A recent article in The Stanford Daily highlighted worries expressed by some students about what may occur if they contact Counseling and Psychological Services (CAPS) for support. Our entire CAPS team is committed to addressing any obstacles that keep students from getting the support they need — including misconceptions that students may hold about CAPS or its role on campus. The cost of allowing these misconceptions to continue is significant: Students who are in distress may become discouraged from asking for help, just when they need it most.
Asking for help when things aren’t going well is never easy. And for many Stanford students, it has become even harder amid the disruption and isolation that they have experienced over the past year. The loneliness, losses, grief and traumas of this past year have increased the levels of suffering that students are experiencing. At this moment — more than ever — it is critically important that students feel safe in seeking help when they need it.
For that reason, I’d like to speak directly to the main concerns expressed in the Daily article.
Quality of care and access to care at CAPS
CAPS provides services to over 20% of the student body each year. Due to this volume of demand and the need to ensure equitable access for all students, CAPS therapists work in a brief treatment model that focuses on students’ presenting concerns. When students have more complex or longer-term needs, CAPS will help with referrals for the appropriate level of ongoing care.
Our providers are selected based on specific qualities that are essential to care for the Stanford student body — including clinical excellence, cultural humility and a dedication to serving students with diverse identities. CAPS has also prioritized timely access for all levels of student need.
The quality of our staff and services are reflected in the results from a recent survey, sent to 477 students (33.1% response rate) who received care from CAPS this January: 100% agreed that their provider was respectful and considerate of their identities; 99% agreed that the response by their provider had been appropriate for their presenting need; and 97% agreed that they had been able to get an appointment at CAPS with relative ease.
Due to licensing laws that all California health care providers are required to follow, there are limits on the range of telehealth diagnostic and treatment services that CAPS can provide to students residing outside of California. We are working to finalize an arrangement for CAPS to cover the cost of brief therapy sessions, provided by a national/international organization, for out-of-state students.
CAPS has a care management team that is dedicated to supporting students who are hospitalized or discharged from the emergency room. The vast majority of students who are hospitalized do return to campus after their inpatient stay.
Involuntary transports to the hospital
At CAPS, we regard the protection of students’ rights and student privacy as a core aspect of our mission. We are aware of some students’ concerns that seeking care at CAPS will result in their being “placed on an involuntary hold or [facing] other punitive measures from the University,” as reported in The Stanford Daily. To address these concerns, I want to share a few key points.
Having suicidal thoughts alone is not grounds for a CAPS counselor to place a student on an involuntary hold for transport to an emergency room (called a 5150 transport hold). CAPS therapists work with students every day who are experiencing thoughts of suicide or other serious symptoms, and we help students to engage with the treatment and support they need to remain safe.
A 5150 transport hold is a rare, last-resort measure to save a student’s life or protect against serious harm. It is used only when less intensive measures are not adequate. A 5150 hold written by a CAPS staff member or a public safety officer only allows for a student to be transported to a safe setting, such as an emergency room, for further evaluation. The hospital staff will then conduct their own evaluation to determine if a student should be admitted to an inpatient unit for further care, or if the student is able to leave the hospital with a treatment plan in place.
Involuntary leaves from Stanford
Involuntary leaves are extremely rare events, managed by the Dean of Students office (DoS) under the university’s Involuntary Leave of Absence and Return Policy. CAPS does not make referrals or recommendations to DoS regarding involuntary leaves. As health care providers, our only role is to support students in their treatment needs and care plans.
DoS may request that a student provide authorization for CAPS, or another care provider, to give information to DoS about a student’s treatment needs during a leave review. Students can decline to provide this permission without affecting the support they receive from CAPS in any way. The CAPS care management team will remain available to help students set up care plans before they go on a leave and as they transition back to campus.
Commitment to dialogue
At CAPS, we understand how hard it can be to reach out for help. Please know that our providers are deeply caring, committed and skilled — and they are here to support any student who takes that step. I am glad to speak confidentially with any student about their questions, feedback or concerns about seeking care. Students can reach me by calling CAPS at 650-723- 3785.
Bina Pulkit Patel, M.D., is the Director of Counseling and Psychological Services (CAPS) at Vaden Health Center.
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