Tag Archive: Mental Health

  1. AACC highlights mental health challenges

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    On Thursday evening, Yale’s Asian American Cultural Center hosted its “Thoughtful Thursdays Kick-Off Panel” — the first in a series of discussions on how mental health and wellness intersect with Asian identity.

    The event, which ran from 6 to 7 p.m., began with a panel discussion featuring Asian-identified students and mental health professionals. It ended with break-out sessions during which each panelist addressed the event’s major themes with a smaller group of attendees. While the event touched upon a number of mental health issues pertinent to the Asian and Asian-American communities at Yale, the panelists placed particular emphasis on holistic wellness as well as the importance of self-care and community support.

    “Holistic mental health and wellness, to me, means at the minimum living beyond a day-to-day survival mode,” said Lining Wang ’17, one of the panelists and a member of the Asian-American Students Alliance. “It means being intentional about self-care in our daily routines … and it means self-advocacy, particularly in the therapy context.”

    Wang added that both at Yale and within the Asian and Asian-American communities, there is a need to destigmatize conversations surrounding mental health issues and recognize that “being vulnerable, sharing stories and seeking help” is brave and not shameful.

    The panelists spoke about how a lack of conversation regarding wellness needs in the Asian and Asian-American communities makes it difficult for those confronting mental health illnesses to reach out to their peers for support.

    Jennifer Fang, a panelist and Yale School of Medicine associate research scientist, spoke to the ability of a supportive social network to augment traditional forms of therapy provided by mental health professionals. She added that a support system derived from members of the community reassures people struggling with mental health problems that they do not have an “adversarial relationship with [their] environment.”

    The panel discussion also addressed problems arising from the “model minority’ stereotype frequently attached to the Asian community. Wang said that this stereotype, which associates members of the community with a higher degree of socioeconomic success than the population average, accelerates the development of various mental health issues in the Asian and Asian-American communities. Wang added that this stereotype weakens the family support structure, especially in families where the parents are first-generation immigrants who often expect their children to thrive within this “socially accepted” framework.

    Anand Sukumaran, a panelist and psychiatrist at Yale Mental Health and Counseling, echoed Wang’s sentiment. He stated that there exists some tension between the idea of self-care and “obligations felt from a cultural or familial perspective.”

    In addition to discussing how both the individual and the wider community deal with mental health issues, the panelists talked about the importance of institutional engagement.

    Wang pointed out some specific improvements Yale Mental Health and Counseling could make to support holistic mental wellness, including increasing the number of trained therapists and psychiatrists — in particular, people of color who are trained in recognizing how race intersects with mental health issues. Audrey Luo ’17, a panelist and co-president of Mind Matters, said that the withdrawal policy enforced by Yale Mental Health and Counseling makes people wary of approaching their deans to discuss their mental health needs. She added that because people worry that speaking to their residential college dean will result in them being sent home, they often keep their mental health issues to themselves.

    Thursday’s event marks the start of a yearlong series aimed at addressing the unique wellness issues faced by the Asian and Asian-American communities, according to Justine Xu ’19, an AACC staffer involved in organizing the event. During the break-out sessions, the panelists handed out surveys to the attendees which featured a checklist of various potential topics for future events. Xu, who spoke to the News prior to the event, said the panel would be an important means of gauging the specific areas of mental health that Asian-identified students at Yale are interested in. She added that the AACC will use feedback from the first panel discussion to shape future events, which could range from workshops to activities such as study breaks.

    According to Xu, the AACC hopes to be “as intersectional as possible” in its selection of themes for the discussion series. She said that the series will take into account how issues of gender, sexual identity and class, among other factors, intersect with mental health wellness in the Asian and Asian-American communities.

    George Huynh ’18, an attendee and co-resident of the Vietnamese Students Association at Yale, expressed his enthusiasm for the event.

    “I think it was a rather low-stress, warm and welcoming event to get the conversation around Asian-American experiences with mental health started,” Huynh said. “But in many ways just having an hourlong event is only the beginning. We’ve identified a lot of problems, but it’s going to take a lot more time and many more events like this to identify solutions and work toward improving mental health and wellness in the community.”

