By Tristan Benedict, Mikayla Cooper, Sydney Leibfritz, Grace Sims
Hiydees Feliciano-Torres (C’20) will have you know that she is not that messed up, thank you very much. Her depression just makes her do weird stuff. Take last semester for example. Some Friday nights, as music from the fraternity house behind her McCrady dorm room blasted through her closed windows, she would just lay on her floor.
In fact, the struggle of learning to cope with her mental illness– officially diagnosed as dysthymia, at age 17– has always played a role in Feliciano-Torres’ life.
However, despite spending the majority of her adolescence in isolation, Feliciano-Torres was anything but alone. In the past decade, awareness of mental health issues have seen a dramatic increase, particularly among college students and teenagers. This generation seeks counseling services more than any other in American history. According to the American Psychological Association, counseling centers have seen a 30 percent rise in students seeking appointments from the 2009-10 academic year to 2014-15. College counseling experts cite cultural, social, and political changes as main factors for the increase in students seeking out mental health treatment.
In addition to students becoming more comfortable with reaching out for help, the sheer number of students on any given campus has surged in the last 20 years. According to the National Center for Education Statistics, in 2016 total undergraduate enrollment increased by 28 percent from 2000, 37 percent between 2000 and 2010, and is expected to jump by 3 percent from 2016 to 2027.
The mass influx of new students has left many colleges under-equipped to accommodate the growing demand for mental health resources. National efforts have focused resources toward initiating further change on campuses, including the 2004 Garrett Lee Smith Memorial Act, which funneled millions of dollars toward toward suicide-prevention research, early interventions and referral programs.
However, aside from the national funds allowed specifically toward this research and strong initial push to reshape mental health over the past decade, the growth of resources on campus has seen little change in the past year. In fact, according to The Atlantic, almost half of counseling centers at universities across the nation did not hire more employees, and most schools’ budgets have stayed the same despite staggering growth in enrollment and need for mental health resources.
The results of these schools’ failure to meet student demand for psychological services are reflected by lengthy waitlists for counseling appointments, few openings for free counseling sessions, and students being forced to take medical leave.
When Feliciano-Torres was in the college application process her senior year of high school, she cites mental health resources as one of the most important factors in her decision to come to Sewanee: The University of the South. She had concerns about the campus’s rural isolation, but quickly found information on their Counseling and Psychological Services (CAPS) department online.
Currently, CAPS serves as the primary source of mental health treatment for students on campus with only two or three other therapists competing for clients on the mountain. Armed with six therapists and more than 1,700 stressed out undergraduates, the therapy landscape is limited, to say the least, but prides itself in guaranteeing everyone at least two appointments.
However, the current state of CAPS is miles ahead of what it used to be. Counselor Ben Craft (C’09) currently works in the office but remembers how in his time as a student at Sewanee, there was only one counselor. Craft laughs, “When I was here, the only reason you ever went to counseling was… usually if you got in trouble. I’m glad we’ve moved away from that.”
Since Craft has returned to Sewanee as a clinical case manager, he has noticed a little change but notes most of it occurred in his absence. He credits the evolution of CAPS to Dr. Nicole Noffsinger Frazier, the Executive Director of the University Wellness Center. After years of increasing student outreach, further developing CAPS, and hiring more clinicians to accommodate the growing need for treatment, Dr. Noffsinger Frazier’s most recent success is receiving a grant from the Substance Abuse and Mental Health Services Administration (SAMHSA).
However, CAPS still has much to achieve in regard to satisfying the campus’s growing mental health needs, and one of its biggest drawbacks is its infamous waiting list. Rumors of this list circulate among the student body, whispering that CAPS doesn’t accept any new clients.
The truth, however, is not as ominous as these rumors lead one to believe. The waiting list is not so much a death sentence but rather a two week waiting period, which is standard for most practices. Even then, Craft clarified, “if you’re added to the waitlist, you are guaranteed at least one session, sometimes two, depending on what’s going on. By the end of that, that is sometimes three sessions if you count the triage sessions [meetings for students in crisis]. Oftentimes during triage, we go right to work depending on what the issues are. So, no matter who you are, if you’re an undergraduate student on this campus, you’re guaranteed to get at least two, possibly three sessions no matter what our waitlist is.”
Of course, two sessions cannot remedy a lifelong problem. As Erin Dockery (C’20) explained of her experience with the Wellness Center over the past two years, “Therapy isn’t a magical solution though. It takes a long time to find what works for you and who works well with your needs. You’re literally reforming how your mind thinks, and it’s just going to take a while. You have to stay patient with it.”
With only two appointments at a student’s disposal, there often is simply not enough time to delve into everything that needs to be addressed. When their limited window expires, options become limited. If a student wants to remain in individual therapy, where it’s just them and a counselor, they normally must seek out another provider, whether that’s in Sewanee or an hour’s drive away in Chattanooga or Nashville. Some students avoid travel costs by calling a therapist from home, but most insurance providers do not cover therapy sessions of any variety, meaning students living on a ramen noodle budget typically have to pay for each session out of pocket, whereas services at CAPS are free for university students.
