Access. Availability. Affordability.
Those are the three keys to crafting mental health legislation, said Mack Shelley, university professor and chair of political science at Iowa State.
Democratic presidential candidate Hillary Clinton recently released a mental health plan that includes a portion specifically focused toward college campuses.
When it comes to mental health, colleges don't see a large portion of public funding, which Shelley explained is partially due to elderly mental health taking up those resources.
“The people who really count are the ones who show up on Election Day, make contributions,” Shelley said. “These people are not 20 years old.”
Young people’s inactivity in politics is one reason Shelley listed as being responsible for a lack of mental health resources available to the age group. Shelley also added that Iowa has had an opposite approach compared to Clinton’s.
“The Branstad approach has been to trim back on mental health services in particular,” Shelley said.
Gov. Terry Branstad pushed through a plan that closed two of Iowa's four mental health institutions in January. Shelley said Branstad’s recent move of privatizing Medicaid doesn’t help matters.
“Whatever [Clinton] would be able to implement — assuming she gets elected in the first place — at the national level would have to trickle down,” Shelley said.
Clinton’s plan for mental health on campus comes in three parts: provide federal support for suicide prevention, ensure minority students are receiving adequate mental health coverage and support comprehensive health centers.
Republican presidential candidate Donald Trump’s mental health plan can be seen on his website.
“We need to reform our mental health programs and institutions in this country," the plan reads. "Families, without the ability to get the information needed to help those who are ailing, are too often not given the tools to help their loved ones. There are promising reforms being developed in Congress that should receive bi-partisan support.”
“I think [suicide prevention] is something critical on every college campus,” said Mark Rowe-Barth, director of student wellness. “We have so many needs that we are trying to meet.”
Rowe-Barth said many things connect back to mental health issues, including stress, substance abuse and eating issues. He wants to continue to provide resources on the front end to reduce those issues.
“There’s a lot of prevention we would like to be able to do,” said Joyce Davidson, associate director of Student Counseling Services. “Suicide prevention is wellness.”
Part of Clinton’s plan for suicide prevention is to invest up to $50 million per year in campus suicide prevention for almost 5,000 U.S. colleges.
Whether that would be enough for universities is up in the air. If the plan can trickle down to the Iowa State campus, as Shelley discussed, it would then be heavily dependent on who is running the institution, as well as the state government.
“University budget is about $1.4 billion,” Shelley said. “Nineteen percent comes from state funding.”
Iowa State student wellness and the majority of Student Counseling Services are completely state funded, however, the Thielen Student Health Center is completely funded by the student health fee and some billing for certain services.
Davidson and Rowe-Barth agree that any time more funding is mentioned, they view it positively, no matter the candidate or political party.
“We always know that this is a presidential campaign,” Davidson said. “It all looks so promising and we love to see anything that a future president would want to make [mental health] a priority.”
Taylor Blair, freshman in pre-industrial design and Clinton campaign intern, appreciates Clinton’s action on always creating a plan for all of the issues important to her, especially mental health.
“[Suicide] is such an avoidable thing,” Blair said. “It’s not something that needs to be taboo and not talked about."
Blair is part of the LGBT community, a community that Clinton specifically sites in her campus mental health plan. The plan states that gay youth are four times more likely to attempt suicide. Both LGBT students and students of color have a disproportionate unmet mental health need on campus.
Blair, who is an expert in all things Hillary Clinton, sought the LGBT student services and met with faculty. He knows where he can go if he has a problem.
“I always find out everything about wherever place I am,” Blair said. “But I know a lot of people aren’t that way, especially with mental health problems.”
Clinton’s plan wants to work with institutions to find the most comprehensive way to provide those minorities with specialized counseling.
“We try to keep [diversity] in mind so that students of all kinds can find someone that they feel like they connect with,” said Erin Baldwin, director of the student health center.
Baldwin hopes she will be able to hire even more diverse employees soon and proposed an additional $12 to the student health fee each semester. Student Government already unanimously voted in support, but the proposal still has hoops to jump through.
Baldwin explained that the increase of the fee would go to hiring an additional psychiatrist, nurse practitioner, registered nurse and medical assistant for the student health center. Student Counseling Services also would receive three additional psychologists.
“Ballpark for all of those resources is a little bit over $800,000 a year,” Baldwin said. “That’s for salary and benefits.”
If Baldwin, Davidson and Rowe-Barth could have their dream mental health utopia, it would all be under the same roof.
“Our picture dream would be if all the health and wellness mental health services could all be together,” Baldwin said. “We would love to all be in the same space and that would help us better coordinate care for students.”
That type of comprehensive care is the final part in Clinton’s plan for mental health on campus. She wants each campus to have a Certified Community Behavioral Health Clinic (CCBHC). In order to be a certified clinic, it must provide emergency psychiatric care, treatment for mental health, substance use disorders and peer support.
Clinton’s plan requests a $5 billion investment over a span of 10 years to create the clinics in every state. Clinics also would receive reimbursements similar to federal health centers.
Clearly there are a lot of dollar signs in the plan. Kate Fitzgerald, the Clinton campaign's Midwest regional policy director, believes finding the money won’t be an issue
“As with all of our policies, we'll ensure that our mental health agenda is fully paid for and doesn't add to the national debt over the next 10 years,” Fitzgerald said. “We'll be making the wealthiest, big corporations, and Wall Street pay their fair share.”
While the Center for Collegiate Mental Health has found an increase in students seeking mental health services during the last six years, 32.9 percent of students still seriously considered suicide in 2015.
“There’s a backdrop of a world that is pretty anxious,” Davidson said. “There’s a lot to worry about in this world today.”
Throw in the increase of tuition, Rowe-Barth pointed out that it’s easy to see why students are stressed more now today than in the past. But if only one positive thing can come from Clinton’s plan, it's that people are talking about the issue of mental health, he said.
“Anything that brings up these issues is positive,” Rowe-Barth said.
Student Counseling Services is open for walk-ins Monday through Friday from 8 a.m. to 3 p.m. Any calls that come through after hours will be directed to the National Suicide Lifeline at 1-800-273-8255. Also, any calls directed to the student health center will be connected to a staff of nurses qualified to help with any mental health issues.