This article is an opinion piece and thus maintains the position of the writers’ opinions. Additional student experiences are shared in this article.
Freshman Neha George hadn’t been sleeping well. She didn’t know what had thrown off her sleeping patterns, but she had noticed that she was getting behind in her schoolwork and felt anxious. After putting her mental health aside for a few months, she finally decided that it was time to talk to a therapist.
“I don’t fully process everything that I’m feeling or understand everything until I say it out loud and work it out with someone else,” George said.
College life can take a toll on students’ mental health. With the combination of newfound independence and demanding classes, students find themselves abruptly making adjustments and facing significant life decisions. On top of these burdens, current Wash. U. students have had to deal with the challenges of the COVID-19 pandemic, which has exacerbated mental health problems worldwide. Many, like George, have turned to Wash. U.’s mental health resources.
When George first called Habif at 11:15 a.m. on Feb. 25, no one answered. That phone call was her second attempt at setting up a consultation; she had tried to schedule a consultation a few days prior through the student portal, which she found confusing.
“I had a bunch of issues the first couple times I tried to sign up where it wasn’t giving me any valid appointments,” George said.
While Habif called George back later that day, some students have experienced repeated failed attempts to get in contact with mental health resources. Three calls, two emails and a whole semester later, freshman Grace Chen was still not able to access mental health resources at Wash. U.
“I called three times on different weekdays at different times. The first time was in the afternoon and outside of their operating hours, but the next two, I called during their [business] hours. I got an answering machine all three times, which only gave instructions for what to do if I had an emergency,” Chen said.
Although Chen never was able to access the mental health resources she needed, some students have been able to make it through the multi-step process to set up an appointment. In many instances, however, complications and setbacks in the process remain due to the confusing nature of the websites and phone lines.
“My experience made me think Habif’s mental health services are not effectively organized or accessible enough,” Chen said. The services are not accessible enough––it is not impossible to access mental health resources, but the process is often not an easy one.
Who do you call?
While researching mental health resources at Wash. U., we found it especially difficult to determine how to reach out for specific mental health needs, as different needs require different resources. The centralized location for information is Habif’s main mental health website. While links to other pages are organized on this website, some of the pages lead to confusing information.
The menu option “Assisting a Student in Distress” leads to a “Suicide Prevention Training” program, which lists some “warning signs” of mental health issues, such as being “too busy studying or surfing the web.” This phrase demonstrates that mental health services may be out of touch with students today. An activity such as busily “surfing the web” is not necessarily a telling warning sign of mental health issues––we live in an era where it is common for people to spend most of their time online, especially in our current hybrid learning environment. This fundamental misunderstanding could be harmful when it comes to the ability of Wash. U. mental health services to connect with and understand the day-to-day lives of the average student.
While the mental health page mostly provides information about how a peer can step in to help students in distress, it does also instruct students to call campus police in immediate safety situations, to call the main Habif line for “non-life threatening” emergencies within business hours and to call a different number (314-935-6666) and press one for after-hours service.
The National Mental Health Service phone numbers are located in the menu option “n In Case of Mental Health Emergency and Crisis Response,” which can be helpful resources for students. Students also have the option of calling the after-hours number, which directs students to press one if Wash. U. Express Care––a student resource for “same-day virtual and in-person [medical] care”–– is closed. Wash. U. Express Care is helpful for instances that threaten safety within hours of operation, but they don’t have mental health assistance outside of psychiatry appointments, and in emergency situations, this is not the best option.
The problem with the page for students in distress is that it lists WUPD as the only immediate intervention option. There are many instances in which a student may need immediate mental health intervention that policing cannot help with––this is especially true in cases where bodily safety isn’t an immediate concern. Additionally, students who have not had good experiences with on-campus or off-campus police may be hesitant to reach out if that is their only option, creating a further barrier in receiving help.
With unreliable means of outreach, it can be discouraging for students to continue their search for mental health resources. Taking care of one’s mental health becomes increasingly important in college, so Habif resources should be easily accessible to all students.
The Infrastructure
For Neha George, the area that mental health services should focus on is “transparency.” This could be done by being clear and transparent about how many free appointments students get each semester. According to George, information about how many free appointments she would receive wasn’t provided to her in her initial consultation phone call, and she had to explicitly ask about pricing in that phone call in order to learn that information. George’s call for transparency also applies to the phone lines, business hours and student portal.
“When you’re filling out that initial form, it would be nice to have a little message that says, ‘If you’re having difficulty, this is our number, here are our hours, et cetera,’” George said.
