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Friday, June 6, 2025

Medicaid Cuts Threaten Medical and Mental Health Providers Dependent on Medicaid — and Graduates of Online “Robocolleges”

As states grapple with budget shortfalls and federal funding shifts, Medicaid—the nation’s largest public health insurance program—faces potential cuts that could severely impact medical and mental health providers who depend heavily on Medicaid reimbursements. This looming threat not only jeopardizes access to critical healthcare services but also risks destabilizing the very providers that serve some of the most vulnerable populations in the United States.

Medicaid: A Lifeline for Providers and Patients

Medicaid covers over 80 million Americans, including low-income families, people with disabilities, and seniors. For many medical and mental health providers, Medicaid reimbursements constitute a significant portion of their revenue. Clinics in underserved areas, community health centers, and behavioral health providers often rely on Medicaid funding to stay afloat.

The federal-state partnership funds Medicaid, but states have discretion in determining eligibility and reimbursement rates. When states face fiscal pressures, cutting Medicaid funding or tightening reimbursement rates is often considered a quick fix.

The Domino Effect of Medicaid Cuts

Cuts to Medicaid funding translate directly into lower payments to providers. Unlike private insurance, Medicaid rates are often already low. Further reductions can mean providers lose money on each Medicaid patient treated.

This financial strain can force clinics and mental health programs to:

Reduce services or limit patient intake
Cut staff, including essential behavioral health professionals
Close locations, especially in rural or underserved areas

These outcomes create barriers for patients who already face challenges accessing care. Individuals with serious mental illness, chronic conditions, or disabilities are particularly at risk of losing consistent care.

Impact on Medical Education and Training

Medicaid cuts can also disrupt medical and mental health education programs affiliated with teaching hospitals and universities. These programs often serve Medicaid patients in their clinical training sites. Reduced funding means fewer training opportunities for students and residents, potentially exacerbating workforce shortages in critical health fields.

Mental Health Providers: A Vulnerable Sector

Mental health providers are especially vulnerable to Medicaid cuts. Behavioral health services are frequently underfunded compared to general medical care. Medicaid often serves as the primary payer for mental health treatment, including therapy, psychiatric care, and substance use disorder programs.

Cuts could reduce access to outpatient therapy, crisis intervention, and community-based services, worsening outcomes for people with mental health conditions. The COVID-19 pandemic underscored the urgent need for robust mental health infrastructure, and cuts threaten to reverse progress made.

Robocollege Graduates: An Overlooked Impact

Another group at risk from Medicaid cuts are recent graduates of online for-profit colleges, sometimes disparagingly called "robocolleges." These institutions often produce graduates with degrees in healthcare-related fields such as nursing, health administration, or medical assisting.

Many of these graduates rely on Medicaid-funded healthcare settings for employment. Clinics and community health centers that serve Medicaid patients are common entry points for these workers. Cuts in Medicaid funding could lead to reduced hiring or layoffs in these settings, disproportionately affecting graduates struggling to launch their careers.

Moreover, the limited job security and lower wages typical of such entry-level positions compound the economic challenges for these workers, many of whom already face significant student debt and limited career mobility.

Broader Social and Economic Consequences

Limiting access to healthcare and mental health services has far-reaching consequences beyond individual health. Untreated illness can lead to increased hospitalizations, emergency room visits, and interactions with the criminal justice system. These outcomes are far more costly to society than preventative or ongoing care.

Policy Recommendations

To protect the health and stability of vulnerable populations, the providers who serve them, and entry-level healthcare workers including robocollege graduates, policymakers should:

Avoid disproportionate Medicaid cuts that undermine care quality
Invest in community health centers and behavioral health programs
Maintain adequate reimbursement rates to sustain provider networks and employment
Support integrated care models that combine physical and mental health services
Consider workforce development initiatives that support graduates entering Medicaid-funded care settings

Medicaid is a cornerstone of America’s healthcare safety net, especially for medical and mental health providers serving those in greatest need. Cuts to Medicaid funding threaten not only provider viability but the health and well-being of millions—including the newest healthcare workers striving to build careers. As budget debates continue, preserving and strengthening Medicaid funding is essential to ensuring equitable access to quality care and supporting the providers and workforce on the front lines.

Thursday, May 22, 2025

Mental Health for the Working Class: Who’s Behind the Therapy Boom?

The Affordable Care Act (ACA), commonly known as Obamacare, has significantly expanded access to mental health services in the United States, particularly for working-class individuals and families. The expansion of Medicaid and marketplace plans has made therapy and psychiatric care more accessible. However, the infrastructure supporting this mental health revolution is complex, under-resourced, and increasingly influenced by private equity. As more Americans seek care, questions arise about who is delivering that care—and whether the system prioritizes well-being or profits.