    The Asian American Cultural Center is located at 295 Crown St.

  2. "Constructively Occupied"

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    For Michaela Macdonald ’18, it started in elementary school.

    In and out of treatment for a depressive disorder she discovered early on, she was pleased when, after her senior year of high school, she was feeling better. She stopped treatment before starting at Yale, but soon into freshman fall, she picked it back up again. After an unsuccessful stint with a counselor at Yale Mental Health and Counseling, she turned to a therapist outside the University.

  3. Speaking Out

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    “My amazing psychologist knows that she is willfully violating your rules.”

    Caroline Posner ’17, buoyed by members of a nodding audience, challenged a panel of administrators, including Yale College Dean Jonathan Holloway. She explained that she had long since passed the 12-session limit imposed by MH&C.

    MH&C Director Lorraine Siggins pushed against the accusation.

    “We do not have an absolute limit of number of sessions,” she said, adding that each case is handled on an individual basis. “When someone comes back from the fall semester and things are still not going well in January, we would not stop treatment.”

    She asked that patients who have been given this misinformation reach out to her.

    Posner then addressed the audience, asking those same misinformed students to raise their hands. Roughly 50 hands shot up.

    Siggins began to explain that the MH&C website doesn’t mention any such limit, when a voice sounded.

    “My therapist told me in every single meeting where we were in our 12 meetings.”

    “Mine too.”

    “Same.”

    “P-Set or Mental Well-Being”

    Eugenia Zhukovsky’s weekend has been a little surreal. She hasn’t been back much on campus since electing to take time off earlier in the semester. She decided she needed to focus full-time on managing her anxiety and depression. Technically a visitor, she has no ID card to access campus buildings.

    Seconds after being guest-swiped into her residential college dining hall, several of her friends materialize, and hug her.

    “How is it, being back in the hellhole?” one asks.

    Zhukovsky squints a little. “Weird.” She says she’s happy with her decision. “But it’s not fun. It sucks.”

    For Zhukovsky, being a Yale student and managing her mental health were mutually exclusive. Panic attacks, medication adjustments, subsequent side effects and bouts of depression — all with little help from relatively infrequent sessions with Yale Mental Health & Counseling — simply took up too much time in an unyielding, rigorous academic environment.

    “No one was explaining how I could do it at Yale,” she said, “We’re not given the ‘our health comes first’ [message] as directly as we have to be.”

    Instead of feeling that her health was of primary concern, she felt like it was another, unsolicited, course or extracurricular. She added that the same has been true for other Yale students; friends have admitted feelings of anxiety to her but added that they “didn’t have time” to see a counselor. Zhukovsky calls this notion absurd.

    Posner and Zhukovsky each described a “P-Set or mental well-being” dilemma: nights when they had to decide between sleep-inducing medication and studying. In other words, they had to choose between missing a deadline and facing the repercussions of a mental illness left untreated.

    In Zhukovsky’s eyes, Yalies are high achieving perfectionists. She likes that: their energy, success and drive drew her to the school to begin with. But that same energy can heighten the effects of anxiety.

    Julie* said that when she arrived on Yale’s campus last fall, she found her brilliant peers inspiring, but that they also caused her high school confidence to shrink. During her freshman fall, she began to doubt herself and started to experience intense anxiety.

    She described her daily routine: class, practice for her varsity sport, and then crying while doing her homework in her single. Meanwhile, she felt that everyone around her was gaining confidence and accolades. Julie felt increasingly inadequate, weak and alone — but she kept her feelings secret.

    Almost all of the students interviewed who have experienced anxiety or depression at Yale said that finding and maintaining a supportive social network was one of the most, if not the very most, important way to cope with mental illness on campus. But several have found that the majority of Yale students seem more focused on their own schedules than on the well-being of their friends.

    Monica Hannush ’16, who has experienced severe depression at Yale, has felt this on a personal level. In moments of profound despair, she has resorted to sending her friends desperate text messages. Those texts, she said, follow less desperate messages. Often, when she texts her friends less urgent messages about feeling sad, she receives ostensibly empathetic but distant responses: “so sorry! writing an essay, sending you hugs.” “About to go on a date, but you’re beautiful!”

