Content warning: this story contains references to self harm and suicide. If you or someone you know is at risk, you can call the National Suicide Prevention Lifeline at 800-273-8255. Additional resources are available here.

By the end of fall quarter, Destin Fernandes ’24 was in his “worst state.” Since the start of the school year, he had been dealing with depression, anxiety and suicidal ideation. “I was literally unable to leave my room most of the time,” he said.

“Go to CAPS” — Counseling and Psychological Services — is the conventional wisdom doled out to those struggling with mental health at Stanford, a piece of advice that students hear on a regular basis but do not always heed. This time, Fernandes did, calling up the short-term counseling center that has been the subject of student discontent in recent years. After describing to CAPS the extent of his mental health crisis, Fernandes was still told he had to wait over a month to speak to a CAPS counselor and psychiatrist.

Experiences like Fernandes’s have been a wake-up call to CAPS administrators, who have accelerated work to address student concerns.

For CAPS to regain the trust of Stanford students, leadership will have to overcome some significant barriers. Long wait times have been just one of many student concerns, exacerbated by worsening mental health struggles during the COVID-19 pandemic. According to data obtained from the Associated Students of Stanford University (ASSU) CAPS Survey & Questionnaire, led by undergraduate senator Marion Santo ’23 in February, only 41% of students who reached out to CAPS were able to see a therapist within the timeframe they needed. Moreover, only half of the students surveyed felt that CAPS was at least somewhat accessible.

Students also voiced concerns about accessibility to off-campus healthcare referrals and transitioning to long-term care, alternative treatment for students located outside California and a lack of diversity and cultural competence among CAPS staff.

Informed by student feedback, CAPS has implemented and reformed numerous initiatives. Most recently, CAPS launched a new pilot program known as Work Place Options (WPO) to facilitate same-day appointments and up to five free therapy sessions with off-campus partners.

With the goal of serving as many students as possible, CAPS has long utilized a short-term care model, according to CAPS representatives.

“Feedback from students was that the priority was more about upfront access, as opposed to longer-term treatment options,” CAPS clinical director Amy Wilkinson said. “So we designed our access model accordingly.”

For students with longer-term needs, CAPS helps them locate treatment resources beyond itself for ongoing care. One platform CAPS recommends students use to locate longer-term treatment is The Shrink Space. Funded by Vaden, this online database can help students find local, non-CAPS therapists. It also allows students to view therapist availability and request appointments directly through the site.

Numerous groups and outreach spaces provide mutual support and solidarity for students with specific demographic backgrounds or challenges, including groups for international students, women of color, eating-disorder survivors, students with disabilities and the newly formed group for male-identifying sexual assault survivors. CAPS also offers a range of workshops, such as “Meditation and Self-Compassion” and “Yoga Skills for Stress Reduction.”

“Sometimes students may find it more helpful and supportive to be among other students to be able to share some of these challenges,” Associate Director of Communications for Student Health and Well-being Christine Mineta said. “So these facilitated spaces allow you to be with community and validate the challenges and experiences that you’re going through.”

Before the pandemic, CAPS care providers held regular hours in community centers, such as at the Asian American Activities Center, Graduate School of Business and the Law School to provide in-person support. Although these hours became virtual during the pandemic, CAPS is working to transition these hours to in-person again.

Improving the quality of CAPS care and resources is just half the battle, though. For these improvements to achieve their fullest impact, CAPS will need to spread awareness among the student body. According to the ASSU CAPS Survey & Questionnaire, 73% of respondents said they were unaware of the WPO program, and nearly 75% were unaware of The Shrink Space.

“It seems as though more needs to be done in terms of publicizing the various mental wellness resources available via CAPS to the student body,” Santo wrote.

Student representatives are taking on the awareness problem. In February, the Undergraduate Senate passed a resolution outlining a CAPS liaison program, which would designate a student in each dorm to work closely with CAPS and communicate mental health resources to their peers. Senator Darryl Thompson ’23 said that increasing knowledge of mental health resources on campus is important because “if that is not happening, then it’s no surprise that we’re seeing some of the things we see.”

Aside from the liaison program, CAPS also recently overhauled their website to enhance accessibility, resource navigation and visual coherence.

Still, Fernandes said, obstacles remain for students trying to reach CAPS. Phone calls — which are required for referrals with CAPS — can prove especially challenging.

In 2019, CAPS transitioned to an access-focused service model in direct response to student feedback. Students are asked to reach out by phone, instead of independently scheduling an online appointment, “so that we can better assess their needs and help them connect as soon as possible to the appropriate services,” CAPS representatives told The Daily. They added that students are also welcome to enter CAPS’s physical offices for immediate support from Monday through Friday from 8:30 a.m to 5 p.m.

Another disconnect between CAPS and the student body is the center’s readiness to respond to first-generation and/or low income (FLI) students facing crises, Fernandes said. As a low-income student, he felt the CAPS counselor he spoke to misunderstood his experiences. Facing such misunderstandings is not an uncommon experience for many FLI and queer students, Fernandes said, suggesting that CAPS focus on hiring more diverse cohort of clinicians.

Part of the problem may lie in staffing shortages — throughout the pandemic, CAPS said they have especially struggled to hire and retain mental health providers during the pandemic. Even so, “CAPS staff seek out continuous learning to address racialized trauma, provide gender affirming care and decolonize mental health approaches,” the CAPS team wrote in an email.

Despite the ongoing challenges, CAPS representatives reiterated their commitment to student mental health, in both the present and future.

“Mental health is a community value, and involves the whole community,” Wilkinson wrote. “CAPS is building connections to a wide variety of student communities, where we work to destigmatize mental health on campus, and to connect students to long-term mental health care in the community as well.”