In another thread (on unexpected positives and negatives of college experiences) several people brought up mental health services. It seems like a good idea to start a new thread focused on this issue. Let’s share and discuss which colleges are doing this well and which aren’t, what a good program looks like, and tips for how to navigate the experience.
I’ll start with some general thoughts I have based on my D’s experience with anxiety at the 5C’s. It’s not too hard to get an appointment and a prescription, but they seemed strangely unprepared to deal with the issue of medication over summer break. More importantly, the system is set up to deal with acute problems but not set up to help students learn coping skills for the long haul. I thought there should be more free or low cost group therapy available to help kids learn things like not catastrophizing when there’s a setback.
Also, based on what I’ve read in the student newspaper, the schools struggle with balancing student privacy rights, fear of liability and the need to protect other students. This leads to situations where students are forced off campus or forced onto a medical leave that they don’t really want, but which the school insists on because the student answered yes when asked if they had thoughts of self harm.
Our parent group just had this come up because a member had her daughter ask for an appointment and was told it would be a month! Sounds like this student is in crisis now. The back up offer was to talk to the Dean of Student’s office. No idea if they have trained professionals in that office but it seemed really odd to me that there was no emergency mental health services available on campus.
the central problem seems to be the disparate understanding of the role of health services on campus. Generally, they exist for short-term relatively minor diagnostic purposes and uncomplicated treatment,of physical or mental issues. So ear infections, the flu, boyfriend breakups, roommate woes all can be addressed on a short term basis. Neither complicated nor longstanding physical or mental issues are within college’s purview, so are referred out to others with expertise, including serious physical emergencies like heart attack or mental emergencies like suicide attempts. If one is seeking long-term counseling or treatment for any health issue, or if the issue is serious or complicated, one should pursue a local provider covered by your insurance.
Right, @Roycroftmom. But at her college, D2 got a pretty quick appt for an intro meet to lightly assess need/what sort of issues. Then an appt with a nurse or NP. There was no match there (I’m a firm believer a kid and counselor need to click, the adult has to get it.) D2 requested a change and got an amazing, tremendously helpful, local psychologist associated with the college, who met with her on campus. Life changing. A turning point.
This was relatively long term, but as it went on, time between appointments stretched. Common, as a kid develops insights and awareness. He recommended med changes, not sure who authorized that. But it all worked. She could have seen him as a private patient, but the college managed this.
Serious problems? D2’s were, but not something needing an immediate trip to ER. I don’t think it’s easy to gauge, ahead of time, what a kid will get from student mental health support.
This thread could prove more useful than any other on CC when it comes to finding a school where our kids can grow and thrive. With depression it can literally be a matter of life and death if help is/is not available.
Personally having a D that suffers from depression, it would be tremendously helpful if people could share the names of colleges.
Thank you!
@eb23282 I think a lot of this is individual to the kid, what he/she needs and how they self advocate (in our case, D2 recognizing the need, going, then asking for a counselor change.) The next kid who waits or sticks with the first try or can’t articulate may not see the same results. This is true at home, too.
If a situation is serious enough that a parent could or should be involved, I agree with roycroftmom that you may need a private relationship with a counselor (who specializes in this age group.) We do have to understand the colleges try to take care of a crazy wide array of issues.
One starter tip: see what the health services hours are, whether they run 24 hours and weekends.
@lookingforward yes that’s understood, but as the OP prefaced, I’m hoping the thread will “discuss which colleges are doing this well and which aren’t”. Some schools have excellent counseling services available (not talking about results), while others simply do not. Just as some have excellent gyms, career services, etc, while others do not.
I do think this thread will be more helpful if people are willing to name schools and give specifics of what was helpful and what fell short. That also gives people a starting point for asking questions, checking websites etc. For example, I noticed that at Swarthmore they have two open group meetings described as: “CONNECTING AND RELATING CO-ED Psychotherapy Process Groups.” https://www.swarthmore.edu/counseling-and-psychological-services/groups I stumbled across that while looking up stuff on the Swat website and it made me wonder if more schools have on-campus group therapy options. Going off campus for therapy requires navigating insurance issues and transportation issues, and something like this seems like a good idea.