To continue receiving treatment at the Wellness Center, the only option tends to be group therapy. Typically, students who partake in group therapy do so under the promise that a coveted individual therapy spot waits for them at the finish line.
Even then, Craft explained the difficulties of filling these groups. “We’ve got one good group going right now, but we are supposed to have four altogether this semester, and I’ve only got enough to do the one.” Generally, students see group as better than no therapy but also dangerous territory. Because Sewanee is a small community where secrets are a commodity, many students expressed their fears of opening up in front of their peers.
Craft bemoans the hindrances involved with a long waitlist, specifically for students who need immediate treatment and are the ones often overlooked by the administration. “The students who come in and need treatment that day… I can give them something in two weeks, right? That’s nothing to them. That’s what it feels like in that moment. They get nothing. I think for the higher-ups, it’s harder to understand or to put as much perspective or concentration on that.”
Sara Brandenburg (C’22), who serves as a work study for the Wellness Center, worries about CAPS’ perception among the student body. “I wish people would understand how much they are trying to work on the waitlist they currently have and increasing access in general,” she said. “[The CAPS staff] are really overworked, understaffed, and just need a lot more people. They really can’t help the waitlist at the point they are at. A lot of the anger towards CAPS is misplaced. [Director of CAPS John Jackson] really doesn’t have a say in this. They are trying but aren’t getting the resources that they need from higher ups.”
Brandenburg mentioned that a few years ago, before she was a student, a student driven campus-wide campaign took place to pressure to the administration demanding more counselors, particularly counselors of color. She claims not much came of this initiative and “the administration shut [the students] down.”
Most of the responsibility for mental health advocacy in the administration falls onto Senior Associate Dean of Student Life Becky Spurlock. In response to claims that the administration could be doing more to further expansion of CAPS, Spurlock claims, “Financial investment in these resources is the biggest hindrance. There are many worthy demands on the budget for the University. I have not found leaders unwillingly to support mental health resources, rather there is just fierce competition for the resources.”
In addition to continuing to increase opportunities for CAPS to expand their staff, Spurlock notes that students have a role in supporting each other and themselves. “Students have a role to play in how they shape the community,” she writes, “Students can look for one another, refer their friends, provide support, serve as peer helpers, and teach each other about habits to increase well-being.”
These students have often had to step into these critical roles in supporting their peers. The question, however, is whether or not this is always a good thing. Proctor Sydney Leibfritz (C’20) recalls her training provided by Residential Life each year. “While I think they give us enough training, none of us are really capable of being all that we need to be. Our suicide prevention training is called QPR– Question, Persuade, and Refer– and essentially just has us find students in need and connect them with resources that can help them. With the CAPS at capacity, they may get temporary solutions, but we are the ones who have to make sure they survive until they can get the help they need.”
Even for students not in a leadership position, these shifting dynamics can cause tension. Dockery, for instance, has found herself in this position many times in her three years at Sewanee. After a friend’s suicide in her senior year of high school, Dockery has allowed herself to become a emotional resource to her peers. In fact, she devoted much of her sophomore year to caring for a number of close friends undergoing independent crises ranging from interpersonal conflicts to suicidal ideation.
She often worries about the impact this leaves on her own mental state and continues to force herself to remain conscious of self-care in these times. She states, “For me, I need to be more careful because I’m not good at separating them from me. I’ve always been empathetic and all of it just seeps in. I want to be there for people, but at some point, there just have to be boundaries. They have to find a balance between being a friend and being too involved.”
Leibfritz remembers hearing about nights where residents had to bring in suicidal friends to sleep on their friends’ floors to make sure they survived the night, forcing students to take on responsibility that they are not trained to handle.
“Sometimes it would be a group of four to five friends and they would take turns staying up with the person who needed someone to sit with them. I’ve hear a lot about Proctors having to contact Area Coordinator On-Call to check on a student posting concerning pictures on Snapchat,” Leibfritz said. “When the AC got there, they had to confiscate anything that she may have used against herself and convince her to have a crisis appointment at CAPS the next morning. In that window between the AC on-call leaving and the girl going to her crisis appointment, I don’t think any of my friends involved could sleep. We were just scared, you know?”
For students not wanting to confide in peer resources, there are a few other options. Online services are more readily available now than ever before, whether they are professionalized like Talkspace or something more laidback like 7 Cups of Tea.
Those who cannot afford these resources, free resources might include self help books from the library, guided journaling, or Youtube meditation activities. Having tried most options available, Feliciano-Torres remains hopeful, “These aren’t ideal, but they do help you stay alive until you can get the real help you need.”
Feliciano-Torres warns if students are going to fill the gap of where the Wellness Center comes up short, the campus culture needs to shift in terms of the conversation surrounding mental health. “I don’t necessarily think students need to be trained, but if we could have some sort of campus wide initiative to help those who aren’t in need of help help those that are, we could set guidelines for conversation and raise awareness. A lot of people just don’t know what to do and don’t look into what personally doesn’t affect them.”
Although students play a role and can find substitutes for help if pushed onto the waitlist for CAPS, the issue remains evident. More permanent change is needed towards expanding and diversifying the care available to the student body. One suggestion for after hours care might be an on-call system, in which there is always a counselor available to respond to a crisis 24-hours a day, like that implemented at Tufts University and Vassar College.
