Mental Health at Swarthmore: as a cyclical issue, it seems to come and go, much like the seasonal winds and perhaps the seasonal affective disorder, or SAD, that they bring with them (for many people, at least). However, for those who suffer from mental illness, there’s no such easy escape as changing the subject.
Nor should we change it: according to a poll the Phoenix conducted last spring, 103 of 188 respondents agreed with the statement, “I have experienced anxiety and/or depression at Swarthmore.” 22 of 189 said they came to campus with a previously diagnosed mental illness, while 28 of 189 said that they were diagnosed at Swarthmore. 27 of 181 reported being on medication, while 36 of 186 agreed with the statement, “I have had thoughts of suicide on campus.” These are striking numbers, but even more sobering is that they are in line with national data: in a 2011 poll conducted by the American College Health Association, 30% of college students reported feelings of depression so intense, during the last year, that they had trouble rising from bed. And while the Phoenix’s poll suffers from data-driven errors, such as self-selecting respondents, that it so matches the national trends suggests its broader accuracy.
Indeed, interviewing many students around Swarthmore, I came away with a sense of the deep-rootedness of the problem of mental illness on our campus. Rafi Ellenson ‘16, who took a leave of absence last Spring as part of his continued recovery from depression, recalls his first semester at Swat, saying, “I felt this overwhelming darkness and sadness. I couldn’t do my work. I was having trouble getting out of bed. I was crying a lot.” Ellenson also said that Swarthmore did provide support to him in his crisis, and that the administration was very supportive of his decision to take time away. “There was no shaming along the way,” he told me. “They seemed very invested in my getting better.”
While the majority of students who struggle with mental illness recover on campus, there is a minority of students who, like Ellenson, need to leave Swarthmore to advance their recovery. Jane Quick ‘14 is one such example. She’s battled bipolar disorder since the age of nine, and has left Swarthmore to spend time in a psych ward, a 12-step program, and finally a women’s facility. For students with serious problems, a college campus may simply not be a place where recovery is possible. Quick recounts how students shamed her during her battle against her disorder. First, she got “kind of a bad rep” for her manic episodes. Then, “students began to report to the deans anything I did wrong… I’d make a joke about my mother and they would say, ‘obviously she’s mentally unbalanced.’”
Quick and Ellenson would both have students realize that mental illness, like any physical disease, is not something to be taken lightly. “You wouldn’t tell someone with diabetes to suck it up,” Quick put it, sharply. Indeed, everywhere, people in the know stressed the importance of treating the mental with the same respect we would the physical. Rachel Fresques ‘14, the director of Speak 2 Swatties, a peer-counseling group (you can call 765-727-0555), says one aim of her group is to destigmatize issues of mental health. “We just want people to know that it’s okay to talk about mental health issues; that those are issues akin to getting a cold, or getting the flu,” she said. Beth Kotarski, who directs the Worth Health Center, echoed Fresques, saying that “people have mental health needs just as they have physical health needs.”
Indeed, the idea that mental health is entwined with physical health is long-established in the field. However, that has not necessarily made topics of mental illness much easier to talk about on campus. “There’s a lot of stigma around it,” Ellenson said. Another student, who preferred to remain anonymous, told me that she worries about being labeled, that “the way that I’m known, on campus, if I’m known, [will be] as a crazy person.” Another said that, while students at Swarthmore are in general responsive to issues of mental health, “you have to be the one to take the first step.” Ellenson echoed him, saying that, “there’s a constant sense of burdening.”
Fresques chalks some of this up to to the difficulty we all have with expressing our emotions. “I think pinpointing emotions and putting them into words — especially words that other people might not understand — is a really hard thing,” she explained. Thus, S2S encourages its counselors to be “active listeners” who help students find words by providing “leading questions,” but rarely answers. Fresques added that, after talking to someone four times, she’s seen a marked difference in their wellness. Still, although S2S meetings are well-attended, “it’s usually the same faces.”
Clearly, there’s a silent majority that’s uninvolved, and largely uninterested, in knowing and caring about mental health on campus — even when simply a kind word may be the most helpful thing in someone’s recovery. It’s hard to know if someone is struggling with depression or anxiety without “knowing them pretty well,” as Ellenson put it, yet a “sense of active support” can be vital in helping them get through a rough patch — and that means more than just talking, he went on. “Ask them to coffee.”