My best friend in Cambridge, Ma, is an approved psychologist for MIT and Harvard. Both schools refer to him if the issue is more long term. He also sees professors. He is easily accessible for both. He is so gifted.
From my experience, college deans and/or counselors only refer to,people who accept the college insurance. They keep a list of local therapists and do not hesitate to call or email and keep,track of progress.
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Regarding specifics, I know that Lesley in Cambridge MA takes mental health issues seriously - not surprising since they have great programs in social work and art therapy (among others). I don’t have a student there, so don’t have firsthand experience, but they encourage students to stay with their therapists at home to supplement meeting with someone on campus. They facilitate this by having a private space set aside for students to use for teleconference meetings with their therapists. This way students aren’t asking their roommate to vacate for sessions, or otherwise trying to find a private spot.
As the parent of a young adult with mental health issues, I agree that colleges health services - both physical and mental - are set up for minor issues. There are usually plenty of local providers to whom they can refer students. If this is a concern, I would look for a campus that isn’t particularly remote, so the student has choices - as mentioned above, the student has to connect with the therapist, or the sessions won’t be worthwhile. This would be true for a student with a chronic physical health issue as well.
@Corinthian you hit the nail on the head for Pomona. What is confusing about needing to write a script for summer months? You start someone on an antidepressant, then what, magically the student is supposed to find a new prescriber to take over for 3 months only? Go figure. That one is just plain annoying. My other student’s doctor at Berkeley had figured it out and happily wrote a script for 90 days to get students through summer break.
So my student came home Sophomore year at Christmas break very depressed. It was a different kid than I had sent off to college in August. I had a hard time finding a psychiatrist who didn’t have a wait list and could see her before she needed to go back. Long story short, a doctor friend of mine said to leave a message at Pomona’s student mental health center over the break and ask that when they reopen after holiday break in mid January to give me call which I did and they did. The woman at the desk told me “If your student calls today or tomorrow, she’ll have a 2 week wait to get in, if she call later than that, make it 6 - 8 weeks.” Obviously based on her reply there is a huge unmet need. Why don’t they have a better system of referring off campus as needed?
Maybe there is no one available off campus either. Or maybe no one is accepting new patients. That is quite frequent.
Preppedparent, for the same reason your student can’t call them over the summer with a mental health issue, the health office may not want to medicate over the summer. They are not the student’s primary care physician. They cant be reached for questions, complications or anything else on break. They wouldnt provide summer time oversight of a physical infection, either
@roycroftmom So you’re first argument in #11 holds some water. Yes, it’s possible there is a dearth of mental health providers in the nearby community. But your argument in #12 isn’t correct. I am a physician and board certified psychiatrist, myself. I actually prescribe for a women’s college in the Boston area and an engineering college and I always write a 90 day supply (or more) to get students through the summer until they return. It’s considered abandoning a patient to prescribe for your patients, then leave them high and dry, just because it’s summer break. Once you’re started treatment, that patient is your responsibility.
Your argument that they are not the student’s primary care physician makes no sense. It’s not the primary care physician’s job to take over from a specialist or prescribe for another doctor who has taken on a patient during a school year. It was especially tough to see my daughter hurting and I couldn’t find someone to see her given my own profession, but PCPs are increasingly afraid to prescribe antidepressants given fears of suicide and there is just so few of us. I go to bat for my patients, and I just want someone to treat my child the way I care for those under my care.
You are lucky that you have the ability and resources to take care of the matter yourself. At my kid’s college, no ADD/adhd matters will be considered or treated. No appointments or medicine for it at any time. It is not that hard to take care of it without the college’s assistance.
In my own personal experiences with my two students mental health services on college campuses are lacking. There is a huge unmet need. As parents we all have to be advocates for our and other students.