The Workforce Patchwork

The delivery of mental health services today relies on a varied network of professionals. In community clinics, federally qualified health centers, and outpatient networks, the bulk of therapeutic care comes from mid-level clinicians: Licensed Clinical Social Workers (LCSWs), Licensed Professional Counselors (LPCs), and Marriage and Family Therapists (MFTs). These are master's-level professionals who carry substantial educational and clinical training but are frequently underpaid and overworked.

Psychiatric Nurse Practitioners have also filled a critical gap, often handling medication management in lieu of psychiatrists, especially in rural and underserved areas. Meanwhile, case managers and peer support workers—some with minimal formal education—are tasked with providing wraparound services like housing support, job placement, and crisis management.

Psychiatrists and doctoral-level psychologists, though highly trained, are in short supply and are often unwilling to accept Medicaid or ACA plan reimbursements. This leaves many lower-income patients with few options for specialized care.

Enter Private Equity

In recent years, private equity (PE) firms have aggressively moved into the mental health space. Attracted by rising demand for services and relatively stable reimbursement streams from public insurance programs, PE investors have acquired numerous outpatient mental health clinics, telehealth platforms, and addiction treatment centers. Research indicates that PE firms now account for as much as a quarter of practices providing behavioral health services in some states (OHSU, 2024).

While this influx of capital has allowed for rapid expansion, it has also introduced new pressures on the workforce. To maximize returns, many PE-backed firms rely heavily on newly licensed clinicians or even graduate students under supervision. In some cases, providers are pushed into independent contractor roles to reduce labor costs and avoid benefit obligations.

Clinicians report being pressured to increase their patient loads, reduce session times, and adhere to standardized scripts or protocols designed for efficiency, not individualized care. Turnover is high, and burnout is common. A 2023 survey by the American Psychological Association found that over 60% of mental health practitioners reported experiencing symptoms of burnout (Therapy Wisdom, 2024).

The Role of Robocolleges in the Mental Health Pipeline

The rise of online, for-profit, and quasi-public "robocolleges"—such as Walden University, Purdue University Global, the University of Phoenix, Capella University, and others—has significantly shaped the labor pipeline for mental health services. These institutions mass-produce degrees in psychology, counseling, and social work, often catering to nontraditional and working adult students with limited time and financial resources.

Programs are designed for scale and efficiency, not necessarily for rigor or clinical depth. Courses are often asynchronous, adjunct-taught, and heavily standardized. Clinical placements and supervision, vital components of a therapist’s training, are sometimes outsourced or inadequately supported—leaving graduates with inconsistent real-world experience.

These institutions also disproportionately enroll students from lower-income and minority backgrounds, many of whom take on significant debt for degrees that may lead to low-paying, high-stress jobs in underfunded clinics or PE-owned mental health companies.

While robocolleges expand access to credentials, they may also contribute to a deprofessionalized, precarious workforce—one in which therapists are underprepared, underpaid, and overextended. Their graduates often fill the lower rungs of the mental health care ladder, working in environments where quality and continuity of care are compromised by systemic churn.

Quality and Equity in the Balance

The result is a mental health system that, while more accessible than in previous decades, is increasingly stratified. Working-class patients often receive care from entry-level or overburdened professionals, while wealthier clients can afford private practitioners who offer more time, continuity, and personalized care.

This imbalance is further complicated by a lack of oversight. Licensing boards and state agencies struggle to monitor the growing number of clinics and telehealth services, many of which operate across state lines or rely on algorithms to triage patients.

Meanwhile, the very people the ACA aimed to help—those juggling low-wage jobs, family stress, and systemic disadvantage—are left in a system where care may be quick, transactional, and occasionally substandard.

The Role of Traditional Higher Education

Traditional colleges and universities play a dual role: they continue to train therapists and counselors in more rigorous academic environments, but they also face growing pressure to "compete" with robocolleges in terms of cost, speed, and flexibility. At the same time, these institutions increasingly outsource student counseling services to external mental health platforms—some of them owned by private equity firms.

Thus, the cycle continues: higher education feeds the mental health system, while also adopting many of its structural compromises.

Conclusion

The expansion of mental health coverage under the ACA is a major public policy achievement. But access alone is not enough. The quality of care, the working conditions of providers, and the growing influence of profit-seeking investors and education mills all demand greater scrutiny.

For working-class Americans, mental health has become another arena where the promise of care often collides with the reality of austerity and privatization. And for those training to enter the profession, especially through robocolleges, the path forward may be just as precarious.

