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Upstate's SUNY’s Tele-Psychiatry Network is key to improving access to mental health services for students

Upstate Medical University’s SUNY Tele-Psychiatry Network (STPN) has received $1.3 million in funding from New York state as part of the state’s plan to improve mental health access for students.

The STPN started in 2018 as a way to bring much-needed mental health services to SUNY students in a timely and affordable way after mental health symptoms nearly doubled in college student populations from 2008  to 2018.

Upstate started the program after a call was put out to the four SUNY medical centers to offer these services. The program started with Christopher P. Lucas, MD, MPH, director of the network, a few residents, one part-time psychologist and a part-time nurse practitioner, funded by a small grant. From piloting the program with four campuses in its inaugural year, the network has grown to provide services to 56 of SUNY’s 64 campuses as of spring 2024.

“Many SUNY campus don’t have the psychiatric resources to handle the volume they would need,” Lucas said. “So really in many ways this is the only available solution for students at many campuses, particularly the community colleges. Before the network, students just didn’t get treatment.”
Lucas started the network in the middle of the academic year in 2018 with a $130,000 grant. This year’s funding from the state represents the most funding the program has had.

According to the Healthy Minds Study 2023, currently, 50 percent of college students meet the criteria for a current mental health problem. Yet, only about 35 percent of students with mental health concerns ever receive treatment and only 21 percent of those with needs are currently receiving care.

Lucas said the STPN eliminates many barriers to care—logistical and financial— for college students. Many students don’t have health insurance, can’t afford co-pays and don’t have transportation.

STPN primarily provides psychiatric services and medication management to students free of charge. The network may also provide diagnostic assessments,  short-term Cognitive Behavioral Therapy (CBT) and other structured psychotherapies to students. Thought it isn’t intended to provide long term care, it often does.

Since the spring of 2018, 2,085 students have been seen overall via the STPN, with around 13,430 appointments since that time. Lucas said he projects 1,000 new referrals this year, up from 660 in 2023.

The increase in students seeking care over the last several years is due to several factors, including the fact that more kids with pre-exisiting medical conditions are attending college and they feel less stigma about seeking help. Factors that have impacted young people’s mental health include the COVID pandemic, climate change, Political polarization, discrimination and racism, family breakdown and income inequality, Lucas said.

He said that the network is convenient and since it is state-funded is completely free for students. Other barriers to seeking care for students include stigma and a perception they can handle things, and don’t need mental health support.

Currently, Upstate employs six nurse practitioners, two psychologists, one PhD social worker, a case manager and two more administrative staff to handle the demand. Lucas also integrated the program with Upstate psychiatric residency, so those residents participate in care as well receiving training in CBT with live supervision.

“We are consistently hiring more people,” he said. “We see about a one to two fold increase in referrals year to year. At our busiest, we are getting 20 referrals a week.”

Students seeking help go to the counseling center on their campus and get referred to the network. They fill out an online comprehensive assessment and are then matched with a provider for secure online sessions, available after hours and on Sundays. Lucas said they can generally start seeing a patient within one to two weeks of a referral and are looking to expand evening and weekend hours by hiring more staff.

“Before the network it could take up to seven months to get a new appointment in certain places across the state, he said.

Lucas said there is a big link between untreated mental health issues in college and failure to progress academically. “In many ways we’re really improving the academic trajectories of our students, not just their mental health,” he said. “I think some providers in the general community may not be comfortable dealing with students who are somewhat of a unique population and may not coordinate care as effectively as we do in our links with college counseling centers. They may not be aware of the environment and resources available on a college campus. I think we’ve developed a real expertise in being able to meet the needs of students.”

While Lucas appreciates the generous state funding, the year to year nature of it prevents him from planning too far ahead. “This is so crucial to the success of students that we need to work out a sustainable way to run this long term,” Lucas said. “Year to year funding always gives us uncertainly and doesn’t allow us to plan.”

For more information on the network, click here.

Caption: Christopher Lucas, MD, MPH, associate professor of psychiatry and behavioral sciences, directs the SUNY Tele-Psychiatry Network.