If there ever was a time to get up to speed on the necessities and opportunities of online counseling, this is it. Fortunately, the Higher Education Mental Health Alliance (HEMHA), an alliance of nine professional associations and organizations (including NASPA) recently published a report that takes a thorough look at the topic. College Counseling from a Distance: Deciding Whether and When to Engage in Telemental Health Services was published in 2019 and is publicly available.
The report covers benefits and risks, licensure, technology and an assortment of practical considerations. According to the Guide, its purpose is to “1) outline the potential benefits, limitations and legal and ethical concerns regarding telemental health services in the field of college student mental health; and 2) aid mental health professionals who serve college students and Higher Education administrators in engaging in dialogue about these benefits, limitations and concerns in order to make informed decisions about if, when, and to whom telemental health services should be provided.”
Two issues have surfaced as colleges and universities have tried to provide students with continued mental health services: compliance of communication technology platforms with HIPAA regulations, and state licensure requirements that prohibit practitioners from crossing state lines to provide services. Both are being addressed at the federal and state levels.
In the past, technical requirements conforming with HIPAA regulations placed significant limitations on the use of distance counseling technology for any clients, including college students. However, in the wake of COVID-19, and in response to requests from the associations that represent higher education and counseling professionals, the Department of Health and Human Services, specifically the HHS Office of Civil Rights, has issued a Notification of Enforcement Discretion for Telehealth Remote Communications During the COVID-19 Nationwide Public Health Emergency that promises “OCR will exercise its enforcement discretion and will not impose penalties for noncompliance with the regulatory requirements under the HIPAA Rules against covered health care providers in connection with the good faith provision of telehealth during the COVID-19 nationwide public health emergency.”
The state licensure issue has been taken up by the American Council on Education (ACE) with support from numerous higher education groups, including NASPA. On April 2, ACE sent a letter to all U.S. governors pleading for a temporary relaxation of licensing requirements that prohibit the treatment of clients outside the state in which a provider is licensed. The licensing requirements are an obvious obstacle to providing care with students who have dispersed to other states and countries. The letter states “In order to help strengthen our collective response, we need all governors to take immediate action in their state to temporarily suspend or modify licensing restrictions in the manner set forth below to ensure that sufficient health care and mental health services are available to meet the needs of individuals in their state. We respectfully urge that such temporary suspension or modification remain in effect for thirty (30) days after the end of the period of the declared COVID-19 public health emergency.”
As of this moment, there has been no coordinated response by the nation’s governors. It may occur on a state-by-state basis. NASPA encourages its members to stay informed of this effort through its health and counseling associations, including the American College Health Association and the Association of University and College Counseling Center Directors (AUCCCD). NASPA will provide an update here as more information becomes known. HEMHA also has a useful list of its member organizations’ own resource lists which will be worth checking on often in this constantly-changing environment.