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Kate Fritzsche '10: Is 'good and getting better' enough?

Yesterday, Psychological Services announced its plans to hire a new psychotherapist in order to expand resources available to students. This move will increase the number of free visits students are allowed each year from five to seven, and it should also reduce the waiting time before students are able to have their first appointments at Psych Services.
Mental health services available through Psych Services are hugely beneficial to the student body, but there are many improvements that could make the process easier and less stressful. Some of these improvements will come with the hiring of a new psychotherapist, but there are certainly issues that this change won't address.

Students don't usually go to Psych Services until things are pretty bad, because we don't want to admit that we're having a tough time with any sort of mental issue. The temptation to try to keep up appearances is strong; no one wants to admit to emotionally instability, even though more people are struggling with psychological problems than you might realize.

For one thing, getting an appointment at Psych Services can often take more than a week if it's not an emergency. Unfortunately, most of us let the situation get pretty desperate before we make the call for help, even if we don't get to the point of a technical emergency. Trying to get help should be a positive step forward, not a difficult one. The hiring of a new therapist should reduce this waiting time, which would do a great service to students in need of urgent, but non-emergency, psychological assistance.

Once they get an appointment, undergraduates are limited to five free visits per year at Psych Services. While for many students, this may be sufficient to help them over whatever struggles they were coping with, for most in need of assistance, five visits is not enough. And so, the counselors at Psych Services often try to refer students to outside providers early on in their treatment if they can tell that five visits won't cut it. Again, this is an area where the new psychotherapist will be hugely helpful to students. Having seven free visits instead of five is a significant difference and may allow some students to complete the treatment they need on campus without ever having to deal with the referral process.

Psych Services has many different types of psychotherapists on its staff, and some students are initially placed with a therapist who can't provide what the student really needs for his or her particular issue. In many cases, when we need to see a specialist for a specific type of psychological treatment, we are referred off-campus. But when an in-house counselor can be of help, the process of getting an appointment with that provider should be a lot easier than it is. I've heard from friends who saw a generalist for as many as three appointments before they were able to see the specialist they really needed, even when the diagnosis was clear. Once we are able to see the specialists, they are extremely helpful, but if we could get appointments with them more quickly, the psychological healing process could begin a lot sooner.

The process of referrals, most significantly, can be a huge headache for students who are already feeling overwhelmed. I have spoken with several students who have been asked to call their health insurance companies and ask them for names of providers near campus who would be covered by their policies. This is standard practice at Psych Services for students who have insurance outside of Brown's Student Health Insurance Plan. While this may not seem unreasonable, some students may not want their parents to know they are receiving psychological help, so using their parents' insurance creates a whole other host of problems. And even without that obstacle, just making a phone call about mental health issues can be stressful or embarrassing.

Once a student finds an outside provider who will be covered by his or her insurance, Psych Services can provide the formal referral. However, for many distressed students, starting to open up with one counselor is already difficult. Being told they need to switch to seeing another psychologist and start all over again can be even worse for the students most in need of psychological help. While Psych Services tries to refer these students quickly to someone who will be able to provide ongoing treatment, it would certainly be easiest if they were able to simply continue seeing the same provider at Psych Services for the duration of their treatment.

Ultimately, Psychological Services is there for students when they need it, and its services are covered in our regular bills for the semester, so it has no marginal cost to us. But the administration of the process could be a lot more student-friendly, and students deserve to have it be easy to receive help when they ask for it. Taking the first step can be hard enough, so when we say we need help, we really need it to be there.


Kate Fritzsche '10 is an applied math-economics concentrator from Kennebunk, Maine. She can be reached at katherine_fritzsche@brown.edu.




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