If a student’s meds are in the stage where they need monitoring and maybe tweaking, I wouldn’t want a 90 day Rx and, “See you in Sept.” In advance, there should be some way to ensure care at home. My kid went through many tweaks initially, with her home psychiatrist. On campus, two years later, the psychologist needed to tweak again. Not uncommon. I believe her home psychiatrist approved/ordered the changes. You don’t (imo) expect the school doc to become the ongoing primary.
Some of this is very particular to the kid, the history, the needs.
So if someone has been on meds and the right dose and medicine is already determined, then yes, a 90 day supply over the summer makes sense. What doesn’t make sense is to stop the medicine abruptly, because oh well, summer is here, and I don’t work over the summer for you. It’s irresponsible to stop a medicine because you only work at the student health center and guess what school’s out for the summer.
Agreed, meds shouldn’t be stopped abruptly, but care should be passed off to somebody, and finding that “somebody” is the responsibility of the student. Once under the care of the health center, they should start looking for care at home, so a 30 day prescription from the health center will be sufficient. If we’re not talking about major mental health issues, a PCP will often be willing to prescribe and monitor over the summer. On the surface the policy seems irresponsible, but it might be a way of ensuring the student sees someone at home over the summer.
I’ll just add that with my D at the 5C health center, her provider seemed surprised when D asked for a 90 day prescription to carry her over the summer. The provider had given no forethought to the fact that the semester was ending. If the policy is not to prescribe over the summer, then shouldn’t it be incumbent on the provider to raise the issue far enough in advance and give the student suggestions for the best ways to deal with it? Especially if the student doesn’t have a pre-existing relationship with someone at home. Getting a new patient appointment often requires 60 days advance notice in my experience.
Elder kid was at OU (Oklahoma) and developed overwhelming anxiety and depression after 1st year. He independently went through the campus resources, which felt completely short for him. Being who is is, after that failed experience it took an additional semester for him to let me in on what he was going through (despite regular calls/contact). Once he did, we had to find a local provider to get him through until I could get him home (school was 900 miles away). He’s okay now now - he has a local doctor, has an almost full-time job to keep him occupied, and is working out his next steps.
Younger kid is a 1st year, at a small LAC (North Central College). I would peg her as the more anxiety-ridden and prone to issues of the two. College has been a lot to adjust to for her, but she also recognized early that she is in some aspects overwhelmed and found help at the campus health center. They are advising her within the limits of their center, but also looked up her insurance options, are walking her through finding therapy and md options, etc. It helps that she is more open with me about what’s going on.
There are a lot of variables related to the kids themselves, but it in my very limited experience it seems that some smaller schools may have a better system to help their students with regard to mental health. Might well be part of what we’re “paying for.”
Oberlin: My son was able to get an appointment within a week, and then receive regular counseling thereafter. He also got a prescription to cover the summer break.
Wellesley: Counseling is set up for short term only, but it’s easy to get an appointment quickly. For long-term mental health support and meds, daughter had to set up a Zipcar account and drive herself to therapy.
@MaineLonghorn , your daughter might want to bring enough meds to last the entire time she is gone, just in case. My daughter was in Europe for 12 months (July to July) and was able to get an entire year’s worth of her medication to take with her. This required a note from her doctor to her insurer.
She also found a therapist in England who would Skype. We had to pay out of pocket for her, but she was able to use the therapist in England and France and still uses her in the US. We are trying to get her to switch to someone local, but it’s hard to break up with a therapist who has really helped.
Agree with @Corinthian that it is the provider’s responsibility to hand off care if they are not available to continue treating the patient. BTW, most insurance wants prescribers to prescribe a 90 day supply and that has become normal practice. PCPs as I mentioned already don’t want to get involved for the most part. They don’t want the responsibility of covering other practitioners, that’s not their job either.
My D reports that mental health services are really pretty good at Notre Dame. It can sometimes be a wait (a few weeks) to get an appointment but they offer counseling, group therapy, and have several psychiatrists on staff the students can see who will prescribe meds. They will also prescribe enough to get through summer and even a study abroad semester.
