More Open Doors: Mental Health at Harvard

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Last year, students claimed the University was not providing enough support for mental health in a stressful, challenging environment.  In the wake of Monday’s bomb threats, mental health services at Harvard have again been questioned as insufficient.

And yet many attempts have been made to improve the availability and accessibility of resources on campus. Student organizations have worked diligently to educate and support the community by providing resources and working to make those resources more obtainable and over 40 percent of students have reached out to mental health services at some point during their college years. University Health Services has made structural changes and continues to work to better serve student need. The multifaceted network of mental health resources can and does support. A more pertinent problem may be that such a diverse system is difficult to navigate for someone looking for an open door.

Room to Grow    

The Director of University Health Services, Dr. Paul Barreira highlighted two areas in which he believes there will be constant room for improvement. When asked where he thinks future efforts should focus to improve the availability of mental health resources on campus, Barreira stated that access and capacity would always be issues. “How quickly can someone be seen?  How much treatment can they get? Is there enough staff to do what is needed to serve the student body? There are always questions regarding how we make this better.”
An underutilized resource in which students can seek guidance, support, and direction is Linda Cannon, the UHS Patient Advocate, who further alleviates the possible overwhelming nature of these several “open doors,” In an interview with HPR, when asked what issue she assisted with the most, she stated, “often times, the problem may be navigation, and I can help them understand the system.” Cannon noted freshmen often struggle the most, as they are typically not well-acquainted with meeting their own healthcare needs. International students may also face a unique barrier in comprehending the American healthcare system, and Cannon, well versed to address both challenges, helps them all.
However, she also stated that one of the greatest tragedies of her position, is that many students are not aware it exists.  To increase student awareness and create forums for more feedback, Cannon also works with a Student Peer Advocate Workgroup consisting of representatives from both the College and several Graduate schools. These individuals meet with Cannon monthly to discuss issues as well as initiatives to improve patient experience at both UHS and MHS. Cannon hopes this new group will continue to gain strength and its members will serve as leaders among the student body for student healthcare advocacy.
Opening New Doors
On a positive note, according to data from the Student Mental Health Services Patient Satisfaction Survey conducted in April of 2013, nearly three-quarters of students found their treatment helpful and would recommend the clinician to a friend. Clearly, SMHS is on the right track.  In a constant effort to improve, Dr. Kathy Lapierre, Chief of Student Mental Health Services, also identified current plans MHS is working on, many focusing on prevention. In an effort to prevent students from waiting too long to seek help, MHS is coordinating with the Wellness Center on a new “Mindfulness Program” to teach stress management techniques. “[We] have also been increasing staff gradually, and I anticipate if need continues to grow, we will meet that need.” Forty percent of students from the satisfaction survey had indicated clinician availability was a barrier to scheduling an appointment. Therefore, during times of probable heavy traffic (i.e. in the beginning of the year, during midterms, and again during finals), Lapierre says they now temporarily hire more staff members that have worked with UHS before and are familiar with the system.

Additionally, Lapierre commented on additional efforts to effectively educate students about strategies to better cope with stress management. Data from the Harvard University Health Services Health Assessment Survey, conducted in the spring of 2012, indicated that 36 percent of students felt stress affected their academic performance. She hopes that by providing media outlets such as apps and podcasts, students can more easily learn how to manage their difficulties in a healthy way: all in the palm of a hand.

Any Open Door

Lapierre stressed in her interview with the HPR the presence of strong communication channels between the various branches of the mental health resources network. “Any open door is fine, we will get you there. They [students] can go anywhere. There are multiple points of entry. All the groups know each other, and have the ability to communicate. People can go to multiple places at one time.” Each facet of the network can address a specific issue regarding mental health, because mental health concerns are rarely one-size-fits-all. By opening any open door, students can begin to find the right solution for them. Various peer education groups on campus have also launched a strong presence in the past year with initiatives like Harvard Speaks Up, a video campaign through SMHL that collects submissions from students, tutors, or professors in the Harvard community and streams them on their website. Seth Cassel ‘13, a former SMHL, began the project as a way to create a voice on campus and create a forum to encourage individuals to discuss mental health issues, rather than withdrawing and feeling alone. This initiative has received tremendous feedback and is now being implemented in other universities such as Johns Hopkins and Yale.

Lapierre concluded, saying, “We don’t want people to suffer. It is important to get the word out that it’s not because you were at Harvard.” There is often a misconception that Harvard students experience more mental health related problems than the national college population has a whole.  In reality, many of these conditions have a significant genetic basis, and in some cases, regardless of a student’s environment, symptoms may present themselves.  One final misconception students may have is that MHS is an “arm of administration” as Lapierre states. Many students fear that by approaching one of the mental health resources on campus, their academic record, credibility, and status will be negatively affected. However, barring an emergency or life-threatening situation, information regarding a student’s health cannot be released without written permission. “When rumors become folklore, I worry that people who need our services will be afraid.”

Moving Forward

In terms of what to do next, Barreira says efforts should focus on working in coordination with specific cultural, racial, or ethnic groups on campus to identify why students may feel there is a “barrier” to mental health resources. “We have gotten more sophisticated in thinking about, ‘what is stigma?’ There may be different solutions for each group.” Rather than blanketing the entire diverse Harvard population with proposed universal “barriers” to access, we must recognize that there are critical differences between individuals or communities on campus that may present exclusive hurdles requiring a particular intervention or support.

For those struggling with mental health issues, it takes courage, it takes support, and most of all, self-honesty to seek out and accept help. However, if students can get past any internalized barriers, they will find a UHS that is ready and eager to help students succeed. After that first step, the road to recovery, though it may not be an easy one, begins to flourish with hope and promise. There has been significant movement in a positive direction, and both MHS and UHS continue to respond to structural and logistical issues that periodically arise.  To further aid these efforts, students can also contribute by continuing to “speak up.” If we can celebrate progress, improvement, and overcoming problems rather than focusing on what was wrong in the past, Harvard can continue to move forward and become a better place.