Student health centers report high demand for services

More than a year and a half after the start of the COVID-19 pandemic, with many college campuses returning to normal capacity, student health centers are feeling the pressure.

There is an increased demand for routine health services now that students are back on campus, and they are also seeking more mental health care. Health centers find it difficult to hire in a competitive labor market and staff members are overworked and tired. There is a lot of stress to go through.

“Our campus is fully in person, as many are this year, and so for many students, they have also had to delay care for health issues because so much was closed last year,” said Cheryl Hug-English, medical director of the Student Health Center at the University of Nevada at Reno. “We are catching up with a lot of health issues, both physical and mental, in addition to managing all visits for COVID issues. “

“Even if you removed COVID from the image, our number of visits would increase, but then you add COVID testing and COVID vaccination, and for our campus, that’s definitely more than double what our standard would be,” he said. said Hug-English.

Directors of student health from different campuses point to common challenges.

“The challenge facing our academic health centers is that people have gone through a really grueling 18 month period,” said Sarah Van Orman, student health officer at the University of Southern California. “Now we’re back and all the normal things we do are still here – a normal number of illnesses and injuries – but a lot of the responsibilities of COVID are still there. “

Like Hug-English, Van Orman described a “pent-up demand for services” from students who delayed care or were not on campus last year to access preventive services, with this pent-up demand coming from ” add to the ongoing needs related to COVID testing and COVID case management. Students with cold-like symptoms who may have self-treated before the pandemic are now seeking medical attention and professional testing to rule out COVID. And the number of students on campus for the first time is about double the normal number on many campuses – many sophomores studied remotely in the last academic year – forcing staff members to do so. more vaccine checks (for COVID and others) and perform more health screenings of incoming international students.

“Each of them is manageable,” said Van Orman, “but when you put it all together, coming on top of a workforce that has worked really hard for 18 months is a challenge. “

Labor shortages and high attrition of the healthcare workforce have also not helped matters.

“Another thing I hear from many colleagues is that there is a shortage of healthcare workers in their community and it is very difficult to recruit and retain healthcare workers due to demand within the local community, ”she said.

Rachel Mack, spokesperson for the American College Health Association, said members cited staff exhaustion, staff shortages and a “business as usual attitude” as their top concerns in a recent poll.

“Generally speaking, I think it’s fair to say that academic health is currently experiencing similar issues to traditional healthcare, but with different challenges,” Mack said via email. “More work, as many employees or fewer (IHEs are experiencing a significant exodus) and a large percentage of students on campus for the first time… The mental health needs, already high in this population, have increased.

“Each year that I have been in university health, it seems that each new year has increased the demand for services,” said Mr. Scott Tims, assistant vice president for student health at Tulane University in New York. -Orléans. “I think what makes this year unique in that regard is the layering of having been in a pandemic for a long time and the stress that comes with it. We’re seeing a significant mental health load, which, again, isn’t unusual, but I also think it’s a little different from the typical transition issues we see. These are people who are afraid of COVID, people who missed their first and second year of high school. “

Jake Baggott, associate vice chancellor and executive director of academic health services at the University of Wisconsin at Madison, said there was at least a 20% increase in mental health visits this fall compared to last year, building on what was already an increase of 6%. in demand for mental health services from the academic year 2019-2020 to 2020-2021.

“The needs for mental health care are enormous,” said Tara Girard, associate dean of students for recreation, wellness, and engagement at Beloit College, a small liberal arts college in Wisconsin, and principal by acting at Beloit’s Health and Wellness Center, a position she previously held for about seven and a half years. With about 900 students on the Beloit campus this year compared to about 600 last fall, she called the demand for health services in general this fall “outrageous.”

“For the most part, people stayed home when they were sick last year, and on top of that, flu season was almost non-existent,” Girard said. “On campus, we wore masks indoors and outdoors. We had fewer people on campus. Most of the students were single. Everyone was on alert for the transmission of germs. In addition, people did not seek treatment for routine things. Now everyone is back in full force seeking health care again. “

In addition to her many responsibilities, Girard, a registered nurse, sits on Beloit’s COVID task force and also helps define college-wide policies on COVID.

“Every COVID question comes to me,” she said. “It really felt like a job 7 days a week, 24 hours a day for about a year and a half.”

Kathleen Pridgen, associate director of medical services at the University of Alabama at Birmingham, said: “What made this fall really tough is it looks like everyone is ready to go back to their medical care. routine, but also when we started the semester there was a surge in a lot of parts of the country. There was therefore all the makeup care in addition to a lot of care related to COVID at the level of visits and tests. COVID hasn’t been slower than it was at times last year, but general medical affairs were busier. “

Pridgen said COVID takes a lot of bandwidth. “There are obviously sick patient issues that require immediate attention, but also on the less acute side of things, COVID creates a huge amount of questions,” she said. “It clogs the phone lines. It obstructs the [online] portals. It’s just constant “Can I go to class?” “” Do I need a test? “” Don’t I need a test? “” When should I test? “

Middle Tennessee State University experienced a peak in COVID cases this fall with more students on campus this year than last year and with little mitigation in the surrounding community, said Richard Chapman, director of student health services. The university has an indoor mask mandate, but the surrounding community does not.

“The lack of masking and social distancing in the community has resulted in our spike in cases,” Chapman said.

Middle Tennessee does not enforce COVID vaccination, but the university tracks vaccination rates.

“We have seen a steady increase in the quarantine among students to over 50% among students now and over 70% for our faculty and staff,” Chapman said. “Obviously, getting the population vaccinated is the best way out of all this. “

Lisa Schrader, director of health promotion at Middle Tennessee, said of ongoing immunization efforts: “It’s really now that you are making progress one person at a time. “

Schrader recalled last winter and spring when vaccination efforts began.

“It was our first real sense of hope that we could get out of the tunnel we lived in, so there was a lot of excitement and rejuvenation over the months,” she said. “To move quickly into the summer and fall, how the Delta variant has now caused these spikes again and how even those vaccinated are getting breakthrough infections – it’s a blow to the stomach not to have the feeling like you know when you’re going to get out of it.

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