It’s 3:30 p.m. on the third floor of University Health Services and despite the prescription rush downstairs, the patients here manage to stagger the seating: empty chair, someone staring at the rainbow-colored patchwork mural, empty chair, someone else reading an old Newsweek, empty chair.
The room is full of thick carpeting and muffled voices; it is the last step in the long line for University-provided therapy.
This year, one in six Yale students will sit along this room’s walls. Countless others will knock on freshman counselors’ doors or college masters’ offices, talk to their suitemates or Walden or private care providers.
They are all part of a generation of college students — particularly Ivy Leaguers — that seeks therapy in greater numbers every year, that more frequently arrives at school already medicated for psychological problems, and that has more reported cases of serious mental illness than any generation before them.
Princeton treated 950 people last year, said Dr. Marvin Geller, the director of Princeton’s counseling services. Every year, he said, the numbers have increased, and over the last two years, the school’s mental health facility has seen a 25 percent increase in patients.
At Harvard, the mental health center sees 2,000 students total, or between 12 and 14 percent of their total student body.
Brown posts its statistics on a Brown Psychological Services Web site: “Each year a significant number — about 1,000 — of Brown students come to our office for free, confidential, individual appointments,” and 2,000 more come for group therapy or workshops.
At Princeton and Harvard, mental health administrators offer exact figures from files on their desktops.
But UHS officials refuse to disclose similarly specific figures.
“The numbers are misleading,” UHS Director Paul Genecin says. “It’s enough to know the numbers are very, very comparable, very similar [to those from other Ivies].”
All UHS Psychiatrist In Chief Lorraine Siggins would say is that Yale’s Department of Mental Hygiene sees between 14 and 18 percent of the combined graduate and undergraduate Yale population in one year, which likely translates to 800 to 1,000 undergraduates annually.
Harvard Program chief Richard Kadison compared the rates at Harvard — which hold fairly consistent throughout the Ivy League and similar institutions — HMOs at larger schools or for the public, where only around 6 percent of subscribers get therapy.
“There’s a greater degree of sophistication in Ivy League schools,” he said.
But the sharp minds and high SATs aren’t the only reason overachievers need more therapy.
More illness or better cures?
Half of the 2,000 students seeing Harvard shrinks are on one of the four most popular and most widely advertised anti-depressants, Kadison said.
This may actually be a sign of progress; the “Therapy Generation,” as the current crop of 18- to 22-year-olds has been labeled by The New York Times, is not necessarily in dire psychological straits.
Kadison said that in recent years new drugs have allowed bright but mentally ill students — particularly those who are bipolar — to get into top schools. Unmedicated, such students were often unable to make it through high school.
Geller says the higher numbers of those seeking treatment are the result of a destigmatization of therapy among the educated classes and in society at large. And more prescriptions, he said, come from commercials for drugs.
“You can turn on the TV and you’ll see an ad for social phobia [treatment],” Geller said.
The availability of medication, he said, is also related to decreased stigma.
“There’s been a whole move, I think, a biological-ization of psychological issues,” Geller said. “When people feel they have biological problems, there’s less shame attached to them. People may feel more comfortable coming forward, so it feels like an illness they have.”
But the news isn’t all so promising.
Over the last decade, Geller said, Princeton’s facility has seen consistently higher numbers of “serious cases.” Geller professes uncertainty as to whether the increased number of serious cases is a sign of increasing rates of mental illness or better-advertised treatment bringing reluctant students into the center.
According to their directors, schools around the Ivy League have noticed similar trends, almost the same percent of students receiving therapy and similar yearly increases.
The general increase is perhaps more acute among the Ancient Eight, but this brand of students is by no means an anomaly. The 18 to 22 age bracket is where many psychological diseases begin to appear, Genecin said, and the added stresses of college life can bring out latent problems.
The home front
But what’s different about Yalies, if Genecin is to be believed, is that they are receiving the best mental health care of college students anywhere.
“We have a richer and more comprehensive mental health service for students than any school in the country,” he said. “Hands down.”
This year the program, the first of any university in the country, celebrates its 75th birthday, and it is as busy as it has ever been. Mental Hygiene has between 18 and 20 staff members, of whom half are psychiatrists, 10 percent are clinical psychologists, and 40 percent are clinical social workers, Siggins said.
The staff members, both she and Genecin emphasize, is young and old, male and female, and with enough levels of education and specialization to suit the myriad students who bring diversity to the College and its mental health waiting room.
Along with the variety of care providers, Siggins listed the variety of care needed: “We handle primarily sexual identity issues, eating disorders, anxiety, some apprehension about the future, drug and alcohol issues, and body image issues.”
The goal, Genecin said, is to make sure students have a “sound mind as well as a sound body so that they can succeed.”
And top of the line though it may be, it remains to be seen whether UHS has the capacity to meet the unprecedented demands of the Therapy Generation.
Tomorrow: The first of its kind and a model for most others, Mental Hygiene at Yale struggles to treat students long enough and fast enough.
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