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Tuesday, August 2, 2022
Michael Fletcher
Michael A. Fletcher, Psy.D., director of University Counseling Service

IOWA CITY, Iowa –Michael A. Fletcher, Psy.D., joined the University of Iowa staff as director of University Counseling Service (UCS) on July 11.

Fletcher joins the university after serving as lead faculty at Columbia College of Missouri, Illinois campus, since 2019. He has 14 years of higher education experience, 22 years of experience in the field of human services, and an extensive trajectory of leadership in behavioral health settings. He earned a Doctor of Psychology and Master of Arts in clinical psychology from the Illinois School of Professional Psychology at Argosy University, and a Bachelor of Arts in applied behavioral science from National Louis University.

Fletcher fills the UCS director position previously held by interim co-directors Kelly Clougher and Holly Davis. Clougher and Davis were appointed to lead UCS when Barry Schreier left the director position Feb. 11 to become the director of higher education programming for the UI’s Scanlan Center for School Mental Health and work as a clinical professor in the College of Education.

Holistic well-being and success is one of five priorities outlined in the university’s 2022-27 Strategic Plan, and before welcoming students, faculty, and staff to Iowa City for the fall 2022 semester, Fletcher shared his thoughts with the UI Division of Student Life.

Q: When you observe the university’s existing mental health programs, where do you see opportunities to further amplify and advance Iowa’s reputation as a campus that cares for every member of its community?

FLETCHER: There are several opportunities to advance the Iowa’s reputation as a campus that cares for everyone. We are constantly building and, in some cases, strengthening strategic partnerships across campus to create meaningful collaborative access. For instance, a great partnership with Student Care and Assistance offers help to students who are experiencing crisis and emergency situations—from mental health concerns to hospitalization and everything between. That might include medical emergencies or long-term illness, chronic conditions, death of a family member, natural disasters, off-campus living concerns, and unexpected events or challenges. Partnering with each other is how we help everyone succeed.

The effort put forth in reducing stigma of mental illness is certainly an opportunity to further amplify and advance Iowa’s reputation as a campus that cares for every member of its community. These efforts signify that we want people to access care. We care about people’s health, so we seek to remove any barrier to people accessing the needed services, and at the same time promote wellness. Stigma is one of the more worthy opponents in the fight to create access for all who need it.

Another opportunity that exists is for University Counseling Service (UCS) to have a greater presence on campus and reaching out to people who might be reluctant to seek help.

Q: The UI is pursuing a vision to become a first-choice destination for those seeking a place to grow, learn, contribute, and thrive. Where do you see optimism in the campus culture at Iowa and the well-being of its students, faculty, and staff?

FLETCHER: The university’s commitment to diversity, equity, and inclusion (DEI) is certainly one of the optimistic draws for students, faculty, and staff. The Division of Student Life’s DEI Action Plan outlines several robust initiatives that will bring people together, break down barriers, and in some cases provide an opportunity to move from oppression to liberation.

The other point of optimism is the plethora of resources the university offers to develop the whole person. I am not naïve to the rising costs and challenges of colleges across our nation, and our students deserve the best experience possible. Each student will have their own unique needs, and I am confident that many of their needs can be met by the resources already established through the university.

Q: What do you think is the most important service the UI provides to its talented students, faculty, and staff, and how does a campus measure the success of that service?

FLETCHER: As an academic institution, one of the goals is to provide a meaningful and highly valued education that will serve people well in the global community, allowing them to be a functional member of society. However, the university has taken that extra step in developing resources that allow students, faculty, and staff to reach their potential of growing holistically. This is the opportunity for each individual to grow emotionally, academically, spiritually, and socially, and to be relevant. Whether this is caring for the young, maturing student, the non-traditional student, or the faculty or staff member building their career in research or experience, all are moving toward self-actualization. We measure that success by our retention rates of students, staff, and faculty; and ultimately by alumni becoming innovators, leaders, and contributing functionally to society.

Q: Because mental health does not discriminate, does that mean treatment is universal, or are there services the UI provides that apply specifically to a community of higher education?

FLETCHER: There are aspects of treatment for mental illness that are universal, like building a therapeutic alliance with clients, without which you have nothing. Also, there are evidence-based practices that are widely used in treatment, but not always. The university population that seeks services tend to need short-term therapy. but they are not immune to chronic persistent mental illness. To best address this need, we often see students for only a limited time, generally eight to 10 sessions or less. Essentially, we see more issues based around development of identity and cases of anxiety and depression related to academic performance, and adjustment issues compared to the more organic disorders.

I again speak to the importance of alliances with campus partners, staff, and faculty in helping meet the non-clinical mental health needs of the campus community. It is extremely important.

Q: What are some avenues you expect to explore to help improve access and awareness for holistic success at Iowa?

