Content warning: This piece contains reference to suicide and mental health struggles.
The first time I called UC Santa Cruz Counseling and Psychological Services (CAPS) crisis line with the intent to kill myself, they dropped the call. It was around 10 a.m. on an empty, quiet street near the De Laveaga golf course. I had left the house to run, hoping to lift a low mood that had persisted for months, and stopped at the top of a hill when I had a moment of clarity and burst into tears as the weight of my feelings hit me. This was near the beginning of lockdown, and I felt incredibly isolated.
I sat down on a curb and stared blankly for a while before ultimately googling the number for the crisis line. I had stopped crying, but as I heard the first few rings I could feel my face get hot and my eyes welled up again. I remember being asked my name, student ID number, and being told “hold on while I transfer you,” and then complete silence.
After holding my phone to my ear for 45 seconds I looked down at the screen. In tearful disbelief, I realized the call had ended. After two minutes of panicked sitting, wondering if they had made a mistake, I realized that they were not going to call me back. I think about it often. What if I had been a different person, if I had taken it as a sign, what if I hadn’t called back?
The stresses from the transition to online learning, fires, power outages, and general political unrest means that now more than ever having access to quality psychological assistance is a necessity for college students.
It is also an open secret among UCSC students that CAPS is underfunded and understaffed. The CAPS website currently lists 17 paid counseling staff employees, four psychiatry staff, three postdoctoral fellows, and three interns, totaling 27 staff members. UCSC student enrollment as of fall 2019 was around 19,700 students. This translates to one staff member for every 792 students. It seems unlikely that a staff of this size could adequately service the UCSC campus.
On the day I called, the person on the other end was an intern. I didn’t know that when I spoke to her. After a 15 minute conversation where she asked about my feelings, my intent to harm myself, whether or not I had a plan, and many other invasive questions, she decided I was a danger to myself.
Unfortunately as an intern she couldn’t do anything with that determination, or at least that was what I was told over the phone, so I had to be put on hold again while she searched on the other end for full-time counseling staff to make a definitive call. Once the full-time counseling staff was on I was forced to repeat the questioning process.
This was not the intern’s fault, but it meant I sat alone through twenty minutes of silence and uncertainty as I wandered a neighborhood I did not know, doubting my decision to call. It was twenty minutes again where I desperately wanted to, and could have hung up. Looking back, it’s hard not to feel like the bureaucratic limbo I was held in could have been avoided by a better staffed and better-funded office.
On that phone call in the early morning, I remember being asked if I needed to go to the hospital. I remember thinking, “How can I possibly know that? How can someone who is not in the right state of mind make such a determination with that many unknowns?”
What I did know in those early days of COVID-19 was that I was terrified of being held in any sort of medical facility for the risk of being exposed to the virus. I was also wary in general of the prospect of being hospitalized. At the time I was well aware that voluntary psychiatric hospitalization did not mean that I would have any control over when I left.
For those unfamiliar CAPS they do not offer long term treatment through their offices for students, operating instead on what they call a “brief therapy model”. In essence, this means that a student choosing to see a CAPS therapist will have targeted appointments aimed at solving a particular problem in a limited number of sessions, while the student has the option to look for treatment off-campus concurrently.
While this model sounds acceptable in theory, in practice it seems like a temporary solution CAPS has chosen to employ because they lack the resources to provide long term treatment themselves. The off campus resources that students are funnelled into are not much better, particularly for queer and BIPOC students who are confronted with an overwhelmingly white and straight pool of therapists. Many students must choose which facet of their identity they would like to have felt represented in a person giving them intimate treatment.
In my case, since I did not want to go to the hospital, the intermediate compromise was a third party intensive outpatient program. Due to COVID-19, the outpatient program was a three hour daily ordeal on Zoom, five days a week, for around two months, with additional check-ins from CAPS. I stayed in school and continued working during that time. Out of embarrassment, I didn’t tell any of my professors. I just tried to keep my head down and push through.
In Santa Cruz, the existing intensive outpatient care facilities are not geared towards the needs of students. The particular program I entered had a focus on substance abuse and heavily relied on group therapy. I was in a fragile enough state of mind that the structure of attending treatment five days a week was stabilizing, but it wasn’t much more than that.
The facilitators of the program were older, as were the majority of the members. Their issues and experiences had some overlap with mine, but as the only member of my group actively dealing with suicidal ideation it was hard not to feel misunderstood.
I distinctly remember a day of group discussion where we were told to explore religions as a way to cope with our addictions. I was immediately put on edge as I lacked both spirituality and an addiction in that moment. I remember reading the serenity prayer out loud as a group — “God grant me the serenity to accept the things I can not change, the courage to change the things I can, and the wisdom to know the difference” — thinking that it felt like a sick joke to have this prayer presented as my salvation.
I was not battling a choice to be depressed, I just was.
At some point, a CAPS representative checked back in with me and I expressed my dissatisfaction. I was told that there was another intensive outpatient program in town that dealt with eating disorders, which might be a better fit because the members would be younger. That too felt like a joke. What new ways were there out there for me to feel out of place?
I have since been discharged from the outpatient program. I’m still looking for long term therapy and still using CAPS services. I am not the perfect patient; I miss appointments, forget to refill medications, and often have doubts in my ability to coexist with my mental health issues. But I try, very hard, to keep my head up. And I know scores of UCSC students who face similar struggles quietly, shamefully, and with inadequate assistance.
I’m careful here also to elaborate only on my experience, and I know that it is neither unique nor universal. But it also feels remiss not to speak out at all. All too often, the stigma surrounding mental health issues means that public discourse is sterilized and removed from the impact of individual experiences.
The CAPS office is staffed by many well meaning people who lack the resources needed to truly help most students succeed. When I have pointed out the pains and difficulties I have experienced while using their services, I have been commended on navigating a broken system. I don’t feel stronger or better for having fought an uphill battle, I feel tired, disappointed, and often very alone. If UCSC truly intends to support its students during this time, the university must channel more funds into CAPS and expand their services. For some students, it’s a matter of life or death.