Mental Health Services Examined

In an effort to provide Harvard students with better mental-health care—a more accessible and tightly coordinated network of services—a provost-appointed committee has issued a report with recommendations for University-wide improvements. “The years of late adolescence and early adulthood mark not only the common traumas of young adult development,” the report notes, “but also the onset of most serious psychiatric conditions.” These kinds of conditions can be particularly difficult to identify in a university setting. “Is difficulty living with roommates a cultural adjustment or a manifestation of social phobia?” the report asks. “Is a change in behavior or appearance a struggle for a new sense of self, or a reflection of incipient schizophrenia?”

The committee, chaired by associate professor of psychiatry Paul Summergrad, referred to a wide range of data and publications, consulted with mental-health experts, and interviewed 75 faculty members, administrators, and students in eight months of study. Anecdotally, the incidence of mental illness among college and graduate students appears to be on the upswing, making better care even more important. “Almost all deans of students…emphasized the increasing fragility of students and apparent higher incidence of depression and serious mental illness,” the report states. Though the committee found no hard data on the apparent increase, similar concerns are being raised at other universities. Better treatment before college may allow more young people with a history of mental illness to enter college or graduate school. And many students today arrive at college without a stable, supporting family background, says associate dean of the College Thomas Dingman ’67. “The report’s aim,” Dingman says, “is to see that systems are in place to insure that students gain maximum benefit from their time at Harvard.”

The report’s findings? The mental health services of Harvard’s University Health Service (UHS) “[seem] to be understaffed” when compared with those at MIT and Yale, and even the College’s own Bureau of Study Counsel; UHS should place more emphasis on student care; hours should be extended and emergency access to care should be more immediate (within 24 hours, 48 hours at most); coordination between UHS, the bureau, and other providers should be improved; and a Student Health Coordinating Board should be formed.

The Student Health Coordinating Board met for the first time in early January. Reporting to Provost Harvey Fineberg, a former dean of the School of Public Health, the board will advise, review, and encourage collaboration among UHS, the bureau, and other student mental health providers. Educating the University community about mental-health resources and issues and considering “initiatives to help reduce the stigma of using mental-health and counseling services” will be among the mandates of the newly formed board, according to the report. The latter issue is particularly tricky, because some students are reluctant to raise personal issues with academic advisers whom they might later need to ask for recommendations. And faculty members may wonder how they can provide support to a student suffering from mental illness and still uphold the standards of veracity expected in a letter of recommendation.

“These are issues for the faculty,” notes Summergrad, who believes the University “should be commended for taking the initiative” on the matter. “Harvard is a very varied, perse environment and this report has allowed us the opportunity to begin to deal with difficult issues.”