Oberlin Counseling Center promises it will help students find therapists in their area, it downplays the unique challenges faced by college students while seeking care from home.

While mental health service websites, such as BetterHelp, can help students find therapists in their home states, these services cost hundreds of dollars that many college students simply don’t have.

Why is Therapy Across State Lines a Problem?

When I first learned that out-of-state students could not access therapy through the College, I was puzzled. Teletherapy exists to connect therapists with their clients wherever they are; so why can’t Oberlin students stuck at home schedule an appointment with Oberlin counselors?

To help answer this question, I spoke with Dr. Christine Muller-Held, an Ohio Psychology Association Member, and a staff psychologist at the U. of Cincinnati’s University Health Services Clinic.

Understanding our present reality with mental health, she explained, requires acknowledging trends in mental health prior to COVID-19. According to Dr. Muller-Held, “the general trends on college campuses completely outside the context of COVID-19 is that more and more students are coming to college with pre-existing mental health diagnoses. … Students who are surveyed once they are at college are experiencing increasing rates of depression, anxiety, suicidal ideation, suicide attempts, stress, [and] relationship concerns.”

She explained that the problem out-of-state college students have in accessing care stems from state licensure laws. These laws allow professionals to practice in a given state, and each state has complete control over the requirements it takes to gain certification in their state. State licensure laws can vary widely, and before the pandemic it just didn’t make sense for therapists to pursue certification in multiple states because they were seeing their clients in-person.

Now, during the pandemic, state licensure laws pose a huge problem. With teletherapy the new normal mode of operation, many therapists are no longer seeing clients in their offices.

The pandemic has thrown into sharp relief what should seem a reasonable assumption: a therapist certified in and working from Ohio should be able to provide services to a student in, for example, Indiana. But, in such a scenario, the law considers the therapist to be illegally practicing in Indiana because their certification only applies in Ohio.

The Legislative Picture: Missed Opportunities

Unfortunately, Ohio’s government has not passed any legislation to deal with the problem. During the start of the pandemic last year, Governor Mike DeWine instituted temporary emergency orders that relaxed licensing requirements for mental health professionals, but these orders have long since expired.

The state government has also failed to enact legislation regarding the Psychology Interjurisdictional Compact, which could help address this problem. PSYPACT acts as a central licensing board for psychologists across the country. Once a psychologist is certified in one state, they simply have to apply for PSYPACT licensing, and then they can practice in other states that also allow PSYPACT to operate. Currently, 14 states have passed PSYPACT legislation, and it’s under consideration in 15 more.

Frustratingly, PSYPACT legislation failed to pass in Ohio last year. Despite receiving almost unanimous support in both chambers, the bill never made it to the governor’s desk.

According to Dr. Brad Potts, the advocacy chair for the Ohio Psychological Association, PSYPACT didn’t pass last year because it was introduced during a lame-duck session of the Ohio Congress in December. During such periods, multiple bills are often combined to reduce the time spent voting on legislation, and PSYPACT ended up clumped together with some highly unpopular bills. Fortunately, PSYPACT legislation has been reintroduced this year with overwhelming support, but it is still not clear when it will be passed. 

Arman Luczkow and Reginald Goudeau have both written articles explaining how the status quo around mental health issues at Oberlin College is unacceptable. While I understand that the College does not have control over issues like state licensure laws, it does have the responsibility to acknowledge that students’ well-being extends far beyond their protection from COVID-19. Collecting mental health data on the student body would be a start, but, as Luczkow revealed in his piece, the administration blocked Student Senate from distributing a mental health survey in coordination with the College.

I hope this article reminds on-campus Obies of our broader Oberlin community. Until very recently, the lives of students living off campus had never really crossed my mind. Yet the challenges they face need to be heard because, as Obies, we care deeply for one another. That makes us who we are.