As part of our wellness special issue, The Daily sat down with Vice Provost for Student Affairs Susie Brubaker-Cole and Vice Provost for Graduate Education and Postdoctoral Affairs Stacey Bent to discuss community concerns about mental health on campus. They responded to challenges and criticisms expressed in The Daily’s collection of community voices and spoke to administrative efforts to increase mental health support on campus. 

University administrators also addressed CAPS, duck syndrome, graduate student life, the Faculty Staff Help Center and more.

These responses have been lightly edited for clarity and brevity. 

The Stanford Daily [TSD]: How do you respond to student concerns that the University is not putting enough resources into mental health care? 

Susie Brubaker-Cole [SBC]: We are deeply engaged in student affairs in working on addressing students’ mental health and wellbeing needs. It is probably my number one priority as Vice Provost for Student Affairs alongside issues of diversity, equity, inclusion and belonging, which are sometimes hard to separate. And I think it’s critical that as we work to meet the evolving needs of students around mental health and mental well being, we hear from students frequently, and we also hear from people who work with students frequently to understand how those needs are evolving. 

We have indeed added substantial resources for student mental health and wellbeing in many forms. And I want to emphasize that those many forms include more full-time equivalent in CAPS, in therapists — but that is not all. We need to be looking at non-clinical resources as well that allow students to access ways to reflect on and improve and bolster their own mental well-being before it rises to a level of needing counseling. And I would like to identify one of the premier programs that we have added in recent years, which is the well-being coaching program. That is a part of the Vaden portfolio programs, but it’s not a clinical service. And it’s something that’s accessible to students all over campus and they can engage in one-on-one wellbeing coaching. It’s been extremely well received by students.

I think it’s important to highlight that this is a multifarious strategy. There are four main threads of what we’re doing. The first is to address clinical needs. And that includes both adding additional therapists and also continuing to assess the access model and to assess the effectiveness of students’ ability to access services. It also includes considering other modes of service like group therapy and workshops, which have been very well received by students and are an evidence-based approach to supporting mental health and well-being. 

The second kind of major approach that we have is what we call our preclinical interventions. That includes the well-being coaches that I’ve mentioned, but it also includes some really important work we’re doing to train faculty, staff and students, particularly students in leadership roles like RAs and others, on how to respond to and support a student who’s in distress or in need, and this includes how to get students connected to the most appropriate resources for additional support. Last I talked to my colleagues who run these trainings, we have trained over 5,000 members of the Stanford community, which is really impressive and important. ​​The purpose of this is to expand the number of people on campus who feel comfortable and equipped to recognize when a student is in distress, and then to know how to respond to that student in distress in a caring way and how to do a basic referral of that student for resources. If I could say one thing that I’ve heard as feedback about both the design of the training and those who’ve completed it — they’ve shared that it makes it feel like we’re turning this into a more human campus, where people feel able to show the care that they feel for their students. 

The third strategy is thinking about ways that we can ensure that our resources are all culturally attuned. We have incredible diversity in our student population, and we need to be sure that our resources are placed in locations and designed in ways that resonate with our students with different student populations. For example, we currently have embedded counselors and/or well-being coaches in our community centers. They also work in the ethnic theme dorms. We have embedded therapists in the GSB and the Law School, in the Knight Hennessy Scholars Program we have a well-being coach, and in the Graduate Life Office. There’s also specific mental health support for students in the School of Medicine, and then a similar program for student athletes. It is just critically important that we have these resources where our students go habitually and where students feel comfortable going and accessing.

Which takes me to our fourth big approach right now. I hear frequently from students, ‘Oh, I didn’t know that that resource existed. That sounds great. How do I access it?’ And I hear that from undergraduates, graduate students — students from all over campus. And so it’s really important that we communicate effectively about what these resources are and how to access them, and that’s sort of our fourth leg of our chair of what we’re working on. We’ve built a new web presence that helps students navigate the resources available. We have a communication campaign about strategies for healthy lifestyles for students. 

So those are sort of the big ways that we’re working on expanding resources, knowledge of resources and ensuring that they’re culturally aligned with our students’ needs.

Stacey Bent [SB]: We really share the students’ concern about the difficulty and the students mental health and well-being and we really tried to put forward University resources to address them. I think about the graduate side of things, and I want to just mention a few things. One of the things that we know is that there can be stress from relationships with advisors. The relationship with advisors is a really key part of the graduate student experience. And we also know that in some cases, it’s a very unique relationship and it can be stressful for grad students. Those many resources that Susie mentioned are available for graduate students, and we encourage our students to seek those out as needed. There’s also resources within departments for graduate students. So I encourage our graduate students to connect with the department or program director of graduate studies, especially for academic sources of stress. There’s also the expert staff at the GLO office (Graduate Life Office), who can help manage academics and graduate life concerns. The deans and GLO are a really great resource for pointing students in the right direction to get other resources as well. 

We know that affordability can be a major source of stress during students’ time in graduate school, and this is something we care really deeply about and have actively worked on over the last few years to address. Just recently, we announced the 100% subsidy for Cardinal Care insurance and increased programs for need-based funding. What we are really working hard to do is try to reduce the stress associated with affordability for our graduate students, and that’s something we’ve worked very hard on over the last couple of years. 

TSD: People often talk about Stanford in the context of “duck syndrome,” in that we all look like happy ducks floating on the surface, but underneath, we’re paddling aggressively just to stay afloat. How do you view duck syndrome from your perspective as administrators? 

SBC:  I hear from students every month about duck syndrome. So I know that it’s real. I know that it’s a struggle that students have. Sometimes it’s also very proximate to what people refer to as imposter syndrome. And I think that that is a cultural phenomenon and a phenomenon of some of the environmental factors around campus that we need to work on as a community. I spoke earlier about how our community has so much care. It’s not always something that people feel comfortable expressing.

