Should Universities Have Mental Health Facilities

[Wahoo Redux]

Fair enough.

But I think that is more-or-less what we have now.

[marshwiggle]

Let's not pretend health services are like convenience stores on every corner either.

There are now. They're called Urgent Care Clinics.

Uh huh.

Have you ever dealt with someone with the severe, dangerous, pervasive versions of depression, bi-polar, borderline, self-esteem, and addiction illnesses?  Ever had an already mentally ill family member get addicted to meth?

You think you can treat someone like that in an Urgent Care Clinic?

Are you suggesting campus mental health services should be sufficiently staffed and resourced to handle all of those things?  And how big does a campus have to be to provide that level of service?

That's the question; not whether some sort of counselling should be available on campus, but what level of mental health problems ought to be able to be dealt with completely in-house, rather than being referred to external organizations whose mission is treating mental health issues, rather than being treated by an organization whose mission is education, and is only concerned with mental health issues as they affect members of the organization.

As I said earlier, it's like campus police. If there is a murder on campus, they're not expected to handle the criminal investigation, because they can't possibly have the resources to do so. Something that serious (and rare) needs to be handled by the external organization which has the resources because they provide the services to a much bigger population and thus where it isn't as rare.

[mahagonny]

Not to mention, there is schizophrenia that can't be treated with all the facilities in the world. Because the patient won't go.

The question has to be 'how much can be provided that's a reasonable measure of available options.'

[smallcleanrat]

Let's not pretend health services are like convenience stores on every corner either.

There are now. They're called Urgent Care Clinics.

Uh huh.

Have you ever dealt with someone with the severe, dangerous, pervasive versions of depression, bi-polar, borderline, self-esteem, and addiction illnesses?  Ever had an already mentally ill family member get addicted to meth?

You think you can treat someone like that in an Urgent Care Clinic?

Are you suggesting campus mental health services should be sufficiently staffed and resourced to handle all of those things?  And how big does a campus have to be to provide that level of service?

Campus services could do much better than an urgent care clinic at making assessments and referrals for treatment (under student insurance) and/or suggesting taking a leave for such issues. And they can do so before a student's need gets to the point of needing urgent/emergency care.

[mamselle]

+ 1,000.

Also,

Just another bundling strategy.

You can't bundle pink-papering from a university center to a full psych ward easily.

The problem with innocence is it leads to ignorance.

M.

[marshwiggle]

Let's not pretend health services are like convenience stores on every corner either.

There are now. They're called Urgent Care Clinics.

Uh huh.

Have you ever dealt with someone with the severe, dangerous, pervasive versions of depression, bi-polar, borderline, self-esteem, and addiction illnesses?  Ever had an already mentally ill family member get addicted to meth?

You think you can treat someone like that in an Urgent Care Clinic?

Are you suggesting campus mental health services should be sufficiently staffed and resourced to handle all of those things?  And how big does a campus have to be to provide that level of service?

Campus services could do much better than an urgent care clinic at making assessments and referrals for treatment (under student insurance) and/or suggesting taking a leave for such issues. And they can do so before a student's need gets to the point of needing urgent/emergency care.

Making referrals is absolutely reasonable. Providing primary care for many conditions requires more resources than an institution can reasonably afford, if it doesn't have its own medical school and hospital.

[Wahoo Redux]

Let's not pretend health services are like convenience stores on every corner either.

There are now. They're called Urgent Care Clinics.

Uh huh.

Have you ever dealt with someone with the severe, dangerous, pervasive versions of depression, bi-polar, borderline, self-esteem, and addiction illnesses?  Ever had an already mentally ill family member get addicted to meth?

You think you can treat someone like that in an Urgent Care Clinic?

Are you suggesting campus mental health services should be sufficiently staffed and resourced to handle all of those things?  And how big does a campus have to be to provide that level of service?

No.  I misunderstood what dismalist was arguing earlier.

I am ambivalent about mental health services on campus myself and have no voted in my own poll because of that.

But I think what you then describe is pretty much exactly what we have with most university health services.  At least at the places I have worked or attended we have essentially an emergency staff that will provide something like 6 free sessions with a counselor paid for by student insurance.  After that, the student is responsible for the bill.

