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College counseling service departments report an increase in the demand for mental health services. Simultaneously, college counseling centers are reporting a shortfall in budgets to meet the increased demands. Furthermore, they are not prepared for the severity of the presenting problems found in today’s student population. Behavioral health leaders on college campuses must find a balance between meeting the student population’s immediate needs and meeting organizational outcomes, such as retention and student success. This qualitative case study focused on a College Counseling Service Department at a Midwest college serving a diverse population of college students. The strategies behavioral health leaders used to assess counseling center needs and set goals that align with the targeted outcomes of the organization were investigated using the Baldrige excellence framework. Analysis of the Behavioral Health Organization consisted of reviewing Board of Trustee meeting minutes, internal emails, Town Hall meeting reviews, and interviews with 4 of the college’s senior leadership members. Analysis revealed that there is a need for leadership to assess the needs of the students and assess outcomes of the student counseling services to determine strategy in aligning goals with the organizational targeted outcomes. The results of the case study converge with literature, indicating the need for increased awareness, reduction of stigma, and need to assess ways of meeting the needs of an increasing college population seeking mental health services. The social change implications of the study results include the need for increased outreach, education to reduce stigma, and reduction of barriers for the college student population seeking services.