The Chicago Department of Public Health’s recent decision to close five mental health centers on the South Side is just one indicator: mental health is not being taken seriously. The University of Chicago is not without its share of stress, and while the Student Counseling Resource Service tries to address the needs of its students, the current system seems to ask a lot of them, as well as the SCRS staff. Sometimes, it might take two or more attempts to find a successful treatment.
In a field where first impressions often betray only the complexity of the problem at hand, the SCRS tries to accurately evaluate students during their “intake” appointment. Students seeking help may not be fully aware of what it is they need, and it puts an unwieldy burden on the staff to discover the nature of their problems after spending only an hour with them. “Tracy” (all names have been changed to protect the individuals’ identities) left her intake appointment with three options: “drugs, therapy, or a combination of the two.” Leaving this important decision up to patients–with so little information gleaned from the initial meeting–can make them feel, in the words of the student, “that they didn’t care.”
We live in an age in which textbook symptoms of psychological disorders are literally at our fingertips, allowing anyone with Internet access to earn a virtual PhD in self-diagnosis. Tell-tale signs cannot be taken as such anymore. It is more than likely that a student has researched his or her problems before coming to the SCRS. Jane, a third-year student, describes her confusion as a result of the research she did on her own before her intake appointment: “I remember looking up all the things about depression and trying to figure out whether that was what I was doing there…I was reading all the language of what people say when they have depression, so I don’t really know if I was manipulating them.” She was prescribed a medication that she decided to stop using several weeks later.
While it’s true that it can take several trials to find a medication that works for an individual, or even to discover that alternative methods are more effective, many feel that the SCRS rushes these decisions, which can lead to disastrous diagnoses. Jane remembers the seemingly cursory first appointment she had with a University psychiatrist. “After an hour and a half she said I was borderline bipolar… that I was definitely depressed.” Another student, Joanna, went to the SCRS unsure of whether or not she had an eating disorder and seeking counseling. During that first intake appointment, she was diagnosed with anorexia and forced to take time off from school. During her medical leave of absence she saw a therapist. “She told me I definitely didn’t have anorexia. I had an anxiety disorder—it was extremely common. She said I could have stayed in school.” The University may have acted in such a way in order to protect itself; in fact, it’s normal procedure for a school to request that the student take a leave of absence if he has a disorder that threatens himself or others. However, these types of diagnoses cannot be made in an hour.
The school has since changed its policies: now students are allowed a second opinion. Still, the feeling of uncertainty and pressure among students seeking help persists. John describes his hesitancy about going on medication. “I felt kind of pressured into taking the drug and it was really awkward. Like honestly, I didn’t want to, and ultimately, I didn’t.” This uncertainty is not limited to medication. When students are not aware of or not comfortable with their right to request alternatives, it can lead to students leaving the SCRS before their problems are resolved. As many students are ambivalent about seeking counseling in the first place, the SCRS should make every effort to make them feel informed and in control of their treatments.
Because mental health is such a delicate issue, it must be treated as a mutual interchange between the student and his or her therapist. Some of the more negative accounts of therapy at the SCRS depict unconcerned and distant psychologists. In these cases, students left their sessions feeling worse than when they started. John recalls, “She seemed uninterested in anything I had to say and didn’t really care to listen to me. She probably made me more depressed and more screwed up. I felt like I was talking to a wall and that nothing was being resolved.” Looking back on her first experience on the SCRS, Jane believes that her therapist was avoiding commentary because she was following a specific psychological theory. “She was just waiting for me to say things and wouldn’t say things herself…that didn’t work for me.”
Psychologists don’t need to share their life histories, but being open about their techniques or methodologies can help to match them to students more effectively–another step that is frequently overlooked at the SCRS. Some students are uncomfortable with requesting a change, even if their therapy is not going well. The manner in which students still speak of these events is striking. Even when recounting a session from a year or two ago, their emotion bubbles to the surface. Jane’s voice quickens as she recalls, “It was horrible and it made me so angry I would just walk out, about to kill someone, and I thought, ‘Why am I doing this? This is not why one goes to therapy, is it?’ It was absolutely horrible.” In some ways it’s surprising that any of these students came back to the SCRS. But for those whose problems weren’t solved the first time around, it’s understandable that they would want to try again.
In general, the students that were interviewed seemed to have better experiences the second time they visited the SCRS. It’s unclear whether this is due to the SCRS changing its policies after such incidents as Joanna’s anorexia misdiagnosis, or rather due to changes in the students themselves. They are now prepared to defend their choices, request specific treatments, and refuse others. It leads John to an uneasy conclusion: “Had I not gone there and had a terrible experience I wouldn’t have been able to go back and demand what I wanted.”
John describes interacting with the SCRS as “jumping through hoops to feel better about yourself.” Having to argue your way towards self-discovery makes for an interesting, if inadvertent, form of therapy, but the path to well-being needn’t be paved with tears. When dealing with mental health, problems cannot always wait until “next time” to be appropriately handled. The SCRS can be an overwhelming institution that takes time for students to learn how to navigate. The people who go there are trying to be open about their problems; it’s the least one could ask that the SCRS opt for the same kind of transparency in their treatment.