Major psychiatric problems are treated at other facilities.

[smallcleanrat]

Echoing Wahoo. That matches my experiences as well.

And I've been at several universities that do have associated medical schools.

Any kind of specialized/long-term treatment is paid for out-of-pocket or through insurance.

You might get some costs pro-rated if you agree to be part of a clinical research study, but I would guess that's coming out of research grants and not student tuition money?

[marshwiggle]

Let's not pretend health services are like convenience stores on every corner either.

There are now. They're called Urgent Care Clinics.

Uh huh.

Have you ever dealt with someone with the severe, dangerous, pervasive versions of depression, bi-polar, borderline, self-esteem, and addiction illnesses?  Ever had an already mentally ill family member get addicted to meth?

You think you can treat someone like that in an Urgent Care Clinic?

Are you suggesting campus mental health services should be sufficiently staffed and resourced to handle all of those things?  And how big does a campus have to be to provide that level of service?

No.  I misunderstood what dismalist was arguing earlier.

I am ambivalent about mental health services on campus myself and have no voted in my own poll because of that.

But I think what you then describe is pretty much exactly what we have with most university health services.  At least at the places I have worked or attended we have essentially an emergency staff that will provide something like 6 free sessions with a counselor paid for by student insurance.  After that, the student is responsible for the bill.

Major psychiatric problems are treated at other facilities.

I'd like to hear from people who voted "yes" to the survey. Is this level of on-campus mental health services sufficient, or should treatment for more serious issues be provided on campus (other than through a medical school)?

[Puget]

Let's not pretend health services are like convenience stores on every corner either.

There are now. They're called Urgent Care Clinics.

Uh huh.

Have you ever dealt with someone with the severe, dangerous, pervasive versions of depression, bi-polar, borderline, self-esteem, and addiction illnesses?  Ever had an already mentally ill family member get addicted to meth?

You think you can treat someone like that in an Urgent Care Clinic?

Are you suggesting campus mental health services should be sufficiently staffed and resourced to handle all of those things?  And how big does a campus have to be to provide that level of service?

No.  I misunderstood what dismalist was arguing earlier.

I am ambivalent about mental health services on campus myself and have no voted in my own poll because of that.

But I think what you then describe is pretty much exactly what we have with most university health services.  At least at the places I have worked or attended we have essentially an emergency staff that will provide something like 6 free sessions with a counselor paid for by student insurance.  After that, the student is responsible for the bill.

Major psychiatric problems are treated at other facilities.

I'd like to hear from people who voted "yes" to the survey. Is this level of on-campus mental health services sufficient, or should treatment for more serious issues be provided on campus (other than through a medical school)?

I know I said I was done responding, but in case you are genuinely seeking information here--
No campuses that I know of are providing anything more than that. No one is suggesting campuses provide inpatient care (university hospitals do, but that's completely separate from the student counseling services and serves the whole community).

The vast majority of students seeking mental health services on campus do so for anxiety and depression, not something like psychosis. They get group therapy and/or a limited number of individual sessions (CBT is generally something like 8-12 sessions-- this is not lying on a couch for years therapy that you may be imagining). If indicated, the (part time) staff psychiatrists can proscribe and do medication management appointments.

Yes, their insurance gets billed for all this. Yes, counseling centers may provide other services not covered by insurance, such as workshops and support groups, which come out of the university budget. So do a whole lot of other things that probably have a lot less of an impact on student experience and retention.

[marshwiggle]

The vast majority of students seeking mental health services on campus do so for anxiety and depression, not something like psychosis. They get group therapy and/or a limited number of individual sessions (CBT is generally something like 8-12 sessions-- this is not lying on a couch for years therapy that you may be imagining). If indicated, the (part time) staff psychiatrists can proscribe and do medication management appointments.

These are the kinds of comments that make it unclear what level of serious problems should be dealt with on campus:

Especially after having walked with two different students to facilities at two different schools.

They didn't need band-aid level help.

They were in full-blown, "I'm afraid of what I could do to myself" need for competent, complete intervention.

.
.
.

In both cases, I was glad I wasn't passing the student off to a "mental health lite" facility.

