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?”

To learn more and 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!

      FAQ: How should we handle clinicians that did not work the whole year? 

If a clinician worked at your center for half of the year or less, count 50% of their clinical hours to reflect their contribution to your overall clinical capacity more accurately (e.g., if a clinician was contracted to provide 24 clinical hours a week, but only worked at the center for 6 months or less last year, you should count their capacity as 12 hours).

If a clinician worked at your center more than half the year, count 100% off their clinical hours towards your overall clinical capacity even if the clinician worked at the center for less than 12 months (e.g., if a clinician was contracted to provide 24 clinical hours a week, but only worked at the center for 10 months, you should count their capacity as 24 hours). 

2021-2022 Distribution

  • July 1, 2021- June 30, 2022
  • 626 colleges and universities
  • Minimum: 21
  • Maximum: 291
  • Mean: 106
  • Median: 100
  • Standard Deviation: 41
  • Zones
    • Low: Less than 66
    • Mid: Between 66 and 147
    • High: Greater than 147

2020-2021 Distribution

  • July 1, 2020- June 30, 2021
  • 565 colleges and universities
  • Minimum: 12
  • Maximum: 314
  • Mean: 90
  • Median: 84
  • Standard Deviation: 43
  • Zones
    • Low: less than 48
    • Mid: 48 to 133
    • High: greater than 133

 2018-2019 Distribution

  • July 1, 2018- June 30, 2019 
  • 567 colleges and universities
  • Minimum: 30
  • Maximum: 310
  • Mean: 119
  • Median: 112
  • Standard Deviation: 47
  • Zones
    • Low: 30 to 72
    • Mid: 73 to 167
    • High: 168 to 310

2017-2018 Distribution


  • July 1, 2017- June 30, 2018
  • 432 colleges and universities
  • Minimum: 37
  • Maximum: 308
  • Mean: 118
  • Median: 114
  • Standard Deviation: 44