    A News survey on mental health resources, completed by 233 students, found that although 61 percent of students have experienced symptoms of depression, anxiety or other psychological conditions, only 28 percent have sought formal treatment, either on campus or elsewhere.

    Julie recalled the moment in her freshman year when she felt like she couldn’t take it anymore. She decided to visit Yale Mental Health & Counseling. On her walk over, she was wracked with paranoia and shame. Afraid of being seen, she kept her head down in the waiting room — but she felt comforted by the presence of other people in nearby chairs. She was not alone.

    Breaking the Stigma

    Once, when Posner went to her chemistry professor to explain why she had been having particular struggles in the class, she ended up in tears. Posner said that when she told him about her severe anxiety and depression, he simply responded, “T.M.I.”

    Although diagnoses have been rising steadily for years — a Harvard study showed that the number of patients in the U.S. increases by about 20 percent each year — many still consider mental illness an uncomfortable, even taboo, subject. While 60 percent of the News survey respondents confirmed that they felt comfortable talking about their own mental health with others at Yale, 27 percent of survey respondents said that they were not at all comfortable with such discussions.

    And that mindset, according to Posner and Zhukovsky, perpetuates a culture of undeserved shame for the suffering. Anxiety disorders affect nearly one out of every five American adults, a 2014 statistic listed by the Anxiety and Depression Association of America.

    Zhukovsky feels that Yale, specifically, needs to better educate its students.

    “I didn’t really know what depression or anxiety were until I had them,” she said. “There was this time when I felt alone, and like there was nothing I could do about it, and it was the worst time in my life … it’s so important to me to talk about this, and to help people from getting stuck in that place. It can be treated. It can be helped.”

    Following the death of Luchang Wang ’17 in January, members of a shocked and grieving community have resolved to push for the changes they feel are necessary. Concerned students have been speaking up, demanding that Yale reevaluate resources and policies, and that the community take steps to break the stigma surrounding mental illness.

    Many have begun fighting for change on campus — friends like Posner, or like Geoffrey Smith ’15, who co-authored a pledge to boycott the Senior Class Gift along with six other seniors. Smith suggested that alumni and the administration regard participation in the Senior Class Gift as a bellwether for student opinion, and so he called on seniors to abstain from what he sees as an endorsement of University policy. Nearly 97 percent of seniors donated to the Gift in 2014. This year, 78 percent of seniors chose to participate.

    A few days after Wang’s death, Posner, Korbin Richards ’15 and Charlotte Storch ’15 created “Nox Et Veritas,” a Tumblr blog, where they publish stories, sometimes written anonymously, about MH&C, withdrawal and readmission. With this new forum, they hope to bring untold stories of mental illness to light and foster dialogue on campus. Already, seven entries have been posted, and Posner said that the blog has between two and three dozen followers.

    According to Richards, the problem is not that Yalies do not want to talk about mental illness.

    “Once the topic is introduced, everyone wants to join the discussion,” she said.

    Rather, she believes that the problem lies largely with the Yale administration. She feels that the administration has been less open and eager to converse with students. After Wednesday’s forum, she said she was proud of the active and vigorous student participation, but disappointed in the continued administrative distance.

    “If the panel’s job was to not answer questions, then they did exceptionally well,” Richards said.

    Even if students are engaged in the conversation on mental health, Genevieve Simmons ’17 worries the renewed discussion may be short-lived.

    “The prevalence of talking about mental health has been sensationalist — movements when we hear a horrible mistreatment about behind the scenes, or a loss of one of our peers,” she said. “Then the discourse fades into the background.”

    Moments like this have come before. MH&C Director Lorraine Siggins recalled, for instance, student meetings similar to Wednesday’s event that took place in the 1970s. She said that in her more than 40 years of working on campus, she has seen interest in mental health on campus wax and wane.

    To many students, like Zhukovsky, letting this moment of heightened discourse slip away is not an option. She said she could not overstate the importance of creating mental health reform: this, she said, is about quality of life, and life itself.

