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GUEST SUBMISSION: Stepping into the light ⎯ a move toward wellness

Western’s Counseling and Wellness Center finds new ways to accommodate students after seeing a rise in those seeking mental health services

Western Washington University’s Counseling and Wellness Center sits on the fifth floor of Old Main. In response to a growing need for care, the Counseling and Wellness Center is seeking more effective ways to serve students. // Illustration by Milo Openshaw



Editor's note: Students interested in learning more about mental health resources can visit the Counseling and Wellness Center’s website or call the Counseling and Wellness Center at 360-650-3164 to schedule a drop-in phone consultation. After-hours crisis support is also available by calling 360-650-3164 and pressing or saying “1.” Students and community members can also access support through the National Suicide Prevention Lifeline at 800-273-8255. More resources can be found here.

Content warning: This story references suicidal thoughts, suicidal ideation and self-harm.

When fourth-year student Izzy Liska walked through the doors of Western Washington University’s counseling center for the first time, she was overwhelmed with many different feelings.

Most of all, she felt nervous.

As a first-generation college student, Liska was new to navigating Western. She’d never gone to therapy or had a conversation about mental health, and she didn’t have the money or insurance to see a counselor off-campus. As she sat down in a plastic chair in front of the counseling center and began meticulously filling out intake paperwork, she wondered if Western would even be able to help her.

“It was nerve-wracking in the beginning,” Liska said, “because I thought they were just gonna tell me I didn't have any options.”

Liska was lucky enough to find resources that met her needs. But as the number of students seeking services and reporting mental health conditions on Western’s campus surges, many more students face the question of whether they’ll get the care they need.

Last year, Western’s reported clinical load was higher than 85% of universities nationwide.

Western is now grappling to find creative ways to add counselors, support students and diversify its staff.

In September 2022, Western asked the state Legislature for emergency funding to hire an additional psychologist in response to a growing number of students seeking services.

But an increase in staff is only one part of the picture. Western is also transitioning to a new model of embedded counseling that would place counselors at different locations on campus.

Incorporating the embedded counselor model into Western’s system fits into a larger shift toward holistic wellbeing, Sislena Ledbetter, associate vice president of Counseling, Health and Wellness, said.

As a branch of a predominantly white institution, Western’s Counseling and Wellness Center also faces pressures to find culturally competent staff to serve the needs of diverse student populations with different concerns. Western and counseling center data show that students who identify as multiracial access formal counseling services at rates more than five times higher than white students.

In June 2020, Western’s Black Student Organization asked that the Counseling and Wellness Center hire two Black counselors. As of fall quarter 2022, this is yet to happen.

STUDENT NEED RISES

Nationwide, university counseling centers have experienced an increase in need since before the pandemic. The Center for Collegiate Mental Health 2021 Annual Report highlights a 20% increase in the average number of individual sessions nationwide between the 2019-20 and 2020-21 academic years.

A similar trend can be seen at Western.

Western’s Counseling and Wellness Center asked the state Legislature for emergency funding in its 2022 Supplemental Operating Budget Request in response to a 30% increase in students seeking counseling services between the 2013-14 and 2018-19 academic years. In its request, the Counseling and Wellness Center sought funding specifically to hire an additional psychologist.

Not only is the number of students seeking services at Western’s Counseling and Wellness Center increasing, so is the reported level of need.

According to the 2023-25 Budget Proposal Narrative, data from Western’s Healthy Minds Study — a survey emailed to students to collect data about students’ mental health and mental health services at Western — indicates an increase in reported student mental health symptoms from 2017 to 2020. These symptoms include anxiety, depression, eating disorders, non-suicidal self-injury and suicidal ideation.

Ledbetter said in an April 18 WWU Faculty Senate meeting that, unlike private practices, which often offer long-term counseling, Western's services have historically been capped at between three and five visits.

In a written response, Director of the Counseling and Wellness Center and Clinical Psychologist Sarah Godoy said Western cannot offer unlimited sessions to its students, but the counseling center is willing to make exceptions and work with certain students to accommodate factors like lack of health insurance.

