Last semester, a psychiatrist at Worth Health Center prescribed Calla Bush St. George ’20 SSRI inhibitors to help cope with anxiety. She began taking the medication on Jan 28. A week into the course, she awoke to intense nausea and depression.
“I just wanted a therapist, a professional, to give me their opinion on what I was doing [considering dropping the medication]. I was spending 16 to 18 hours per day sleeping and still feeling exhausted. It was absolutely insane,” Bush said.
By chance, Bush had an appointment scheduled at CAPS the next day. But the appointment she had scheduled with her normal psychiatrist was canceled due to a family emergency. So, Bush scheduled a walk-in appointment at 4 p.m. for that coming Thursday.
Upon arriving at her walk-in appointment, Bush was juggled between psychiatrists and psychologists, only getting 10 to 15 minutes with each before having to wait in the hallway when their scheduled appointments would disrupt her session. According to Bush, there was no additional staff to meet with her.
“They didn’t have anyone to see me between the times of their other appointments,” she said.
At nearly 6 p.m., Bush was told to go over to Worth Health Center and talk to the staff there.
“I had probably been at the Worth-CAPS building for two hours,” she said.
A nurse at Worth took her blood pressure and other vital signs—which was the extent of the examination.
“I wanted to be reassured by somebody that it would be okay,” Bush said. “I was thoroughly disappointed by the whole experience.”
For some students, like Bush, access to mental health services on campus has been a continual source of frustration. Why this is the case is not entirely clear, although according to CAPS, there has been a recent spike in student demand. At this point in the semester, student demand for CAPS services has increased by approximately 30 percent compared to all of the last academic year, according to CAPS director Dr. David Ramirez. Ramirez listed several reasons why he believes student demand for CAPS has risen, including the threat of economic disenfranchisement and deportation.
“People are upset, families are living in fear. There was a thing in the news last night about how students from Latino families who were U.S. citizens and under no threat of being thrown out of the country are more fearful and more depressed on NBC News. There was a study … [that] showed just having connections to vulnerable populations makes you more vulnerable, makes you more fearful,” he said.
While CAPS has seen a steady uptick in student demand over the last couple of years, the magnitude of this year’s increase may indicate something more dramatic taking place. Ramirez said that CAPS keeps tabs on how many students in the graduating class have been to CAPS by the time they reach graduation.
“We track at graduation the number of students who have been to CAPS … that number was a stable one-third of the graduates. Then a couple of years ago it jumped to half,” Ramirez said.
The number of groups and administrators that refer students to CAPS has gone up, according to Ramirez.
“We are on a lot more people’s radar… There are more entities in the college community that are looking out for students, and looking out for students who have concerns, who are using CAPS as their go-to referral source,” he said.
Ramirez also believes it is becoming more acceptable to use CAPS at the college.
“Where we used to worry about barriers to utilization, about people feeling afraid or ashamed, and I think for some students that is still problematic,” he said. What we see now is students telling each other ‘I am going to CAPS, you should go!’ They are encouraging one another.”
CAPS saw 476 students last academic year. As of last Friday, CAPS has scheduled 492 students for this academic year. Ramirez predicts that CAPS will see as many as 600 students by the semester’s end.
CAPS employs 13 clinicians but has only nine offices, one of which is occupied by CAPS administrative assistant Terry McGrath. In 2004, the Worth-CAPS complex underwent a multimillion-dollar renovation. The number of CAPS clinical rooms went from four to eight. Director Ramirez says he regularly gives up his office space so other staff members can use it meet with students.
CAPS hired an additional three clinicians last semester on a part-time basis and switched to a digital scheduling system to better meet student demand. It is their mission to provide an “unlimited amount of psychological support for students,” according to Ramirez. In keeping with that philosophy, last semester CAPS implemented a 24 hour CAPS On Call system, so that students in crisis can talk to a therapist at any time. The college pays for the system, and even students studying abroad make use of it, Ramirez mentioned. Another priority this year has been making sure students can walk into CAPS without an appointment.
However, it is unclear whether CAPS has adopted a policy of offering students weekly or bi-monthly appointments. Ramirez said that CAPS instituted a new policy the fourth week of last semester: incoming students would start out meeting with a therapist bi-monthly.
“CAPS is a community resource, and so there is only one of us, and there is this large community, and so we’ve made changes. We’ve had to ask students to be thoughtful about their use of CAPS and be prepared to share CAPS with one another,” he said. “Because there is only so much of an increase that you can impose upon … an essentially limited resource, with a certain number of offices and hours.”
The quality of CAPS and the appropriation of resources has elicited debate among students. The Daily Gazette article titled “Dean Braun’s Wellbeing Committee Unfocused on CAPS and Worth, Buys Soundproof Chairs” drove students to ask why the committee was spending funds on what students have begun to call “cocoon chairs” rather than on improving CAPS. The Ad Hoc Committee on Wellbeing, Belonging, and Social Life does not, however, have any say over CAPS spending, although they are both overseen by Dean of Students Liz Braun.
However, Ramirez feels that CAPS does not lack funding and that Dean Braun has always been receptive to CAPS budget requests.
“Dean Braun has always supported spending the money provided, that [I], the director, has thought the college [needed it]. I have had tremendous support … the constraint is really how to operationalize that,” he said.
Cassandra Stone ’20, a student representative of the Ad Hoc committee, wrote in the comment section of the Daily Gazette article, “I find that the title of this article, as well as its contents (primarily by way of omission), are misleading.”
When asked if the Ad Hoc Committee should be more focused on CAPS, Director Ramirez said that expansion of mental health services on campus has a physical limit.
“When deans say there isn’t a constraint [on providing unlimited support to students], it’s true, but there is also reality. A reality of limits,” Ramirez said.
For at least one student, CAPS policy changes came as an unwanted surprise. Abby* was told by her psychiatrist last semester that they might have to stop their weekly visits this semester, and switch to every other week.
“I was seeing my CAPS therapist, and she mentioned that next semester—so this semester—I might need to change my weekly appointments to every other week instead. And she said that they wouldn’t necessarily force me to change my hours, but because there were more students trying to meet with therapists that … it would help other students,” Abby said.
After hearing this information, Abby voiced her discontent.
“At the time I really didn’t want to do that. So I just told her point blank I really, really would like to keep coming every week because it’s been really helpful. And she said for my situation that that would probably be acceptable if she was able to talk to the person who organizes all the appointments.”
Questions arise whether it was clear to students who actively use CAPS that the visitation policy was changed.
“[My therapist] said that she technically wasn’t supposed to be spreading that sort of information to students because she didn’t want to freak people out. When I asked about CAPS capacity to take on students, she said that I should talk to the person above her and express that to them,” Abby said.
However, there are students like Natasha Markov-Riss ’20 who have had positive experiences with the current state of Worth and CAPS.
“Worth has always done everything I needed it to do for me. I got a great flu shot, very competent nurses, and the CAPS person I saw [was] very personable, very helpful. I felt heard and I felt helped although I cannot speak for other people,” Markov-Riss said.
CAPS plans on expanding next semester to two additional rooms on campus, which would provide an additional 50 hours per week of counseling services. This would be in addition to the 225 hours of face-to-face counseling CAPS currently provides each week, according to Ramirez.
The answer to why there has been a 30 percent increase in student demand this semester remains mostly opaque. In the meantime, students continue to ask for improvements in mental health facilities and administrators continue to promise to meet those demands. It appears that supply has not yet to have caught up with that demand.
*Names were changed to preserve the identity of the people involved.
Edit: A psychiatrist’s name was removed.