    Phone Tag

    When Richards was evaluated at MH&C during her freshman year, she only told one lie. She said that she hadn’t been having suicidal thoughts.

    She called this self-defense, as some of her friends had been sent home because they had expressed suicidal thoughts. These stories frightened her  — withdrawal was a financial impossibility for her family, and would worsen her condition. Richards says that the fear of MH&C forcing students to leave campus, or keeping them from returning, prevents those with suicidal thoughts from expressing them. And that, she believes, is dangerous.

    Holloway agrees that the fear surrounding the treatment policies of MH&C is unsafe. Before Wednesday’s panel, he told the News that he worries many public perceptions of treatment at MH&C are incorrect, and that he hoped the event would clarify misconceptions and alleviate unfounded fear.

    Richards told the panel about her lie. She explained that the fear she had felt was pervasive on campus — a statement echoed by the snaps around the room — and asked how the panel planned to address it.

    Siggins responded by pointing out that MH&C sees around 2,500 students each year, and that the vast majority of students who withdraw on medical leave do so voluntarily. Later, she described circumstances that might lead to a forced withdrawal. She said that a patient would need to have a plan for self-harm, as well as the means to execute it — “in other words, if we’re concerned imminently that this person in the next 24 hours may be at great risk.” She added that the individual in question would be hospitalized, and never simply sent home, under such circumstances.

    Zhukovsky, for instance, withdrew without any pressure from Yale administrators or MH&C clinicians. She said that MH&C could not provide her with weekly therapy, which she needed, and so she saw no alternative to leaving. It was not until she withdrew that her mental health began to improve.

    The thought of other students continuing to wade through the support provided by MH&C saddens her.

    “I know that they’re struggling, because I struggled through it, and it wasn’t helping,” Zhukovsky said. “The care I was getting was just okay, and ‘just okay’ is not an option.”

    Others remember experiences of MH&C therapy that were worse than mediocre.

    Richards called her first and only appointment after her initial consultation “one of the worst experiences [she’s] ever had with another person,” recalling how her doctor skipped the handshake in their greeting. “He didn’t shake my hand, didn’t ask about how I was doing. He went straight into ‘Why are you here?’ and then ‘When’s the last time you menstruated?’”

    Julie, initially comforted by the presence of other students in the MH&C waiting room, gave up on MH&C after a couple of unsuccessful visits. She said that the therapist she was assigned to was cold, clinical and impossible to open up to, and so she turned to long-distance communication with a therapist from home.

    Still, others have had positive experiences at MH&C.

    Adriana Miele ’16 has been regularly seeing the same therapist since the beginning of her freshman year, an experience that she said has “kept her afloat in a lot of ways.”

    MH&C also allows patients to request a change in therapist if they are dissatisfied, a process Posner went through at the beginning of this academic year. She’d seen a therapist throughout her freshman year, but found their sessions unproductive, so requested a change. Even though she had to wait for six weeks for MH&C to process her request, Posner said that her new therapist has made a tremendously positive impact on her mental health.

    On Wednesday, when Posner publicly praised her new therapist’s violation of the supposed 12-session protocol, snaps and murmurs of accordance echoed throughout the forum: evidence, perhaps, of her belief that MH&C’s largest problems have less to do with the quality of therapy that most of its practitioners provide than with its difficult bureaucratic system.

    As the MH&C system stands now, according to Posner, students must advocate for themselves in order to obtain quality care. She equated communicating with MH&C to a game of “phone tag,” with constant missed calls and miscommunications. At the forum, when Šimon Podhajskỳ ’16 asked why MH&C does not utilize email communication, students banged their desks in agreement.

    Siggins responded that she “couldn’t agree more” with students that communication between MH&C and patients needs to be improved. She explained that the system currently does not allow email correspondence because MH&C had been concerned about the security of emails, but that it was currently pursuing ways of legally incorporating email communication.

    She and Genecin have announced their commitment to reforms at MH&C. In an attempt to hear student voices, they held a series of “listening sessions” in the residential colleges last spring. Last week, Genecin sent an email to the College with a set of MH&C improvements, including an increased staff size and expediting the period of time between a consultation visit and a first appointment.

