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January 26, 2017

Long Waits for Students Seeking Mental Health Care from Student Counseling Services

By Alex Ward   

The University’s Student Counseling Services (SCS) is working to increase the size of its staff in light of decreased numbers of clinicians and long wait times.

Dr. David Albert, the director of SCS, acknowledged that the service’s staff has decreased in recent years. But Albert claimed that UChicago has more clinicians than most schools its size; he said the current student-to-clinician ratio of 702:1 (including two currently vacant positions) is less than one-third of the national average for schools of UChicago’s size. Without the two vacancies, the ratio is approximately 771:1. “While we are operating with fewer part-time staff psychiatrists than we have in the past, we are currently working to fill these vacancies,” Albert said in an e-mail.

Albert cited a national shortage of psychiatrists, which he said has made filling open positions a challenge. Albert also said that SCS is creating two new positions: an Advanced Practice Psychiatric Nurse who would help with student medication needs, and a full-time staff member who will focus on crisis intervention. SCS has also begun using counsellors from ProtoCall to expand its after-hours phone services. ProtoCall counsellors can talk to students about non-emergency mental health concerns, though Albert said that SCS clinicians would still handle after-hours emergencies.

Albert said in an e-mail that the average time between a student scheduling an intake appointment and being seen is less than five business days for this academic year so far. “Because of our current vacancies in psychiatry, students are waiting a little longer than in the past to see SCS psychiatrists for routine appointments. In some instances, students opt to see an off-campus provider rather than wait to be seen at SCS,” Albert said. “However, because the shortage of psychiatrists is not limited to SCS, the wait to see someone in the community is often longer than it would be at SCS.” 

Students have reported long wait times both for internal appointments and for referrals to mental health providers outside SCS. Michael Weinrib, a third-year in the College, said in a recent interview that he experienced long delays after seeking treatment in November 2015. Weinrib was initially scheduled for an intake appointment, which is the first step for any student who visits SCS. The scheduled appointment conflicted with one of his midterms, and he said he wasn’t able to reschedule until the next week. An intake appointment is used to determine basic information about a student’s condition, and does not involve any prescription of specific treatment.

Generally, after the intake appointment, students will be scheduled to meet with an SCS staff member, who is usually—but not always—a psychologist. In some cases, either at the intake appointment or during a later meeting with a therapist, a staff member may decide that the student should meet with a psychiatrist and potentially receive medication. The first appointment with a psychiatrist is always an evaluation, though the evaluation can sometimes take multiple sessions.

Three weeks after seeking help, Weinrib was able to meet with a counselor, and was referred to an SCS psychiatrist in his second session a week later. “What I found frustrating was the fact that it took me three weeks from when I was at the point that I sought help before I could get any help, and then it was an even longer amount of time before I could get any psychiatric evaluation,” Weinrib said.

Due to overbooking, Weinrib was put on a waitlist to meet with a psychiatrist in December 2015, and eventually received an appointment in February 2016, after half of winter quarter had passed. Because of the nature of psychiatric treatment, his medication only took effect after the end of the quarter.

“Because so many things operate on a quarter-to-quarter basis here, the fact that there was such a long wait period really fucked me over for two quarters, the fall quarter as well as the winter quarter,” Weinrib said. He was also told by SCS staff that he would need treatment beyond the 10-session maximum for students receiving in-house counseling, and was referred to a list of Chicago-area psychiatrists.

Scheduling frustrations aside, Weinrib said that the appointments themselves were helpful.

“I feel like once I got there and was able to access the services, it was very helpful, at least in my experience. It was more a matter of getting access to the services,” Weinrib said.

An archived version of the Student Counseling and Resource Service’s staff page from February 2005 shows a staff of 21 clinicians, including licensed clinical social workers and four staff psychiatrists, and not including trainees or externs. The SCS staff page currently lists 13 practicing clinicians, including three staff psychiatrists, although Albert confirmed in an e-mail that not all three psychiatrists are full-time. Both figures are slightly lower than average for universities of UChicago’s total enrollment. Stanford, which has a similar student body size to that of UChicago, lists 20 staff clinicians on its counseling website, including six psychiatrists. MIT, which is smaller than UChicago, lists 21 clinicians, including eight psychiatrists. The Maroon did not receive a response to a question about how the current SCS budget compares to its budget in previous years.

After this article's publication, a University spokespwerson wrote in an e-mail: "[The 2005 comparison] does not take into account that in the past (including 2005), SCS had more clinicians who worked part-time or less than part-time. The most reliable point of comparison is the number of FTEs, or full-time equivalents, which more accurately reflects how much work an office is capable of doing. SCS ran a comparison: In FY2005, SCS had 15.48 FTE clinical staff, not including pre-doctoral trainees or residents. Currently, if one includes the open 1 FTE psychiatrist and 1 FTE psychiatric nurse positions, SCS has 16.62 FTE clinical staff. Counting those positions, SCS has about 1 more FTE than in 2005; if you leave them out, it has 1 less FTE."

Student Counseling Services’ ability to handle the mental health needs of the student body has received additional attention recently because of concerns about the well-being of undocumented students.

A letter delivered to Provost Daniel Diermeier and President Robert J. Zimmer with 386 faculty signatures on December 1, 2016 asked the University to take steps in response to President Donald Trump’s stated intention to cancel Deferred Action for Childhood Arrivals (DACA). DACA is an executive action initiated in 2012 under the Obama administration that provides deferment of deportation for undocumented immigrants who entered the country as children younger than 16 years of age and meet certain other criteria, including having graduated from high school or being currently enrolled in school. 

The letter includes a section reading, “Campus mental health services are overburdened, and overlong wait times for counseling are only likely to increase given the potential mental health consequences of the current political environment. We request an increase in the number of counselors to support undocumented students and students protected by DACA, as well as other students in need of services.” At the time of publication, the petition had nearly 2,000 signatures from members of the University community.

On January 4, Provost Diermeier released an announcement to the University community responding to the letter. According to his statement, “The University is committed to ensuring that all members of the campus community can continue to participate fully in University programs and activities, and have access to the University resources and assistance they need to succeed.” 

“To help address the need among students for mental health services, the Student Counseling Service (SCS) is consulting closely with Chicago-area counseling services with expertise in issues facing immigrant and undocumented populations, working to add more psychological counselors, and to minimize wait times,” Diermeier wrote.

A January report by the University’s Diversity Advisory Council (DAC) recommended that the administration focus on “Mental health and wellness counseling and outreach targeted to URM [underrepresented minority] graduate students.” The report noted that graduate students lack many of the social opportunities available to undergraduates, including house life, varsity sports, and Greek life, potentially making overall wellness more of a challenge. The DAC suggested that the administration should work with Student Health and Counseling Services, the Office of Campus and Student Life, and graduate student leadership to determine how to implement this initiative.

Clarification on Feb. 1, 2017, 5:58 p.m. CST:

This article was updated to clarify Albert's comment that the student-to-clinician ratio is less than one-third of the national average for schools of UChicago’s size.

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