I think one way that we all need to address the duck syndrome is to think of it as related to stigma — about mental health, and about struggle, and about the challenging world that we live in today, and about the challenges of being in an intense, high achieving culture of the University. And I think that, there are some great things that have happened historically, across campus to begin to address duck syndrome, and because students are still experiencing it today, I think our work is not done. We have to talk about mental health more. I think I’d have a hard time finding a person on this campus who either personally or through family or friends has not witnessed some sort of mental health struggle, and the duck syndrome is one of those, and I think we need to bring it out and talk about it. And it needs to be okay to not be okay. 

SB: I can add something that I think is interrelated with the duck syndrome, which is a sense of isolation, and we’re really trying to address that. Especially for some graduate students, the time can come with isolation and a sense of loneliness. And this is definitely a concern for us. We really want a graduate student’s time to be not just marked by intellectual growth, but also meaningful relationships and connections and community, and so we encourage graduate students to invest in various opportunities. We have a lot of resources through the GLO office and other activities to really bring people together and try to avoid this sense of isolation.

TSD: What would you say to students who don’t feel comfortable with or have faith in utilizing Stanford’s resources? 

SBC: The first thing that I would say is that I care and that I acknowledge and validate their struggle, because I think that what we all need to do is make it clear that this is a place full of individuals who care deeply and want to help. 

We have some really poignant data that shows the effectiveness and the positive reception that students have of CAPS. And we have some data on the well-being coaches. We do a survey periodically of students who access resources at CAPS, and we did one in this last winter quarter (winter 2022). That survey revealed a very high level of positive reception of the CAPS services by students. For example, 92% of respondents were able to access CAPS in a timely manner and with relative ease. Ninety-seven percent of respondents agreed that their provider was respectful and considerate of their identities. CAPS has worked extremely hard to recruit a diverse clinical staff, and they’ve been very successful. In that same survey, 94% of respondents said that they would recommend CAPS to their friends. To have those three results over 90% is really striking. That’s part of what helps to eliminate stigma and it sometimes can open students to seeking help. Many students — over 90% — have excellent interactions with CAPS, and I think that speaks to the quality of services there. 

I think it’s important that we convey everywhere we can that one of the habits of highly successful people is recognizing when they need help, and seeking that help. And I think that when we share that successful students, successful faculty, successful staff, successful university leaders, seek help when they need it, we normalize help seeking. Hiding things is not the way to be helpful to each other and it’s not the way to care for oneself. Help seeking is what successful people do. 

TSD: Many students come to Stanford already dealing with mental health struggles. How does the University view its responsibility to help students with their mental health given that many struggles often derive from issues that extend far beyond Stanford? 

SBC: That’s a really important question. There’s just accumulating data every month that student mental health outcomes in high school students and even middle school students is declining and is in a state of crisis alongside college student and graduate student mental health. It’s important because we know from talking to students, and from national surveys, that students who experienced challenges during the pandemic when they were not able to be on campus, either at Stanford or many universities across the country, have delayed or deferred seeking treatment and for very understandable reasons. It might be because that’s something that their home environment would not support. It might be because of lack of accessibility, or it might be because of prohibitive costs. All of those make a lot of sense. But we are on our campus and other campuses across the country seeing a lot of deferred care because it wasn’t possible during the pandemic. And that has produced additional pressures on CAPS. And we’re seeing that in a way that is both positive and negative. We’re seeing a larger proportion of the student body seeking and accessing CAPS help than has been the case in the past. — so a larger proportion of Stanford students, grad and undergrad, are using CAPS services than has been the case in the past — and that’s a good thing, because you know what that means? It’s help seeking behavior. 

TSD: You’ve spoken to how the administration has focused on building resources here on campus. How does the administration make the distinction between when a service should be provided on campus and when it’s something that outside resources are better equipped to provide? 

SBC: The counseling services in the surrounding Stanford area are as taxed and overburdened in this mid-pandemic mental health crisis, as our campus resources are. Access to therapy is difficult in most places, and we know that our students have challenges when they try to access a therapist off campus. CAPS is there to assist with that referral process. And we know that it’s challenging. We also know that CAPS is designed to be a short-term therapy resource, and long-term therapy is something that we refer to off campus and we’re here to aid students in finding those therapists. We know that’s difficult and there’s definitely work to do there. But it’s something that CAPS has always done and continues to do. There are some students who have a lot of success with that and others who struggle, and so I would like to see the struggle go down. But that’s going to be challenging because people who are not affiliated with Stanford who are seeking therapy off campus have wait times of six months to get access to a therapist. Fortunately for CAPS services, that wait time is not six months, it’s in peak periods of the quarter, more a matter of a week or a couple of weeks. So I think that we have to keep into perspective the relative accessibility of therapy services on campus compared to what people in communities off campus experience.  

The Daily also reached out to the University about concerns regarding the Faculty Staff Help Center (FSHC). 

FSHC, according to the Center’s director Rosan Gomperts, provides mental health support to faculty, staff and postdoctoral students and their families through their University-sponsored medical plan, in addition to providing free resources. The Center is designed to provide short-term support, assess the needs of each individual and refer patients to additional services if needed. 

“The Faculty Staff Help Center is committed to supporting Stanford staff, faculty and post docs and we are always open to conversations with the people we serve to learn how we can better meet their needs,” Gomperts wrote in a statement to The Daily. 

Gomperts added that FSHC is “aware of the increasing needs in the community and continue[s] to find more and better ways to provide support services.” She highlighted the University’s recent additions of Meru Health, a free online platform for employees and adult dependents suffering from anxiety, stress and depression, and Brightline, an in-network provider of child and adolescent mental health services.