References:

Private Equity’s Inroads Into Mental Health Bring Concern
The State of the Behavioral Health Workforce, November 2024 – HRSA
Private Equity’s Move into Behavioral Health Care and Disparities
Therapist Burnout and Toxic Private Equity in 2025
Private Equity Is Gutting Autism Services – The Nation
OHSU Study: Private Equity Expanding into Mental Health
University of Phoenix and the Business of Selling Degrees
The Cost of a Walden Degree

Tuesday, April 15, 2025

The Tragedy of NCAA Athletes Who Died Young

[Editor's note: This article was written before the tragic death of former LSU football player Kyren Lacy, who died of an apparent suicide.]

The NCAA has long been a cornerstone of American college sports, offering a platform for student-athletes to showcase their talent while pursuing higher education. These athletes are revered for their commitment, discipline, and often exceptional abilities, balancing the pressures of academics and the demands of competitive sports. However, there exists a darker side to this world—a series of tragedies that have shattered lives and futures. The untimely deaths of NCAA athletes, often in their youth, cast a long shadow over the collegiate sports landscape and demand reflection, discussion, and action.

A Stark Reality: The Lives Cut Short

In the past decade, there have been numerous heartbreaking stories of NCAA athletes who have tragically passed away at a young age. These athletes, in the prime of their lives, were known for their fierce dedication to their sports and the promise of success that lay ahead. From football players to track stars, the common thread among these stories is the shock and disbelief that accompany such sudden losses.

The deaths of athletes like Zachary Easter, a football player at the University of Iowa, or Mitch Petrus, a former Arkansas Razorback who played in the NFL, demonstrate the vulnerability of young athletes. These athletes, often strong and healthy, were still susceptible to the dangers of both physical and emotional stress, and the grim reality is that their stories are not isolated.

The causes of these deaths vary greatly. Some, like Easter, succumb to the pressures of mental health struggles, while others, like Petrus, tragically fall victim to cardiovascular events or other undiagnosed health conditions. However, the impact on families, friends, teammates, and the entire college community remains the same: profound grief and a relentless questioning of how such a loss could occur.

The High Stakes of College Sports

One of the underlying factors contributing to these tragedies is the intense pressure faced by student-athletes. The NCAA and its member institutions hold their athletes to extraordinarily high standards, both on and off the field. The expectation is often that they must excel in their sport while maintaining their academic standing—balancing an often grueling schedule of training, games, classes, and personal life.

While these demands can shape athletes into disciplined and resilient individuals, they can also contribute to physical and mental strain. Physical exhaustion, injuries, and the demands of performance can take a severe toll on the body, sometimes in ways that are not immediately visible or diagnosable. Mental health struggles, too, are increasingly recognized as a significant challenge for student-athletes, with many feeling isolated or overwhelmed by the pressure to succeed. Tragically, this pressure sometimes leads to a point where the athlete cannot carry on.

Further complicating matters is the culture of silence surrounding mental health in sports. Athletes are often expected to "push through" pain and adversity, leading many to mask their struggles, avoid seeking help, or underreport symptoms. This cultural stigma, combined with a lack of adequate mental health support, creates a deadly cocktail for some athletes, whose needs go unnoticed until it is too late.

The Role of Colleges and the NCAA

As institutions of higher education, colleges and universities have a responsibility to care for the well-being of their students—athletes included. However, there is a growing concern that some universities and the NCAA as a whole have not done enough to address the physical and mental health challenges faced by student-athletes.

The NCAA has made some strides in recent years, implementing policies designed to improve the health and safety of athletes. From concussion protocols to mental health awareness initiatives, these measures reflect a growing acknowledgment of the risks that student-athletes face. However, critics argue that these efforts are still insufficient and that the culture of winning at all costs often takes precedence over athlete welfare. The pressure to perform continues to outpace efforts to safeguard the well-being of athletes, leaving some to wonder whether the systems in place are truly protecting those who are most at risk.

Moreover, the lack of comprehensive long-term health care, especially for former athletes who may face long-term consequences from injuries or undiagnosed conditions, further highlights the systemic shortcomings in how the NCAA handles athlete health. While some colleges have programs to support former athletes, many feel that these programs are often inadequate for the long-term needs of those who were once part of the athletic community.

Mental Health: A Critical Issue

One area that has garnered increasing attention in recent years is the mental health of student-athletes. While the physical demands of sports are often the focus of attention, the psychological toll of being a college athlete can be equally, if not more, devastating.

Studies show that student-athletes are at higher risk for anxiety, depression, and other mental health issues compared to their non-athlete peers. The pressure to perform at a high level, combined with the stress of academic work, social expectations, and sometimes traumatic injuries, can be overwhelming. Tragically, this sometimes leads to self-destructive behaviors or even suicide.