One of the main tools used to gauge the ability of Western’s Counseling and Wellness Center to serve its students’ needs is the Clinical Load Index, or CLI, a standardized assessment developed by the Center for Collegiate Mental Health based on enrollment, student need and utilization rates.

The lower the CLI, the more care provided.

A low score might represent a counseling center providing weekly appointments to its students while a center with a high score might provide fewer appointments and result in less improvement of students’ symptoms over time, according to the Center for Collegiate Mental Health.

Western adopted the CLI model in 2019. In 2020, its score was calculated to be 182 — higher than 90% of universities nationwide, according to the 2023-25 Budget Proposal Narrative presented to the state Legislature.

Now, Western’s Counseling and Wellness Center currently scores at 133 — higher than 85% of university counseling centers nationwide, according to the same Budget Proposal Narrative.

The budget request acknowledges the decrease might be due to the fact that fewer students accessed counseling when COVID-19 prompted a shift to remote services.

The number of individual clients seeking services at Western’s Counseling and Wellness Center dropped by roughly 40% between the 2019-20 and 2020-21 academic years, according to data provided by Godoy. This aligns with the switch to remote services due to the pandemic.

During the same timeframe, however, the number of individual client sessions increased by nearly 60%, according to the same data.

“One of the big challenges during COVID-19 was: You have to be in Washington to receive counseling services from a Washington licensed clinician,” said Melynda Huskey, Western’s vice president for Enrollment and Student Services, the division that oversees the Counseling and Wellness Center. “So if folks went home to Idaho or Colorado or Oregon, our counseling center staff aren't licensed to provide services, necessarily, in those other states.”

Such was the case for Sadie Spektor, a Western student who lived at home in California during remote learning.

Others, like Liska, said they chose to stop seeking services at the Counseling and Wellness Center because they didn’t want to do virtual appointments.

Godoy said during this year of increased average individual appointments, students experienced greater symptom reduction than in previous years.

“In short, having more therapy means that there is more time for improvement,” Godoy wrote in a statement. “We hope to continue trending in this direction, but it is only possible if utilization stays low and/or if we increase our staff size.”

Godoy said she anticipates utilization to continue to rise as students return to in-person learning.

Given the limitations of staffing, Huskey said the Counseling and Wellness Center operates under a brief counseling model — that means students can usually have a few appointments with a counselor before they’re referred out to counselors in the community, most of whom require private insurance or payments.

Huskey said the Counseling and Wellness Center also provides group therapy sessions to try to manage student needs without overloading staff.

Liska said when she first reached out to the Counseling and Wellness Center in 2018, she got the impression that it mostly acted as a referral service. As a low-income student without insurance, however, she explained that seeing a counselor off-campus wasn’t an option for her.

Liska instead started going to a weekly therapy group focused on grief. A week or two later, she received a call that a graduate student working at the Counseling and Wellness Center had room in their schedule for her.

“It really wasn't a long-term solution, unless you worked with one of their grad students,” Liska said. “And I couldn't afford to do counseling off-campus, so I signed up to do meetings.”

Liska said group and individual therapy sessions both had their benefits and that she appreciated being able to see someone consistently. She said she got the most from group therapy sessions her freshman year because it was one of the first spaces she was able to talk about her mental health in a community.

“It was a little nerve-wracking to have my first experience with counseling opening up in front of other people,” Liska said. “But it was pretty nice to have, kind of, common experience with the other people in my group.”

But going into her next year of college, Liska began to feel her needs shifting. She still continued group therapy — this time, a group focused on social anxiety — but she also found herself wanting to work with a counselor on more individualized solutions. Now that some of her basic needs, like acknowledging her mental health and sharing with other people, had been fulfilled, she was ready to dive deeper.

That year, Liska began counseling sessions with a new graduate student to work through more specific trauma, body image and self-esteem issues.

After a voluntary pause in counseling during the pandemic, Liska returned to the Counseling and Wellness Center going into the winter. At that point, she said her understanding was that the Counseling and Wellness Center was only doing one-time emergency sessions. Ultimately, she opted to find a counselor off-campus because she needed more consistency.

“I didn't want to start talking about something and kinda have to be dealing with that for a week or two weeks, or however long it took for me to get another emergency session, and then not really have a conclusion to those feelings,” Liska said. “I would just have to start all over again and re-explain myself every meeting, and that felt exhausting.”

