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The need for mental health services on campuses across the country has intensified during the pandemic. With it has come an increased awareness among college counselors and administrators about the importance of meeting the needs of every student — especially those who hold marginalized identities and may have experienced extraordinary hardship over the past two years.

While grappling with pandemic-related challenges and typical college student woes, Black students may be dealing with increased public attention on police brutality and distress in their communities, for example. Latino students may be grappling with heated debates on immigration policy that affect their loved ones, or the challenges of straddling two different cultures. LGBTQ+ students may face questions about gender, sexuality, identity and acceptance.

Kelsey Moran is a counselor and coordinator of LGBTQIA+ counseling services and programming at the College of the Holy Cross in Massachusetts. “When we’re working with them, we’re not just working with them and their anxiety,” she said of the LGBTQIA+ students she serves. “We’re working with them and their full background and identity as an understanding of self.”

Related: Students to administrators: Let’s talk about mental health on campus

Research shows mental health treatment is more effective when it’s in line with the client’s culture and when clients perceive their therapist to be culturally competent. But many colleges are still figuring out how exactly to care for students from underserved groups.

Others, like College of the Holy Cross, have been able to rely on systems they built before the pandemic to help students through a particularly difficult time.

LGBTQ+ students

Moran started as Holy Cross’s first LGBTQIA+ coordinator in 2018. Alongside a multicultural services coordinator and a coordinator who works specifically with student athletes, Moran works across campus to make sure that queer and transgender students are able to get the mental health care they need. She provides individual therapy and also runs three support groups for queer and trans students on campus. 

The resources have become even more relevant as queer and trans students suffered particular challenges during the pandemic.

Two years ago, when the coronavirus first caused the college to shut down, some students were excited to spend time at home and be reunited with family. But for many queer and trans students, particularly those whose families weren’t accepting of their gender or sexuality, “it was a terrifying shift,” Moran said.

Related: Nation’s skeletal school mental health network will be severely tested

Politics have also presented a challenge for LGBTQ+ students, they said. The wave of bills to limit the mention of LGBTQ+ topics, ban certain books and categorize gender affirming care for trans children as abuse is “targeting people’s existence and their ability to feel safe and supported,” Moran said.

Keygan Miller, advocacy manager at The Trevor Project, a nonprofit focused on suicide prevention for LGBTQ+ youth, said that a therapist doesn’t have to identify as queer or trans to help a student who does. Instead, therapists need to be well versed on what Miller called “101-level issues” in the LGBTQ community and affirm the student’s identity.

Queer and trans students may come to therapy with extra layers of concern and distrust, they said. Students may have fears that the therapist will disclose information about their identity to their family, or that they will be asked to change who they are. Trans students also often need therapists to help them access gender affirming care, like surgery and hormone replacement therapy, with letters and other documentation, Miller said.

Black students

In addition to recognizing and affirming the identities of LGBTQ+ students, counselors also need to be sensitive to students’ race, ethnicity, socioeconomic status, immigration status, religion and disability status, among other identities, therapists and administrators said. That hasn’t always been easy for college campus center staff, some 70 percent of whom are white.

Reyna Smith, a doctoral candidate at the University of the Cumberlands in Kentucky, was working in a college counseling center in 2020 when George Floyd was murdered by a former Minneapolis police officer. When she felt the center didn’t handle it appropriately for students or staff, she left her position. 

“Especially as enrollment increases, and diversity increases on campus, you need to be able to support the needs of all students.”

Reyna Smith, a doctoral candidate in psychology at the University of the Cumberlands in Kentucky

“There are students here on campus that are affected by this, are you going to do something about it?” Smith said she remembers thinking.

Now, she is studying the experiences of Black students seeking mental health care on predominantly white college campuses. 

Related: Anxiety, depression hit students in underrepresented groups   

She said that when someone is part of a minority group and feels isolated or misunderstood, it can contribute to anxiety and depression and produce other social and academic harms. And when students don’t see themselves reflected in counseling staff, they can be discouraged from seeking treatment or end treatment early if they don’t feel their therapist understands them. 

She said campus counseling centers should aim to hire more Black staff and people from other underrepresented groups. But like Miller, she believes they can improve services by training the staff they already have on the best ways to counsel people of different identity groups. 

“I think there’s a need to adjust to the population,” Smith said. “Especially as enrollment increases, and diversity increases on campus, you need to be able to support the needs of all students.”

This story about LGBTQ+ student counseling was produced by The Hechinger Report, a nonprofit, independent news organization focused on inequality and innovation in education . Sign up for the higher education newsletter.

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