As the UNC community grappled with mental health last semester, attention turned toward the University's Counseling and Psychological Services.
Student and community advocates called upon the University and CAPS to address student need for accessible mental health services.
“What campuses need to do is they really have to be able to adjust and move to address where the needs are now, not where they were in 2019,” Dr. Samantha Meltzer-Brody, chairperson of the psychiatry department in the School of Medicine, told The Daily Tar Heel last semester.
In late October, a petition that garnered more than 1,000 signatures called for action, including increased funding for CAPS.
“Currently, CAPS offers brief therapy sessions, but this does not seem to be enough as the latest news has shown," the petition, titled "Make UNC put more funding towards CAPS!" said. "CAPS needs to offer long term-therapy options for those who need it, and they also need to have more funding to work with so that this can be done."
While community members continue to pursue efforts to support students’ mental health, CAPS has instituted measures to address immediate need — but the push for more funding and resources is more complicated.
Breaking down CAPS funding
The University categorizes CAPS as a student service. Within the school’s budget, the operating expenses allocated to student services in the 2020 fiscal year amounted to roughly $37,208,572. CAPS accounts for around nine percent of student services expenditures, with a typical budget between $3 to 4 million per fiscal year.
The CAPS fiscal year budgets over the past three years are as follows, according to numbers provided by UNC Media Relations:
- Fiscal year 2019 budget: $3.161 million
- Fiscal year 2020 budget: $3.369 million
- Fiscal year 2021 budget: $3.543 million
Roughly 90 percent of the budget accounts for CAPS employee salaries. Salaries vary by position and can range from $50,000 to $100,000 annually.
Here are the starting yearly salaries for some of the positions within that range, according to Media Relations:
- Social workers: $57,000
- Psychologists: $65,000
- Psychiatric nurse practitioners: $100,000
Between interns, providers and support staff, the CAPS team ranges from roughly 40 to 50 members.
CAPS hired two new Asian American and Pacific Islander-identifying counselors in August. The change came after a student-led petition created in March called for more inclusive, representative mental health services for AAPI students following the Atlanta area spa shootings. Six of the eight people who were killed were Asian women.
Last semester, CAPS saw a waitlist for ongoing individual counseling for the first time in 14 years. In November, CAPS announced a partnership with teletherapy service Uwill.
“In bringing on Uwill, it was really sort of a continued response to students saying we want more access to brief therapy, and we want more extended hours,” CAPS Associate and Clinical Director Avery Cooktold the DTH.
On Wednesday, CAPS received confirmation of $81,667 in additional funding for the 2022 fiscal year and $140,000 for the 2023 fiscal year through the Campus Security Fee. According to Media Relations, this funding will support the University’s Uwill telehealth contract — an effort to address student requests for more "accessible anywhere" counseling.
The student health fee
Every UNC student is required to pay the student health fee each semester. This fee supports services from both Campus Health and CAPS, with 27 percent of the fee going to CAPS and 73 percent going to Campus Health, according to Media Relations.
During the 2021-2022 school year, each student paid $205.08 per semester in Campus Health fees, or $410.16 for the year.
Media Relations said the 27 percent of funds allocated to CAPS goes almost entirely to direct patient care. Additionally, the 73 percent of the student fee funds allocated to Campus Health helps cover administrative costs for both Campus Health and CAPS including billing, human resources and facility maintenance. The Campus Health portion also supports UNC's Student Wellness programming.
When CAPS needs additional funding through campus health, it primarily comes from the student health fee. Because of this, CAPS has the ability to submit a fee increase request to the Student Fee Advisory Subcommittee of the Tuition and Fee Advisory Task Force. The task force is typically co-chaired by the University's vice chancellor for finance and operations and the student body president.
“For context, in Fiscal Year (FY) 2022, the student campus health fee was increased by $10 per student with 100 percent of the fee increase going to CAPS,” Pittman said in an email.
Following the money
With its current budget, CAPS provides certain mental health services for students.
“CAPS provides a wide range of mental health services and resources to all students,” Media Relations said in an email. “Those services include an initial assessment, one-on-one, couples and group therapy, medication management and referral coordination.”
Up to this point, CAPS has existed as a facilitator for students in need of immediate help and a service to those looking to coordinate further care, according to the CAPS website.
At the current capacity, CAPS does not have the structure to support comprehensive mental health services for every student.
“Much like campus mental health services at other universities across the country, CAPS is intended to be a first step in the overall process of identifying the kind of help a student needs, either immediately or long term,” Media Relations said.
CAPS typically refers students in need of long-term treatment to community providers after consultation or short-term treatment on campus. CAPS referral coordinators are available at no cost to students to assist with a transition to community care.
“Referral coordinators also provide guidance and assistance with insurance and transportation,” Media Relations said. “If a student is unable to see an outside provider within a reasonable amount of time, CAPS will treat students in need until they’re able to meet with a community therapist.”
The future of CAPS
Given the current funding structure and budget allocations, CAPS operates at full capacity. Still, concerns about student need haven’t faded.
Mental health advocates across campus see a greater need for a more expansive and inclusive version of CAPS.
Student Body President Lamar Richards' administration made mental health and wellbeing a focus of its platform through the following priorities:
- "Formalizing peer support and outreach programs to address lack of trust in counseling services among underrepresented students.
- Expanding service offerings on CAPS to include more longitudinal and long-term care options, especially during the summer.
- Working to better incorporate student voices into decision-making centered around Campus Health, and eliminating economic barriers for students seeking health services.
- Educating the campus community on issues that impact mental health and emotional wellness and circulate quality information about available resources for student use, especially information targeting marginalized communities."
Despite student efforts, Pittman said the University does not plan to offer long-term therapy through CAPS.
“There is currently no plan to provide long-term therapy to students within CAPS as it is beyond the scope of mental health services typically provided by college counseling centers,” Pittman said. “Additionally, long-term therapy is better provided by therapists with more specialized expertise in the areas which necessitate longer-term care.”
However, Pittman said CAPS will continue to offer treatment to students incapable of meeting with outside providers within a reasonable time period until they are able to connect permanently with a community counselor or therapist.
The University’s challenges with student mental health and expanding support are reflected beyond campus.
“What we're seeing on campus is really a microcosm of what we see in the state and what we see nationally," Meltzer-Brody told the DTH in November. "And I think that everyone is really just getting a sense of the full impact of it.”
CORRECTION: An earlier version of this article incorrectly stated the members involved with the Tuition and Fee Advisory Taskforce. It is typically co-chaired by UNC's vice chancellor for finance and operations and the student body president.
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