Harvard restructures its mental health services.
This week, the Harvard Independent is bringing you an article from our October 25, 1984 issue on Harvard deciding to restructure its mental health services.
Going to Harvard is like walking a tightrope. It’s said they involve the same motions. The long passage from Yard to diploma can demand a stupendous balancing act, and they say the wire is pretty thin.
If the daredevils take a tumble—too bad. Harvard will await them below, like a giant safety net looming to break their fall. But Harvard will not be up there steadying them aloft. For its said that this is strictly a solo performance.
There are some people on campus, however, who refuse to accept this scenario. The University’s mental health workers—ranging from the psychiatrists on the third floor of UHS to the student counselors manning a basement office called Room 13—make it their business to help students maintain a rather delicate equilibrium.
They point out that all Harvard students, whether insured on a family plan or by the University’s Blue Cross/Blue Sheild, are paying $500 a year for out-patient psycho-therapy. And they stress that it’s ok to need some help.
“If we could,” maintains Dr. Randolph Katlin, psychiatrist and chief of Mental Health Services (MHS), “we’d be right up there with them, holding on.”
Psychiatric care is a thorny issue, particularly at Harvard. Mental health specialists on campus are the first to admit that Harvard students can be somewhat timid when it comes to seeking aid. Justin Richardson’85, co-director of Room 13—a peer counseling group open nightly from 7:00 pm to 7:00 am—suggests that the country at large believes that, “There’s something wrong with me if I go to a psychiatrist.”
“Among Harvard students,” Richardson says, “if they go, they won’t tell. Or if they tell someone, they’ll say, ‘It’s just for one time,’ or, ‘I just went to get a sleeping pill.”
Overcoming the stigma branding mental health care has become a big problem for mental health workers, especially because it seems to be reinforced by the Harvard mystique. “Harvard is a difficult place to be,” notes Marcia Rorty’85-’86 co-director of Eating Problems Outreach. “Our campus puts an emphasis on self-achievement, on the person rather than on interdependence with other people. And it’s hard to admit that you need other people, because the stress is on the autonomous individual. It can be a lonely place.”
Isolation on a hushed campus where psychiatric care is taboo can lead to the worst possible situations—notably suicide—Katlin points out. The MHS director remembers the case of one Harvard student who, in the months leading up to his death, became increasingly introverted and later left notes indicating that he was hearing voices. According to Katlin, the student’s fellow classmates assumed that he was “just doing his own thing.” They left hi m alone. “Don’t let people get too uninvolved,” Katlin advises.
Sometimes it’s not that easy though. Interceding in such cases requires can be extremely delicate. According to Katlin, “If you say, ‘Well, you seem disturbed, you should see a psychiatrist,’ then that may put them off.” But Kathleen Kniepmann, health educator at UHS, points out that, regardless of what approach is taken, anything is better than not saying anything at all. “Because there tends to be a shroud of secrecy, there’s a belief that hardly anyone else has mental health problems,” she says.
Harvard undergraduates, however, have very real mental problems. Most of these dilemmas are developmental rather than congenital, Katlin reports. “For undergraduates, there is a pressure that is felt to be involved, to be responsive, to make commitments and deal with the consequences. And they’re certainly concerned about rejection and depression about attachment and obligations.” In simple terms, this translates into homesickness, boyfriend-girlfriend breakups, roommate problems and other such everyday college worries.
And being in Cambridge can make it all worse. “It’s exacerbated by the fact that everyone wants to be an overachiever here,” claims Michelle Healy’81, patient advocate at UHS and liason between the Health Services and the Student Health Advisory Council (SHAC). “Its hard to sparkle here.”
“I don’t think it’s the Harvard environment per se,” Quincy House senior tutor Eliot Cohen’77 contends. “The student body here is highly motivated—they couldn’t have gotten in if they hadn’t been driven. Meeting with failure for the first time—that’s a critical experience and often a difficult one.”
Cohen pauses, adding quickly, “I don’t think it’s that Harvard students are crazier than anywhere else. I think they’re better adjusted than, if you’ll forgive me, an MIT student for example.”
The central problem, then, is reaching the people who need help the most. MHS does no good if it exists cloistered within Holyoke Center, says Katlin. For this reason, among others, the Mental Health Services has set its roots, both overtly and covertly, into the College community.
At its quietest, MHS affiliates all psychiatrists, psychologists and psychiatric social workers with a House of freshmen advisory unit. Staff members then hold bi-monthly meetings directly with the senior common rooms and senior tutors, trouble-shooting and finding ways to cope with student problems. “Its very important to know your own limits,” Cohen says. “To know when you’re touching on things that are best worked on by a professional.”
Senior tutors are charged by MHS to canvass their Houses continuously, alerting themselves especially to roommates who may be concerned about their friends. “If I hear reports that are sufficiently alarming,” affirms Lowell House senior tutor John Lee, “I’ll investigate them.”
Confidentiality plays a large part during these conferences. “We try to talk somewhere in between general and specific terms,” Lee emphasizes. “But one of the basic ground rules of all discussion about students is anonymity.”
Better-known channels of MHS access to undergraduates are the campus network of peer counseling groups and the Bureau of Study Council. Once a week, UHS’s Nadja Gould meets with Room 13, RESPONSE (for rape crisis and sexual harassment issues), Eating Problems Outreach, Peer Contraceptive Counseling, and Gay and Lesbian Student Association (GLSA) representatives. Each group undergoes extensive orientation in the fall and is supervised closely—by these meetings—throughout the year.
The peer groups, Gould says, “operate in a very matter-of-fact way, student-to-student. I think one of the most important things we’re doing is outreach.”
Through student organizations, MHS subtly taps directly into student concerns without appearing under the intimidating banner of “psychiatric care.” Room 13’s Richardson suggests, “We may seem less threatening. Some people are worried that if they go to UHS, it means that they have a problem.” Room 13 receives an average of 2.5 calls each night and 1.5 “drop-ins” to its Stoughton Hall basement office. Fifty-seven percent of its clientele is male with 43% female.
Sometimes talking to a fellow student, however is just not enough, “Usually students seek out peer counseling on their own,” Cohen says. “Going to the Mental Health Services is a bit bigger step. You can tell someone that you think maybe they ought to see someone at the Mental Health Services and frequently, they give a sigh of relief. It’s been something they’ve been turning over in their minds for a while.”
While the atmosphere around mental health at Harvard and the ways in which we discuss it continue to change, it is clear that this is a burden many Harvard students have been carrying for years. With a little insight from the past, and an optimistic view of the future, perhaps this burden will become lighter.