Tackling mental health issues will take time

Jan. 14, 2010, 12:06 a.m.

It took one-and-a-half years for Stanford’s 48-member Mental Health and Well-Being (MHWB) Task Force to evaluate campus mental health issues. Addressing these issues is likely to take years more.

More than a year has elapsed since the 88-page MHWB Task Force Report was first released, and the University is still in the information-gathering phase. In that time, “mental health” has become a buzzword, the Wellness Room has sprung up and students seeking counseling have increased, according to Counseling and Psychological Services (CAPS) Director Ronald Albucher.

Still, tackling the report’s list of 18 wide-ranging recommendations has proven to be a sluggish process. While the MHWB Oversight Committee, the body formed in October 2008 to monitor the report’s implementation, has made gains in certain areas, many of the proposals remain in the discussion stage.

“The Oversight Committee is focusing on qualitative and quantitative measures to assess progress at this point,” wrote MHWB Initiative Project Manager Ralph Castro, also the manager for Health Promotion Services (HPS) Substance Abuse Prevention Program, in an e-mail to The Daily.

“A lot of the year has been building a new framework for looking at the recommendations and gathering information,” said ASSU student representative and Undergraduate Health and Wellness Co-Chair Alisha Tolani ‘10.

The Committee, whose progress can be tracked on its Web site, is comprised of health professionals, faculty members and students, who meet two to three times throughout each quarter. The body is subdivided into three work groups that gather more frequently: Faculty and Academic Initiatives, Education and Outreach, and Policies and Practices.

Quantifying Progress

Against the odds, the Oversight Committee has been able to post several gains.

Many proposals have already solidified: a change in the Academic Calendar aimed to reduce stress, a new course to promote happiness and stress-reduction, the addition of a staff position to mentor first generation and low-income students and the continuance of suicide prevention QPR counseling through CAPS.

Mental health has also become less of a fringe issue, with candidates for student government often making mental health a part of their platforms.

“I think that mental health issues are something that people are becoming more and more aware of, which is great,” wrote undergraduate student committee member Sandra Yen ‘10 in an e-mail to The Daily. “It is not an easy topic to talk about.”

Castro also cited the critical importance of the maintenance of CAPS resources throughout multiple rounds of budget cuts in supporting mental health efforts, as well as the increase of funding to the gradate Community Associate program, which supports graduate students living in on-campus housing.

“We did take a minor hit [in funding], but overall, in terms of clinical time, there was no impact,” Albucher said. “The University really wanted to prioritize staffing and funding for mental health.”

CAPS has undergone the most changes since the formation of the MHWB Task Force in 2006. Using additional funding from the University’s general fund, CAPS hired more staff people, a case management official and a new director — Albucher — in November 2008.

According to Albucher, CAPS currently has 16 full-time equivalent positions, along with three psychology trainees, three psychiatry residents and three child psychiatry fellows.

With the increase in personnel, CAPS also shifted focus to raising intake capabilities.

“Our goal for most students is to get them in within a week’s time of first contact,” Albucher said. After an initial screening, CAPS will then refer the student to the appropriate service if necessary.

CAPS has been succeeding in achieving this goal. According to case intake data from October 2009, 84 percent of students were seen by a clinician within a week of contacting CAPS. Reasons for the 16 percent of delays included students’ requesting specific therapists and scheduling conflicts. In one to two percent of cases, CAPS was unable to identify a reason for the delay.

In the past year, there has been a 10 percent increase in requests for counseling and a 30 percent increase in requests for medication evaluation and medication management, according to Albucher. Every week, CAPS receives between 50 and 60 requests for new evaluations — the same rate Albucher told The Daily in November of 2008.

CAPS services, from triage to intake to counseling, are provided free of charge to students, paid for by the Vaden health service fee instituted fall quarter.

Due to resource constraints, however, CAPS is unable to offer long-term counseling for most students.

“Under Review”

But not every initiative has met with success.

For many of the recommendations, the current progress merely reads, “Under review,” and the Web site does not include updates from the 2009-10 academic year.

Tolani defended the pace of the changes. “We’re checking in frequently enough — I think [the outreach working group] had four to five meetings last quarter — and we’re going as fast as we can, keeping in mind faculty schedules,” she said.

“Though there doesn’t seem to be a concrete deadline, the Oversight Committee is holding to a tight deadline,” she added.

Part of the difficulty stems from the lack of a single, proven solution for improving mental health. According to Yen, the Oversight Committee has also been looking at how other universities are combating the same issues.

“I think the biggest problem is that there is still a lot of stigma and people are afraid to talk about it because they are afraid how their peers will respond,” said ASSU Undergraduate Health and Wellness Co-Chair Jen Hawkins ’11.

“Often, CAPS sounds like a good idea to students until it comes time that they are the ones who need it,” added committee member and Earth Systems Prof. Julie Kennedy.

Student Involvement

If all else fails, the lasting contribution of the MHWB task force may be the collaboration between groups working to support and raise awareness for mental health issues. In particular, cooperation between Vaden, HPS, CAPS and student initiatives is on an upward swing, according to Tolani and Hawkins.

Student groups like Stanford Peace of Mind, the Stanford Theater Activist Mobilization Project, the Bridge Peer Counseling Center and Project Love, along with the Wellness Room, are all targeted at raising student awareness and de-stigmatizing the issue. These groups often work with CAPS and HPS, bringing clinicians into dorms and hosting panels. Personal accounts of students who have sought counseling are some of the most effective methods of outreach, say Hawkins and Kennedy.

The ASSU will be hosting a wellness week in February, bringing together various student organizations and formal health services to promote mental health.

“We want to stress that taking positive steps in addressing mental illness is really a sign of strength,” Tolani said.

Updates on the progress of the MHWB Oversight Committee can be found on its Web site, www.stanford.edu/group/mhwb/.

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