This is the last in a four-part series on crisis response and mental health resources on campus. For part one, a look at how the University responds to student mental health crises, visit here. For part two, an examination of Stanford’s safety net, visit here. For part three, an informal survey of student experiences with campus resources, visit here.

Over the past week, The Daily has examined how the University responds to and works to prevent mental health crises, the campus resources that exist to help students who are struggling and how students themselves experience those services.

Today’s piece examines how students and administrators think the University and student body can work together in the wake of tragedy to destigmatize the discussion of mental health and illness. Many administrators said they believe more focus must be put on giving students the tools to deal with everyday stress. The Office of Student Affairs, Residential Educational and Counseling and Psychological Services (CAPS) are all either finishing reports and initiatives related to student life and mental health or about to undertake new task forces on the topic.

 

Wellness and education

According to Carole Pertofsky, director of Wellness and Health Promotion Services (HPS) at Vaden Health Center, the University needs to devote more resources to the mental health and well-being needs of students who are not clinically diagnosed with a disorder.

“I think we are so amiss in focusing all of our attention on students when they are already downstream and not looking at what we can be doing upstream,” Pertofsky said. “I’m about the 80 percent of students who struggle and find themselves sometimes thriving and sometimes barely coping, sometimes thriving and flourishing, sometimes hanging on, sometimes falling off, resilient enough to brush yourself off and get back on eventually.”

Pertofsky said HPS reaches thousands of students a year – through classes, programming and the Happiness Conference – with a staff of only five people, but the department needs more resources. The Happiness Conference has sold out its 400-person capacity within 24 hours in recent years, and Pertofsky said that feedback after the event always encourages HPS to host the event more frequently during the year.

The allocation of University resources changed following a 2008 report on Mental Health and Well Being, but Pertofsky said the changes did not aid the prevention of students becoming depressed or suicidal.

“I was very disappointed because although there was a lot of lip service given to quote ‘prevention,’ in actuality, every penny went to hire more mental health clinicians,” Pertofsky said. “That is not prevention.”

Greg Boardman, Vice Provost of Student Affairs, and Dean of Student Life Chris Griffith said they have not seen any formal HPS requests for additional resources.

 

Resilience from Grief

“The recent student deaths [have] a large impact on students, even those who may not have directly known the students who have died,” said CAPS director Ron Albucher. “It gives people pause, it makes people reflect – not only on their own mortality, but maybe thoughts that they’ve had on their own about suicide or about family or friends who have dealt with it.”

“I’m hoping that a sense of compassion for the whole student body is kept in mind,” Albucher added.

Julie Lythcott-Haims  ’89, dean of freshmen and undergraduate advising and associate vice provost for undergraduate education, shared some lessons she learned from her own grieving 20 years ago, after the loss of her brother and father in her late 20s.

“I didn’t grieve the death of my brother in a healthy way – I put blinders on, so I could finish law school,” Lythcott-Haims said.

“It was three months after my father died that I realized I couldn’t think very clearly – couldn’t organize my thoughts, couldn’t organize my day, “Lythcott-Haims said. “A friend pulled me aside and said, ‘I think you’re grieving.’ I didn’t know what that meant.”

Helena Bonde ’12, a friend of Cady Hine, the junior who died at her home in Palo Alto on April 1, said that she feels there is no proper way to grieve.

“I was angry at myself for not getting over [Hine’s death] faster, for not productively grieving all of the time,” Bonde said. “For not somehow getting through it ‘right’, doing everything ‘right.’ Being able to compartmentalize it enough to do work, and then go back and do it properly, like I was some kind of perfect grief-handling product that could just do it all.”

Lythcott-Haims suggested that the Student Grief and Loss Workshop, sponsored by CAPS, ResEd and the Office for Religious Life, be held more frequently than twice a quarter. Making this resource more permanent, she said, would increase visibility to students and reduce stigma around looking for support while grieving.

 

Decreasing stigma, deflating the ‘Duck’

In addition to citing stigma surrounding student grief, every student and administrator interviewed for this series identified a stigma around discussing mental health and seeking treatment. While this stigma exists elsewhere, many agreed that there are challenges unique to Stanford – most notably, the “Stanford Duck Syndrome.”

Students and administrators both commented on the pressures and conditions of Stanford – to find a group of friends, to do well in classes, to be successful and to ‘change the world.’ This pressure, they said, creates an environment where struggling – or even showing signs of struggle – is futile against the backdrop of blue, sunny skies, palm-lined roads and smiling students.

