An evaluation of SMU’s mental health resources

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In her 17 years as SMU’s associate chaplain, Judy Henneberger has witnessed trauma, crisis and death. Henneberger is the university face who approaches students in these moments, comforting bereaved students or visiting students in the hospital. Each SMU student holds a place in Henneberger’s heart.

When a student takes their own life, Henneberger has her own way of remembering the loss that she developed.

“I write down all their names because I don’t want to forget them,” said Henneberger, who keeps a list tucked in a large navy binder under her desk. “I’ve been to many of their services over the years. I’ve been with many of their families … I don’t want time to go by, and it’s just a student who died.”

In the past two years, SMU has seen an increase in rate of student suicides among other universities. In a national survey of over 500 universities, the mean number of suicides at universities of SMU’s size was one student per year. While in years past SMU has seen rates similar to or below this national average, SMU saw three suicides during the 2015-16 academic year, followed by one on-campus suicide in fall 2016.

After four TCU students died by suicide between 2010 and 2012, the chancellor established a Council for Mental Health & Suicide Prevention to reduce the risk of students, leading to the start of their HOPE initiative from a generous grant. SMU has not made a similar public initiative.

College students are vulnerable to the effects of mental illness. Seventy-five percent of mental illness cases start by age 24 according to a 2005 study on the prevalence of disorders. About a fifth of individuals ages 18–25 exhibited a mental illness from 2014–2015 according to a 2015 data set from the Substance Abuse and Mental Health Services Administration (SAMHSA).

SMU’s population falls mostly within this age group, and the university has many programs in place to support them. However, many of these programs do not connect with each other to address the complexities of mental health, and they do not offer some of the timely services that similar universities do.

The primary resource for mental health care at SMU is through SMU Counseling and Psychiatric Services (CAPS) in the Dr. Bob Smith Health Center. CAPS offers “short-term individual counseling and psychiatric services”. CAPS provides other resources such as group counseling and workshops.

While support groups are open for students to attend, attaining private counseling sessions at the counseling center is not as simple. A student who wishes to receive counseling must complete a 30-minute initial triage appointment, scheduled Monday through Friday between 1–3 p.m. Students can schedule these appointments over the phone or through the Mustang Health Services Patient Portal, but the Patient Portal does not show real time availability.

“The portal never works, which deterred me from making an appointment when I initially wanted to,” SMU junior Adrieanna Reyes said. “It was a very uncomfortable process for me to call in and make an appointment due to how I was feeling at the time.”

Students can schedule initial consultations within a week of calling over the phone.

In this 30-minute initial meeting, a clinician will discuss concerns and review a student’s health history. After this consultation, students are then either referred to group counseling, workshops, substance abuse referral, individual counseling or off-campus resources. If a student requests individual counseling, the student is referred to an assigned clinician or must wait for an available appointment that meets their schedule. This wait time varies depending on availability and the seriousness of the student’s concerns. A student in crisis, however, has accessibility to a crisis counselor during business hours or a 24-hour crisis number after business hours.

“For much of the semester, an initial consultation can be scheduled within a week, and the intake that begins treatment can be scheduled within two to eight business days,” CAPS director Cathey Soutter stated in an email.

Some students who responded to a Daily Campus query via Facebook said they had positive experiences seeking individual counseling. An SMU sophomore sought counseling in fall 2015 and still continues with weekly appointments.

That wasn’t the case for an SMU junior who requested an appointment last October. She scheduled an intake within a week of calling. Her clinician recommended that she seek individual counseling; she put on a waitlist for an available appointment slot. She remained waiting until the end of the semester when she was contacted again by counseling services.

“I was worried since I was at such a low point that this would make my symptoms become worse,” she said.

In comparison to other universities in the annual Association for University and College Counseling Center Directors Annual Survey, approximately 65 percent of universities reported not having a waiting list. At SMU, the last four to six weeks of the semester commonly results in a waiting list with wait times that can range much longer than the typical eight business days. At this point, counseling services will refer students to group counseling or workshops or off-campus if they prefer not to wait for an availability.

Off-campus counseling may suit many students best, but it is difficult to consistently maintain on a college budget.

A 2013 study from Brigham Young University shows that patients who attend weekly sessions show the most progress. Individual appointments are not cheap, however, ranging from $50 to $240 across markets. At SMU, the most work-study available offers $4000, or around $333 a month over 12 months. To pay for this care, a student would likely be forced to work more hours, which could increase stressors, or rely upon family members to afford care.

SMU students already provide funds for SMU’s mental health resource. Residential students contribute funds from their room and board fees to maintain the facility. Non-residential, full-time undergraduate students contribute $100 per semester and graduate or part-time students contribute $50 per semester.