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The door to Western Washington University’s Counseling and Wellness Center is a common sight for students seeking in-person services. Data shows that over time, the number of students with serious mental health needs at Western has increased. // Photo by Olivia Palmer



COUNSELING CENTER SEEKS RESOURCES

In general, a reduction in CLI score might come about if a university or college counseling center imposes a limit on the number of sessions a student is allowed. The best way to decrease CLI, however, is by hiring more staff, said Marcus Hotaling, president of the Association for University and College Counseling Center Directors (AUCCCD).

In theory, a greater number of full-time equivalent (FTE) staff available to see clients can provide more appointments and better meet student needs. One FTE can be made up of a single full-time staff member or multiple part-time staff members.

According to data from Godoy, the Counseling and Wellness Center currently has six psychologists, four mental health counselors, one marriage and family therapist, four doctoral interns, two temporary therapists and a clinical social worker.

The FTE of these clinical staff members adds up to 16.917 for Western’s student body population of roughly 16,000 students. This FTE-to-student ratio falls within the recommendation of the International Accreditation of Counseling Services, which is one FTE staff member to every 1,000-1,500 students.

However, Godoy said Western’s Counseling and Wellness Center has shifted to using the CLI as its primary standard for assessing the counseling center.

In its 2022 Supplemental Operating Budget Request, Western requested funding to hire a 0.90 FTE psychologist for a recurring annual total of $104,280.

While hiring more staff can be an important factor in decreasing CLI, Hotaling said it’s only part of the solution.

The Counseling and Wellness Center’s 2021-22 budget included over $1.1 million in state funds and over $659,000 in self-sustaining funds. Self-sustaining funds are those that come from student tuition and fee payments.

The Counseling and Wellness Center receives about a quarter of Western’s Health Services Fees, according to data provided by Elizabeth Linke, administrative assistant for Counseling, Health and Wellness.

The quarterly payment for the Health Services Fee is currently $117. When adjusted for inflation, this fee has remained relatively consistent over the past five years.

For the 2021-22 fiscal year, about 33.5% of the counseling center’s budget — not including Prevention and Wellness — comes from the Health Services Fee revenue while the remainder of the budget comes from the state, according to the same data provided by Linke.

Over the past five years, the ratio of state to self-sustaining funds has remained consistent, although Health Services Fees contributed to a slightly higher proportion of the counseling center’s budget in the 2016-17 academic year.

“I don't think we can hire our way, realistically, out of this problem,” Hotaling said. “Could we, if we had unlimited funds? Absolutely.”

STUDENTS CALL FOR DIVERSIFIED STAFF

Alone in Wisconsin, Jaiya Peaks could not leave the confinement of her room. Depression and suicidal ideations infiltrated her life once again — the night before, she had gone to a rock wall and tried to throw herself off of it.

She knew leaving this space would lead to self-harm.

“If the entirety of the world was going to treat me this way, then I don’t see any point in living,” Peaks said, recalling experiences with racism that had driven her to an all-time low. “But, I made it.”

Peaks, a paraeducator and therapist who graduated from Western in 2021, identifies as a neurodivergent Black woman living with depression. She said over time, her racial identity has become more interconnected with her mental health conditions.

At Western, Peaks met with a therapist at the Counseling and Wellness Center. During a 14-week-long required internship in Wisconsin, however, these sessions were put on pause due to laws prohibiting counselors from practicing across state lines.

While away, Peaks was able to find a new therapist in Wisconsin. But during the internship, she said she quickly began to experience racial discrimination from her internship staff, which contributed immensely to her depression.

“Hearing the same message over and over and watching your oppressor be rewarded makes you start to gaslight yourself — so I stayed in my room thinking I wasn't deserving of basic care at all,” Peaks said in a follow-up written response.

After finishing her internship, Peaks returned to the university campus where she found herself back at the Counseling and Wellness Center. Her regular counselor provided helpful “stepping stones” to process the trauma gradually — still, she said it felt like her life was falling apart.

