(PS5-C75) Intervention Implementation on College Campuses: Patient Needs, Available Resources, and Barriers for College Mental Health Counselors

College and university mental health counselors (CMHCs; hereafter, we will use the term college for both) face substantial student mental health needs and increasing rates of burnout (Gorman et al., 2021; Lipson et al., 2022). Such challenges make it difficult to implement evidence-based interventions (EBIs); indeed, CMHCs report barriers to implementing EBIs successfully, such as lack of time, inability to provide enough sessions, staffing challenges, and a lack of resources (Cooper, 2005; Kannan et al., 2021). EBI implementation may be most successful when there is goodness of fit between the interventions being implemented, the needs of the clients, and the resources available (i.e., patient needs and resources) (Damschroder & Lowery, 2014). Therefore, it is important to understand patient needs and resources (Safaeinili et al., 2020) and corresponding implementation barriers (Stevens et al., 2021) from a provider perspective. To better understand how these systems-level contextual factors (i.e., implementation determinants) work together, we used qualitative interviews with CMHCs at 55 colleges to characterize implementation determinants derived from the Consolidated Framework for Implementation Research (CFIR; Damschroder, 2009). Since CMHC burnout has been suggested by prior research as a major implementation challenge, we tested whether these implementation determinants were associated with CMHC burnout to inform resource allocation at the college level.

The study sample includes CMHCs (N = 29), from colleges participating in a prevention intervention trial. Participants mostly identified as female (76%) and White (79%). The majority of CMHCs ages ranged from 31 to 35 (24%) and 58% reported a Ph.D. or Psy.D as their highest degree with 6.85 years (SD = 5.83) of professional experience. CMHCs were interviewed before any intervention activities took place. Qualitative data were coded through thematic analysis with CFIR as a guiding framework (Damschroder, 2009) and then calculated into numerical values, based on the frequency endorsed, for analysis with burnout data. Qualitative analyses revealed that CMHCs primarily described their clients’ needs as related to internalizing disorders and high acuity disorders (i.e., suicidality, trauma). Many CMHCs endorsed difficulty in serving their populations due to lack of clinical specialization and inability to provide long-term services. Regarding resources, CMHCs reported receiving funding from various sources such as: from within their institution, grant funding, fundraising, and private donations. Common barriers that CMHCs endorsed were being understaffed, limited budget, patient buy-in, time, and cultural mismatch. Lastly, results found that qualitatively reported patient needs and resources (r(27) = .29, p = .12), available resources (r(27) = -.18, p = .34), and barriers (r(27) = .10, p = .62) were not associated with burnout for CMHCs. These findings contribute to the emerging literature specific to implementation conditions in college settings. They also provide an initial exploration of implementation determinants and burnout, which may influence whether college mental health counselors decide to implement EBIs (Wilkinson et al., 2017).