Have you ever dealt with someone with the severe, dangerous, pervasive versions of depression, bi-polar, borderline, self-esteem, and addiction illnesses?  Ever had an already mentally ill family member get addicted to meth?

Posts like this suggest that some people expect interventions significantly beyond what you have described.

[Wahoo Redux]

The vast majority of students seeking mental health services on campus do so for anxiety and depression, not something like psychosis. They get group therapy and/or a limited number of individual sessions (CBT is generally something like 8-12 sessions-- this is not lying on a couch for years therapy that you may be imagining). If indicated, the (part time) staff psychiatrists can proscribe and do medication management appointments.

These are the kinds of comments that make it unclear what level of serious problems should be dealt with on campus:

Especially after having walked with two different students to facilities at two different schools.

They didn't need band-aid level help.

They were in full-blown, "I'm afraid of what I could do to myself" need for competent, complete intervention.

.
.
.

In both cases, I was glad I wasn't passing the student off to a "mental health lite" facility.

Have you ever dealt with someone with the severe, dangerous, pervasive versions of depression, bi-polar, borderline, self-esteem, and addiction illnesses?  Ever had an already mentally ill family member get addicted to meth?

Posts like this suggest that some people expect interventions significantly beyond what you have described.

Backsliding, Marshy.  Contrarian.  Don't argue just to argue.  I've already explained.

We have these problems in campus communities, BTW. 

[marshwiggle]

The vast majority of students seeking mental health services on campus do so for anxiety and depression, not something like psychosis. They get group therapy and/or a limited number of individual sessions (CBT is generally something like 8-12 sessions-- this is not lying on a couch for years therapy that you may be imagining). If indicated, the (part time) staff psychiatrists can proscribe and do medication management appointments.

These are the kinds of comments that make it unclear what level of serious problems should be dealt with on campus:

Especially after having walked with two different students to facilities at two different schools.

They didn't need band-aid level help.

They were in full-blown, "I'm afraid of what I could do to myself" need for competent, complete intervention.

.
.
.

In both cases, I was glad I wasn't passing the student off to a "mental health lite" facility.

Have you ever dealt with someone with the severe, dangerous, pervasive versions of depression, bi-polar, borderline, self-esteem, and addiction illnesses?  Ever had an already mentally ill family member get addicted to meth?

Posts like this suggest that some people expect interventions significantly beyond what you have described.

Backsliding, Marshy.  Contrarian.  Don't argue just to argue.  I've already explained.

I know you did. Mamselle's post suggests that dealing with serious crises should be part of the mandate of campus mental health services.

We have these problems in campus communities, BTW.

Sure. Does that imply that campuses should have mental health professionals on call 24/7 for serious crises? (Again, from Mamselle's post, not yours.) The fact that these problems exist in campus communities doesn't imply that they need to be handled completely in-house. People on airplanes occasionally have medical emergencies, but that shouldn't require airlines to have medical professionals on every flight.

Students often have financial struggles. Should universities have professional financial advisors on campus for students?

For things that are not part of the core mission of the institution, it makes sense that typically these things ought to be handled by referrals to other organizations and resources which do have that as part of their core mission. Trying to provide on-campus resources to handle any kind of situation which occasionally arises on campus is a hole with no bottom.

[jimbogumbo]

ETA: If there had been no mental health faculty on campus, Mamselle would have escorted the student to an emergency room. I think just about any of us would.

Except I don't own a car, and the nearest hospital in each case was over a mile away.

I doubt if I could have gotten an hysterical student to walk that far with me through the urban landscape without bolting, or worse.

M.

Mamselle also posted this marshwiggle.

[marshwiggle]

ETA: If there had been no mental health faculty on campus, Mamselle would have escorted the student to an emergency room. I think just about any of us would.

Except I don't own a car, and the nearest hospital in each case was over a mile away.

I doubt if I could have gotten an hysterical student to walk that far with me through the urban landscape without bolting, or worse.

M.

Mamselle also posted this marshwiggle.

This is like my example of emergencies on planes. The fact that "something happened that would have turned out differently had not X been available" is a bottomless pit. The frequency of those incidents has to be considered to make sane policies.