“I thought I was achieving all the things I wanted to do and now it is crumbling before my eyes. I don't know who I am,” she said. “I feel hollow. I feel empty.”

Peaks said although she appreciated her counselor and the services provided at the Counseling and Wellness Center, all of her counselors have been white women. She said she feels Western lacks diverse counselors that may be able to identify with Black students and their experiences.

Western currently has no Black-identifying clinical staff seeing patients. Counseling center staff did not respond to requests for more details about the demographics of their providers.

In June 2020, Western’s Black Student Organization published a list of demands to Western’s administration. This list included a demand for Western to hire two Black counselors.

According to the written demand, “Too often, sole Black counselors and Black faculty are tasked with addressing all of our needs. Racism is too consuming of an issue for this burden to fall on just a few. We demand this nationwide search for additional counselors start immediately and that the university includes Black students as part of the hiring committee.”

This demand reflects a larger trend at Western’s counseling center — a historically more diverse group of students are using clinical services, yet no Black providers have been hired.

Godoy provided percentages of clients from different demographics engaged in formal therapy services at the counseling center, which are collected through clients’ initial intake forms. This excluded recorded drop-in sessions. 

According to this data, 72.8% of the counseling center’s clients during the 2020-21 fiscal year were white; however, Western’s student population is also primarily white. When compared with student population data, white students at Western access the Counseling and Wellness Center at a rate similar to the overall student body.

Data from intake forms, in comparison to student enrollment numbers from The Office of Institutional Effectiveness, shows that students who self-identify as multiracial or Black access services at a greater rate than the campus population overall. Although multiracial students make up just over 1% of the Western population, in spring 2021, 26% of multiracial students accessed counseling services and 6% of Black students accessed counseling services compared to 4% of all Western students.  

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This table shows the racial and ethnic breakdown of students who visited Western’s Counseling and Wellness Center during the 2021-22 academic year. Data was provided by Sarah Godoy and the Office of Institutional Effectiveness.

A limitation in these comparisons is that the data collected and shared by Godoy is via intake forms and may not account for the ways in which people self-identify. For example, a student might report being multiracial on an intake form but may also identify as Black, Asian American or Latinx. Also, the Counseling and Wellness Center, unlike the Office of Institutional Effectiveness, does not have a category for “non-resident aliens” and “unknown” groups — as worded by the Office of Institutional Effectiveness. Therefore, those numbers were excluded to avoid false comparisons.

A 2019 study on intersectionality in clinical counseling found the race and gender of a client do not affect how receptive they are to treatment but relatability between counselors and clients may make a difference.

Barry Schreier, director of the Higher Education Program in the Iowa Center for School Mental Health and one of the study’s authors, said if the client has to educate their counselor on their racial identity or endure unintentional microaggressions, the client-therapist relationship becomes less focused on the client’s needs.

“I'm coming to therapy, I'm already sort of in a one-down position, right?” Schreier said. “I want to come to counseling, and I want to be seen and heard, and I don't want to do work to bring you on board.”

Peaks said that sometimes it has been hard to be truthful and discuss feelings surrounding her race with her white counselors.

“After I finish saying everything, I immediately go ‘You don't know what I'm talking about, you don't get it.’ Like ‘Oh, I shouldn't have said that.’ ‘Oh, that sounds so rude,’” Peaks said. “Like I kind of start to check myself as opposed to just being honest with my feelings.”

She said she feels racial identity is relevant to clinical therapy.

“You can't separate yourself in therapy because it's an experience where you're being vulnerable, and you're seeking out support in your vulnerabilities,” Peaks said. “And if you can't be completely vulnerable because you know deep down that person you're talking to doesn't get it, then we're not succeeding as therapists, and that needs to be addressed.”

As someone identifying as part of the Latinx community, Liska said she has faced a similar challenge finding counselors who she feels understand her family and cultural backgrounds. The first graduate student she saw was Latinx, but beyond that, she has seen little diversity in the Counseling and Wellness Center.

“Almost every other counselor I worked with throughout my time at the counseling center was white,” Liska said. “And so while that didn't turn me away, it does feel a little frustrating at times just not to have that connection or that understanding when I talk about something that's specific to Latinx history or culture.”