Quick, too, stressed dialogue and companionship as key to overcoming the burden of mental illness. “Someone’s stressed over a paper and maybe it’s trivial but it means something huge to them,” she said. “The simplest thing to do is ask.” Not surprisingly, being a good friend to someone seems one of the best ways to help them. And when students can’t find appropriate support on campus, it may be best to take some time away.
Swarthmore’s intense academic environment is another reason that on-campus recovery from intense mental illness can be difficult. Quick recounted that she was failing many of her classes as a result of her illness, but that, to their credit, the administration was “enormously forgiving.” Administrators, for their part, dismissed the idea that academic rigor itself leads to mental illness, saying instead that it “tests students’ coping capacity,” allowing them to “understand that not all is well with them” — so David Ramirez, director of CAPS (Counseling and Psychological Services), put it. Dean Diane Anderson added that some students “set inhumane standards for themselves.” They have “been on a hamster wheel all their lives,” she continued, “and sometimes they get tired.”
Thus it does not seem that any reduction in difficulty is going to come about at Swarthmore anytime soon, and yet the administration has been, in both Ellenson’s and Quick’s experiences, as well as its own statements, supportive of students who need to take drastic measures to combat their illnesses. In addition to encouraging students to take leaves of absence or reduced course-loads when appropriate, administrators such as Anderson, Ramirez and Kotarski are working to provide a host of other resources to students in need, recognizing that even if mental illness does not become a full-blown problem, it can remain debilitating for a long time. To this end, they have implemented preventive measures such as CAPS, where students can receive free psychological and psychiatric care on weekdays. After 4:30 PM, when CAPS closes, students in need can even go to the Worth Health Center to receive counseling. And CAPS has been massively successful: it’s used by about 400 students, or one fourth of the student body, who receive treatment for disorders ranging from ADHD to psychosis.
The Worth Health Center, for its part, administers the NACHA, or National Health Assessment, every few years, which is uses to identify areas of primary concern among students. The last NACHA, administered in 2008, “lifted up two areas of prevalent stress,” Kotarski said. “Students felt that they didn’t have any help around issues of stress, and the other was sleep, so insomnia, sleep patterns, and how the two affected their overall well-being.” (Indeed, recent studies have found that “curing insomnia in people with depression could double their chance of a full recovery,” the New York Times reported recently.) As a result of such findings, Swarthmore has hired Satya Nelms to be its first full-time wellness coordinator. In this role, she will, among other tasks, help students combat insomnia, teaching them relaxation and breathing techniques. The Health Center has administered the NACHA again this year, but results are still pending.
Still, despite the success of CAPS, there are students who would rather not come to a traditional psychologist with their concerns, or who would prefer not to think of themselves as suffering from any spectre of mental illness, however slight. Yet mental illness is something nearly all of us deal with, at least to a limited extent. Religious advisor Joyce Tompkins told me how students come to her “usually wanting to talk about an issue around spirituality, some struggle around meaning. But as we talk,” she went on, “issues that we would identify as mental health issues always arise in connection with those larger problems.” In today’s society, the mental, spiritual, and physical have become deeply entwined, and it is difficult to talk about one without spilling into the other. How we feel affects how we act.
The wide range of resources on campus, ranging from S2S’ peer counseling to the more formal psychologists of CAPS, means that students can usually receive appropriate help for whatever they’re facing without stepping off campus. Yet clearly there are some, like Quick and Ellenson, for whom Swarthmore did not provide appropriate support: is this a failing of the school, or were their illnesses of an intensity that Swarthmore should not be equipped to handle? Indeed, we would not expect any school of 1,500 students to possess the capacity to set a broken leg, for instance. We would rush that student to the hospital.
Yet Quick and Ellenson both stressed that, even if their off-campus recoveries were a necessity, their on-campus revitalizations must be helped along by the “active support” that Ellenson mentioned. They also hope to help extend that support to others, and to this end, Ellenson has begun a support group through CAPS. Already over 20 students have expressed interest, and CAPS will re-advertise the group — which is closed for now — this Spring. Quick, for her part, stressed that we all need to take better care of each other, and that acknowledging human frailty might be a first step: “If we all accepted that we’re breakable,” she said, “we’d be so much more open to the idea of making sure other people don’t break.”
