Tele-Psychiatry for College Students: Challenges, Opportunities, and Lessons Learned from the Pandemic

Abstract

College students are the human capital of a nation, and their college education lays the foundation for their success as future leaders of society. However, their ability to advance is often impeded by stress. Changes in lifestyle, increased academic workload, student debt, forming interpersonal relationships, and coping with new adult responsibilities may result in clinically significant anxiety and depression that require medical attention. Left untreated, these illnesses hinder academic progress and decrease graduation rates. College students constitute a highly mobile population frequently traveling for breaks and school-related activities and, as such, at increased risk of interruption and/or discontinuation of care. The COVID-19 pandemic challenged our ability to offer consistent mental health care for students and forced us to implement public health measures that were long overdue. Temporary governmental policy changes allowing for the provision of remote care across state lines at the same reimbursement rate as in-person services were vital to student mental health recovery, retention in school, and graduation rates. The time-limited loosening of state-based medical licensure restrictions clearly demonstrated the feasibility, benefits, and dire need for widespread implementation of telehealth. These are important lessons that should inform future policies for student health. In this paper, we advocate therefore, that the temporary loosening of the licensure restrictions and equitable reimbursement rates be codified into law. The current licensing regulations have not kept pace with the lived experience of college students or modern society in general. Given more mobile lifestyles, these restrictions result in frequent inevitable transitions of care which are highly undesirable. Even if providers outside metropolitan areas were readily available,1,2 these transitions of care are fraught with considerable risk for medical error. We also advocate for a national standardization of tele-psychiatry policy and procedures, including access to electronic health care records for providers taking care of matriculated students. To date, student mental health services are a patchwork of organizational models of varying funding and efficacy.