In the Center for Collegiate Mental Health’s 2021 Annual Survey, over half of the providers in surveyed college and university counseling centers were white while 12% were Black or African American.

Smaller percentages were reported for the other racial and ethnic groups of providers.

Just under 8% of providers identified as Hispanic or Latino, while those identifying as American Indian or Alaskan Native and Native Hawaiian or Pacific Islander had the lowest percentages at less than 1%.

Similar trends were seen in client demographics as well.

According to the report, increased CLI has a disproportionate effect on the level of care available for individuals who struggle with self-harm, suicidal ideation and trauma, or whose race, gender identity or registered disability may require additional support.

When CLI increased, the number of individual appointments for these groups decreased, resulting in “significantly less treatment,” according to the report. As CLI rises, groups that are typically seen as high priority to institutions see a reduction in services.

Hotaling said he acknowledges that based on his appearance and race, clients may not be willing to open up and share what they are going through.

“It's white men, and historically white men, that are the problem when it comes to racism, sexism, all the ‘-isms.’ That’s something we need to recognize,” he said.

In response to efforts to find more diverse staff, Huskey said she wanted to be clear that the Counseling and Wellness Center is not hiring based on race or sexual orientation. 

“The positions that we're hiring for are for clinicians with experience, training and demonstrated skill in serving a community,” Huskey said. “That can be anyone.”

She said the Counseling and Wellness Center is looking for culturally competent counselors to provide appropriate services to the different communities on campus. This includes students who may be veterans, live with eating disorders, students of color and those who are first-generation students.

Peaks said she acknowledges that Western has a policy, informed by anti-discrimintation laws, to not hire based on race. These laws were discussed and taught in her recreational management program.

“We have a class specifically dedicated to the hiring process, and what the employment [process] looks like,” Peaks said. “There were a lot of laws, that I understand on the face of it because they're meant to fight discrimination, but at the same time I find that, in a practical sense, they tend to be used to stop diversity.” 

In an April 18 Faculty Senate meeting, Ledbetter said Western is working to make sure the Counseling and Wellness Center has a diverse mix of staff to serve student needs.

In subsequent interviews, Ledbetter said that Western has hired a Native American and Indigenous student support specialist and an LGBTQ+ student support specialist.

Although there were hopes to hire a Black counselor, the position was declined by the first candidate, Ledbetter said. The Counseling and Wellness Center is now interviewing other candidates.

Similar experiences were shared at Union College, which failed two searches for a Black, Indigenous and people of color (BIPOC)-focused position in its counseling center, Hotaling said. Part of the difficulty of hiring BIPOC counselors stems from a shortage of BIPOC clinicians, Hotaling said, noting that only 4% of clinicians nationally are Black. Data from the American Psychological Association supports this claim.

The American Psychological Association also reported in 2018 that 4% of the psychology workforce were Hispanic and 6% were Asian — making the majority of the United States’ psychologists white.

Hotaling said another challenge in the hiring process is salary competition.

“I mean, it is about supply and demand,” he said. “When you have fewer underrepresented populations that are available to be hired, they can therefore demand a higher price.”

Like Hotaling, Ledbetter said she attributes these hiring setbacks to lack of funding but also to broader affordability and diversity concerns, such as whether staff would be able to afford to live in Bellingham and whether their children would see kids who looked like them in school.

“Saying you want to attract Black and brown counselors to a space is one thing. Waiting for someone is different than being prepared for someone,” Ledbetter said during the Faculty Senate meeting. “So being prepared to receive Black and brown counselors on campus is something we are working towards.”

The counseling center also recognizes the need for cultural competency with counselors to serve the LGBTQ+ community.

Kelsey Moran, a queer-identifying staff psychologist and coordinator of LGBTQIA+ Counseling Services and Programming at College of the Holy Cross, said being in an unsupportive environment can put transgender students and trans students of color at risk and contribute to depression, suicidal thoughts and suicidal actions.

For many students at her institution, Moran said returning home during the pandemic was a reason for celebration. But at an LGBTQ+ support group, the announcement was met with tears.

“That [excitement] was the case for some of our queer students,” Moran said, “but was very much not the case for the majority of them, where school is the only place where they get to be fully out and authentically themselves and connect with community that feels affirming and supportive and being able to have certain conversations that wouldn't necessarily be tolerated at home.”

