Mixed feelings reported by students after TimelyCare’s first active year

from TIMELY CARE, page 1 specific provider she sees each time. It’s not something she uses every day, Guin said, but it’s nice to just have the option when she needs it. She’s been to JMU’s Counseling Center before and said she thinks the Center is working to make itself more available to students. At the same time, Guin said that because the Counseling Center is busy and can only see most students for a couple of sessions, it can be stressful to go there.

Of the nearly 3,000 visits as of April 24, about 1,700 were scheduled counseling sessions, 829 were psychiatry appointments, 389 were TalkNow visits and 41 were health coaching. After each session, users are offered a chance to rate the visit and their provider, or counselor. Although less than half of visits and providers received a rating, the ratings reflect positively on the service. On a five-point scale, all visits ranked at least a 4.9 except TalkNow, which received a 4.79. Students rated providers for all types of visits at an average 4.95.

Miller said it’s “interesting” that the ratings are that high, but he doesn’t want that to lead to complacency on JMU’s part. He also recognized ratings don’t always show the full picture.

“What I don’t want is for us to think, ‘OK, we’re good, we don’t have any more to do,’” Miller said.

Miller said he’s heard anecdotally from some students as well — some find it difficult to keep getting appointments on TimelyCare and some prefer in-person counseling, while others have told him they like the flexibility of the virtual service.

JMU receives data from TimelyCare on the reasons students give for each visit. When making an appointment, users are asked to select from a list of issues.

“I feel like that’s a lot of pressure because as a student, you’re like, ‘OK, well, I have to get what I need out of this visit in case I can’t come back,’” Guin said, adding that a referral to outside care could be expensive and time-consuming for many students.

The ability to return has been a major benefit of the TalkNow feature, Guin said. While JMU has allotted 12 scheduled counseling sessions on TimelyCare per student per year, TalkNow is 24/7 and unlimited. Guin said this aspect of the service has been helpful.

“Especially when talking about panic attacks and stuff like that, they’re not on a scheduled day to line up [to] the Counseling Center,” Guin said. She still recommends the Center for students who want to get into regular, longer-term counseling.

Guin said she hasn’t done a scheduled counseling visit, either through JMU or TimelyCare, because she’s getting what she needs from TalkNow.

She couldn’t afford traditional therapy, and students in the counseling program are discouraged from using the JMU Counseling Center, she said — many students in the program apply to intern at the Center, and if they’ve ever been a client there, they’re taken out of the running for the job. So, she tried TimelyCare.

“I liked the process of signing up for it because it can be intimidating calling a counseling office and talking to someone you don’t know about all these things you’re going through, just for it to be, like, written down on a sticky note and passed on to the next person,” she said. While she said signing up for the service was less intimidating, she added that virtual counseling can have some limitations — it can feel impersonal, and “there’s nothing like sitting in the room with a person,” but the experience can depend on the counselor and the client. She recommended the JMU Counseling Center and the JMU Counseling and Psychological Services (CAPS) over TimelyCare but recognized that some students don’t feel comfortable or don’t have access to in-person counseling.

When making an appointment, students can scroll through a list of providers in the state and see their background and areas of expertise. Once the student got to the point of selecting a provider, she said many of the ones she was interested in had wait times of three to four months, which she said would defeat the more “streamlined”

A flexible alternative Students who spoke to The Breeze reported mixed experiences using TimelyCare.

Sophomore Emily Guin struggled a lot at the beginning of this semester. She’s a first-generation college student and very close to her family, she said, so she found it hard to acclimate when returning to campus after winter break.

Guin, a self-described “grandma” when it comes to technology, said she found it difficult to sign up for the service, as it asked about medical history, insurance providers and other information. She wasn’t registering just in case, Guin said — she was signing up because she needed help in that moment. Outside of not being “tech-savvy,” though, she said registration was fairly easy.

She said she appreciated the option of telehealth, which she found when searching for resources on the JMU Counseling Center website.

“You can also make appointments through the Counseling Center, which was a highlight because [I didn’t have to] go in person and talk to people and fill out these forms,” Guin said. “I’d rather get help through the app.”

Guin mostly uses the TalkNow feature, so she doesn’t have one

Guin gets panic attacks sometimes. She said the weekend before spring break, she was sobbing on her bathroom floor. None of her friends were around because everyone had gone home already, so, ‘Who else do you turn to in that moment?’ She logged on to TalkNow.

“It’s really comforting; in a sense, it’s more of a conversation,” Guin said. “It doesn’t feel like you’re at a doctor’s office … It feels very casual but still taking something home.”

She said the providers help talk through whatever she’s feeling in the moment and teach her some breathing and sensory techniques to help with anxiety — tools she said she hadn’t been aware of before, having never received medical counseling.

Guin has used some of the self-help videos available through TimelyCare, and she said she plans to keep using those and TalkNow for the foreseeable future.

“I hope more students become aware of it,” Guin said. “I feel like sometimes we think we’re completely alone, like going through our school stuff, but you’re not ever really alone.”

‘Wasn’t for me’

A graduate student, who requested to remain anonymous because she’s in JMU’s clinical mental health counseling program, said she wanted to try TimelyCare to help her process everything she was learning and experiencing as a therapist-in-training.

effect of TimelyCare.

