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Print Editions Thursday September 28th, 2023

Mental health council advocates striking limit on CAPS therapy sessions

Expansion of CAPS staff and changes to medical leave system already underway

The Mental Health Community Council proposed a bevy of measures to expand the scope and accessibility of Counseling and Psychological Services in a report released Wednesday.

Most notably, the council’s recommendations include eliminating the seven-session limit for students seeking CAPS therapy — a frequent student criticism of existing policy — as well as revising the medical leave-taking system by improving communication between students on leave and the Office of Student Life and increasing the number and diversity of CAPS staff members.

The council’s report comes after the suicide of Hyoun Ju Sohn GS last semester and on the heels of a summer during which Brown drew negative attention for its handling of mental health following a Buzzfeed article that described the University’s contentious relationship with an undergraduate on leave. The University has repeatedly denied the student readmission since it first placed him on leave in March 2013 and issued a no-contact order against him in October 2014.

Though the report emphasizes that CAPS will still provide therapy only on a short-term basis, eliminating an explicit session limit would align University policies more closely with those of its peers and would be feasible to implement by 2017, according to the report.

“There’s a growing recognition of the fact that the demand for these types of services has increased dramatically — not just at Brown but at every other college,” said Steven Rasmussen ’74 MD’77 P’13, chair of the council and medical director at Butler Hospital. “Just like everywhere else, it’s not like there are unlimited resources. … There has to be some way to use the resources that are available judiciously.”

The council also made several recommendations to ease the transition to non-University providers — an area the University began to address in June by hiring Jorge Vargas as its first student care coordinator. Vargas will help students transition from CAPS providers to others in the greater Providence area.

Accessing providers off campus can be costly for students, as some health insurers do not cover mental health support. To address this, the council suggests improving information about Brown’s student health insurance, which covers unlimited mental health sessions, with a co-pay of $15 each session, said CAPS Director Sherri Nelson.

An MHCC subcommittee will likely meet with the Office of Financial Aid this academic year to discuss the cost of Brown’s health insurance for high-need students, according to the report.

The University will continue to grow the CAPS staff this academic year as it seeks two post-doctoral fellows in psychotherapy. Existing staff members’ hours have also seen a “substantial increase” — the equivalent of adding nearly two more providers, according to the report.

These additional hours will facilitate the creation of more appointment slots for students in crisis, allowing CAPS to make sure students who need immediate therapy can be in the office that day, Nelson said.

CAPS has also been placed under the umbrella of Health Services, centralizing their leadership and their missions, said Medical Director of Health Services Unab Khan.

“I am a big proponent of seeing every human being as a whole,” Khan said. “The mind and body are not two different parts.”

The report also outlines a number of changes to the process for medical leaves of absence, which are processed by the Office of Student Life. The revised process is currently being implemented and includes earlier readmission deadlines for the fall and spring semesters.

Under the new system, students may take summer courses prior to returning with a full course load in the fall semester, and OSL will keep in contact with students on medical leave “so they don’t feel isolated or shunned by the University,” Khan said.

Rasmussen said the number of students who have applied for readmission and been denied was “fortunately a very, very small percent of students who come into mental health services.”

The small number of students taking a medical leave has allowed the University to tailor its readmission policy “to each student’s needs” to date, Rasmussen said. Nonetheless, he said he hopes the University will outline more specific criteria for readmission in the future.

The council’s report cites the pervasive “misperception” among students that the University can place them on medical leave against their wishes as a significant deterrent to students who might otherwise seek mental health resources. It recommends better messaging to clarify that all medical leaves for mental health reasons are voluntary, in accordance with the Americans with Disabilities Act.

The report also takes steps to improve and clarify information about mental health resources, recommending that the University develop trainings for students, faculty members and staff members about referring students to the appropriate campus resources.

The University has already held a training session for “Question, Persuade, Refer,” a nationally recognized suicide prevention program. In addition to the 30 faculty members, students and staff members trained earlier this year, Residential Peer Leaders will also receive training this fall, the report states.

Following student confusion about the purpose of various resources, the council suggested clarifying the role each University office plays in handling specific student needs. Information detailing the functions of various offices on campus would be offered online in an easy-to-use format, the report states.

Part of making these resources accessible on campus means making their availability known to graduate and medical students as well. Though CAPS services are provided to the entire campus, graduate students commonly perceive them as for use only by undergraduates, according to the report.

Student groups like Active Minds and Project LETS have already been working to expand the reach of mental health support on campus, and the council’s report recommends that the University partner with these groups. A student hotline, jointly run trainings and a collaborative wellness center that would employ both students and professionals are two options currently under discussion.

Of course, with such sweeping proposals for change, the University must find the monetary resources needed to implement them.

“The operating budget has been an issue overall,” Rasmussen said, but added that “there will be some additional resources that will be allocated toward mental health as a result of what was done by this committee.”

The council will continue to meet this academic year.

The Brown University Community Council will discuss the report and campus mental health at its Sept. 29 meeting, which will be open to the Brown community.



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