A web of support that works

"Princeton, Interrupted."

First, the provision of mental health services has to be understood in its proper context. Nationwide, services are busier today than 10 years ago, with growing numbers of both routine visits and complex clinical encounters. Our Counseling and Psychological Services (CPS) has experienced increases consistent with these national trends. But far from any semblance of disinterest or doubts about the commitment of resources to assist students with mental health concern as is suggested in the ‘Prince' article - the University administration has been responsive and proactive in the face of these trends, and our model of care is well suited to meet student needs.

Mental health issues are a high priority at Princeton. Initiatives such as the University's Task Force on Health and Well-Being and the Healthier Princeton Advisory Board are clear examples of the University's commitment to physical and mental health. Further, at a time when staffing at many universities is frozen or even downsized, the University has increased the resources allocated to campus mental health initiatives. Our current clinical staffing ratio exceeds best practices in this area: There is one clinician to 575 students at Princeton, versus the recommended national benchmark of one to 1,500 students.

In addition, CPS has been proactive in modifying its model of care. This shift involves offering a range of services within University Health Services (UHS) and fortifying connections outside, creating a stronger safety net.

Within UHS, resources once oriented to assisting developmental struggles like homesickness and relationship problems are now focused on managing more serious problems. Wait time for non-critical services has been reduced significantly and, in line with the modified model, services have been enhanced. Enhanced offerings include crisis management, psychopharmacology services and psychotherapy within limited treatment frames. With respect to crises, clinicians are on call 24/7 and UHS inpatient service permits in-person evaluations after hours. Few universities offer such access.

More students are arriving at college taking prescribed medications for depression or anxiety or are interested in exploring the possibility of a medication trial. We've augmented psychiatric services, moving from a handful of weekly consulting hours to employing three staff psychiatrists.

Yet these enhancements in psychiatry might lead to the (mis)perception that prescribing medications is largely what we do at UHS, or that brief 15- or 30-minute appointments, which are typical of routine medication follow-up visits, represent the norm for most contact with therapists. This is not true. Our main service remains counseling visits, and these visits are usually 45 to 50 minutes. Though our therapy offerings are time-limited (usually up to two or three months of visits), these limitations are instituted flexibly, allowing for exceptions. Even students primarily interested in or requesting medication are asked to meet with psychotherapists, as we believe that medications are complements to, not substitutes for, therapy relationships.

Contrary to the doubts expressed in the ‘Prince' article, many students indicate considerable satisfaction with mental health services, and this point may have been obscured in last Wednesday's article. Annual surveys conducted "for students by students" who serve on the Student Health Advisory Board suggest that most students are very satisfied with their experience with us. Last spring's survey showed that more than 95 percent of students seen at CPS agreed or strongly agreed with a statement indicating satisfaction with mental health visits.

Serving students who seek out our services is part of what we do - finding broader ways to make connections with students outside of our service is another. Since many national campus tragedies involve students who are not in counseling services, we target students who are not inclined to access traditional mental health services. We are among a handful of colleges participating in the National College Depression Partnership, a consortium that integrates mental health screening into medical visits. This is a way to better ensure that we identify students at high risk for depression.

Also, our campus-wide depression-awareness program (PDAP) has trained more than 450 adult first responders - including faculty, staff and other students - to identify the signs of students in distress, to become familiar with resources and, at times, to take steps toward securing student safety.

Optimizing campus mental health and wellness is a shared responsibility that is best accomplished in collaboration with other on-campus health professionals and other campus partners (such as the Office of the Dean of Undergraduate Students, the Office of Religious Life, Graduate School, Public Safety and faculty). We do this well and often, as students are best served when a web of coordinated support services comes together.

Janet Finnie is the interim executive director of UHS and can be reached at jfinnie@princeton.edu. John Kolligian is the director of counseling and psychological services for UHS and can be reached at jkjr@princeton.edu.