The cost of healthcare continues to be a pressing issue for Americans across the country. Rising premiums, lack of adequate insurance, and ineffective government programs further exacerbate this problem. For college students, it can be even worse. With exorbitant tuition costs and other financial barriers to accessing care on their campuses, students may find it even more difficult to access critical services, like mental healthcare.
Mental healthcare has continued to soar in its importance with 37% of students having depression that “made it difficult to function” and 21% of students having “overwhelming anxiety” according to a 2016 American College Health Association survey. The pandemic has elevated problems with mental health, with a preliminary study finding demonstrating that 71% of students had increased anxiety or depression since the onset of the pandemic. To access treatment for mental health services, students at universities are typically assessed a health fee to cover the initial costs of getting care. These fees can vary widely at different universities, and can even act as a barrier to care.
Provided the financial burden posed by the health fee, and its similarity to an insurance premium (in that it must be paid up front to access care), I chose to conduct research on how the initial costs of healthcare can act as a hindrance to care, and also looked at how this may affect health outcomes of individuals. My two research questions were:
•Do students who attend universities with higher health fees utilize counseling and psychological services at similar levels as students attending universities with lower health fees?
- Do students who attend universities with higher health fees have higher rates of alcohol usage?
I hypothesized that:
- Students who attend universities with higher health fees will utilize counseling and psychological services less.
- Students who attend universities with higher health fees will have higher rates of alcohol usage.
To study this, I conducted a survey of 274 students attending 13 of the 14 universities in the Big Ten conference (Rutgers excluded). I asked about their usage of university mental healthcare services, key demographic information, and how often they were engaging in risky behaviors such as alcohol use (which previous research indicated leads to elevated rates of morbidity and mortality). These results were compiled within Qualtrics, a survey administration system that compiles the results into easily manageable documentation. Following this, I was then able to draw comparisons between the health fee for each of the respective universities (data collected from bursar offices) and the frequency of people utilizing counseling and psychological services. I could also draw conclusions between the health fee and the frequency of people consuming alcohol.
The first conclusion that I could draw from my data was that only 5.5% of the variation in the rate of people utilizing counseling and psychological services could be attributed to the health fee. This is not very significant, and stresses that there may not be a robust correlation between the cost of the health fee and the frequency of students using these services. This may be attributed to students paying the health fee up front and not having to think about the cost of it when they go to access care. My study also didn’t take into account other costs assessed on students who choose to access care, like individual appointment costs or even copays.
There was more of a connection seen between the health fee and students who chose to consume alcohol. 9.74% of the variation in the percentage of students who never drink alcohol could be explained by the health fee. Looking at specifically students who drink alcohol 3-4 times per week, this figures rises to nearly 20% of the variation in the percentage of students who drink alcohol 3-4 times a week that can be explained via the health fee (see below).
I believe that students may be less likely to get therapy care as the cost of the health fee increases; this may lead to increased alcohol usage if students are not able to get support for mental healthcare.
With the impact of a higher health fee now understood (based on my research) to have a considerable impact on the frequency of risky behaviors, it is important for university administrations to remove this financial barrier preventing students from accessing crucial mental healthcare resources. Without doing so, they may further contribute to the prevalence of alcohol usage on campus as well as to increasing mental healthcare issues.
Leave a Reply