    In the News survey, 54 percent said they believed that Yale’s mental health resources are insufficient for those who use them, and 30 percent of students responded that they felt dissatisfied with the reforms described in Genecin’s email. One survey respondent commented that “there were no concrete numbers given to the proposals, which makes me deeply skeptical.”

    Indeed, it appears that students crave more numbers and facts from MH&C. At the forum, multiple students asked the panel for more statistics and greater transparency from administrators.

    Holloway and Genecin emphasized, though, that many specifics cannot be discussed because federal law mandates strict confidentiality. Holloway told the News that his inability to be fully forthcoming is “totally appropriate,” though he added that he is always as transparent as possible.

    For instance, Holloway said that the withdrawal and readmission committee he formed in January cannot disclose information about its discussions until the committee finalizes its recommendations. He expects this to happen in four to six weeks.

    Given such legal constraints, Holloway said that he did not believe assertions that the administration has been silent or unresponsive were fair.

    At Wednesday’s forum, English professor John Rogers, the chair of the committee, mentioned that one of its six members was a student. He also pledged to take seriously the recommendations and complaints that students had expressed to him.

    Zhukovsky worried that administrators would view Wednesday’s event as a way for complaints to be aired, rather than attempt to get to the roots of the grievances. She simultaneously felt that complaints alone would not lead administrators to make changes.

    “I’m all for talking,” she said. “I just think that there has to be more push from students to make a specific change. There’s been a lot of reaction, and a lot of opinion, but there needs also to be initiative.”

    Alternatives, and new options

    Natalie Wolff ’14 suffered from depression between the ages of 13 and 21, and credits her recovery in large part to the care she received at MH&C while she was an undergraduate. At Wednesday’s event, she presented a list of 10 recommendations to streamline MH&C’s system — recommendations that included using the medical program MyChart to schedule appointments, administering screening questionnaires and hiring more secretaries to field more phone calls.

    The panelists expressed gratitude for Wolff’s recommendations, asking for her written list, but Siggins noted that some of the items, such as mandatory follow-up phone calls if a patient misses an appointment, are already MH&C policy. She encouraged students whose therapists have broken MH&C policy by sharing misinformation to contact her. She said that, in those cases, she would remedy the misunderstanding.

    At the same time, several students said that MH&C policy was so obscure that they would not know if their therapist had misrepresented it. Siggins admitted that MH&C has not done an adequate job in the past of educating Yale students on its policies, but she added that administrators are working to increase transparency. She then cited the MH&C advisory committee, a liaison between the department and students convened at the beginning of the spring semester in 2014.

    Corinne Ruth ’15 and Olivia Pollak ’16, currently serving on the committee, seconded Siggins’ view. Pollak recognizes that communication between students and MH&C can often seem “starkly two-sided,” but hopes that both sides can listen to each other.

    “They [MH&C] want students to be happy, they want them to be successful, they want them to come back. The discussion then comes to … how do we best listen to each other?” Ruth said.

    The Mental Health Advisory Committee began at the end of last spring, as part of the Coalition for Mental Health and Well Being, a larger umbrella student organization. The committee members convey to the administration their impressions of campus culture.

    She cites the coalition as key, a way to bring together students in organizations concerned with wellbeing. Last year, the committee updated the YCC resource sheet and the FAQ section of the MH&C website.

    Ruth and Pollak assert that the relationship between MH&C and students is a difficult one to navigate — they echoed Holloway’s comment on confidentiality, as did the forum’s panelists, but asserted that some channels between the administration and students have opened in the past few years.  Ruth cited last year’s listening sessions with Dr. Genecin, which fewer students attended than was expected.

    Ruth and Pollak also pointed to resources outside of MH&C that they feel are underutilized, notably Walden Peer Counseling, the Chaplain’s Office and the Peer Liaisons.

    One day in the fall of 2014, as Natalie Rose Schwartz ’17 wrestled with new symptoms of depression amid long-standing anxiety, her mother told her over the phone that she had to find someone to be with, if she could. Schwartz’s dean, who had been very helpful during regular weekly meetings, was unavailable, so she walked into the Chaplain’s Office. Schwartz knew Sharon Kugler, the University chaplain, from “Cookies and Coloring,” a weekly study break held in the Welch basement.