In 2020, the death of Riley O’Neill, a University of Texas swimmer, shocked the collegiate community. O’Neill, a highly talented swimmer, struggled with depression and the pressure to perform. His death highlighted a broader issue of how universities and athletic programs often fail to provide adequate mental health resources or to address the stigma surrounding mental health struggles.

The tragedy of O’Neill’s passing, like others, underscores the need for universities and the NCAA to take proactive steps to ensure that student-athletes have access to counseling and mental health services. These services must be integrated into the athletic programs in a meaningful way, removing barriers to access and ensuring that athletes feel safe and supported in seeking help.

A Call for Change

The untimely deaths of NCAA athletes serve as a painful reminder of the sacrifices these young individuals make in pursuit of excellence. Their lives, cut short too soon, represent not only personal tragedies but a systemic issue that demands attention.

To prevent further heartbreak, colleges, universities, and the NCAA must make a more concerted effort to prioritize the physical and mental well-being of student-athletes. This means improving access to mental health services, providing better protections against physical risks, and creating a culture that values health and safety over performance and achievement.

In honor of those who have passed, we must ensure that future athletes do not have to suffer in silence, that their health is protected, and that their futures remain bright, even as they face the unique pressures of being a student-athlete. It is only through such efforts that the untimely deaths of these young athletes will lead to meaningful change, sparing others from the same fate.

The tragic loss of so many young athletes calls for us to reflect on the human cost of competitive sports, pushing for a shift in how we view success—one that values life and well-being as much as it does athletic performance. The NCAA and its member institutions must rise to the occasion, ensuring that these tragedies do not continue to define the legacy of college sports.

Friday, April 25, 2025

Madness on Campus: The Unseen Struggles of College Students

College campuses are often portrayed as vibrant places of learning, personal growth, and social exploration. For many, these years are full of excitement, new experiences, and the thrill of shaping one’s future. However, beneath the surface of campus life, a darker reality lurks—a reality that is rarely discussed but increasingly hard to ignore. The mental health struggles of college students have reached a crisis point, and the pressure to succeed academically, socially, and professionally is often pushing students to their breaking point. The “madness” on campus isn’t just about late-night study sessions or the intensity of competitive sports—it’s about the unseen battles many students are facing every day.

The Pressure Cooker of College Life

For today’s college students, the pressure to succeed is more intense than ever. In addition to excelling academically, students are expected to balance internships, extracurriculars, social lives, and the looming uncertainty of their futures. The fear of not measuring up, of failing to secure a job after graduation, or of not living up to parental expectations can be overwhelming. These pressures are compounded by financial burdens, the weight of student loans, and in many cases, the struggle to make ends meet while navigating the high cost of living.

While the modern college experience has evolved to include more support systems than in past generations, the demands placed on students have also grown exponentially. Many students find themselves caught in a cycle of stress and exhaustion, trying to juggle the high expectations placed upon them. Unfortunately, these expectations can be detrimental to their mental health, leading to feelings of inadequacy, anxiety, and depression.

The Silent Epidemic: Mental Health on Campus

According to recent surveys, mental health issues among college students have skyrocketed in the past decade. Anxiety, depression, and stress are at all-time highs, with more students reporting feeling overwhelmed and mentally exhausted. A 2023 study from the American College Health Association found that 60% of students felt “overwhelming” anxiety at some point during the previous year, and 40% reported feeling so depressed that it was difficult to function. Despite this, only a small percentage of students are receiving the mental health support they need.

The stigma surrounding mental health remains one of the biggest obstacles to seeking help. Students often feel they must appear “perfect” in order to meet academic and social expectations, and admitting to mental health struggles can feel like an admission of failure. As a result, many students suffer in silence, exacerbating their problems and making it harder to find a way out.

Campus resources, while they exist, are often overwhelmed. Counselors and therapists on many campuses are stretched thin, with waitlists sometimes extending for weeks. This leaves many students without the help they so desperately need. Additionally, the counseling services offered on many campuses are often seen as temporary fixes—band-aid solutions to much deeper, systemic issues that go unaddressed.

The Tragic Consequences of Ignored Struggles

The mental health crisis among college students is not just a matter of academic performance or emotional distress—it has life-and-death consequences. A growing number of tragic stories are emerging from campuses across the nation, with young people taking their own lives in response to their struggles. Suicide is now one of the leading causes of death among college-aged individuals, with an alarming number of students feeling they have no other option.

One heartbreaking example is Riley O’Neill, a talented swimmer at the University of Texas, whose death in 2020 shocked the college community. O’Neill, who had been struggling with depression and the overwhelming pressures of college life, took his own life after feeling isolated and unable to cope with his struggles. His death, like many others, brought attention to the unseen mental health crises occurring on campuses and underscored the urgent need for better mental health resources and support systems for students.