Western’s Counseling and Wellness Center has hired an LGBTQ+ supporting counselor, Ledbetter said in the interview. Before this offer, the faculty website listed one clinician actively trained in intersectionality.

Looking at who uses the Western counseling center by gender, Godoy wrote that, based on client demographics for 2020-21, those who identify as a “non-trans woman” use counseling services the most at 65.5%, followed by those who identify as a “non-trans man” at 24.1%.

Eight percent of those seeking formal therapy services at the Counseling and Wellness Center identify as nonbinary while 4.2% identify as “Genderqueer/fluid,” according to Godoy’s data relayed through email.

Demographics regarding gender identity are not similarly broken down by the Office of Institutional Effectiveness, which only provides seven race identifications and two gender categories. This leaves overall campus comparisons of those within the LGBTQ+ community and their access to services unknown.

PROVIDING A SAFE SPACE

Rainbows displayed on each wall around the room. Engagement photos of two women displayed on the computer monitor screen.

This is Moran’s way to make LGBTQ+ students feel more comfortable in her office and communicate that, regardless of the differences in their experiences, she can relate to them.

“Every single wall in my office has something rainbow on it. You can't miss it,” Moran said. “[I’m] really going out of my way to signal as much as I can that this is a space where it is OK to be yourself.”

Moran said this kind of signaling can be a critical way of connecting with clients of shared identities, but for counselors who don’t share the identities of their clients, conversations about identity are just as important.

Schreier said that to make counseling culturally appropriate, it is up to the therapist to open the gate for conversations around gender and race.

“It really becomes incumbent upon the therapist to bring those topics and sort of say there's permission and an understanding and room for that to be talked about during the course of your work,” Schreier said.

Schreier said one way he’s tried to build relationships and trust across identities is by becoming more involved in research, advocacy and events among the trans community. Schreier identifies as a cisgender male; therefore, he said he’s cautious not to mislead anyone about his own gender identity since he is not a part of the trans community. Instead, he views himself as a visitor.

“If you really want to be effective in communities, you have to be part of the community,” Schreier said.

Moran said she tends to be cautious around displays of allyship. She said it’s important to pursue allyship in an informed way rather than an aspirational way. That means not just having good intentions but putting in all the work necessary in order to know what is “genuinely helpful” and staying up to date about what it means to be an ally through training.

Moran said she feels the other key in creating a counseling center environment that meets the needs of diverse student identities is having an administration that shows a commitment to diversity through its hiring.

“That's such a powerful way to signal to students that you care enough about them to hire someone who looks like them, and who has had similar experiences in your office,” Moran said.

At the Faculty Senate meeting, Ledbetter said Western’s Counseling and Wellness Center is working hard to try to have diverse staff who can meet students’ needs. Students want to have their own identities mirrored by those who are teaching them, Ledbetter said.

“When you see yourself, you say, ‘I belong here,’” she said.

WESTERN TRANSITIONS TO THE EMBEDDED MODEL

As Western’s Counseling and Wellness Center looks to hire additional counselors, it also is reenvisioning how students will access those counselors.

At Western’s April 18 Faculty Senate meeting, Ledbetter announced that the Counseling and Wellness Center will be transitioning to an embedded counselor model — a model that designates counselors to different areas across campus with the goal of serving the specialized needs of different populations.

Ledbetter said the point of transitioning to the embedded model is to increase accessibility to counseling services by having therapists closer to students in different departments.

“We recognize that … increasing [students’] access to counseling in cultural centers, in academic spaces, in schools and colleges, is just the way of institutions now,” Ledbetter said in the April 18 meeting. “It’s just one of those things that I think is the next frontier as we think about the work that we need to do in terms of increasing access and placing [students] in a context that supports their growth and wellbeing.”

According to the AUCCCD 2020 annual report, just over 20% of all college counseling centers surveyed reported having at least one embedded counselor. Among schools of comparable size to Western, over half had some form of embedded counseling. The most commonly reported areas for embedded counselors were athletics departments, individual schools and colleges, health services and underrepresented student service offices.

