ARIAS: Mental health under the elms

“The state of mental health care at Yale is unacceptable, and we should be outraged.”

“The Yale program is probably the oldest and most fully developed of that in any college or university in the world.”

It is difficult to believe that these two statements, published in the News over 50 years apart, describe the same department. Given the recent outcry regarding the current state of mental health services at Yale, it may surprise many to learn that Yale’s mental health department was once considered exemplary, its founder heralded as “the acknowledged leader in the field” and its reputation beyond reproach. Today, Mental Health and Counseling has been the focus of much criticism and concern, prompting a YCC report, several published articles and a university-wide response from the administration. Much, it seems, has changed since the time of elm trees in New Haven.

In spite of these developments, a history of mental health care at Yale has been conspicuously absent from recent conversations. The origin of Mental Health and Counseling is a fascinating story, and a number of points from the department’s history can shed light on the present.

In 1925, Yale established the Division of Student Mental Hygiene, the predecessor of the current Mental Health and Counseling program. In its early years, the Division was focused on increasing its presence on campus and connecting more intimately with the student body. This mission was undoubtedly hampered by its location, situated as it was at the Medical School and thus at a considerable distance from the central campus. It was not until 1930 that the Division acquired new office space, moving into present day Leigh Hall. The new location on Cross Campus led to an increase in student visits and, as the Department would later note, “gradually built up an acceptance of psychiatry as part of normal medical service.”

The Division’s mission and understanding of mental illness were broad in scope. Seeking to promote the “happiness and effectiveness of every student,” the Division took a comprehensive approach to counseling. The staff held open office hours, conducted private counseling appointments, showed students how to study and use the library system and even “taught something of the organization of Yale social life and mores.” The primary focus in Yale’s counseling was to “review [the students’] social and cultural equipment as it related to fitting into Yale and what could be done to fill in the gaps in their lives and training.”

After WWII, clinical demands on the Division significantly increased, with both a greater number of students enrolling at Yale and a greater number of them seeking mental health counseling. The Division was able to meet the rising demands in part due to the contributions of Paul Mellon ’29. A Mellon grant kept the Division funded through 1949, whereupon Mellon — through the Old Dominion Foundation of Washington, D.C.— made a $2 million dollar gift to Yale to continue the mental health care program for several decades more. At the time of the donation, Yale’s mental health program was at its zenith.

The money, however, ran out. In 1968, Yale’s chief psychiatrist, Robert Arnstein, warned that rising student demand in the past decade and narrowing fiscal resources might lead the clinic to a crisis point within a year or two. The $2 million dollar endowment from the Old Dominion Fund was evaporating, and the University was struggling to make up for the deficit. In response, Arnstein instituted a waiting list policy. As a News column related, “Although a troubled student may have an initial interview within 48 hours, he may encounter a wait of between three weeks and two months to begin regular therapy, depending on the acuteness of his problems and on his class seniority.”

As demand stayed high, students began objecting to perceived deficiencies in the system, noting growing wait times and the difficulties in getting seen by a counselor. Such outcry has persisted — perhaps growing even louder — into the present day.

The lessons from the history of Yale’s mental health department are of paramount importance, especially as Yale turns to address the future of Mental Health and Counseling. Two new residential colleges are under construction, both within a block of the Yale Health offices. As it did in 1930, the convenience of attending counseling sessions will rise for nearby students, likely resulting in the increased use of these resources. Undergraduate enrollment is expected to increase by 15 percent with the new colleges. Consequently, demand for counseling can be expected to rise in tandem. Meanwhile, a budget deficit and an operating budget still in recovery pose challenges to the expansion of extant services. None of this bodes well for a department already under criticism by the student body.

In 1968, rising student demand and tighter budgets combined to critically hinder Yale’s mental health service. Without appropriate action, they may do so again.

Daniel Arias is a junior in Calhoun College. Contact him at daniel.arias@yale.edu .

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