After selecting a provider, who the student said she thinks was a licensed social worker instead of a counselor — which are trained similarly, but not exactly the same — she said the counseling “kind of went out the window.” The student was struggling with anxiety surrounding the work she was doing in class, and the provider suggested “surface-level” self-care techniques, like taking a walk, taking a bath or watching her favorite TV show.

“It sort of gave me the ick, the counseling ick,” she said, “because those are things that you hear, like, stereotypically self-care. But that’s not the work that you do in counseling.”

She said she’d be open to trying TimelyCare again, just with a different provider. Although she felt “invalidated” by the experience, she said she hopes other people have a better experience with it. The service can be helpful for students experiencing stress around finals, among other issues, but she said it may not be the best solution for long-term counseling.

While the student said she thinks ‘surface-level’ counseling can happen anywhere someone goes, she said she’s heard similar reports from friends who’ve tried TimelyCare.

Miller said a counselor may not always say exactly what a student wants to hear, and he hopes students in that situation would “not throw the whole thing away” and perhaps try to select a new counselor through TimelyCare.

JMU’s future with TimelyCare

With a year of telehealth under its belt, JMU is now looking at revising its contract with TimelyCare to adjust service plans as needed for next year. Miller said JMU has signed up for three years of TimelyCare. This year alone cost $435,600, a price Miller said is worth it — but he’ll be looking to alter the service plan to get as much as possible out of the partnership.

The telehealth company’s media relations manager, Mallory Olson, told The Breeze last year that around 20% of a student body typically signs up for the service in the first year — higher than the 14% at JMU in its inaugural year in the partnership. Miller said he thinks JMU’s registration rate is higher than other schools, like VCU and Virginia Tech, which also partnered with TimelyCare last year. Miller said he and his team have been trying to market the service to students all year, but he still wants more students to sign up — he’s considering requiring all incoming students to download and register for TimelyCare during orientation week. In four years, then, he said almost every JMU student will have the service.

Miller said JMU has used almost its entire psychiatry visit allotment for the year, currently set at 4% of the student body, about 880 sessions. JMU has used about 840, he said, so he’s going to look at raising that availability. He said it can be even more difficult to find psychiatry than counseling, so JMU will try to increase access to that through TimelyCare. It’ll be around $50,000 to add an extra 200 psychiatry visits to JMU’s plan, he said, but “we’re absolutely going to need that.”

He’s also looking at adjusting the number of available scheduled counseling sessions. Although the current allotment is 12 per student per year, Miller said some need to go beyond that. At the same time, he doesn’t want to pay extra for every single student to have 15 or 16 sessions. Instead of spending hundreds of thousands of dollars to increase sessions for everyone, Miller said, JMU could stick with 12 or fewer sessions per student and spend around $20,000 to get those additional sessions for the few people who require them — but it’s something he wants to investigate more before making a decision.

As for TalkNow, Miller said the 24/7 crisis support “has no t been the service I hoped it would be.” JMU kept its other mental health crisis line, ProtoCall, and Miller said the university recommends ProtoCall over TalkNow, which has only had a couple hundred uses. ProtoCall has licensed clinicians that can help “clear” a student in distress — they’ll help the student come up with a safety plan for the night, which Miller said makes him feel more comfortable than TimelyCare, which uses people who are still obtaining their license.

“TalkNow, to me, feels like a really qualified friend, whereas ProtoCall is a licensed clinician,” Miller said. “Friends are good. But it’s also the reason why we have both. I don’t actually want to get rid of either.”

While Miller said students aren’t using all the services provided by TimelyCare to their full extent, he said that if it helps even one student, he’ll keep paying for the service.

A $200,000 donation to JMU helped fund this year’s new mental health initiatives, and Miller said part of the donation will help pay for the next year of TimelyCare as well. JMU also used leftover CARES Act funding allotted during the pandemic to help pay for the service last year, and Miller said JMU hopes to receive some more state funding to help out this year. The year after that, 2024-25, is when JMU will likely have to come up with the money itself.

“It’s a university priority, so we’re finding the money,” Miller said.

Part of TimelyCare’s value, Miller said, is it’s helped decrease the JMU Counseling Center’s wait times. At its longest last year, the wait time could be two to three weeks for an appointment, Miller said. This year, the wait time hasn’t exceeded one week. And if the Counseling Center has to refer students outside the Center, there’s now a more direct and accessible option.

“I feel better because the team is not disappointing students,” Miller said.

TimelyCare has eased some of the overload on the Counseling Center, too. Last year, Miller said, “you could not keep up at all.” And while the counselors certainly aren’t bored and are still probably doing paperwork and extra responsibilities after hours and on weekends, it’s less than it was.

“They are still incredibly busy and, I would argue, overwhelmed a lot of the time. But I will tell you that it probably went from being completely and totally overwhelming to now just mostly overwhelming,” Miller said. “Maybe instead of carrying 500 pounds, they’re carrying 300 pounds. But they’re still carrying 300 pounds.”

Miller said the “release valve” for the Counseling Center, the diversity of counselors available on TimelyCare and the psychiatry service have been the biggest benefits for JMU. The challenges, he said, are that not everyone wants telehealth, but even more so that many students just don’t know TimelyCare is an option for them.

“We will continue to do everything we can to make sure everyone knows,” Miller said.

CONTACT Charlotte Matherly at mathercg@dukes.jmu.edu.