Hotaling said one of the strongest benefits of the embedded model is the way in which it aids outreach by placing counselors where students exist in their day-to-day life.

“It helps in having the faculty and staff be aware of the resource [and] make the referral, but it also helps the student see like, ‘Oh, there's the counseling department right there. And I can go see them after practice, or I can go see them right here in my residence hall,’” Hotaling said.

Despite its increasing popularity, there is no one embedded model, Schreier said. Universities will often make different decisions about the cohort populations they want to serve or the methods of funding they rely on.

The University of Iowa is one university that has successfully transitioned to the embedded model.

At the University of Iowa, Schreier said, implementing an embedded model of counseling means that individual colleges and departments pay for their designated counselors. In this way, the embedded model has allowed the university to tap funding that it wouldn’t otherwise have access to from the provost side of campus.

Schreier said the embedded model has also increased accessibility.

After introducing embedded counselors in the University of Iowa’s residence halls, students who live on campus became the second-highest users of counseling services, Schreier said. Embedding a counselor into the university's school of dentistry, where students attended class from 8 a.m. to 5 p.m., five days a week, allowed them to access counseling services that they wouldn’t normally be able to outside of regular business hours.

While embedded counseling helped to bridge a gap between students and services, Schreier said it also contributed to a mindset change in embedded communities.

“Now they had mental health people raising questions and serving on local committees and hosting events,” Schreier said. “And it began to change the culture of those locations that became much more inclusive of wellbeing and mental health initiatives that were never there before.”

At Western, Ledbetter said the Counseling and Wellness Center has begun to implement the embedded model. She has already had a conversation with the head of the athletics department and the College of Business and Economics about the new model, with plans to meet another dean as well. As of fall 2022, the only department with an embedded counselor is athletics. 

When questioned about this, Scott Young, dean of Western’s College of Business and Economics, said in an email that the college requested funding for an embedded counselor in 2017. This request was not granted.

However, the College of Business and Economics did receive funding from the university for a Student Success Coordinator, who serves as an independent resource and counselor, Young said.

Ledbetter said there are two main ways of approaching an embedded model at Western. One would be to designate all of a counselor’s appointments for students in a particular college, and thus have that college pay for 100% of the counselor’s salary.

The other option would be to designate half of the counselor’s appointments for students in a college and have the college pay for 50% of the counselor’s salary.

Ledbetter said because of limitations to finances and the amount of physical space available for embedded counselors, most embedded counselors would likely operate under the 50% model.

If it weren’t possible for a college to help with funding, the Counseling and Wellness Center might also move forward with the embedded model anyway, Ledbetter said.

Despite these limitations, Ledbetter said one point of the embedded model is to increase sources of funding and space for additional counselors. If departments and colleges partnered with the Counseling and Wellness Center to share finances and office spaces for embedded counselors, it could potentially allow for more clinical staff in the main office.

“If we do this right, we will then free up resources to even have more counselors,” Ledbetter said.

The College of Humanities and Social Sciences is Western’s largest college, according to the Office of Admissions. Paqui Paredes Méndez, dean of the college, said in an email that it consists of 14 departments and two interdisciplinary programs that are housed all around campus. Given the size and unique range of focus areas within the college, she said one embedded counselor would likely not be enough.

Paredes Méndez said the College of Humanities and Social Sciences currently does not have the budget or means of funding for an embedded counselor; they would need new funding to come into the college, possibly through a budget request.

In a follow-up email, Paredes Méndez said the Council of Deans met with Ledbetter and discussed feasibility, potential uses of existing spaces and possible funding models at the beginning of the fall. The College of Humanities and Social Sciences would need to have a further conversation before moving forward with the embedded model, but Paredes Méndez is supportive of the idea.

Looking to the future, Western’s Counseling and Wellness Center already has some counselors who could be embedded in different spaces, Ledbetter said. One of Western’s counselors, who formerly did environmental work, could be an asset to students in the College of the Environment; another, an engineer-turned-counselor, could connect with engineering students; a third, who is an athlete, could potentially serve students in the athletics department.