At the moment, the majority of administrative attention toward mental health at the moment has been focused toward the relocation of the current Wellness Center into the new Wellness Commons, located on the site of the former University bookstore.Expected to be completed in spring 2020, the University Wellness Commons will house all the current occupants of the Wellness Center: health services, student accessibility services, and CAPS.
In addition, other existing offices like the Sewanee Outing Program, a new fitness center, and the Lay Chaplain’s Office will also take up residence there to provide “a more comprehensive view of wellness” as Dean of Student Life Marichal Gentry stated at the groundbreaking for the new complex.
Proposed visual of the Sewanee Wellness Commons, which is expected to be completed in 2020. Photo courtesy of sewanee.edu.
Response from students has been mixed. Feliciano-Torres stated she loves the idea of having the commons in such a close proximity. “My freshman year, I would have to bike or walk half a mile from my dorm to go there. I never drove, and for people who didn’t have cars, I see how that could get annoying,” Feliciano-Torres said. “I love the idea of having the Wellness Commons on central campus, specifically for that reason. It’s just easier to get to. I think a lot of people who go to the wellness center for the health side don’t go, especially when they are sick and can’t walk over there.”
Some students remain more wary of what the move means for student privacy. Dockery fears that it may do more harm than good. She stated, “I don’t think it will discourage people to go because of privacy issues, but I also don’t know if it will draw in new faces. I think having all of those offices in the same place is a little weird, especially if you expect students to hang out and work out right above their therapist’s office. It’s uncomfortable.”
When asked about privacy concerns, Dean Becky Spurlock expressed that the administration and planning committee for this project have put a lot of thought into how to manage these concerns, citing plans for a new waiting room with a separate door for entering and exiting as well as soundproofing the walls.
Though they hope to remain sensitive to these concerns, she says that they cannot neglect the fact that mental health treatment cannot be further stigmatized. “We did not put a direct door into the Wellness Center from the outside because we do not want to reinforce this idea that this is the way it has to be.”
Upon hearing this statement, Dockery stated, “This is just such a vulnerable topic and it’s unfair to put people in a position where they feel they have to share their story when they aren’t ready to.”
As for the CAPS staff, they remain pretty hopeful and are excited to see the new space. Director John Jackson explained how the biggest benefit of the move will be the “extra visibility on campus” as well as the hope that more students will seek out the help they need. “We have to be ready to meet that demand though, and that has to do with staffing, strategic planning, support from other offices on campus. It won’t be a drawback but it will be a challenge.”
Craft, a self proclaimed skeptic, worries that the new Wellness Commons will lead to further division between CAPS and the administration. Though he sees the privacy concerns as minimal and maybe better than the current system, he stated, “ I’m slightly concerned that what will happen after that will be ‘Oh well, we put you guys in a new building, you have new supplies, so surely you don’t need two new clinicians, right?’ That being said, I will gladly and with open arms accept a new office. Having two new therapists though will be a big benefit to a lot of students and me and my colleagues. I worry though just having the new building will be coming up short.”
While a new structure cannot provide a catch-all solution to a national epidemic, the administration remains hopeful that it is a step in the right direction. Spurlock expressed her hope that in relocating the Wellness Center to central campus, conversations about wellbeing will “move from the wings and into the heart of campus.”
However, many remain skeptical of a building’s ability to produce the systemic change the administration hopes for. Feliciano Torres echoes this sentiment.
She states, “I think [conversations on campus about mental health and illness] are lacking, especially in terms of attendance. A lot of the events we have on these topics are only attended by people who are already familiar with those topics and who are directly affected. I don’t know why, but the lack of attendance hurts the effect it could have on campus if people talked about the issues.”
As the campus’ mental health resources wait for these changes to be fully implemented, Feliciano Torres and others wonder if the need for more care will ever truly be satisfied.
In the time the University spends struggling to accommodate its current needs, more students will begin to need help and the mental health crisis will intensify. Much like mental health concerns themselves, the push for more resources fluctuates from year to year in the University community, both from the administrative side and in student advocacy. To create the landscape the student body requires, there must be more consistency in growing these resources.
Regardless of the resources available, the issue of mental health continues to grow at Sewanee and nationally. There’s a sense of finality in the idea that students will always struggle. With that in mind, Feliciano Torres sighs. “It’s just something I have to come to terms with as part of myself,” she says, “I know that I’ll get to the point where the good days outnumber the bad, but I will always have this illness. That’s pretty terrifying, if we’re being honest, but I think the idea of not having any help available on then might be even worse.”
CORRECTION 2/4/19: While The Purple originally reported that “Most of these funds have been channeled towards relocating the Center from the outskirts of campus to a new Wellness Commons” and that “Some of it has also gone toward funding grant coordinator Julian Wright (C’17) and Outreach Coordinator Sabeth Jackson,” the Garrett Lee Smith Award from the Substance Abuse and Mental Health Service Administration (SAMHSA) has strict policies against using funds for such purposes and the University Wellness Center used the grant for no such objectives. The story has been updated to reflect this change.