George only had to wait one day for her consultation, which was “pretty standard.” After the consultation, she scheduled her appointment with a therapist for about two weeks out. As none of her needs were immediate or life-threatening, George didn’t mind the two-week wait.
For sophomore Sam Cohen, however, having to wait multiple weeks for an appointment was not an option. Last fall, with the combination of school, the pandemic and other factors, Cohen’s anxiety was returning at concerning rates. She was starting to have panic attacks again, something she hadn’t experienced in a long time. As someone who has had a therapist since the fourth grade, Cohen recognized her symptoms quickly and knew she needed to contact Habif.
The first appointment she scheduled got canceled last minute, as Habif had accidentally scheduled her appointment with a therapist that only talked to graduate students. But now, Cohen needed immediate assistance––she was having a panic attack. She called the after-hours Habif line for non-life threatening emergencies, which connected her to an on-call therapist.
Although she was able to meet with a therapist, for Cohen, the appointment felt like an “interrogation” rather than a helpful conversation. At the end of the appointment, Cohen learned that the soonest she could see the therapist again was in three weeks.
“At that moment in time, I knew I was going to have to start going back to therapy every week,” Cohen said. She decided to seek off-campus resources, something that she acknowledged she is privileged to have access to.
This wasn’t Cohen’s only interaction with mental health resources on campus. In January 2020, she contacted Habif, seeking a refill for her anxiety-related medications. After sending in her medical records and receiving no response, she called Habif again about a week later, when she learned that the person who was in charge of reading medical records was out sick.
“I was like, ‘You only have one singular person reading the medical records and organizing them?’” Cohen said. “It was very strange to me that one person was sick, so that halted their operation.”
From her experiences, Cohen attributes the setbacks and frustrations she faced to an overwhelmed staff.
“They need more than they have,” Cohen said.
Wash. U. currently has 11 therapists and five psychiatrists directly affiliated with the University. In addition, the University has partnered with Provident Behavioral Health as an extra mental health resource specifically for after-hours support. This locally operated business has an independent crisis response number, many different types of counseling and therapy and support groups. This is a step in the right direction, and it is a resource option that Habif and Wash. U. should more effectively communicate to students. With further implementation and accessibility, this resource could greatly benefit the student population.
The COVID-19 pandemic has impacted mental health resources across the globe. While Wash. U. has been similarly affected, the University has also made some efforts to accommodate the increased mental health needs on campus. Two additional therapists not directly affiliated with Wash. U. have been assisting with mental health services this semester.
However, despite the extra help from both Provident and the two additional therapists, mental health resources are still overwhelmed––students like Cohen have had to wait for two to three weeks to set up appointments. As Cohen pointed out, an overwhelmed staff isn’t something new to Habif.
“It’s a little sad that they [Habif mental health staff] couldn’t even keep up with people back in January before the pandemic happened,” Cohen said.
Looking on to the future
The lack of available mental health professionals had led to a lack of support for students, as is also seen in the campus’s immediate mental health intervention response. As of now, after hours support is limited and somewhat ambiguous. Calls to change the policing system at Wash. U. have involved the context of mental health emergency response, in which WUPD is the primary responder to any emergency, including mental health emergencies.
The University’s public safety report, released in February 2021, has acknowledged some of students’ concerns about WUPD being the only immediate intervention resource besides the Emergency Support Team (EST). The report recommended “new methods for triaging responding to non-traditional public safety concerns,” such as to “send resources that are appropriate to the incident, not just WUPD because they answer 24/7.”
EST is composed of Wash. U. students who are trained through their undergraduate experience to respond to on-campus emergencies, but they are still reached only through the WUPD phone number. While this leads to some diversity in the emergency response team, it still doesn’t give students the option to choose between who actually responds. The public safety report also acknowledged that this “creates barriers” for students whose interactions with police have not been positive.
If the public safety committee follows through with their suggestions, Wash. U. could be on track to successfully addressing these concerns, but acknowledgement is not action––the public safety committee must follow through by making concrete changes to how WUPD and EST operate. For example, allowing students to call EST without having to go through WUPD could create an opportunity for students needing immediate mental health intervention to confidently seek help. Despite steps in the right direction, the committee also recommended increasing funding to WUPD in order to add the mental health resources that they recommend. By adding funds to WUPD to complete this task, that response team would still be affiliated with WUPD, which goes against the goal of creating an environment where students feel safe and comfortable contacting emergency mental health services. This funding should instead be used to create a response team that is completely separate from WUPD––and could be called upon instead of WUPD––with professionals who are trained in mental health services and available 24/7. In order to ensure a distinction from WUPD, the response team could also become a part of Habif instead of being a completely independent service. Despite the problems with emergency response as well as with accessing resources in the first place, many students have been able to go through the process and access the resources they need. Wash. U. student Sage Vasconcellos-Merryman’s first semester of college didn’t start out ideally, so she decided to get in touch with Habif to discuss her options.