“By having therapists who intimately know the nuanced culture of a particular academic college or university department, we create a mental health support option that is culturally sensitive,” Godoy said in her written statement. “Not only does this mean a more personalized therapy experience, but it creates easier, quicker access for faculty who need to consult about a student of concern and for students who want to stop by for a therapy session in between classes.”

While Ledbetter has expressed a commitment to transitioning to embedded counseling, that transition will take time.

In her presentation at the Faculty Senate meeting, she called upon departmental faculty to begin thinking about the role they could play in supporting students.

“Our preliminary research says that faculty members are the gatekeepers of student wellbeing,” Ledbetter told the Faculty Senate. “That means that I need your help in order to facilitate the warm handoff that usually meant sending a student across campus and making that phone call or walking that student across campus. We’re trying to facilitate a partnership that allows you to walk that student up the hall because that therapist is now situated very close by in your building.”

Students interested in learning more about mental health resources can visit the Counseling and Wellness Center’s website or call the Counseling and Wellness Center at 360-650-3164 to schedule a drop-in phone consultation. After-hours crisis support is also available by calling 360-650-3164 and pressing or saying “1.” Students and community members can also access support through the National Suicide Prevention Lifeline at 800-273-8255. More resources can be found here.


ABOUT OUR DATA ANALYSIS

For our Counseling and Wellness Center (CWC) student demographic comparisons, we used databases, surveys and recorded numbers provided by the Counseling and Wellness Center themselves. Two most notable data sets were provided by Counseling Center Director and Clinical Psychologist Sarah Godoy and student enrollment numbers collected by the Office of Institutional Effectiveness at Western Washington University.

The Office of Institutional Effectiveness collects numbers and data on students’ gender, sex and race/ethnicity through different student interactions and by admissions applications. Both students and staff are also allowed to update these categories through their Web4U portal. These numbers are then provided in a breakdown of categories by each quarter on the Office of Institutional Effectiveness' website — where they offer interactive charts where users can choose which quarter to identify and analyze.

Student demographics are collected by the Counseling and Wellness Center by initial intake forms students are required to fill out when requesting services. Due to patient privacy, these statistics are not publicly provided by the CWC unless requested.

To adjust for per capita one quarter’s worth of student enrollment numbers broken down by race/ethnicity were used in comparison to the 2020-21 fiscal year data provided by Godoy. Our process and analyses included taking the raw student demographic numbers by each race category and dividing them by the raw student demographic by enrollment provided by the Office of Institutional Effectiveness. This is how we found that 26% of multiracial students on campus access the CWC for formal therapy services.

Some limitations in these comparisons are that the data collected and shared by Godoy is via intake forms and may not account for the ways in which people self-identify. For example, a student might report being multiracial on an intake form but may also identify as being Black, Asian American, or Latinx. Also, the Office of Institutional Effectiveness data used was for one quarter, while the Counseling and Wellness Center was over the stretch of the 2020-21 fiscal year. Also worth noting was that the Office of Institutional Effectiveness had two other categories for race/ethnicity which included “unknown” and “non-resident alien” while the CWC did not. Those other two categories were not included in the data analysis to avoid false comparisons.

The Counseling and Wellness Center was given the raw excel sheet with our data claims and comparisons, noting our limitations. They did not respond.

The rest of the statistics and data used by our reporters were taken from international or nationally published surveys open for viewing to the general public. This includes data from the Association of University and College Counseling Center Directors to identify Clinical Load Index averages and data on counseling center usage and data from The Center for Collegiate Mental Health for counseling center staff and student demographics across the United States and its territories.


Olivia Palmer

Olivia Palmer (she/her) is the city news editor for The Front this quarter. She's a fourth-year environmental journalism major who loves running, playing violin and swimming in alpine lakes. She's excited to be spending her last quarter at Western back in the newsroom.

You can reach her at oliviapalmer.westernfront@gmail.com. 


Aria Nguyen

Aria Nguyen is a third-year student majoring in news and editorial journalism with a minor in sociology. Her reporting is typically centered on stakeholder and community needs. Outside of the newsroom, she likes to practice martial arts and play the sims while listening to Harry Styles. 

You can reach her at arianguyen.thefront@gmail.com

You can also find her on Instagram @_arianguyen_


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