Stories like O’Neill’s are tragic reminders of the real, human toll of mental health struggles on campus. They should serve as a wake-up call for universities to reevaluate how they support their students and to prioritize mental health just as much as academic performance or career success.

Sexual Assault on Campus: An Overlooked Crisis

Another critical issue that often goes unaddressed is sexual assault on college campuses. According to the National Sexual Violence Resource Center (NSVRC), 1 in 5 women and 1 in 16 men experience sexual assault while in college. This staggering statistic highlights the reality that sexual violence is an endemic problem on many campuses across the country. Yet, many victims of assault feel isolated, shamed, or even responsible for the violence they’ve experienced. The trauma of sexual assault can have severe, long-lasting effects on mental health, including depression, anxiety, post-traumatic stress disorder (PTSD), and suicidal thoughts.

Part of the reason sexual assault continues to be a pervasive issue on campuses is the culture of silence that surrounds it. Victims often feel afraid to come forward, either due to the fear of not being believed, the social stigma, or the complicated legal and institutional processes that often seem to favor the accused rather than the survivor. This fear can lead to underreporting, with many victims choosing to keep their trauma hidden. Additionally, some students may feel the pressure to remain silent due to concerns about their academic and social standing on campus.

It’s crucial that campuses provide safe, supportive environments for students who have experienced sexual assault. Universities must have clear policies and resources in place to support survivors—ranging from accessible counseling services to campus security that is trained to handle these cases with sensitivity and professionalism. Survivors of sexual violence deserve to feel heard, validated, and safe while navigating the aftermath of their experiences.

The Role of Alcohol and Drug Abuse in Campus Struggles

In addition to mental health challenges and sexual assault, substance abuse is another issue that is deeply intertwined with the campus experience. Alcohol and drug use are unfortunately common among college students, and for many, partying or experimenting with substances is viewed as an integral part of social life. However, for some, these substances become a coping mechanism for the stress, anxiety, and depression that they are grappling with.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that about 60% of full-time college students between the ages of 18 and 22 drink alcohol, with 40% engaging in binge drinking. Excessive alcohol consumption is often linked to risky behaviors, including unsafe sexual activity, physical injuries, and academic struggles. For students already dealing with mental health issues, alcohol can exacerbate feelings of depression and anxiety, creating a dangerous cycle of dependence and emotional turmoil.

Drugs, including prescription medication misuse, marijuana, and party drugs, are also prevalent on campuses. These substances may be used to self-medicate for anxiety or depression, or they may be part of a social trend. The consequences of substance abuse are severe, ranging from academic failure and legal issues to addiction and overdose. For students in crisis, turning to drugs and alcohol may feel like an escape, but it ultimately only deepens their problems.

Campuses need to take substance abuse seriously by offering programs that promote responsible drinking, early intervention for at-risk students, and support for those struggling with addiction. Universities must also be proactive in educating students about the dangers of alcohol and drug abuse, providing resources for students who may need help overcoming addiction, and ensuring that they have a clear path to recovery.

The Months After Graduation: A New Set of Pressures

For many students, the madness doesn’t end when they graduate. In fact, some may argue that it intensifies. The months following graduation bring a new set of challenges and anxieties. While some students quickly find jobs, others face the harsh reality of a competitive job market, uncertainty, and the pressure to establish themselves as successful adults.

Recent graduates often struggle with the transition from the structured environment of college to the ambiguity of the professional world. Many face the disappointment of job rejections or the discouragement of landing positions that don’t align with their degree or career aspirations. The search for meaningful work, combined with the financial strain of student loans, can lead to feelings of failure, depression, and isolation.

This period is especially challenging for students who may have expected to step into a job immediately after graduation or who lack a clear career path. The societal pressure to “have it all figured out” within the first few months of post-graduation life can exacerbate anxiety and self-doubt. Graduates are expected to succeed quickly, to climb the career ladder, and to live independently—yet many are struggling with the emotional fallout from the relentless pressure of college life and the overwhelming uncertainty of the future.

Moreover, the feeling of isolation can be particularly pronounced during this time. Students leave behind the community of friends and professors that supported them through college, and in the midst of job applications, networking, and interviews, they often find themselves feeling disconnected. The support systems that existed in college become harder to access, and many graduates feel like they’re navigating their post-college life alone.

A Call for Compassion and Understanding

The madness on campus isn’t just about the chaos of late-night cramming sessions or the excitement of sports games. It’s about the unseen mental health struggles that affect so many students every day. It’s about creating a system that values students as whole individuals, not just as future professionals or academic performers.

In the face of this crisis, it is imperative that colleges and universities act now. By prioritizing mental health, fostering a culture of compassion, and offering the resources and support that students need, we can ensure that the madness on campus transforms from a chaotic burden to an environment of healing, growth, and well-being. The future of higher education must be one where students are supported in every sense—academically, socially, and emotionally. Only then will we be able to protect our students from the madness that too often consumes them.

