Counseling Center sees policy change


   The UNI Counseling Center has altered its scheduling policy for the 2019-2020 school year.

Counseling sessions, which had previously been unlimited for students under the mandatory student health fee, are now limited to five per year. Any additional visits must now be billed to the student’s health insurance.

The reason for the change is partially based in declining enrollment, according to Shelley O’Connell, Executive Director of Health and Recreation Services.

“The mandatory student fee is a significant portion of our budget,” she said. “Less students means less fees to support services. We provide a very comprehensive program, so [we thought about] how to continue to meet the demands of student needs. Families are already paying for the [health insurance] coverage of students, instead of us raising or implementing a fee to cover a service.”

Under the Affordable Care Act and Mental Health Parity Act, all health insurance plans are mandated to cover mental health diagnoses, “just as if it were a cold or diabetes,” according to O’Connell. Every student with health insurance will have coverage for counseling visits.

For those without insurance, the cost of each fifty-minute session beyond the five included yearly visits is $199 for the first visit and $114 for each subsequent visit.

Ricki Hall, senior sociology and philosophy major and President of UNI Active Minds, believes that the five included sessions are insufficient.

“Students need counseling, and if they know they’re only going to get five, why would they go?” Hall said.

As president of Active Minds, a student organization committed to changing the conversation and breaking the stigma around mental health, Hall works with the Counseling Center through Active Minds’ adviser, Brian Nissen, who is the Suicide Prevention Educator at the Counseling Center. However, Hall said the two organizations are not affiliated, and her group had no involvement with the changes to Counseling Center services. She learned of the changes during spring 2019, along with other campus leaders in NISG and the UNI Mental Health Council.

“It was devastating, honestly,” she said. “For the students who really need it the most, five is not enough. Sometimes, students were being seen twice a week. That’s only two and a half weeks of counseling. And even then, I don’t think you could make a connection and be able to solve anything.”

Jennifer Schneiderman, Counseling Center Director, said that the five-session threshold was chosen based on Counseling Center surveys, which indicated that 64 percent of students who use Counseling Center services use five or fewer sessions per year.

“And we didn’t just pick one year,” said O’Connell. “We can go back and run reports for years, and that’s a pretty consistent statistic.”

Hall also worries about students who don’t have health insurance, as well as those that do but don’t want to involve parents or family members in their Counseling Center visits.

“If you’re in severe need of it, and you don’t feel comfortable going to your parents, your insurance is going to get billed and therefore your parents would know,” she said.

She also said that in her own experience, the deductible for a counseling session is higher than that of a regular doctor’s visit.

O’Connell and Schneiderman acknowledged these concerns and mentioned several options for students wishing to avoid billing sessions to health insurance. If initial assessments indicate that it is clinically appropriate, students may qualify for one of the Counseling Center’s six weekly therapy groups, which are included in the mandatory student fee and will never be billed to students’ insurance.

The Counseling Center has increased its group therapy offerings and now offers at least one group each weekday. Topics for the groups range from anxiety to social connection to family relationships. Every Counseling Center staff member is in a group, another change from last school year, O’Connell said. This ensures that students who previously saw a certain staff member for individual sessions can join that staff member’s group if they wish to continue working with them.

As another alternative to avoid billing sessions to health insurance, if clinically appropriate, students may see one of the Counseling Center’s interns, who are current graduate students in UNI’s counseling master’s program.

“Interns cannot bill insurance,” Schneiderman said. This means that students who have paid the mandatory health fee have access to unlimited sessions with interns.

For students without health insurance, Student Wellness Services has a case manager who can help students explore resources and enroll in an appropriate health insurance plan.

In addition to the changes in scheduling for the Counseling Center, the UNI Pharmacy, which had served students since the 1960s, permanently closed on June 20, 2019.

Hall said that this closure is detrimental to students with mental health diagnoses.

“If you are prescribed something, anything, whether that’s your birth control or anxiety medication, if you don’t have access to it, that’s going to stop you from going sometimes, especially if you don’t have a vehicle to get there,” she said. “If people aren’t getting the medication they need, their grades can suffer dramatically. It’s just added stress to an individual who’s already not in the right frame of mind.”

Although students can no longer pick up prescriptions at the Health Clinic, Schneiderman said, any professional at the Counseling Center can prescribe medication. Prescriptions are then electronially sent to a nearby pharmacy, of which there are plenty, O’Connell said.

“One factor that helped us to really cement the decision [to close the pharmacy] is that there are seven pharmacies within four miles of campus, and at least two will deliver,” O’Connell said.

Although she is disappointed, Hall said she understands the financial concerns.

“Obviously, it’s funding,” she said. “You can’t just be negative about it and not try to find a solution, so I know they’re trying to find different ways to fix things and help the situation. It’s just a hard and sad reality. That’s why we think Active Minds should be growing just to get people aware of what’s happening, because a lot of students don’t even know there’s not a pharmacy anymore. I also think it should be stated when you’re enrolling at UNI in general.”

The desire to make resources and information more accessible to UNI students is what ultimately unites Hall, O’Connell and Schneiderman. All three discussed the work that Active Minds and the Counseling Center are doing, especially in the face of these changes, to promote Student Wellness initiatives such as Mental Health Ally training and QPR (Question, Persuade, Refer) training for students to help peers who may be having suicidal thoughts.

“[We need] more education in general,” Hall said. “Sometimes it’s not as complicated as some people think it is.”

Wellness Services staff have also recently provided resources  for faculty and staff, to equip them to help students and “create a culture of care,” according to O’Connell.

She also mentioned Wellness Coaching, covered under the mandatory student fee, where students work with Wellness staff rather than therapists to address health goals.

“We’re in the process of continued evaluation of where we’re going, and we will respond appropriately,” O’Connell said. “We’re trying, and we will continue to try, because student needs are always changing.”