David Bush can't pinpoint the exact reason, but he's seen more students than ever before in Utah State University's counseling center asking for help.
It could be that the stigma associated with mental illness is dissipating. It could be that higher expectations have led to more stress and anxiety. Or it could even be that instant access to news is overwhelming and unsettling, said Bush, director of USU's Counseling and Psychological Services.
But whatever the reason, USU's counselors are being stretched beyond their capacity. With the equivalent of seven full-time and one part-time therapists, the average wait time for an appointment is three to four weeks and they refer about 30 percent of students to outside entities for therapy, said Tim Vitale, the school's spokesman.
It's a problem schools across the state are facing. More and more students are seeking help, but there aren't enough counselors — or hours in the day — to accommodate the need.
Utah State hopes to alleviate the problem next year by adding an additional counselor through student fee increases, but even that likely won't be enough to significantly shrink the burgeoning waitlist.
"It's clear that with the ever increasing complexity that surrounds students, the problem is not going away," Bush said.
Too little help • For the past year, Utah State students have been raising awareness about the counseling access problems.
After passing a campus resolution declaring it a "mental health crisis," they teamed with state Rep. Edward Redd, R-Logan, on a legislative resolution declaring mental health issues a public health crisis across the state. That resolution, which urges state and local entities to develop long-term solutions, was sent to Gov. Gary Herbert this week.
And now this week, a $3.50 student fee increase was approved by students so the counseling center can hire an additional therapist. The increase needs approval of the Board of Regents before going into effect.
"This goes to show how the students of USU recognize that this is a crucial and important problem that needs to be addressed," said Matthew Clewett, USU Student Association's student advocate vice president.
It's important, Clewett said, because mental health problems often are tied to poor school performance.
A 2009 study by the University of Michigan and Harvard Medical School found that mental illnesses, such as anxiety and depression, are predictors of low grades and a higher likelihood of drop out. And the American College Health Association found in 2014 that more than 50 percent of college students had experienced "overwhelming anxiety" in the past year.
But even with adding a counselor, USU still will not meet the recommended national therapist-to-student ratio.
Those recommendations state that colleges and universities should have one full-time therapist per 1,000 to 1,500 students. Given the about 16,000 students attending classes at Utah State's main campus, there should be between 11 and 16 therapists.
But USU isn't the only school in Utah that does not meet these benchmarks.
Utah Valley University only has 7 therapists for about 35,000 students, meaning there is only one counselor per 4,997 students. And the University of Utah has one therapist for every 2,617 students, though the U. is in the final stages of hiring two additional therapists.
Students at both schools can face wait times longer than a week.
Three schools in Utah — Brigham Young University, Westminster College and Southern Utah University — are on par with or better than the low end of the recommendation.
BYU has 29 therapists and four pre-doctoral interns to serve about 33,000 students — equating to a ratio of about 1 therapist to 1,000 students — and Westminster has three counselors for about 2,800 students — equating to a ratio of about 1 therapist to 930 students. Southern Utah has one therapist for every 979 students.
Counseling wait times, however, still plague students at those universities.
Carri Jenkins, BYU spokeswoman, said students can wait three to four weeks for assistance depending on the time of year. Westminster and SUU students also can wait several weeks, according to school officials.
Most schools reported daily counseling slots for students in an immediate crisis, such as suicidal thoughts, a sexual assault or a death in the family. But even those slots can fill up quickly.
So, officials at Utah schools are seeking ways to mitigate these wait times, while getting students the help they need.
Focusing on prevention • Officials at many Utah schools say they have found that not all students need one-on-one counseling to address their mental health problems, freeing up appointments for others.
Group counseling can help many, officials said, and so can the immediate crisis positions available each day.
Schools also do their best to focus on prevention. Students at the U. can access workshops through the Mindfulness Clinic, and Bush said USU tries to teach students to be emotionally self-reliant and promote physical and mental health.
"One of the messages we're trying to promote on campus is to do everything you can for yourself and problem solve yourself," Bush said. "The other message we're trying to promote is interdependence and that you cant solve it all by yourself."
Additionally, Jenkins said BYU students have access to stress management services and development classes in study skills, life planning and career selection.
But the lack of access to counseling likely will continue to be a problem everywhere, said Lauren Weitzman, director of the U.'s Counseling Center.
Weitzman doesn't believe the increase in need is simply due to growing enrollment, she said, but rather a variety of reasons that are bringing more students to the counseling center. Like USU, Weitzman said officials at the U. are trying to get more counseling services on campus. She's putting together a strategic plan that would lay out how long it would take the school to get to the recommended therapist-to-student ratio.
"Our primary mission is to support students being successful in school," Weitzman said. "For some students, their mental health issues affect their [school] performance and behaviors."