University officials would not release the budget for the SMU Health Center.

Compared to other cohort and aspirational and cohort peer universities as defined on the SMU website, SMU has some of the highest counseling staff/intern members-to-student ratio. The health center reports six full-time counselors, three part-time staff members and four fellows or interns.

With an enrollment of over 11,000, this leaves SMU with a staff to student ratio of around a 1,300-to-1 or 900-to-1 with fellows and interns. Nationwide, this ratio is in line with guidelines from the International Association of Counseling Services, which states that universities should maintain a ratio between 1,000-to-1 to 1,500-to-1 without trainees.

“Whether it’s a good or bad thing, it is not a place where we are in a position to put our resources,” said Joanne Vogel, SMU Vice President for Student Affairs ad interim and a professional in the mental health field for over 17 years. “Because these ratios are good, we would not be adding to staff there.”

However, after comparing these ratios with 22 of the universities SMU “seeks to be comparable in characteristics and quality” as well as universities SMU “defined as operationally comparative,” 80 percent have lower staff-to-student ratios, including post-doctorate trainees. The average staff to student ratio among these schools averaged to around 870-to-1, compared to SMU’s 1,300-to-1 ratio.

While some universities had higher counseling staff ratios than SMU, SMU also had a significantly higher cost of attendance for full-time, residential students than 75 percent of these schools.

All of these except Brandeis University offer only short-term individual counseling sessions before referring a student off-campus. SMU CAPS does not aggregate how many students are referred off-campus, according to Soutter.

“The university is really acting as a screening place and then sends the students to health care professionals like psychiatrists or psychologists who are really trained well in suicidology to do a suicide assessment,” said Skip Simpson, a Frisco-based lawyer specializing in suicide malpractice. Simpson is a board member of the American Association of Suicidology.

This semester, SMU senators Trey Dalton and Ben Ovenshire started the CAPS initiative to “evaluate students’ experiences with CAPS and CAPS itself,” according to pre-major senator Dalton.

“We’ve heard rumors that it takes two months to get an appointment,” Dalton said. “My freshman year I used CAPS extensively… and to hear that other people didn’t have this experience shocked me a little bit.”

The committee comprises campus leaders from various SMU organizations such as The Assembly of Residential Students, Student Senate, resident assistants and PsyChi club. The committee plans to release a survey to gather student experiences within the next few weeks and speak with CAPS. Later in the process, the committee hopes to host a Wellness Week to offer an opportunity to speak about mental illness on a campus level.

Vogel also plans to dig deeper into the internal efficiency of the health center over the summer.

“I’m bringing in a consultant that does this across the nation to sort of look at wait times, service levels, the amount of students one provider sees and making sure that it’s all in balance and healthy and doing the best that we can for our students,” Vogel said. “I’m excited to see what they will recommend for us.”

Aside from the health center, a variety of other resources is available for students. However, client privacy laws make communication difficult between the different resources, and some of these resources do not really touch on mental illnesses specifically.

In the past 10 years, SMU began a new initiative to serve as a support system to students who may be in distress. In 2007, the Office of the Dean Student Life implemented the Caring Community Connections (CCC) program. While the CCC program sees some mental health concerns, the highest concern that enters this office is usually from teachers when students miss class or perform poorly on exams the program’s primary intaker Michael Hogan. The program can refer students to CAPS; however, the student is then given the responsibility to take the next step in seeking help.

“The counseling center is an operation that operates under a level of confidentiality that is much tighter than our office,” Hogan said. “They will let us know with the student’s permission if they attended an appointment, but that’s about as far as they will go.”

Outside of the Dean of Student Life, SMU also offers confidential counseling available through the Chaplain’s Office. Many students, however, do not know about this resource.

“Our office is sort of like a secret,” Henneberger said. “We are going to have to look at referral ways for students to get what they need quicker and not so late.”

While these resources are available, students in many ways are given the reins to find their own help. After leaving these resources, a student may never make their way to their referral or may get lost on the way to finding the next step.

The SMU junior said while she unable to obtain counseling through CAPS, she progressively improved thanks to the support of friends instead of professional help. However, not everyone’s story is the same.

Editor’s note: Students used as sources in this story have been granted anonymity.


IMPORTANT RESOURCES

  • In case of an emergency, call SMU Police at 214-768-3333.
  • For confidential counseling, call 214-768-2277 to reach Counseling Services. An emergency contact number is provided at all hours.
  • The Chaplain’s Office also provides confidential counseling. Call 214-768-4502.
  • To seek help for a student, contact SMU’s Caring Community Connections online: smu.edu/ccc
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