Resources for Students Struggling with Mental Health, Sexual Assault, and Substance Abuse:

If you or someone you know is struggling with any of the following issues, here are some resources to reach out to:

National Suicide Prevention Lifeline: 1-800-273-TALK (1-800-273-8255) – Available 24/7 for confidential support.
Crisis Text Line: Text HOME to 741741 – Free, 24/7 text support for those in crisis.
National Sexual Violence Resource Center (NSVRC): www.nsvrc.org – Offers resources and support for sexual assault survivors.
RAINN (Rape, Abuse & Incest National Network): 1-800-656-HOPE (4673) – National sexual assault hotline offering confidential support and resources.
Alcoholics Anonymous (AA): www.aa.org – Provides support for individuals struggling with alcohol addiction.
National Institute on Drug Abuse (NIDA): www.drugabuse.gov – Provides resources for students dealing with substance abuse issues.

These resources are here to help students navigate the challenges of mental health, sexual violence, and substance abuse during and after their college years. Don’t be afraid to ask for help—it’s a critical step in finding support and healing.

Thursday, March 13, 2025

Mental Health and Financial Barriers Threaten College Student Success (TimelyCare)

Seven in 10 students have considered taking a break or dropping out.

FORT WORTH, Texas, March 12, 2025 /PRNewswire/ -- Mental health struggles and financial pressures are jeopardizing college students' ability to complete their education, according to a new study by TimelyCare, higher education's most trusted virtual health and well-being provider,

"Many students are slipping through the cracks due to unmet financial, academic, and emotional needs."

The survey, which gathered responses from 740 students attending two- and four-year colleges across the U.S., exposes significant barriers to student success and calls for specific action by educational institutions to address pressing concerns.

Key Findings:

Students at Risk of Stopping - More than half (53%) of current college and university students said they had considered taking a break from school, and 17% considered dropping out and not returning.

Financial Strain - Nearly one-third (31%) of respondents cited financial strain as a primary reason for considering withdrawal. Additionally, a significant portion of students reported relying on a combination of financial aid, scholarships, and part-time or full-time work to cover costs.

Success Barriers - An overwhelming 95% identified at least one obstacle impacting their success. Mental health (53%) and finances (49%) were the top challenges, followed by physical health (33%), academics (28%) and social belonging (26%).

Gaps in Support Access - While 90% of students had used at least one school-provided resource such as academic advising, tutoring, or mental health counseling, issues like lack of awareness, inconvenient office hours, and inaccessible locations kept many from getting the needed help.

Success Defined
Students identified GPA, gaining knowledge, and graduating or completing their coursework as their top measures of success in line with a 2024 survey. Interestingly, non-traditional students placed graduating and gaining knowledge above GPA.

"This study makes it crystal clear that many students are slipping through the cracks due to unmet financial, academic, and emotional needs," said Nicole Guerrero Trevino, PhD, Vice President for Student Success, TimelyCare. "Our institutions must rise to the occasion to ensure no student is left behind."

What Can Be Done?
In an open-ended question, students identified several ways institutions can better support their success, including:

Promoting Awareness of Resources: Students called for more accessible and transparent communication about resources like tutoring, counseling, and career services.
"Make a comprehensive list of all resources in one place."
"Talk about these services more openly. I didn't know they existed when I needed them."

Tailoring Support for Non-Traditional and First-Generation Students: Develop targeted programs and policies, such as childcare options and evening/online classes, to support students balancing multiple roles.
"Offer different hours for people who work full time during regular work hours."

Engaging Faculty and Staff: Train educators and advisors to proactively identify struggling students and provide personalized support.
"Make it feel more normal that all students are impacted in some way and encourage all students to look into getting the help they need. It still feels almost taboo to seek out help in most situations."

Expanding Mental Health and Financial Well-Being Resources: Increase counseling availability, destigmatize mental health challenges, and offer virtual and flexible options for access. Streamline communication about scholarships, grants, and emergency funding while providing robust financial literacy resources.
"Give access to virtual services or anonymous services"

TimelyCare virtual success coaching supplements on-campus academic preparedness, career readiness, and financial wellness support with an integrated 1:1 care and coaching model.

A complete list of questions and responses from the February 2025 survey may be found here. Click here to download a related infographic.