BTW, I’m not lucky at all. My student also has a significant medical condition, and we bought the student insurance so she would have access to a nurse and doctor on campus. The first time she tried to access their care, they told her (despite us having paid for the school insurance), “you’re too complicated, go the Emergency Room.”
And by the way, I couldn’t take care of any matter myself. I felt helpless because there are rules and doctors aren’t allowed to prescribe for your own family members. Imagine how helpless I felt when my child needed help, and I’m busy taking care of everyone else’s child, and I couldn’t even find anyone to see my child when she needed it. We need more mental health services on campus, not less.
In DS’s case, the student health center at UT-Austin did a good job of recognizing that he was seriously mentally ill (out of the blue). They gave us the name of an excellent psychiatrist who dealt with college-aged kids with psychosis. That was the end of their role.
Susquehanna has been really good for our D. She sees a doctor at home who prescribes meds, but then gets weekly counseling at school. There’s a center that she can visit whenever she needs to destress. She is currently not taking any meds (with her doctor’s permission, of course) and is doing well. The university did warn her and the other study abroad students not to expect counseling overseas this semester! She has planned and paid for quite an extensive trip at break (southern Spain, where she studied in high school, and then on to Beirut to see her brother). I can see her anxiety acting up - she’s getting stressed out at the thought of catching all those planes and trains. She is reconsidering the trip! I told her to video chat with her counselor here at home and we’ll see what that professional thinks…
a bit off the subject, but I read a good op-ed on mental health over the summer by a recent Pomona College grad “The tough pre-college talk I wish my parents had initiated” http://www.latimes.com/opinion/op-ed/la-oe-gedye-college-mental-health-20180615-story.html
^^^thanks for sharing. Very worthwhile. Not sure what she meant in the article by “safe partying” except maybe to not drink anything left unattended to avoid date rape, but much much more also needs to be discussed about substance use in addition to depression and anxiety.
When my freshman headed off to college we had a series of “talks” compressed into a few weeks. I would give her scenarios, and then we would troublshoot possible soluntions together. One was about a group of kids sitting around the first week of college in a dorm room, and someone pulls out a joint or two. Everyone joins in because of peer pressure and they’re too afraid to say no because they won’t fit in.
The solution was to say “I love you all, but it’s not my thing, I’ll see you all in the morning, and exit stage right.” Boy, did we have a good laugh at long weekend when daughter said fiction became reality and played out almost verbatim. It definitely helps to talk talk talk about forseeable challenges such as roommate issues, break-ups, feeling socially isolated , getting sick, and feeling behind as well as Depression and substance use. etc.
@preppedparent you’re lucky to live in an area where there is a good supply of providers, but unfortunately that is not the case in many communities. It’s not just the colleges that don’t have the providers on staff, but the communities that don’t have enough provider to provide adequate coverage for referrals. While I agree that a prescriber should be willing to provide a 90 day prescription, I can see why they might not want to for a relatively new patient, particularly if they work for the campus health service, and won’t be available over the summer to deal with any complications. When my daughter finishes at the community college, and hopefully goes away to finish her BA, she will maintain her relationship with her local therapist, and may stay with her psychiatrist as well - though depending where she goes, she may have him consult with someone local to the college so she has someone to see on an emergency basis, without having to visit the ER. Those who complain of having to wait a month or more to get an appointment might not understand that is unfortunately a typical wait - if you go to the ER, you will be seen immediately, and then referred to someone who will often see you sooner because the ER has certified that your need is critical. Unfortunately while there are urgent care facilities popping up everywhere to deal with physical ailments, there isn’t a similar model for mental health. I’m not sure whether such a model would even be a good idea. How many patients are going to be that open with a random therapist with whom they don’t expect to build a relationship? And if meds are being prescribed, I would expect a certain level of follow-up that usually isn’t part of that model - with a physical illness, you’re usually referred back to your primary care for follow-up.