A University of Richmond student tells me she has felt suicidal for some time. She can’t get out of bed or find motivation to do work. She often finds herself thinking of home, her brother, and her sister, and the pain they feel or felt. Her friends want to help, but they can only do so much. They just don’t understand.
Enough is enough, she decides. She wants help, so she goes to Richmond’s Counseling and Psychological Services, which offers a range of free, short-term mental health-related services to full-time, degree-seeking students at Richmond.
Nervous and anxious, she walks into the office hoping to schedule an appointment with someone, anyone, who can help her.
But there has been a demand for services unlike anything CAPS has faced. CAPS’ eight full-time employees are already stretched as far as they can be stretched without breaking. The office saves slots for emergency cases, so she went to ask for help during this time. While speaking with one of the counselors, however, she was informed that her case was not urgent enough to use one of the emergency slots.
“I think I went back one more time to another counselor a few weeks later for a follow up, but I never went back after that because of what the one counselor said,” she said.
Asking for help is hard. And being told no when you desperately need support can be devastating. During the fall semester CAPS, which has had a waiting list in each of the past nine semesters, has been forced to send an unexpectedly large number of students to its waiting list, which was as large as 36 people. Through 10 weeks of classes, 344 students used CAPS for counseling, according to Richmond’s website, a 28.8 percent increase from the previous academic year.
“This is a very abnormal jump,” said Peter LeViness, who has served as the director of CAPS since 2002. ”I’ve never seen it that big.” LeViness said he and those part of the counseling center world felt strongly that it was important to keep students off of a waiting list.
“Usually they struggled for a while,” LeViness said. “We might be their last option. You don’t want someone who has tried everything else and is on the edge to come then you say, ‘No room here.’ We worry about that.”
To learn more, LeViness conducted a survey on students’ attitudes about waiting lists at CAPS. The survey revealed that 86 of the 102 respondents, all of whom had spent time on CAPS’ waiting list, said that even a small waiting list is problematic, if the wait is longer than one week. About 52 percent said they had a more negative attitude toward CAPS, and about 30 percent said they were less willing to use CAPS services again.
“Being put on a waiting list can feel as though your problems are not a legitimate concern, that perhaps even CAPS does not care,” A student who responded to the survey wrote. “Mental illness isn't rational. It will take any opportunity to destroy a person's self worth, and waiting for help can be interpreted as, ‘You don't matter. You don't deserve help.’"
Some students who need help and treatment aren’t receiving it. To some, the services CAPS provides can be a lifesaver – literally. Trust me, I know.
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Mental illness would never affect me, I thought at the start of my sophomore year at Richmond. Depression and anxiety, I assumed, were extreme conditions only a minute subsection of society struggles with, and often these illness are easily distinguishable. A homeless man on the street or a deranged teenager probably suffers from some mental illness, but a high-achieving college student like me would never face anything of the sort.
Oh, how naïve I was.
I didn’t necessarily acquire new traits that fall, but some aspects of my then-undiagnosed anxiety worsened. My always-volatile temper reached new levels; I over-analyzed social interactions, especially with strangers, assuring myself that they disliked me and looked down at me; my self-criticism worsened to the point where I frequently asked myself, “Would anyone really care if I died tomorrow?”
My thoughts were like a boulder tumbling down a hill; the momentum grew rapidly, compounding on itself, to a point where it was too forceful to halt. I felt worthless, and then I felt worthless for feeling worthless. I drank and smoked as a form of self-medication, a way to take my mind off these thoughts, and would then chastise myself for drinking and smoking. I thought I was both a failure and an anomaly. My thinking was, once again, naïve.
Serious mental diseases often wage war against students during their college years, an already difficult time for many. With new freedoms and responsibilities, students search to find who they are and what they want to be. The vast majority of mental health disorders emerge during one's adolescence or early 20s, said Johanna Jarcho, a postdoctoral fellow at the National Institute of Mental Health. In 2011, a nationwide survey of college students found that about 30 percent reported feeling "so depressed that it was difficult to function" at some time in the past year. And then there’s the extreme: suicide. Suicide is the second leading cause of death for college students, and the No. 1 cause of suicide for college student suicides is untreated depression.
CAPS saved me.
A close friend strongly encouraged me to seek help, so I went to CAPS. Fortunately, there was no waiting list, and I had an appointment a few days later. Through counseling and eventually prescribed medication, I slowly improved. I’ve suffered hiccups along the way, and CAPS has always caught me when I needed catching. As a whole I am much healthier now than I had been. I am lucky for many reasons, one of which being I wasn’t told I had to wait when I sought much-needed help at a time when I felt all was lost.
CAPS has grown vastly since Steve Bisese, now vice president for Richmond’s student development division, was an area coordinator for Richmond College from 1985-1990. “If I am remembering correctly, there was only the director, who saw all the clients and a half-time person for the same number of students as we have now,” he said.
The growth in counseling services, while undoubtedly encouraging, has been seemingly retroactive as demand for services has increased and, based on trends over the past decades, will likely continue to increase. The number of Richmond students seeking mental health services at CAPS has increased by more than 300 percent in the past 30 years, with the greatest proportion of this increase occurring since 2002-2003, according to CAPS data. There has been a 90 percent increase in students seeking mental health services at CAPS over the last 12 years, according to CAPS Services and Mental Health Trends.
“It’s refreshing to see a lot of students being willing to access us,” LeViness said, “but it’s frustrating when there’s not enough of us to meet the need.”
While there are multiple influences for the increase in demand, the main factor has been the reduced stigma and a greater wiliness to seek counseling. According to a 2007 Behavioral Risk Factor Surveillance System survey, 78 percent of adults with mental illness and 89 percent without believed that treatment was an effective method to help patients lead healthy and normal lives. “People who have a need are more likely than ever before to see mental health services as an acceptable option,” LeViness said.
CAPS even increased about 10 percent of talk therapy hours from independent contractors in preparation of a jump from last year, LeViness said. He said he had told the contractors that they would be needed by late September or early October. But then there was the unexpected jump.
“By the end of the second week of class we already had nothing available,” LeViness said, so he asked the contractors to begin working in early September.
Bisese said he has asked for an increased budget for CAPS or the student health office almost every year since he became vice president for Richmond’s student development division in 2006. “He’s incredibly supportive,” LeViness said.
In addition to Bisese, LeViness, and all those a part of the CAPS office, other Richmond administrators are working to combat the problem. Dozens of Richmond’s top administrators attended a presentation LeViness led on a Monday afternoon that focused on college mental health needs. The only student at the presentation, I sat in back and watched some of Richmond’s deans and other leaders take meticulous notes and ask follow-up questions.
But as these administrators are continuing to discuss these challenges, some Richmond students continue to grapple with sometimes life-threatening mental illnesses. My freshman-year roommate, for example, suffered from severe depression, and in May depression won. Now he is just a picture in my wallet and just a memory my friends and I reminisce about. Although his official cause of death is listed as suicide, anyone who knew him knows his mental illness killed him. He could have been saved. Others could have been saved. Others can still be saved.
“I’m just wondering why the national conversation doesn’t have more urgency to it,” LeViness said, as his usually soft, controlled voice rose with some anger. “If this was a medial disorder… I can’t help but think there would be a different urgency to the response. Why is it when it’s mental health that it doesn’t seem as urgent?”
Contact editor-in-chief Jack Nicholson at firstname.lastname@example.org
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