Mental illness and suicide rates in young adults have become a rising national epidemic in the past five years, and universities are vying to keep up with providing effective resources to increase suicide prevention for students.
For SUNY New Paltz, annual spending for the counseling center has jumped from $300,000 in 2010 to $400,000 in 2015. With five full-time counselors and a consulting psychiatrist operating Monday through Friday until 5 p.m. at the campus Psychological Counseling Center (PCC) with individual and group sessions, the expansion of resources and help for students in need is a constant search.
Many students who have tried to use PCC have reported frustration with the inability to make appointments as a new patient in the near future. Upon calling the PCC, it is not uncommon to have a wait period of a week or two before seeing a counselor.
“There is a backlog across the nation for student counseling,” said Director of Student Counseling Gweneth Lloyd. “When a student calls and their first request is ‘I would like to make an appointment,’ the first question we ask is ‘is it urgent, are you having a crisis?’ We have never turned anyone away saying that we are too busy if they are in crisis.”
Lloyd said the secretaries at PCC are trained well enough to detect the particular tone in the voice of a caller and determine if they are in distress, even if they say otherwise.
If a student is having a crisis and must be seen right away, they may have to sit in PCC and wait for a counselor to be available, but they will be seen that day and they are also a safe environment under the watch of those at the center.
“The other day I walked in and all three of my crisis staff were dealing with a crisis, one for each of them,” Lloyd said. “I walked in from a meeting, and another student in distress was in the waiting room so I went outside and had a conversation with her, telling her she has to wait but we will see her today.”
According to Lloyd, the conversation over the phone and in-person to a student who feels they are in crisis begins with the defining of “urgency” to see a counselor. “Are you concerned about your personal safety or the safety of someone else?” goes along with this definition as well as being an important question for the student to address.
“We have never turned anyone away saying that we are too busy. I know people say that, but that is not the case,” Lloyd said. “There is a large backlog at time just around critical periods such as midterms and finals to make an appointment, so it doesn’t exist at the beginning of every semester. That being said, there is no student crisis walk-in where we say they can’t be seen that day.
According to Vice President of Student Affairs David Rooney, the college is always looking for new ways to address the flood of students at PCC. Additionally, various areas of the administration including department vice presidents, senior counselors and the chief of police, attend SUNY-wide meetings where ways to improve college operations are discussed.
Rooney said at these meetings, campus officials are able to hear about the practices in which other colleges are operating. An example of this is “Let’s Talk,” a service adopted from Syracuse University. This service offers free mental health consultation and support to undergraduate and graduate students at the college with no previous appointment made.
“Let’s Talk” is available on Wednesdays from 11 a.m. to 1 p.m. each week with one of the five counselors in the Student Union Building room 209.
“We are always looking for ways to maximize our means of meeting demands,” Rooney said. “‘Let’s Talk’ not only acts as an informal outlet for students who just need to talk about minor social issues or stress, it also addresses the students who believe there is a stigma attached to visiting counseling center.”
Counseling services at SUNY New Paltz work in conjunction with consulting psychiatrist Dr. Charlotte Murphy for students who are in need of psychiatric medication.
According to Lloyd, the criteria for the engagement of full-time psychiatrist is that the student must be actively engaged in therapy. Medication management refers to the required psychological counseling that is necessary for the consumption of medication. A student must be undergoing therapy in order to be prescribed medication.
Additionally, students who are already being prescribed medication from a psychiatrist at their home can go to the psychiatrist for assistance if they are caught in a bind with attempting to refill their prescription.
“The prescribing psychiatrist takes on a lot of responsibility for someone that they are not seeing they don’t know what kind of reaction they are having or what have you,” Rooney said. “But it is a tool for us to make sure that we can maintain a student’s treatment while they are away from home and while they may be away from their regular therapist.”
Rooney and Lloyd expressed that they treat students who seek out counseling as independent adults, therefore they can be entrusted to take medication. However, if a student is a minor they will need parental consent.