About TimelyCare
TimelyCare is the most trusted virtual health and well-being solution for learning communities, offering personalized, clinically proven care that fosters student success and delivers life-changing outcomes. With an unmatched range of service options on one seamless, easy-to-access platform, including mental health counseling, on-demand emotional support, medical care, psychiatric care, health coaching, success coaching, basic needs assistance, faculty and staff guidance, peer support and self-guided wellness tools, we extend the efforts of 400+ campus wellness teams, ensuring millions of students have direct, anytime access to our culturally competent and diverse care providers. Recognized as a Princeton Review Top 5 Need to Know Organization for Mental Health Awareness, TimelyCare drives measurable and meaningful improvements in depression and anxiety, empowering every student on their wellness journey while strengthening learning environments.

Wednesday, September 6, 2023

Student Loans and a Brutal Lifetime of Debt (Dahn Shaulis and Glen McGhee)

The US Department of Education is holding more than 900,000 student loans that are at least 30 years old. Tens of thousands of these loans originated almost a half-century ago. And it's likely that most of the total balances are the result of interest charges that have accumulated over the decades--from people who can't ever pay back their loans.

Source: US Department of Education

Will these student loans finally be forgiven under the latest Biden forgiveness plan? Or will the US continue to honor (and bail out) the rich while punishing generations of the working class for their mistakes?

The information in this article is part of a larger effort to examine quality of life, disability, and premature death among student loan debtors. Our most recent Freedom of Information requests to the US Department of Education attempt to gather more information.

23-02758-F

The Higher Education Inquirer is asking for the age and cause of death of the last 100 student loan debtors whose debt was relieved because of death. The age and cause of death should be listed on the death certificates sent to the US Department of Education for student loan relief. (Date Range for Record Search: From 09/09/2022 To 09/09/2023)

23-02747-F

The Higher Education Inquirer is requesting the number of loans and the dollar amount of loans that have been discharged each year for the last ten years due to (1) death and (2) disability. If available, we would also like an estimate of the number of debtors affected in that decade. (Date Range for Record Search: From 09/08/2013 To 09/08/2023)

From Glen McGhee:

A study published in the Journal of American College Health[2] reveals that student loans are associated with negative health outcomes among college students, including delaying medical care. The study found that those with student loans are more likely to delay medical, dental, and mental health care[1].

Another study published in Health Soc Care Community[4] found that borrowers behind or in collections on student loans are forgoing healthcare after self-reporting general physical ill-health. The study's objective examines whether falling behind on student loans may compound ill-health by deterring people from seeking healthcare. The results of this study confirm that student loans are associated with poor health.

A survey conducted by ELVTR[5] found that 54% of respondents say their mental health struggles are directly related to their student loan debt. Additionally, over 80% of participants say student loan debt has delayed a major life event for them.

Another survey conducted by CNBC + Acorns Invest In You[6] found that more than 60% of borrowers say student loan debt has negatively affected their mental health.

Citations:
[1] https://theconversation.com/college-students-with-loans-more-likely-to-report-bad-health-and-skip-medicine-and-care-study-finds-209810
[2] https://www.psypost.org/2023/07/study-links-student-loans-to-negative-health-outcomes-and-delayed-medical-care-among-college-students-166116
[3] https://pubmed.ncbi.nlm.nih.gov/36595565/
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9542623/
[5] https://www.cnbc.com/2022/09/21/americans-mental-health-continue-to-struggle-amid-student-loan-debt.html
[6] https://www.cnbc.com/2022/01/29/student-loan-debt-hurts-the-mental-health-of-most-borrowers.html

Saturday, April 19, 2025

Why College Matters: Out of Touch with Social Class Realities

Serve Marketing's Why College Matters media campaign stacks the deck in favor of higher education and expects consumers to believe the story they tell. The problem with this campaign, and its anonymous funders, is that for many folks, college (and life after college) is problematic at best and oppressive at worst.

The Higher Education Disconnect: What Survey Results Miss About Americans' Real Concerns

The Why College Matters campaign presents data suggesting Americans' perceptions of higher education can be positively influenced through messaging. However, when compared with broader research on Americans' attitudes toward higher education, significant disconnects emerge. This analysis examines the gaps between the campaign's focus and the well-documented concerns Americans have about today's college experience.

The Financial Reality Gap: Debt and Affordability Concerns

The Why College Matters campaign notably avoids addressing one of the most pressing issues facing Americans considering higher education: the financial burden. This omission creates a fundamental disconnect with public sentiment.

Student Debt as a Life-Altering Burden

Recent research shows that 70% of middle-income Americans believe student loans are impacting their ability to achieve financial prosperity5. The psychological burden is equally significant, with 54% of student borrowers experiencing mental health challenges directly attributed to their debt load, including anxiety (56%) and depression (approximately 33%)8.

The campaign's focus on abstract benefits like "growing America's economic prosperity" fails to acknowledge that for many individuals, the immediate economic reality is far less promising. Student borrowers report delaying major life milestones including starting families, purchasing homes, and pursuing careers they're passionate about due to debt constraints8.

