BY AMY DIPIERRO

EdSource

Jazmin Guajardo has seen students with the kind of anxiety that “consumes them” not only throughout their day, but outside the normal business hours of the campus mental health center.

“As a peer mentor, I have directly seen these impacts of mental health on student success,” said Guajardo, a student at CSU Channel Islands who serves on the California State University Board of Trustees, during a board meeting this week. 

Cal State leaders say those are some of the reasons they would like to expand virtual, after-hours crisis support across the university system. Officials say students attended more than 5,400 walk-in or crisis appointments during regular business hours, placed at least 3,500 after-hours crisis calls and were transported to hospitals 177 times in 2024-25. 

“Our mandate is clear. After-hours care is essential to a university’s duty of care,” said Dilcie D. Perez, a deputy vice chancellor at Cal State.

But Cal State’s proposed solution is encountering resistance from the union that represents campus counselors. Cal State officials said Wednesday that they are considering expanding their work with TimelyCare, a company that provides students with crisis support through video conferencing and telephone. The California Faculty Association, which represents campus counselors, has previously argued that the service contracts out work that could be done in-house, putting students’ mental health “in the hands of gig economy workers who have not been vetted by the CSU.”

Meanwhile, a key statistic university leaders used to bolster the case for after-hours care was cited out of context. 

A presentation to the board of trustees on Wednesday said that Cal State students reported suicidal ideation at a rate double the national average, but that claim compared data from two different surveys. When drawing data from a single survey only, 28.3% of Cal State students reported one or more thoughts of committing suicide in the past year, slightly less than the national results, 29.4%.

In a statement, Cal State said it recognizes that it should have compared campus survey results to the national figures from the same survey, the National College Health Assessment (NCHA).

“Student mental health remains of critical importance to the CSU,” the statement said. “To have double-digit percentages of suicidal ideation in the CSU is unacceptable. We need to find ways to address the mental health needs of our students.”

Comparing mixed data on student mental health

In a board presentation, university officials cited Cal State’s results from the spring 2024 National College Health Assessment (NCHA). But it compared Cal State’s results to an unrelated survey, the Healthy Minds Study. 

Researchers have documented that the studies’ results differ on suicidality. For example, the Healthy Minds estimate of past-year suicidal ideation is roughly half as high as the rate reported in the National College Health Assessment survey.

There is much evidence that college students can face serious mental health challenges that are not always addressed. 

The Healthy Minds survey, for example, finds that a lack of time and money can be common barriers to mental health care for college students. The study’s 2025 results found that 37% of students report moderate to severe depressive symptoms and 32% report moderate to severe anxiety symptoms.                                                                                                          

Cal State exploring contract for after-hours mental health care

Cal State students already have some options for mental health services. Most campus counseling centers operate on weekdays during regular business hours. Most offer a combination of in-person and tele-mental health appointments. And students on many campuses can also access after-hours help through a phone-based service called Protocall, which they can typically reach by calling the counseling center. 

Cal State is now exploring systemwide mental health crisis support from TimelyCare to fill the after-hours gap, said Perez, who on Monday will begin a new appointment at Cal State as vice chancellor of strategic enrollment management and student success. 

The company’s video and telephone crisis support services are already used by Cal Poly Humboldt and other universities. 

Carolyn O’Keefe, Cal State’s systemwide director for student wellness and basic needs, said one advantage of TimelyCare is providing “a doorway that isn’t through that more traditional doorway” to mental health support for students who may not be comfortable visiting an on-campus counseling center. “One of the reasons we like this approach is it kind of reduces some of those barriers to actually seeking support,” she said.

Concerns focus on contracting out union-represented counselor jobs

But before it moves forward with TimelyCare, Cal State officials will have to contend with questions from the California Faculty Association, which represents the university system’s mental health counselors.

The faculty association in 2022 challenged Cal Poly Humboldt’s decision to use TimelyCare, previously called TimelyMD, arguing that the university had contracted out members’ work without giving the union an opportunity to bargain. The California Faculty Association and Cal State later agreed to a settlement regarding the university system’s use of the service, according to the union. 

Loren Cannon, a philosophy lecturer at Cal Poly Humboldt who serves on the faculty association’s board of directors, said it’s not logical to conclude that the solution to students’ mental health needs is to work with TimelyCare. “You can have all the premises about why our students need psychological counseling,” Cannon said. “But then saying, ‘let’s contract that to this other company based in Texas’ — that’s a complete non sequitur.”

O’Keefe estimated that annual coverage for Cal State students through TimelyCare would cost roughly $2 million a year. Recreating the same infrastructure “would cost way more than $2 million,” she said, since Cal State would have to build a system to respond to swings in student demand, route students to an available counselor, document calls in keeping with patient privacy law and hire counselors willing to work overnight. 

Cal State has been conferring with union representatives since the fall regarding the possibility of expanding its relationship with TimelyCare, said Jason Conwell, a senior representation specialist with the California Faculty Association. 

“If they’re spending so much money on after-hours care, then our position is that they should be hiring counselors to do that and pay them in-house,” said Conwell.