That percentage may also be higher than at other Ivy League schools. About 15 percent of Princeton University's students went to the university's counseling services in 2001, according to a March 2002 article in the Yale Daily News. About 14 to 18 percent of Yale students see the school's Department of Mental Hygiene each year, and Harvard University's counseling service sees between 12 and 14 percent of the student body each year, according to the same article.
The growing use of Psych Services at Brown may reflect a more stressful academic environment than Brown's laid-back reputation suggests, some students say. But Brown officials say the numbers are high because the University provides easy and convenient access to services.
Psych Services is "the place where students can get fairly immediate and also knowledgeable help," said Director of Psychological Services Belinda Johnson. Students never have to wait longer than a week to get an appointment, Johnson said, and there is also always a "crisis clinician" on call.
Though students see Psych Services for test anxiety and psychoses, the most common issue is depression - both short- and long-term.
Each Brown student can have five free sessions with a psychotherapist at Psych Services per semester. If a student needs more treatment, Psych Services provides a referral to a nearby doctor or therapist. Visits to Psych Service's staff psychiatrist, Jonathan Bolton, are unlimited.
Caroline Kersten '07 went to Psych Services in 2004 for bipolar disorder and was later referred to an outside therapist, she told The Herald in an e-mail. She was so pleased with the referral that she is still seeing the same therapist, she wrote.
Last year, about 285 students met with the psychiatrist, according to Johnson. "Some of those students were not prescribed medication, and other students have their medication prescribed by doctors at home or in the Providence community," she added in an e-mail to The Herald.
A national college health assessment by the American College Health Association in 2002 reported that 24 percent of all college students are in therapy for depression, and 35 percent of American college students take medication for depression.
Richard Kadison, chief of mental health services at Harvard, writes in his book "College of the Overwhelmed" that highly publicized suicides like those at the Massachusetts Institute of Technology and New York University force institutions to "choose between trying to ignore or minimize the serious emotional challenges faced in college." By his assessment, Kadison adds, "Most have chosen wisely."
Brown abides by that philosophy. "Do what you think is right for students and then worry about liability," said Margaret Klawunn, associate vice president of campus life and dean for student life. "We really don't make our decisions based on liability."
"There are other institutions that are more focused on the liability issue," Johnson said, emphasizing that Brown's Psych Services aims to do what they think is right before worrying about liability.
Despite Brown's adherence to confidentiality policies, some extreme circumstances call for a break in confidentiality. If a student is in "immediate danger of killing themselves or someone else," confidentiality can be broken, Johnson said. "We don't protect confidentiality at the expense of someone being harmed."
In the case of a court subpoena, Psych Services must comply, also breaking confidentiality.
Last spring's shootings at Virginia Tech and the subsequent suicide of the student gunman sparked debate about institutions' responsibility for students' mental health treatment. According to the National Institute of Mental Health, 12.5 people for every 100,000 people aged 20 to 24 commit suicide each year, based on numbers for 2004.
There have been three "probable suicides" in the last five years at Brown, according to Johnson.
Carrie Schepker '09, co-president of the Brown chapter of Active Minds, a national organization concerned with students' mental health in college, called liability a "non-issue" at Brown. She described Psych Services as a "safe place" where "everything does stay self-contained."
Katie Tsubota '08, also co-president of the Brown chapter of Active Minds, has used Psych Services every year she's been at Brown. "It's a really great resource ... and very convenient," she said.
Brown's chapter of Active Minds holds weekly discussion groups to discuss "all aspects of mental well-being," Schepker said. The group, made up of a "core group" of five to ten students, also aims to "raise awareness about the resources at Brown," she said.
"I've personally found Brown to be a very supportive place," Tsubota said.
Psych Services' funding comes from the student health fee - $306 per semester for the current academic year - that all students are required to pay each year. Johnson said she is satisfied with the current level of funding, but admitted there were "a couple of years when we were really pressed."
Schepker said she wishes Psych Services received more funding, though, to allow for more free visits for each student. "Other colleges are much more liberal" with the number of free visits allowed to students, she said. "We'd like to see finances be a non-issue."
If students have "good enough insurance," Tsubota said, referrals to outside providers work well. But the five-visit limit is "something that's come up" in conversations with students.
Yale, for example, offers students unlimited visits to its mental health service.
Though Tsubota said Brown students do not have exceptional mental health issues compared to other schools, Schepker said Brown's high-stress academic environment is "really overlooked."
Peter Kramer, a clinical professor of psychiatry and human behavior, isn't so sure.
"There is a general impression that stress is high - I'm not sure I buy it," said Kramer, author of "Listening to Prozac." Part of the reason more students are using Psych Services may be because "students are consuming ... different services," he said.
But, Kramer added, "There are plenty of people who think there's an epidemic."
