FAYETTEVILLE -- Expansion of the campus health center at the University of Arkansas, Fayetteville comes at a time of increasing student demand for mental health services and university efforts to teach skills through academic wellness courses.
"We've always said that health and wellness is essential to any comprehensive student success program we develop. And this expansion reflects and, I think, it prioritizes that belief that we have," Chancellor Joe Steinmetz said earlier this month at the formal opening of a 20,000-square-foot addition to the school's Pat Walker Health Center.
Steinmetz noted the doubling of space for mental health services and the addition of three new academic classrooms as part of the renovation.
Mary Alice Serafini, director of the center, told the Arkansas Democrat-Gazette that the project cost about $11 million. The Pat Walker Health Center was 38,000 square feet in size before the recent expansion, said UA spokesman Zac Brown.
"We built up a reserve that we put up the first couple million dollars [for the expansion]. And now we have bonds that we're paying off for the rest of it," Serafini said.
The university in 2014 began billing students' insurance and asking for a co-pay, Serafini said.
"It's given us the opportunity to do more, to expand more, to be more influential on the campus," Serafini said.
Stephanie Hanenberg, president of the American College Health Association, said in an email that campus health centers vary in the scope of services they provide.
UA's health center includes a women's health clinic and laboratory services, in addition to primary care offices, as well as mental health and classroom areas.
"Many schools are moving to models with centers that integrate health, mental health, and wellness promotion with unique designs to access those services," Hanenberg said.
The Pat Walker Health Center opened in 2004. Walker died in 2016. She and her husband, Willard Walker, established a foundation that has donated to various health care and educational efforts in the state over the years, including the UA health center.
When the center opened, UA enrolled 17,269 students, according to university data. The university this fall enrolled 27,778 students.
Student demand for counseling and related services has outpaced gains in enrollment, said Josette Cline, director of UA's Counseling and Psychological Services.
"I think this generation is just more willing to come forward and say, 'Hey, I'm struggling with something,'" Cline said.
Mental health clinic visits at UA increased over the past four years by about 29 percent, to 8,046 visits in fiscal 2018 compared with 6,255 visits in fiscal 2015, according to data provided by the university. Over a similar, four-year time period, fall enrollment increased by about 5 percent, to 27,558 students in fall 2017 compared with 26,237 students in fall 2014.
Cline cited national data from Penn State University's Center for Collegiate Mental Health. A 2015 report found that over five years, campus counseling centers saw usage increase by an average of 30 percent to 40 percent while enrollment over that same time period increased by about 5 percent.
Space limitations made it difficult for UA to add more clinicians to meet rising demand, Cline said. The university now has 16 certified mental health clinicians, a label that encompasses counselors, social workers and psychologists, Cline said. In addition, two psychiatrists work part time, Cline said.
The International Association of Counseling Services recommends a minimum staffing ratio of about one full-time staff member to every 1,000 to 1,500 students, Cline said, though she added that most schools do not meet the recommendation.
The 2017 survey by the Association for University and College Counseling Center Directors found that, for schools the size of UA, campus mental health centers had an average ratio of one full-time counselor for every 2,210 students. The category of schools included those with populations from 25,001 to 30,000 students, and 14 centers responded to the survey.
Recent years have seen staff increases pushing against space limits at UA, Cline said.
"We just kept expanding and taking space from other units who were graciously giving it to us. But we couldn't expand the number of counselors to move closer to meeting that ratio until we had more space," Cline said. She said the plan is to add two more mental health clinicians next year, which would bring the ratio to about 1,500 students per full-time clinician.
The renovation included a customized, 650-square-foot waiting room meant to instantly provide a welcoming environment for stressed-out students, Cline said. Furniture includes tables loaded with coloring sheets and puzzles.
"My overall goal would be that as soon as you come through the door, it's a calming space," said Cline, who has led UA's counseling services for about five years.
It's a change, with the previous waiting area roughly one-third the size of the new waiting room, Cline said.
"At the top of the hour, our waiting room was so full, people were out in the hallways waiting in chairs," Cline said.
The renovation also includes a relaxation room meant for use by all students, whether they see UA counselors or not, Cline said.
Anxiety is the "number one thing that our students report to us," Cline said, noting pressures that come from not only classes but worries about paying for college.
Funding for the 400-square-foot room, which features special lighting, calming music and massage chairs, came from a donation by the family of Lane Marrs, a UA student who died by suicide in 2016. Half of the family's $20,000 gift went toward the room, with the other half going to suicide prevention efforts, Brown said.
Serafini said medical services, too, have seen increased demand. The renovation involved greater space for labs and the center's primary care clinic, she said.
She said the center now has more space for the university's wellness staff, in addition to classrooms where students can take courses of credit on topics such as assertiveness training, masculinity, and resilience and thriving.
The university also operates a separate Wellness Center location that hosts some classes, including yoga courses.
"We're transitioning from topic-based wellness to developing all sorts of skills, in terms of resilience and thriving, and how do you cope, how do you make decisions," Serafini said. "We're really coming after things like substance abuse that we see on our campus."
A total of 104 academic health-and-wellness promotion classes were held in November, according to data provided by the university, with those classes having a total attendance of 1,747 students.
"It's much more focused on what are the skills that our students need," Serafini said.
The renovation's focus on adding classroom space sets apart the Pat Walker Health Center from similar centers at other large campuses, Serafini said.
"I certainly do not know of any other health center that has three classrooms," Serafini said.
UA students continue to pay a health fee, set at $7.25 per semester credit hour. The fee covers some health and wellness services, including most group counseling sessions, according to information on the university's website.
Students make use of parents' insurance plans, though high deductibles of $5,000 or $10,000 are "a hardship," Serafini said, adding that UA encourages families to opt for student health insurance plans that offer lower deductibles.
But for the center, the switch to billing insurance was key to expansion, Serafini said.
"We've been able to be financially be able to put a plan together to expand and to be able to pay it off as we go," Serafini said.
Metro on 12/26/2018