The Middle-Class Squeeze

While the campaign targets adults without college degrees as a key demographic, it misses that middle-class families face particularly acute challenges. These families often find themselves in a precarious position - too wealthy to qualify for significant need-based aid but not wealthy enough to comfortably afford college expenses13. This "middle-class squeeze" represents a significant disconnect between survey messaging and lived experience.

The Employment Reality Disconnect

Perhaps the most striking omission in the campaign's framing is the reality of post-graduation employment outcomes, which directly contradicts the economic benefit messaging.

Widespread Underemployment

Research from the Burning Glass Institute reveals a sobering statistic: 52% of recent four-year college graduates are underemployed a year after graduation, holding jobs that don't require a bachelor's degree14. Even more concerning, 45% still don't hold college-level jobs a decade after graduation14. This creates a fundamental disconnect when the campaign emphasizes workforce development without acknowledging this reality.

The "First Job Trap"

The survey frames higher education as broadly beneficial for workforce development but fails to address what researchers call the "first job trap." Data shows that 73% of graduates who start their careers in below-college-level jobs remain underemployed a decade after graduation14. This presents a significantly different picture than the campaign's simplified message about maintaining a skilled workforce.

Credential Inflation: The Devaluing Degree

The campaign messaging presumes that increased educational attainment inherently produces positive outcomes, without addressing the phenomenon of credential inflation that undermines this assumption.

Degrees as Diminishing Returns

Credential inflation refers to the declining value of educational credentials over time, creating a scenario where jobs that once required a high school diploma now demand bachelor's degrees, and positions that required bachelor's degrees now require master's or doctorates11. This creates a paradoxical situation where more education is simultaneously more necessary yet less valuable - a nuance entirely absent from the campaign narrative.

Opportunity Costs Unacknowledged

The campaign frames college primarily through its benefits, without acknowledging significant opportunity costs identified in research. These include delayed savings, fewer years in the workforce, postponement of family formation, and accumulation of debt11. This one-sided framing creates a disconnect with the lived experience of many Americans weighing these very real tradeoffs.

The Growing Generational Divide

The campaign's focus on adults aged 35-64 misses a critical demographic: younger generations who express the most skepticism about higher education's value.

Gen Z's Value Perception Crisis

Only 39% of Gen Z respondents in one study said advancing their education is important to them, and 46% don't believe college is worth the cost15. This represents a fundamental shift in attitude that the campaign's methodology doesn't capture, creating another disconnect between messaging and emerging social reality.

The Civic Disconnection Context

Research on youth disconnection shows broader trends of civic disengagement, with young Americans becoming less connected to community institutions generally1 9. The campaign's framing of higher education as building community connection happens against this backdrop of declining civic participation - context that provides important nuance missing from the survey design.

Mental Health Concerns: The Hidden Cost

Perhaps the most significant omission in the campaign's messaging is the documented mental health impact of the higher education experience, particularly related to financial strain.

Student Debt as Mental Health Crisis

Research demonstrates clear links between student loan debt and mental health challenges. Beyond anxiety and depression, the financial burden of education impacts overall wellbeing in ways unacknowledged by the campaign messaging8 16.

Postponed Lives and Dreams

The psychological impact of delayed life milestones due to educational debt creates stress that extends far beyond graduation. Student borrowers report putting their lives on hold - a reality that contradicts the campaign's emphasis on "keeping alive the American dream"8.

Ideological and Cultural Concerns

The campaign notably avoids addressing concerns about campus culture and ideological homogeneity that research shows are significant factors in changing attitudes toward higher education.

Faculty Ideological Imbalance

Research from Harvard University reveals striking ideological homogeneity among faculty, with 37% identifying as "very liberal" and just 1% as "conservative"12. This imbalance contributes to perceptions of higher education as disconnected from the values of many Americans - particularly explaining why the campaign struggled to persuade conservative Americans that "higher education plays a critical role in maintaining a healthy democracy."

Conclusion: Bridging the Perception Gap

The Why College Matters campaign demonstrates that positive messaging can improve abstract perceptions of higher education's value. However, for these improved perceptions to translate into meaningful change in Americans' relationship with higher education, campaigns must address the substantive concerns documented in research.

The disconnects identified here - regarding debt, employment outcomes, credential inflation, generational attitudes, mental health impacts, and ideological concerns - represent real issues that significantly impact Americans' decisions about higher education. Any campaign seeking to genuinely improve perceptions of higher education's value must engage with these realities rather than focusing solely on abstract benefits.

Simply improving "feelings" about higher education without addressing concrete problems risks further widening the gap between institutional messaging and public experience - potentially eroding rather than building trust in higher education as an institution.

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