Over the past decade, the topic of mental health on college campuses across America has gained increasing attention and invoked interest as to what institutions of higher education should do to offset what appears to be a changing shift in mental health conditions presented by students to college counseling centers.

This exploratory study examines the challenges of providing mental health services to students on campuses across the United States and how it has evolved over the years. It looks to identify the type of providers utilized at counseling centers, the processes utilized at the centers for primary intake and the decision-making processes used as students enter the system.

Participants in this study were requested to respond to a questionnaire that included both closed and open-ended questions and designed to obtain pertinent information to determine how counseling centers were handling the shift in mental health services. After several university counselors were consulted, a questionnaire was delivered to 213 current counseling directors across the country with 80 usable responses. Herbert Simon's decision theoretical model was used to determine how the counseling process takes place at college counseling centers.

Participants in this study responded to an eight-question questionnaire, made up of four parts. The first part was to determine if the school was public or private. The second part was designed to determine the intake process and wait time at centers today. The third part was eliciting information on the use of a community provider, the level of complexity of students presenting at counseling centers today versus 10 to 15 years ago, and what barriers students are facing to receive mental health services. The fourth part of the questionnaire requested information on challenges facing counselors today and how they are working to overcome them to accommodate students as needed.

Recommendations for alternative methods of improvement include: early intervention, particularly at the onset of admission, continuum of care approach to prevent a lapse in care, increased mental health awareness campus-wide, and changes for the initial intake process of students presenting to counseling centers including a more user-friendly process with face to face interaction.