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CPS needs to stop putting students into boxes

<h5>McCosh Health Center houses University Counseling and Psychological Services (CPS) as well as the Sexual Harassment/Assault Advising, Resources and Education (SHARE) office.</h5>
<h6>Mark Dodici / The Daily Princetonian</h6>
McCosh Health Center houses University Counseling and Psychological Services (CPS) as well as the Sexual Harassment/Assault Advising, Resources and Education (SHARE) office.
Mark Dodici / The Daily Princetonian

Author’s Note: A medical diagnosis made by a counselor during one of my encounters with CPS is redacted due to medical privacy concerns and referred to as “X” throughout this column. 

Mental health on this campus has long been a controversial issue, especially during the recent semesters of virtual learning. In March 2021, the University’s Counseling and Psychological Services (CPS) reported an all-time high in the number of clinical appointments associated with the stress of Zoom college and the sheer pressures of the University. The Princeton student experience is characterized by a culture of constant toxic productivity and a lack of time to do everything we aspire to do without having to compromise our physical and mental health, as Peer Academic Advisor Johnatan Reiss ’23 recently argued.

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Meanwhile, CPS is still struggling to help those who need its service due to staff shortages and overbooking issues. Nevertheless, what startled me most about the kind of service that CPS provides was not so much the difficulty of finding a time slot without having to leave my classes 10 minutes early. Rather, it was the tendency of my counselor to hastily attach a label to experiences I shared. 

During a recent encounter with CPS, as I was sharing about what brought me there, my counselor blurted out: “Wow, that sounds a lot like [X] to me.” Then, at the end of the 20-minute consultation, they offered to help schedule a time for the hour-long intake, which would not be for another two weeks. This delay was not because there were not enough specialists available, but rather because the one specialist they believed would be a “really good fit for me as she is an expert in [X]” would not be available until then. 

Leaving the room that day, I wondered what the counselor saw in me: a student who was brave enough to seek help when she needed it, or simply another case study to be classified and treated. 

Coming from a rather conservative country where discussions about mental health are often swept under the rug, I have always been an advocate for mental health awareness. I hope people know that the acknowledgment that they are going through a rough time is a respectable act of self-love and that words like “depression” or “anxiety” are not shameful badges for those who have to wear them, but rather as ultimate manifestations of strength and courage. 

All of that is to say, I fully support knowing exactly what I was going through — after all, that was why I came to CPS in the first place. Nevertheless, I was not comfortable with seeing all my concerns, just 10 minutes into the conversation, being put squarely into a box with a name from the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5) conveniently attached. While this may help with expediting the treatment process and assigning the next person down the line for the intake, it made me feel as though a simple label would be enough to sum up every issue I was facing at the time. 

In psychiatric contexts, the negative impacts of labeling have long been known to do more harm than good for patients. I know for a fact that my counselor never meant to undermine my problems — if anything, they were just trying to help. But for students who muster all of their courage to seek professional counseling — some for the very first time — this approach inadvertently exudes judgment and appears to lack empathy, deterring them from coming back. Or even worse, it may lead them to believe that their problems are not worthy of being discussed in detail and that they are simply a condition to be treated. 

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Why then, are people engaged in labeling, consciously or not? Undoubtedly, labeling makes things easier. If it is known for certain that one is depressed, then it would be crystal clear what kind of medical support they need. Nevertheless, in real life, we as humans are so much more complex than that and our struggles are never linear, especially when it comes to mental health. For that reason, healthcare providers are not doing their patients justice if they immediately resort to a linear approach to diagnosis and treatment when people come to them with vulnerability and trust.

One may argue that the tendency to put labels on students’ issues stems more from a struggle to keep up with the high demand for mental health support on campus than a genuine lack of care. While I may never know exactly why my counselor so unhesitatingly put names on my issues that day, I know that a shortage of supply should never be an excuse for that kind of treatment. We have the right to always expect to be treated with consideration and for our issues, which are often multi-layered, to receive the personalized attention and care they deserve. 

Ultimately, it is CPS’s responsibility to figure out how to improve on their service as arguably the most important healthcare provider on campus without reducing our struggles to singular DSM-5 labels. In order to do this, they may need to reconsider the duration of initial consultations. Does 20 minutes give students enough time to elaborate on the intricacies of their issues, and for practitioners to assess the situation in the caring manner I believe they are capable of? 

Or maybe, if a longer initial meeting time would mean fewer students can receive the help that they need, counselors just need to hold off their tendency to give out a definite diagnosis until after the hour-long follow-up session when they have a fuller grasp of a student’s condition. This would prevent caregivers from inadvertently invalidating students’ experiences at the moment at which they’re most vulnerable.

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Now more than ever, we need to treat one another with kindness and respect. All I am asking for is a more human-centered approach to counseling on campus. I hope that CPS healthcare providers will start seeing me as a complex human being with concerns that take lots of courage to address, rather than another case study to be solved or another troubled Princeton student to be treated. And I don’t think that is too much to ask, for myself or for anyone else.

Audrey Chau is a first-year from Ho Chi Minh City, Vietnam. She is also an Assistant Opinion Editor. She can be reached via email at audreychau@princeton.edu and Twitter @AudreyBChau.

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