The Office of Counseling and Psychological Services has removed its seven-session limit on appointments in order to increase flexibility and accessibility, said Steven Rasmussen ’74 MD’77 P’13, chair of the Mental Health Community Council as well as a professor of psychiatry and human behavior and the chair of that department. While CAPS will still deliver short-term care and focus on connecting students with long-term specialists outside of the University, the number of appointments provided will be decided on a case-by-case basis rather than determined by an arbitrary limit, said CAPS Interim Co-Director Jackie Twitchell.
“We really didn’t want to create a problem in terms of flexibility when someone needed two or three more visits and the timing was critical,” Rasmussen said. With the removal of the term limit, students will not feel pressure to transfer to an off-campus specialist during an inconvenient time or if they are having trouble finding a long-term therapist who meets their needs, he added.
Vice President for Campus Life and Student Services Eric Estes also wrote in an email to The Herald that the removal of the appointment limit will make CAPS a more attractive resource to students. “Talking about a specific session limit creates an obstacle to more accessible ways of talking about mental and emotional health resources,” he wrote.
Maddy DiGiovanni ’17, former copy desk chief for The Herald and president of the Active Minds chapter at Brown — a group “dedicated to de-stigmatizing mental illness and changing the conversation around mental health” — also said that the removal of the seven-session limit will make a difference to students across campus.
The removal of the session limit occurred as a result of student feedback, recommendations from the community council and efforts within CAPS to fine-tune its process of providing mental healthcare on and off campus.
Active Minds members and members of Project LETS, particularly its founder and executive director Stëfanie Kaufman ’17, participated in discussions over the last year about how CAPS could “adjust to meet the demands of the students,” DiGiovanni said.
The term limit was “frustrating to students who may be having their first encounter with mental healthcare, and they are not quite ready to make the transition from short-term care to longer-term care off campus,” she added.
CAPS and the Mental Health Community Council took student feedback into account while planning the removal of the term limit, said Rasmussen.
“About two years ago we started talking when we were looking at our mission, creating a vision for the center,” said Allyson Brathwaite-Gardner, who is the CAPS interim co-director and also sits on the community council with her colleague Twitchell. “We talked about accessibility — making sure that students didn’t experience barriers to coming and to help-seeking.”
CAPS looked at national standards of collegiate mental health and examined different systems of care when deciding to remove the term limit, Brathwaite-Gardner added.
“When we benchmarked other institutions, it was clear that many of them had moved to a more flexible policy,” Rasmussen said. Certain changes had to be made within CAPS to ensure that the office would be able to keep pace with student demand after the removal of the term limit, he added.
“The issue is that you can’t provide unlimited services, so certainly some of the concern was assuring that we had enough staff to be able to actually allow the limits to be raised,” he said. As a result, new staff members have been hired, and the hours of existing staff have been modified, he added.
CAPS has also instituted a system to assess the urgency of student needs when scheduling appointments, Twitchell said. “We started having a system up front to determine what was a crisis and needed to be seen immediately, what was urgent and needed to be seen relatively soon and what is standard care,” she said.
In 2015, Jorge Vargas was hired as the first student care coordinator within CAPS to facilitate the transition between short-term care at the University and long-term specialists outside of CAPS, said Unab Khan, director of Health Services.
“If you already know that you want to see somebody on a long-term basis in the community, you don’t have to come through us as a gateway,” Khan said. “You can utilize the service of the coordinator.”
CAPS has also expanded its web of outside specialists in an ongoing effort to provide students with diverse options for off-campus care, Twitchell said.
“We also worked on increasing our network of referral providers to make sure that we’re covering all the different issues that people are coming in for,” she said. “(We need) to make sure that we have a diverse group of people to refer to.”
One future goal will be to increase the accessibility of CAPS and decrease the stigma associated with mental health through the integration of staff into the Brown community, Rasmussen said.
Community and faculty training in aspects of mental healthcare will also be a focus in the future, Khan said.
Such training will “really build capacity not just within CAPS but within all of campus life in helping all of us take care of the students’ emotional wellbeing,” she added.