“Between not being on campus for physical classes, the time difference and my family environment, [it] was not good for me because I've had ongoing struggles with depression,” Vasconcellos-Merryman said.
Vasconcellos-Merryman decided to look into campus resources, and she determined that medical leave for the rest of this school year was the best option for her.
“I ended up almost failing my classes because I couldn’t keep up and I was feeling very, very depressed,” Vasconcellos-Merryman said. “Wash. U. resources were very helpful because they did reach out and solve the issue with me, and I really appreciate the level of understanding.”
While the bounds of medical leave are not just within Habif, she is still very pleased with the interactions she did have with the mental health services.
“I was able to talk to a couple counselors, and they were helpful in making my plan with me for the future and planning on a successful return to school in the fall,” Vasconcellos-Merryman said.
Each student will inevitably have a different experience with mental health resources than fellow classmates. Mental health circumstances, access to the services, level of help received and other factors are highly variable. But as long as there are students who are not getting all of the help they require, there remains room for improvement.
The efforts that Wash. U. has made to improve mental health resources on campus have not gone unnoticed. In comparison to other universities, Wash. U.’s mental health services are impressive. When it comes to psychiatry, Wash. U. is in the 63% of universities that provide that service. For therapy and mental health counseling, the average university only has one mental health counselor for every 1,737 students. According to fall 2019 numbers, Wash. U. has an undergraduate population of about 7,850 students, and with 11 therapists directly affiliated with Wash. U., there is about one therapist for every 700 students. Two additional therapists not affiliated with the University have been helping this semester, making the ratio about one therapist for every 600 students. These numbers are impressive: Wash. U. has been able to maintain a significantly higher student-to-therapist ratio than the “average” university.
However, having resources that are “above average” does not mean that the resources are necessarily enough. Available appointments are often weeks away, and students struggle to schedule appointments in the first place due to confusion involving phone calls, websites and other steps in the process. While some may be able to access appointments relatively quickly, wait times are variable and dependent on student demand for resources.
Long wait times may be outside of therapists’ control. COVID-19 has increased the demand for mental health resources, and there are only so many appointments that therapists can take. It is also the University’s responsibility to prioritize the mental health of its students. A commitment to mental health can be demonstrated by providing more funding to mental health services and hiring more mental health experts, ensuring that there are enough staff members to meet students’ needs.
Some students’ needs require expertise outside of Habif’s reach. In those cases, Wash. U. therapists are prepared to refer students to off-campus resources. However, not all Wash. U. students have the means to access resources off-campus that may require high payments and constant transportation. Not everything can be covered in-depth by Wash. U.’s services, but by expanding resources to as many areas as possible, Wash. U. can ensure that students who rely on Habif’s free and reduced-price appointments can get the help they need. Therapists should be aware of the range of students’ needs and should be able to recognize when someone might need a more immediate appointment. Something like a panic attack, as in Cohen’s story, should be given proper attention.
Even with a collective total of 13 therapists for the semester, mental health services seem to be spread too thin. There are long wait times for scheduling appointments, too few counselors and not enough mental health professionals available for immediate intervention. The attention to detail in online resources is not apparent, and if it was, every student would at least be aware of how to find help.
Problems with mental health resources are not due to a lack of care or thought, but there is an apparent disconnect between the availability of resources and the resources advertised. Resources become pointless if not adequately made available and advertised, especially in the field of mental health. Overall, students could benefit from more availability of therapists, distinguishing between WUPD and actual crisis intervention resources, a centralized website that is easy to navigate and a mental health program that is easily and consistently accessible. Students should feel confident and comfortable reaching out for help, and in the current state, that is not always the case.
Wash. U. already has a solid foundation when it comes to mental health resources. Looking forward, there is so much potential for improvements, and these changes can be made to the already existing system. Wash. U. has demonstrated that it is open to making improvements, and students’ concerns have been acknowledged. But listening to the demands of students only goes so far––what must come next is action.