Universities face mental health gap
Sacramento Bee 4/26/07
Things are also rough at UC Davis. The campus's counseling center has seen demand for services rise more than 70 percent since 2000 but has only a few more staff members, creating longer waits and affecting service, officials said this week.
Both colleges are operating well beyond the accepted standard of one therapist for every 1,000 to 1,500 students. UC Davis has one therapist for roughly every 2,500 students. Sacramento State has one licensed therapist for roughly every 4,000 students.
Those figures matter even more in the wake of the Virginia Tech shootings, officials said. Therapy can help deter violent or suicidal behavior.
Seung-Hui Cho, who fatally shot 27 students and five teachers before killing himself on the Virginia Tech campus, was reported to campus police by two female students who said he was harassing them. The campus police were called and Cho was ordered to undergo outpatient treatment, but officials say they do not know whether he did.
"College counseling centers across the country are talking about this," said Bert Epstein, director of Psychological Counseling Services at California State University, Sacramento. "Our capacity will only allow us to see a fixed number of students. We are maxed out."
Students at UC Davis and Sacramento State who are in the middle of a psychological emergency -- say, they are suicidal or in the midst of a breakdown -- are still getting help fast. Both schools have open-door policies for such students, much like a hospital has an emergency room for triage.
The problem comes for the bulk of students who contact the universities' psychological counseling offices -- those who are in pain but not in the middle of an emergency. Say, for example, they are chronically depressed or anxious or dealing with the onset of something like obsessive compulsive disorder.
They have to wait.
At Sacramento State, the wait is especially long. After an initial assessment, a student with moderate to severe concerns can wait five weeks. For those with milder symptoms, it will take seven weeks to see a campus therapist, and nine weeks to see a campus psychiatrist who can prescribe medication, Epstein said.
Because of the long wait, counselors quickly ask students if they have private insurance.
"If they do," Epstein said, "we tell them (seeing a private therapist) may be a good resource."
If a private therapist is not an option, they may be in for some rough weeks. "Sacramento is not a good city to find low-cost mental health care," Epstein said.
These students are seeking help not because they are undecided about which classes to take or worried about balancing work and study, Epstein said.
"Maybe half of the students who come in to see us -- we are talking about very severe issues," he said. "They are survivors of crime; people dealing with death; suicidal; psychosis."
About 1,000 students will come into Sacramento State's psychological services center over the course of a year, Epstein said. The center has the full-time equivalent of about seven licensed therapists and one psychiatrist.
The CSU system has no plans to increase staffing at its counseling centers, said CSU spokeswoman Clara Potes-Fellow.
At the campus level, administrators say they realize times are tough at the Sacramento State center, but finite funding makes fixing the problem harder.
"Everybody has a need for more of this or more of that," said Ed Jones, Sacramento State's associate vice president for student affairs. "There are no pockets of money sitting around with no owners."
At UC Davis, students are typically waiting two to three weeks for follow-up appointments with therapists, said Emil Rodolfa, director of UC Davis counseling and psychological services.
The problem, Rodolfa said, is that the number of clients has outstripped the number of counselors in the past several years.
And, Rodolfa said, "The types of students we are seeing -- they are more severe, their cases are more complex. Their need is just more intensive."
In 2000, 1,700 students sought help at the counseling center, Rodolfa said. In 2006, 3,000 students visited the center.
In addition to a growing student body, Rodolfa said there are a few other reasons for the increase. As the stigma toward mental illness has decreased, more students have been willing to seek help.
Also, relatively new medications have helped students with mental illnesses such as clinical depression -- who might not have been on campus 20 years ago -- to attend today. They often require care during bad times.
The trend has especially affected the college's roughly two medication-prescribing psychiatrists. Demand for them has doubled in the last several years, Rodolfa said.
Rodolfa and Epstein noted that when students get into counseling, their symptoms and pain tend to be alleviated. Rodolfa gave the example of a student he saw about 18 months ago who was feeling isolated and alone and was self-medicating with alcohol. The student was thinking of killing himself.
"He was feeling very disconnected from his family and other students," Rodolfa recalled.
He was able to work through his problems and is in a better state of mind now, Rodolfa said.
Students forced to wait for one-on-one counseling still have a few options, officials at both schools said. UC Davis offers group and peer counseling services. Sacramento State also offers group counseling and points students to some off-campus resources. Many times, though, individual therapy with a professional is what is needed most.
Such problems are typical at campuses across the state, said Michael Young, co-chairman of a mental health committee that made recommendations to the University of California Board of Regents late last year.
"We just don't have enough psychologists and mental health professionals to address the full range of needs," Young said.
Acting on the mental health committee's report, the UC system has devoted a 3 percent increase in registration fees to mental health services. The $4.6 million raised will help, Young said, but will not nearly solve the problem.
Young estimates that in order to get the UC system to an acceptable ratio of therapists to students, the number of therapists needs to be doubled. That could largely be accomplished with a 2 percent increase in general fees.
"If we implemented" the recommendations in the report, said Young, "there would be young people who might have died, but will not."