FLETCHER: As a field, we have seen where more people have been able to access care via telehealth, and the number of attended sessions increased while, at the same time, decreasing the no-show rates. I also believe that the culture of “instant everything” has forced us to pivot toward really meeting people where they are, and technology is the bedrock of the younger generation. We have seen other universities and partners implement mental health tools, which serve to support therapy. Evidence-based research has supported implementing these tools with our populations.

Another important area is to increase the collaborative efforts of partnerships across campus. This is working in conjunction with our faculty, residence hall staff, outside providers, and other support systems of our students. We have a duty to be advocates for our students and help them succeed in their own environment. We can implement tiered approaches to screening and preventative care. This will help us identify those students who are most at risk, as well as normalize mental health issues.

Another way to increase capacity is through the expansion of certain portions of the mental health programs, such as the embedded therapist program and our APA accredited training department where we have an interdisciplinary team addressing the mental health needs of students. We are able to deploy practicum, predoctoral, post-doctoral providers for care, both providing opportunity for educational training, but also helps to increase capacity in UCS.

Flexible and clinically-appropriate scheduling can increase our overall availability to students. We will respond to the clinical needs of students, as we recognize that each student has their own unique needs. Exploring other treatment options beyond one-to-one individual therapy, such as psychoeducational and support groups, peer supports, and application-based programs, can increase growth outside of face-to-face sessions.

Q: You describe yourself as a life-long learner and expert in understanding human behavior. What is the biggest issue you see that prevents people from seeking help for their mental health? How can we address those barriers at Iowa?

FLETCHER: There are several critical issues preventing people from seeking help for their mental health. Among those are stigma, poor social determinants of health (lack of education, low socioeconomic status, access, lack of transportation, insecurities, etc.), peer influences, and lack of trust in the process. As a culture, we need to move away from setting such a high threshold for services. We are person-centered, and most students can benefit from even a brief period of therapy at some point throughout their time at Iowa regardless of diagnosis.

Many of our students who receive our services will talk to their peers about their experience. Building rapport and positive experiences with every student will only have a positive impact on our word-of-mouth marketing. We are a service-driven industry, and the quality of the therapeutic relationship is a priority. There are other practical and logistical barriers to treatment, such as lack of awareness that this resource exists on campus. We can take steps to inform not only the students but the families and friends of our students that this can be the first step to establishing services.

Q: One challenge on the UI campus is the lack of available appointments for individual talk therapy. How will you begin to address this for students, faculty, and staff?

FLETCHER: Making services more accessible is a priority, so we are evaluating how we offer and operate our sessions, how we schedule appointments, how we communicate to our campus, and how we listen and respond to those in need.

One immediate approach that has been successful across multiple settings is group therapy. Group counseling has also afforded us the opportunity to impact more people in one sitting as opposed to an individual in that same time span. Group therapy is also supported in research and peer feedback as a powerful therapeutic tool of change.

Our field has also seen changes in the timing and scheduling of services. Many providers have incorporated the more creative scheduling model of “open access.” One component of an open access model is walk-in or same-day appointments. We know that delaying of services from the moment the client seeks to receive services is a significant barrier to that person following through. Ultimately, the same-day appointments will be beneficial to our follow-up show rates, as well as our efficiency over time. We can also address issues related to availability by looking at opportunities like 30-minute sessions and concurrent documentation.

Consistent with most college counseling centers, we rely heavily on time limited, solution focused services. This is not to say that there will not be a need for other approaches, interventions, or higher levels of care, however a significant majority of cases can be met in less than 10 sessions. There has been growing evidence in research that technology-based support tools to therapy are effective tools relative to overall success. As our students gain competencies to address whatever situation initially brought them into treatment, this will naturally open our availability to other students in need.

Some of the more traditional approaches to building capacity have worked and we are encouraged to continue utilizing those approaches – such as using a cancellation call back list, reminder calls, follow-ups, triaging, and referrals to our strategic partners for cases outside of what we can address. We will continuously work and evaluate the tools available to our providers to decrease the amount of non-direct service time (i.e., record keeping, automated reminder calls, letters, paperwork). These components do add up over time and are measurable, thus we are allowed to evaluate the efficacy over time.

Outreach is a preventive measure and certainly can be effective in many ways – helping to address problems as well as helping to prevent issues, hence reducing the needs for service. I am still learning and listening and seeking to understand the current culture, but surely there are opportunities to making the existing outreach program more robust. Building programs and expecting the students to come is just one facet of prevention. Another aspect of prevention is to reach out and build therapeutic alliance, provide resources, and facilitate access to care.


University Counseling Service is the University of Iowa’s primary mental health service provider for university students. UCS supports the Division of Student Life mission for student success, and fosters the mental health of students, staff, and faculty, while contributing to a safe, welcoming, and multiculturally aware campus community.

To schedule an appointment call 319-335-7294 or visit