Clinical Load Index (CLI)

The Clinical Load Index (CLI) was originally developed in 2017-2018 by the Center for Collegiate Mental Health (CCMH), with support from the Association of University and Counseling Center Directors (AUCCCD) and the International Accreditation of Counseling Services, Inc. (IACS), to inform the complex administrative, funding, and policy decisions related to the resourcing of mental health services in colleges and universities.

An individual CLI score can be thought of as “clients per standardized counselor” (per year) or the “standardized caseload” of the counseling center.

The CLI is intended to provide a specific, reliable, and comparable distribution of scores that describes the landscape of staffing levels associated with particular clinical outcomes (i.e. treatment dosages and distress change).

The CLI is not intended to provide the answer for precisely how to staff a counseling center. Rather, the distribution of CLI scores illustrates the landscape of current staffing levels in order to encourage transparency and clarity about institutional funding and staffing decisions via a reliable and comparable staffing metric. As a result, the CLI helps to shift the question that institutions should be asking from, “How many staff should we have?” to “What services do we want to provide to our students?” or "What experiences do we want students to have when they seek counseling services?”

Locke, B. D., Scofield, B. E., Janis, R., & Cummins, A. (2024). Clinical Load Index (CLI): Design, Development, and Review of Research. Journal of College Student Mental Health, 1–23. https://doi.org/10.1080/28367138.2024.2391750

Resources to learn more about the CLI

Complementary Custom CLI Reports on an annual basis.
Complementary CLI Peer Comparison Reports on an annual basis.
Access to your CLI data on the CCMH website (instructions here)

2023-2024 Distribution

July 1, 2023- June 30, 2024
696 colleges and universities
Minimum: 15
Maximum: 248
Mean: 92
Median: 88
Standard Deviation: 35
Zones

Low: Less than 57
Mid: Between 57 and 127
High: Greater than 127

To calculate your CLI, please visit the CLI site. Before using the CLI calculator, all users should understand the following concepts.

Utilization: The total number of students with at least 1 attended appointment between July 1st and June 30th.

Clinical Capacity: The total number of contracted/expected clinical hours for a typical/busy week when the center is fully staffed (not including case management and psychiatric services). To help organize this at your center, download our Tracking Sheet!