    “I just went to her office, and she happened to be free, and she immediately took me in, and hugged me, and let me talk,” Schwartz said.

    In the News survey, only nine students reported they had used the Chaplain’s Office as resource, while 72 students had gone to MH&C and 82 had relied on residential college deans, masters and freshman counselors. Twelve students had gone to Walden Peer Counseling as a resource.

    Pollak believes Walden’s minimal visibility on campus is a necessary result of its policy of anonymity. Because confidentiality restricts peer counselors from reaching out and putting a face to their services, students may have misconceptions about the issues that Walden addresses. Pollak worries that students think they shouldn’t call Walden unless they have a very acute problem, although she asserts that this is not the case.

    Zhukovsky, on the other hand, said that while Walden allows students to reach out to peers, peer counselors could not and should not replace mental health professionals. She has suggested that Yale implement a its own version of “Let’s Talk,” a drop-in program started at Cornell University, and that 25 other universities have adopted.

    Like Walden, “Let’s Talk” offers drop-in hours for students to talk or seek advice. Unlike Walden, though, “Let’s Talk” employs certified counselors. This would provide immediate professional advice — on medication, for instance — that Zhukovsky believes MH&C does not currently offer and that a peer counselor cannot give.

    Other students are also considering ways to widen the University’s network of resources. Joseph Cornett ’17 has recently proposed an initiative in a News column to implement mental health fellows in residential colleges. Representatives from MH&C, masters and deans would select upperclassmen to serve as fellows. The main job of a mental health fellow would be to refer students to mental health resources, explaining their nature and functions.

    “The mental health fellows should be someone who everyone knows they can talk to about emotional health.” Cornett said. “It will end up normalizing discussion about mental health and destigmatizing it, much in the way CCE’s have destigmatized discussion about sexual health.”

    At the forum, Wolff proposed a safe space to discuss mental health, in the vein of the Sexual Education Literacy Forum, a suggestion greeted with snaps and applause.

    Ruth and Pollak believe that friends sharing correct information with each other may be the most long-lasting, effective improvement to the current mental health climate.

    Smith believes that while friends can complement professional help, they cannot replace it.

    “Friends will ideally be capable of listening and providing love and kindness, but it is too much to expect them to … provide serious help with a specific condition,” he said.

    ***

    After reading out her ten recommendations at Wednesday’s forum, Wolff turned to the audience.

    “Anyone can be an advocate. You also need to be an advocate for yourself. So when they tell you that it’s going to take two months to switch your therapist, say no,” she said. “Just don’t give up.”

    The applause was deafening.

    But before Wolff’s recommendations, and before the applause, Holloway opened the forum. He explained that he wants to close an information gap between students and the administration, to make sure that students have enough faith in the system to get help when they need it, instead of being afraid.

    “The floor is now yours,” he said. “Raise your hand. Speak loudly.”

  4. The Corpse of Fine

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    There is a type of Buddhist meditation that requires monks to find a corpse and meditate over its decay. This decay has ten stages — ten “foulnesses” — that a monk can contemplate, beginning with “the bloated” and ending with a dried-out skeleton. To do this, a monk journeys to a charnel ground, a dumping place for corpses, and finds a corpse that fulfills the specific foulness he wishes to meditate on. He then sets about observing its shapes, colors, concavities and convexities in the hopes of eliminating attachment to the physical world and attaining enlightenment.

    In my class “Buddhist Traditions of Mind and Meditation,” we watched a time lapse of a decaying corpse. The head turned black, like charcoal, and collapsed into itself while the abdomen swelled, turning the color of a fading bruise, until it too suddenly collapsed — almost like it had exploded. From then on the body seemed to wither instead of grow as ribs and bones became more prominent and skin dried up and was sloughed off. The face had long ceased to resemble anything human.

    This form of meditation is ancient, of course, but even contemporary monks contemplate corpses in morgues. More than just examining the body, the goal of this meditation is challenging fears and coming to love and treasure the very thing that first appeared so unpleasant. Reaching this point allows monks to change not only themselves, but also their view of the surrounding world.

