There’s a better way forward for students in crisis

The following article includes reference to student death and mental illness.

University counseling services are available at 609-258-3141, and the Suicide Prevention Lifeline is available 24/7 at 988 or +1 (800) 273-TALK (8255). A Crisis Text Line is also available in the United States; text HOME to 741741. Students can contact residential college staff and the Office of Religious Life for other support and resources. Faculty and staff may speak with a licensed professional by contacting AllOneHealth at 800-451-1834.

Every year, members of the Princeton community experience a psychiatric emergency. For around 30 undergraduate and graduate students, this crisis intensifies to the point of requiring inpatient hospitalization, with some forced to take a leave of absence to receive psychiatric care. And sometimes, as this publication has been forced to report all too often, what begins as a crisis often becomes a tragedy. While the endless discourse around mental health can make it seem like such tragedies are just part of running an elite institution in 2026, they don’t have to be.

In a 2022 conversation with The Daily Princetonian, University President Christopher Eisgruber ’83 correctly noted that the mental health crisis is not unique to Princeton. The incidence of mental illness, including severe depression, has increased dramatically for young people in the United States and worldwide. However, this pervasiveness in no way diminishes the University’s obligation to those suffering from mental illness.

Calls for better resources and more therapists are well-intentioned, but such measures are ultimately insufficient. Hiring a few more clinicians cannot address the totality of the problem; throwing money at the problem will not make it go away.

What’s needed is a change of approach: an intensive outpatient program (IOP).

IOPs provide a more cohesive recovery program while allowing patients to remain at home (or in their dorm) and commute to the program, typically for 10–20 hours per week. Those enrolled in an IOP have access to regular group therapy, a psychiatrist to manage or adjust their medications, and a clinician or case manager. It is a major step up from the individual or group therapy Counseling and Psychological Services (CPS) offers, but doesn’t lead to the same removal from outside support as inpatient hospitalization.

As it stands, students in crisis face options that are limited and unappealing. Aside from being deeply dehumanizing and potentially traumatizing, psychiatric hospitalization can be ruinously expensive — even for those with insurance. The student health plan still leaves students responsible for 10 percent of the cost of treatment, which can amount to hundreds or thousands of dollars depending on the length of stay. The isolating nature of these programs, which entail near-total separation from the outside world, means that even a short stay is likely to derail any attempt to finish the semester. This is worsened by Princeton’s punishing academic calendar, which leaves little room for accommodation.

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Rather than pursue inpatient treatment, students in crisis might instead seek out less extreme outpatient measures. Unfortunately, intense demand means that waitlists for both on- and off-campus resources can be agonizingly long, leaving those in the lurch feeling helpless. Even when treatment is readily available, it may not be sufficient to meet the needs of some patients. For those in mental health crises, weekly group or individual therapy alone is insufficient. To have the best chance at success, patients need all of these services working in tandem, which an IOP can provide.

But without an IOP specifically structured to fit within the confines of Princeton’s schedule, this option remains inaccessible to most within our community. Many IOPs provide their services during the middle of the day and are therefore likely to conflict with a Princeton student’s full course load. As such, enrollment in an IOP typically requires taking a leave of absence. By creating its own IOP informed by students’ specific needs, mental health leave will no longer be the only option.

There is nothing wrong with taking a leave for mental health. But when doing so becomes the only available course of action, it puts care-seeking in opposition to community connection. Going on leave loosens the ties between students and the people closest to them. This might mean returning home to stigma and uncomfortable questions, or just feeling like the year has been wasted. Those costs are real, and they create an ugly incentive: forgo adequate treatment and try to muscle through the semester, rather than deal with the high perceived cost of seeking help. Princeton’s mental health infrastructure should aim to allow a smooth path for treatment, not create barriers that discourage people in distress from seeking the care they need.

The University has plenty of examples to learn from: multiple other institutions have already created models that CPS can and should copy.

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As former ‘Prince’ Managing Editor AG McGee ’22 pointed out in 2023, Rutgers University’s mental health program, Rutgers Next Step, provides patients with access to individual therapy, group therapy, and psychiatric services once or twice a week — the services of any other IOP. Since Next Step is run by Rutgers, its schedule and content are catered to the needs of students, allowing them to receive a higher level of care than would otherwise be accessible while on campus.

The College Option Services for Teens at Risk (CO-STAR), run by the University of Pittsburgh Medical Center, provides another model for on-campus IOP care, offering a combination of group therapy, individual therapy, and psychiatry. CO-STAR often enrolls patients from neighboring universities and works closely with college counseling centers, allowing most students to remain enrolled. This is not unusual. At Epoch IOP, which serves UT Austin students, 77 percent of IOP participants were able to remain enrolled in classes. Compare that to Princeton, where attending an IOP essentially necessitates campus exile.

Given the successful programs already present at other universities, Princeton must work to reorient its considerable resources to where they can do the most good for students in distress. If Princeton is serious about combating mental illness, it should follow the lead of Rutgers, Pitt, and others that provide students with an organized and comprehensive program of care that reinforces rather than untethers their supportive campus relationships.

The University cannot perfectly address the mental health of every student, but it can do more. While an IOP isn’t a panacea, it can provide much-needed support to students in crisis.

Thomas Buckley is a senior Opinion writer from Colchester, Vt., majoring in SPIA. He can be reached at thomas.buckley[at]princeton.edu.