Chalk it up to a “crisis of meaning” or the downwinds of social media — a growing number of Americans are lonely, depressed and anxious. According to a study conducted by Columbia University’s Mailman School of Public Health, the proportion of people in the U.S. suffering from depression rose from 6.6 percent to 7.3 percent, between 2005 and 2015.
But what does a national mental health crisis look like on a college campus? To Dr. Gary Dunn, director of Counseling & Psychological Services (CAPS) at UC Santa Cruz, it’s a roster of about 3,000 students a year, who attend about 12,000 individual appointments altogether. On May 17, City on a Hill Press talked to Dr. Dunn about the particular set of issues that students face and the availability of mental health resources on campus.
What sorts of problems do students come to your office with?
“Very consistently, and this is the case nationally too, anxiety and stress are the highest presenting problems, with depression after that. And that’s fairly consistent. And then after that, it can vary — family problems, academic issues, loneliness, [lack of] self-esteem, stress goes in there with anxiety, sleep.”
Dunn pointed to a table on his computer that laid out a list of 18 mental health concerns, ranging from academic stress to thoughts of suicide, alongside the rates at which students visiting CAPS endorsed these concerns as applicable to themselves.
“Across the board, it’s all going up, at least in terms of that specific measure. I just was calculating this the other day, and it was interesting to me that last year, for depression, 63 percent of the students endorsed, and now it’s 66 percent.”
What’s causing that?
“That’s really the great unknown, right? What’s going on? […] Academic stress, we seem to see a lot of that. The political situation in the country is a complicating factor. Oppression based on race, immigration status, gender identity, sexual identity. […] Students cramming into dorm rooms, having difficulty finding affordable housing off-campus. […] We also have an increasing number of first-generation students and international students. […] Their families can’t necessarily be as helpful as someone whose family has been to college for generations, not to mention the economic insecurity that oftentimes comes with that. We see students who are sending money back home, and they’re skimping on things like their food.”
Dunn also said the increased academic pressure students face in primary and secondary school leave them with little time to develop the social skills and coping mechanisms necessary to navigate college life. He said these problems are particularly prevalent among UCSC students.
“One interesting and important piece is that UCSC students, on several measures, appear to be having more difficulty than other students, both nationally and even within the UC system. And this might have something to do with the reasons I mentioned before, but it’s something that I’m hoping that we can study and get to the bottom of.”
UCSC students receiving CAPS services endorsed concerns related to anxiety, financial pressure, grief, identity, medical status, sleep and substance abuse at the highest rates relative to other UC campuses. Second highest in the UC system were UCSC students’ endorsements of academic stress, learning difficulties, depression, eating disorders, family disputes, loneliness and thoughts of suicide.
What’s the role of CAPS here? How do you help folks who’ve fallen behind?
“I think that we’re starting, as a university, to see that it has to be much more than just CAPS dealing with this. […] How we’re setting up majors and requirements and course demands, all these kinds of things. We’re dealing with the downwind impacts of all these problems. […] Ideally, we want people to come to college with these skills intact. But we also want to be part of the solution of helping students to develop them if need be, although we can’t do it by ourselves. It has to be an institutional initiative.”
Will CAPS enjoy more funding under Gov. Newsom’s 2019-20 budget plan?
“I don’t think so. […] Back in 2015, the regents agreed to increase student services fees UC-wide over a five year period, with at least part of that money earmarked toward direct mental health services. So systemwide, we hired 85 staff with that money. But now, the legislature is thinking that we don’t really need that money after all, so now there seems to be a question of whether or not we will be able to continue to get the increases that were promised to us over those five-year periods.”
According to the UC’s internal statistics, UCSC students wait seven days to see a CAPS specialist after scheduling an appointment on average. Across the nine UC campuses, the average wait time to see a counseling or psychiatric specialist is 14 days.
So CAPS will keep running into impaction issues for the foreseeable future?
“Yes. But we’re in the process of rethinking how we do business — we’re much more than just brief individual therapy. At CAPS, we utilize a ‘stepped care’ model, where basically, we have all these different levels of support. […] What we’re working toward is that when a student comes in, we match them to the level of service that they need immediately.”
Outside brief individual therapy and psychiatry appointments, CAPS services include:
– Peer services
– WellTrack, an online self-help platform
– Therapy Assistance Online (TAO), another online self-help platform to be
debuted UC-wide soon
– Drop-in support groups, including Let’s Talk
– Anxiety Toolbox, a psycho-educational group
Depending on the situation, CAPS limits the number of one-on-one appointments that students can make with on-campus staff to three per academic year. After their third appointment, students are referred to therapists off-campus, which cost $20 per session in copay fees under the UC Student Health Insurance Plan (SHIP).
Many students are critical of UCSC’s CAPS program. A May 2017 letter submitted to City on a Hill Press by then-UCSC senior and previous CAPS Peer Education Program volunteer Grace Shefcik said that, in addition to suffering from impaction issues, CAPS failed to provide sensitive care for LGBTQIA+ students and students of color on a number of occasions.
“In 2016, I solicited feedback from students regarding CAPS’ cultural competency. […] Folks reported being misgendered, being told their self-harm scars ‘weren’t that bad,’ feeling invalidated and even considering self-harm to receive services sooner,” Shefcik said in the letter. “CAPS is not diverse nor culturally competent enough to reflect or meet the needs of our student body.”
In response, Dunn submitted another May 2017 letter titled, “When Does CAPS Help? Most of the Time.” In it, he said that the CAPS staff undergoes frequent training on matters of inclusivity, and closely reflects campus demographics. Of the 23 licensed psychologists and postdoctoral staff at CAPS, seven are people of color.
“97 percent of respondents view CAPS as a necessary service for our university,” Dunn said in the letter. “88 percent were satisfied with their counseling experience and 89 percent would recommend their counselor to a friend.”