    * * *

    In another class, I watched a documentary chronicling the life and work of Chinese contemporary artist Ai Weiwei. Some might be familiar with his series of photos showing famous landmarks, including Tiananmen Square, with his middle finger raised in a sarcastic salute. In his art and his life Ai Weiwei constantly challenges the status quo: Defacing priceless Neolithic vases with the Coca-Cola logo or smashing them to highlight the fragility of history and tradition are par for his course. For him, even something old or venerated might still need to change. This idea is the heart of his activism against the Chinese Communist Party: with every act and every video recording and every piece of art, Ai Weiwei faces down what he sees as a decrepit, bloated structure. In a country known for burying its mistakes, Ai Weiwei constantly confronts a “corpse” of his own.

    In 2008 Ai Weiwei uncovered the names of over five thousand children killed during the Sichuan earthquake because shoddily-built government schools collapsed: five thousand corpses, with names and families, that the government refused to acknowledge to his satisfaction. Later, attempting to testify at the trial of Tan Zuoren, who also investigated theww earthquake, Ai Weiwei was assaulted by a police officer and later required an emergency operation on his brain. He filed claims against several government offices only to be turned away.

    In 2011, Ai Weiwei was arrested, jailed and, upon release, forbidden to leave Beijing. 

    * * * 

    In the West, it can be hard to understand why anyone would voluntarily stare at a corpse; it often feels like people train themselves to avoid thinking about the “foul.” I know when I’m guilty of this: Avoiding a conflict or an awkward text message is oftentimes easier than forcing myself to examine the situation in its cringe-worthy minutiae. Those aren’t national crises, but they’re the little corpses — or maybe small pieces of one, like a dismembered hand — that I need to face.

    At Yale, I don’t think the “foul” is given enough weight. We have the unparalleled privilege of critiquing any aspect of this institution we want, any “corpse,” without fear of reprimand. No police officer will hold us under 24/7 surveillance for months without explanation, like they did for Ai Weiwei, if we question Yale’s mental health policy. As a result, we often look away from the “foul,” accustomed as we are to aimless criticism with no follow-through. 

    What’s foul at Yale is the “corpse of fine.” As in the typical conversation: “How are you?” “Oh you know, fine.” It’s a cultivated culture of fine-ness: when everyone else seems “fine,” it’s hard to admit when you’re not, even to yourself. Yet for once we’ve done a good job of staring down this foul concept in demanding reforms to Yale’s mental health policies. The next step is to challenge ourselves, face our own fears and corpses. We might not be Buddhist monks or radical artists, but we can smash convention in our own way.

  5. “We Just Can’t Have You Here”

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    “I’m Rachel,” I say to the man who is here to evaluate me, extending my hand, trying to put on my best sane face. Problem is, no one ever told me what that looks like.

    He eyes me for a moment, then takes my hand.

    I run him through the story, trying to emphasize my efforts to be honest and to get help.

    I say, “So as soon as I cut, I texted my FroCo for support.”

    “But you admit that you willfully harmed yourself?” he says, like he’s just won something.

    “Well … yes.” Because obviously I admit it. I’m not a liar. If I were a liar, I would never have gotten myself into this mess. Fuck me for not being a liar.

    And so, when I say “yes” to the ‘I admit cutting myself’ part, he nods his head and closes his eyes like someone has just given him a bonbon.

    I tell him when I come back to Yale, I will get a therapist on campus and keep working with the one I have at home. I will stop cutting.

    “Well the question may not be what will you do at Yale, but if you are returning to Yale. It may well be safer for you to go home. We’re not so concerned about your studies as we are your safety,” he says.

    “I’m sorry,” I say. “What makes you think I will be safer away from school, away from my support system?” School was my stimulation, my passion and my reason for getting up in the morning.

    “Well the truth is,” he says, “we don’t necessarily think you’ll be safer at home. But we just can’t have you here.”

    * * *

    On the night of Jan. 27, 2013, I slashed open my right thigh six times with a Swiss Army knife. I then spent four hours thinking about how good it would feel to jump off the fifth floor of Vanderbilt Hall. On Jan. 28, I put on a pretty dress and went to class. Before lunch, my cuts had stained it brown.