Three NU students committed suicide this past school year, including one in May and one in June. I had actually posted about an article regarding Northwestern and mental health services earlier this fall. It compared NU to other elite schools. When I posted it before, someone commented that the number of staff seemed low per capita of students. Here is the article again.
When one of my loved ones at USoCal was having some depression due to the death of her aunt, she was able to see her MD, who referred her to a therapist. I didn’t get details but believe the therapist was not on campus and provided services for several months, until they were no longer needed.
My oldest was ordered by the Dean of Students to have weekly therapy appointments for a whole semester (alcohol, long story). At his third appointment, the therapist told him it was illegal for a dean to demand therapy and kicked him out to make room for someone who really needed it. The waiting list at week three to get weekly counseling was already a month long.
It’s a state U with about 20,000 students and he was told they had 13 full-time MH counselors. No idea what the psychiatrist/psychologist split is. They do keep both walk-in and crisis appointments open.
There are other issues to consider for kids with serious health or mental health issues. Someone mentioned Lesley. I have a kid who has a serious brain-based psychiatric disease who is mostly thriving in an adult learner degree completion program at Lesley. However, those students do not have access to tuition refund insurance the way the “regular” undergrads do. And when she became psychotic while taking a religion class, there was no medical withdrawal, no retracting of a “W” on the transcript, and we had to pay not only tuition but the full amount of financial aid that had been granted. I think it is beyond hypocrisy to have a school for adult college student (non-traditional students) and not have access to these supports. I feel they are even more important than mental health services because those with serious psychiatric conditions may have to withdraw more than once in order to get help.
“Three NU students committed suicide this past school year, including one in May and one in June. I had actually posted about an article regarding Northwestern and mental health services earlier this fall. It compared NU to other elite schools. When I posted it before, someone commented that the number of staff seemed low per capita of students. Here is the article again.”
When I was a grad student at Northwestern, we referred to the Student Health Center as “Student Death”. I got so sick at one point (I had pleurisy that turned into pneumonia because Student Death wouldn’t give me anything stronger than Tylenol and kept sending me home telling me I had a pulled muscle in my chest) that I was hospitalized at Evanston Hospital (I went there on my own after wasting 2 weeks trying to get Student Death to take my symptoms seriously.) At the same time I had a friend who had a serious illness that produced a rash that Student Death diagnosed as spider bites. She also ended up getting help from an outside provider.
As someone who has worked in higher ed for years, my observation is that student health centers are designed for caring for the common cold and not much more. At my current institution I understand the wait for mental health evaluation is about 6 weeks (unless it’s a true emergency, and I have no idea how that is determined. If your child has a medical or mental health condition that requires on-going care, you need to evaluate what services are available before they enroll. It may determine where your child enrolls. And you may have to look to the local community to find appropriate care. (Sorry to paint such a bleak picture, but it’s best to be forewarned and prepared.)
It isn’t bleak, it is merely accurate. Student health services are like those clinics that pop-up in pharmacies or grocery stores in some states. Fine for minor matters, and can probably run a strep test or a handle a boyfriend breakup. If you were expecting more, you were likely mistaken. Some employers have similar such clinics on site for minor employee injuries or sickness. Universities provide minor health services, for a fee, as a matter of convenience only, not as a parent or other party responsible for maintaining anyone’s health or well-being.
@roycroftmom is absolutely right about the purpose of student health services. They’re great if you need a flu shot or get strep, but if it’s something serious, the good ones will realize they’re out of their depth and send you to the ER. The bad ones will just send you home with Tylenol, as @proud_mary describes.
My daughter had a hard time getting health services at Wellesley to take her seriously when her arm swelled up and became very painful. (To be fair, she has anxiety disorder, so is always worried about something.) They said they couldn’t work her in that day or the next. She finally begged them to just measure her arms and note the difference in size. They agreed and had her transported to the ER right away, where she was diagnosed with a DVT.
I don’t believe in getting involved with my kids’ college interactions (grades or otherwise), but if I had a child I believed was seriously ill, I wouldn’t hesitate to keep on top of health services if I didn’t think the kid was self-advocating or that the school wasn’t taking them seriously. Fortunately, my daughter was very pushy and persistent.