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A century of mental health care at Princeton

Trees are outside a brick building with a dark blue door.
McCosh Health Center.
Angel Kuo / The Daily Princetonian

The University began offering a form of mental health care for the first time in the early twentieth century. As Princeton’s counseling and psychological resources evolve The Daily Princetonian looked back on the evolution of mental health care at the University. For decades, mental health resources have been strained under increasing demand from students.

In the 1940s, just as the term mental ‘hygiene’ was being refined to mental ‘health,’ the University started including Counseling and Psychological Services (CPS) in its healthcare services. This was largely driven by the heavy psychological impact of World War II and a growing need for such services for students, faculty, and veterans alike.

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In the decades following the war, the discourse surrounding mental health began to encompass a more holistic definition — prioritizing prevention and early identification of mental health challenges. Universities increasingly relied on professionals, rather than teachers and clergymen, to provide mental health care for their students. While the University has a history of expanding its infrastructure to meet needs, students have called on the administration to do more.

Early pathbreaking

In 1910, the University was the first college to establish a “mental health-specific service” for students. The service provided treatment for when a student’s “socio-emotional struggles” were deemed sufficiently extreme. The program was initially created in response to the observation that many Princeton students were dropping out due to emotional and personality issues. The University’s service was soon emulated at other colleges and institutions.

Evolution after World War II

Ratified by President Franklin D. Roosevelt in 1944, the GI Bill gave veterans the opportunity to seek higher education, and many took up the offer. An uptick in the demand for professionals and clinical psychologists at universities followed.

The University president at the time, Harold Dodds GS Class of 1914, created an advisory program for returning student veterans. Dodd’s team of researchers was tasked to study the effects of counseling on a handful of veterans employed across more than 60 industries.

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The team found that the transition from active duty in wartime to manual occupations would require an “expedi[ted] adjustment” process, highlighting the importance of psychiatric and therapeutic support to quickly reintegrate veterans back into society. The study also concluded that new policies to assist trauma fostered an overall safer environment for both employees and employers. These policies included making employers more cognizant of a veteran’s sensitivity and triggers.

In light of this research, the Princeton Counseling Service expanded the number of facilities and full-time staff available. Of the students who enrolled in the services, 75 percent were student veterans. 

Over time, University Health Services (UHS) expanded resources, creating student-led advisory boards in 1980, Sexual Harassment/Assault Advising, Resources and Education (SHARE) in 1988, and occupational therapy for students and employees in an effort to destigmatize therapy and bolster well-being across campus.

Backlash as the University caps sessions

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As more students sought out care from CPS in the 1980s, the University’s staff became strained. In 1989, during the tenure of Marvin Geller as director of CPS and under the direction of Vice President Thomas Wright ’62, a cap was placed on “the number of private counseling sessions” each student could obtain. Students who exceeded an eight-hour quota would be transferred to group therapy sessions or referred to counseling by an outside provider.

The cap became the source of heavy backlash from students, who feared a reduction in care and the inability of those who ran out of free counseling hours to afford additional costs.

“Where is [the money for external therapy] going to come from?” asked University Student Council (USC) representative Jennifer Zoler ’90 at a Council of the Princeton University Community (CPUC) meeting.

At the same meeting, Wright predicted that the policy would be unsuccessful, saying that there would be “no degree of reduction in counseling.”

The next month, the University’s administrators considered expanding the student health plan to include mental health coverage to alleviate the financial burden on students. Geller and a team of advisors estimated that the costs would be substantial, but would help people “who want or need longer-term resources.” The expansion was finally approved in 1992.

Spikes in demand in recent years

In the decades since, the University has grappled multiple times with spikes in demand for counseling services on campus.

In 2000, Geller noticed an increase in the numbers and severity of cases. The spike in cases, from 4,700 in 1995 to 5,500 in 2000, concerned him.

Marianne Waterbury, an Associate Dean of the Undergraduate Student Admission at the time, attributed the increase to two possible reasons: “people [being] more open [about their disorders] or [that] there are more students in need.”

Even before the COVID-19 pandemic, the number of students struggling with mental health issues was already increasing. In 2012 alone, the Committee on Background and Opportunity reported that one in two women and one in three men at Princeton reported feeling depressed “sometimes or often.”

In a 2014 op-ed in the ‘Prince,’ Kelly Hatfield ’17, a contributing opinion writer, ascribed this phenomenon to the University’s “high pressure, fast-paced environment.” Hatfield questioned why it was such a long, delayed, and “exhaustive” process for students to receive formal help.

The number of students seeking CPS services surged between 2015 and 2021, according to the current Director of CPS Calvin Chin.

At the beginning of the pandemic, 36 percent more students began seeking treatment from CPS. Chin said CPS increased the number of full-time counselors and staff. However, even with the return to in-person instruction, the number of students requiring treatment continues to rise for each graduating class year.

What does it mean to ‘reach out’ for help today?

Some students continue to express concerns with CPS.

“That [initial consultation] session was really rough,” says Aman Dutta ’27, who entered with the Class of 2026 and is currently on a gap year. “It was just … throwing a bunch of difficult-to-answer questions, [without] any consideration towards my feelings.”

Chin noted that CPS is seeking more full-time counselors. Additionally, a CPS Cares Line has been opened for telehealth communication.

Chin said the “many pressures on students to succeed and be perfect” are a barrier to creating a healthier campus.

When students are “over-programmed” and in a high-intensity atmosphere, they might not prioritize their mental health, he said.

The evolution of mental health at the University is clearly not over.

Keeren Setokusumo is a Features staff writer for thePrince.’

Please direct any correction requests to corrections[at]dailyprincetonian.com.

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