“It creates conflict because we recognize their rights to privacy and sometimes their parents might see things differently,” Rooney said.
Lloyd said the consultant psychiatrist has been selected upon her values extra conservative with medication. These values are consistent with the philosophy and practice treatment models of the counseling center.
Controlled psychotropic substances such as Adderall or Xanax are prescribed only after a student has undergone extensive counseling with one of the five counselors and primary therapy with Murphy.
According to Rooney, many students who present a need for psychotropic medications for mental illnesses such as bipolar disorder already have a psychiatrist at home. Murphy will be in constant contact with their regular therapist and psychiatrist from home to ensure that the student is not playing one doctor off another for extra medication or to attempt in getting off of medication when they should not be.
Students must be subjected to lengthy assessment in order to root out if a student is simply “drug seeking.” If a student is found to be this way, PCC will offer them other alternatives to dealing with their symptoms.
Such a hesitation to take psychotropic drugs lends itself to students wanting to preserve a certain lifestyle that medication might interfere. These concerns center around a possible jeopardization of lifestyle choices that include drinking, drugs and/or sexual performance.
Rooney also said the cyclical nature of psychotropic medication where a student may get off medication because “they feel better” and then sink back into their mental illness is a common situation.
“That is why it is important for the psychiatrist to understand the developmental population of the college,” Lloyd said. “Everything about a student must be taken into consideration. A student’s primary therapist knows them very well and can provide information to the psychiatrist about the student’s mental progress and lifestyle.”
A system exists between Residence Life, the University Police Department (UPD) and PCC that is available to respond in the case of an emergency where a student’s life may be in danger. According to Lloyd, this is a protocol for how students can access mental help past 5 p.m. in an emergency.
Each night a different counselor is the emergency contact for the night. It allows 24 hour responders, like the police, to have access to psychological consult. This allows for someone in a UPD position with no psychological training to have access to a therapeutic resource to help a student in mental distress.
“It’s used a lot, any crisis would begin there at any time,” Rooney said. “The distress of a student may come to the attention of a residences assistant (RA) or a residence director (RD), and they can call the counselor on call UPD if the student is in danger.”
The counselor is brought to the scene via the phone and they do a risk assessment over the phone with the student immediately to determine the level of risk and self-harm.
Counselors can only make recommendations for a student who may be putting themselves in danger to be transported to the hospital for further assessment, they cannot mandate it as counselors are not medical doctors.
“We make an assessment to if a person needs a higher level of care, at the point that we do that, we have a team approach,” Lloyd said. “The student is transported to the hospital for further assessment, and we stay in line with them due to the wonderful memorandum of understanding with have with UPD and the hospital.”
Lloyd said they are able to follow up all the way until doctors see the student and this may take several hours. The hospital workers will inform of the counselors if the student will be ok to come back to the dorm or their home or if they need hospitalization.
“We don’t believe that the RA or roommate should be entrusted to keep an eye on the student,” Lloyd said. “I firmly believe that if a student needs to be ‘kept an eye on,’ they need to be in a safe environment with a professional.”
Rooney said however, 25-30 years ago, the standard procedure was to have the RA or roomate keep an eye on the distressed student.
Rooney and Lloyd made it clear that when students say that they are upset that they get sent to the hospital by PCC, it happens because the student was not making rational decisions and needed to be hospitalized.
“Nine times out of 10 a student who gets sent to the hospital will have to stay overnight,” Rooney said.
The goal, according to Lloyd and Rooney, is to keep the student safe and aid them in recovering from such a traumatic night where they were so distressed they had to be sent to the hospital.
“We don’t send them unless we have to, no one wants to be out at 3 a.m. seeing a student in such crisis,” Rooney said. “This is not a situation to be taken lightly people have rights to not go, but I cannot remember an involuntary transport that didn’t result in a hospitalization.”