“I think the greatest threat to Stanford students is recovering from failure,” said Juan-Carlos Foust ’13.

“I think that mental health and struggling with feelings of unworthiness are a lot more common than we might think,” said another student, who is currently on a leave of absence due to anxiety and depression issues. “Once we scratch a little bit below the surface, I feel like everyone I’ve talked to at that level has told me ‘I feel like I’m not doing enough. I feel like I’m inferior.’”

Albucher commented that, with all of Stanford’s resources, one-fifth of the campus is still likely to experience some form of depression or mental illness.

“If you look at typical ages of presentation, most mental health problems show up in the late teens and early 20s,” Albucher said. “And so, while we’ll continue to make efforts at prevention, some people will still nonetheless have depression, anxiety and other problems.”

Deborah Golder, dean of ResEd, said that one step toward solving this problem is to recognize that Stanford is not immune from issues present in ‘the real world.’

“Stanford is not free of society. We are a microcosm,” Golder said.

Students said the most important step is creating a safe space for conversations about these topics in residences, student organizations and especially within groups of friends.

Bonde described feeling like she came to Stanford unable to express her emotions without ‘raining on the parade’ of freshman year, but said her experience was different when she actually spoke out.

“I found people one by one,” Bonde said. “I found individual people who somehow, I or they let slip that actually they were from a really poor family, or their parents were alcoholics, or they just felt so alienated by the culture here. And I’d be like, ‘me too.’”

“The greatest force of healing is community based,” said Sam Pressman ‘12. “We need to have a real understanding of the way community works and what makes community be trusting and loving – of what will allow us to not feel the shame of our struggles and, rather, the commonality of them.”

Lythcott-Haims said she wants conversations sparked by FACES, a panel for freshmen during New Student Orientation (NSO) that seeks to expose the diversity of backgrounds and experiences represented at Stanford, and The Resilience Project, which shares faculty and administrator stories of distress, failure and resilience, to continue past freshman year.

 

Moving foward

Across the University, departments are working on a number of initiatives related to mental health and well-being. Students expressed commitment to fostering dialogue and remained optimistic about what change the collective campus can achieve.

CAPS is making an effort to be more present in the community, both directly – through office hours in community centers like the LGBT-CRC, among others – and indirectly, through attending student events, according to Albucher.

Students still suggest that CAPS might be even more present – through sitting in dining halls, visiting dorms once a month or offering residential programming about depression and mental illness on campus and resources for addressing them.

UAR is revisiting the structure of freshman year through a program called ‘Stanford 101,’ according to Associate Dean Koren Bakkegard.

Stanford 101 seeks to improve how freshmen navigate resources and how they reflect on their personal growth.

The University has completed nearly all of the 18 recommendations made by the 2008 Mental Health and Well Being Task Force, Boardman said, and is now creating an advisory board, chaired by Albucher and Associate Vice Provost for Student Affairs Sally Dickson, to monitor what the University is and could be doing with mental health services and resources.

Students themselves are organizing. One pilot program called ‘Share Your Secrets’ exposes students in Arrillaga Dining Commons to concerns faced by anonymous peers.

Nicoletta von Heidegger ’13, who works at The Bridge Peer Counseling Center and the Stanford Sexual Health Peer Resource Center, sent an email to students and administrators involved with mental health on campus last week, seeking to “create a campus where mental health is something that is worked into everyday at Stanford.”

“My dream would be to have a required series either during NSO or a required class/workshop that students take their freshman year, a Stanford emotional health class, if you will,” Heidegger wrote students. “Or, better yet a ‘help your friend workshop’ where people learn the skills they need to help themselves or a friend who is struggling emotionally.”

Heiddeger is organizing a meeting of students, faculty and administrators – including Human Biology Professor Lisa Medoff, who offers a course on adolescent mental health, and HPS student affairs officer Donnovan Yisrael ’88, M.A. ’89 – to discuss these goals. The group will meet Tuesday at 9 in Old Union.

Many resident assistants (RAs) are promoting open conversation within dorms. Daniel Scott Smith ’13, RA of EAST, sent an email to his residence last week charging students to speak with one another.

“As those affected by suicide, let us not be passive bystanders,” Smith wrote. “Let us talk openly and deliberately about suicide, specifically, but also about mental illness and health more generally. Moreover, we should all know that we have a right to talk about our feelings, and that, at Stanford, there is always someone to listen and to help.”