    That night I texted my Freshman Counselor to tell her what had happened, just as I had done all the other times I felt suicidal and had cut myself. When I went to her suite, I showed her the gashes.

    We went to Yale Health Urgent Care, at around 11:00 p.m., where a doctor bandaged my leg. A psychiatrist appeared. I told her that I had experienced suicidal thoughts the night before, but that the cuts had not been a suicide attempt. I told them that I was no longer suicidal.

    At midnight, I was strapped to a stretcher under the ashen ceiling of an ambulance, on my way to Yale-New Haven Hospital. There I was taken to the locked ward of the ER — guarded by officers with guns — stripped of all my belongings, including my pants (they had a drawstring), and shunted into a cubicle containing nothing but a bed. I was here for my own good, they told me.

    For 24 hours I had nothing to do but listen to the rattling gasping sound coming from the person two beds down, and to a schizophrenic person declare, every hour or so, that he had soiled himself. I was asked to recite the presidents of the United States, in reverse order, as part of a psychiatric evaluation. For more than a day I was not permitted to make a phone call. For more than a day no one had any idea where I was — not even my parents.

    When a bed opened up in the actual Yale-New Haven Psychiatric Hospital, I was transported, again in an ambulance, and introduced to the place I would spend the next week of my life. Upon arrival, I was taken into a small room with two female staff members, forced to take off my underwear, spread my legs, then hop up and down to make sure nothing was hidden “up there.”

    My Freshman Counselor had brought me some extra clothes and a course packet for my travel writing class, so that I would have something to read. The course packet was confiscated. Why? Because I might cut myself with the plastic binding — you know — the kind you get from Tyco. I might commit suicide with that, they said. “You’re a cutter,” they told me.

    For a week, I was not allowed to set foot outside. I was not allowed to stretch my hamstrings or calves or any other body part. I was not allowed to pace my confines. I was not allowed to drink caffeine. I was not permitted to take ibuprofen for my caffeine withdrawal headache. I did not get to take a shower until my third day. Phone usage was restricted and phone calls were closely monitored. I was threatened, by a nurse, with the possibility of having my wrists and ankles tied to my bed, and witnessed this threat be carried out on others. Whoever built the hospital had termed this ward, “Liberty Village.”

    There was little “treatment” in the hospital. Mostly, we watched television, played Pictionary and Connect Four and sat. I was interviewed by various clinicians a few times a day; I saw my assigned psychiatrist only three times, for half an hour or so, over the course of seven days. This limited treatment was fairly standard for all patients, but it soon became clear that it would have little effect on my situation.

    The milieu counselors, nurses and doctors in Yale-New Haven Psychiatric Hospital have absolutely no input when it comes to deciding who gets to stay at Yale and who is forced to leave. In talking to the nurses, doctors and fellow Yale students I encountered in the hospital, I understood that job to belong to Dr. Eric Millman and to chief of Yale Psychiatry, Dr. Lorraine Siggins — two people who work for the University, rather than the hospital.

    I have shared with you my memorable exchange with a senior psychiatrist at Yale Mental Health who came to evaluate me. It was this exchange that led me to keep an extensive and thorough journal during my time in the hospital.

    But Dr. Siggins is the one who makes a ruling: Does Johnny stay at Yale or does he go? And in my talks, a consensus emerged: Dr. Siggins does not always — and by some accounts, rarely — make contact with the student in question. (A Yale senior who was in the hospital with me was not granted a meeting with Dr. Siggins but was still forced to leave Yale.) Neither the staff members I spoke with nor a fellow Yalie who had prior experience in the hospital knew of any Yale student admitted to the hospital who had been allowed to stay at Yale.

    My interview left me terrified of the possibility of leaving school. I called my parents, and they promptly put themselves on Dr. Siggins’ radar, meeting with her twice and securing me a personal interview. All I remember was that my mind was totally blank when I spoke to her, because I was so focused on making her believe that I was “okay.” This, of course, is totally futile when you’re sitting on a cot in a mental hospital.

    She called me three days later to tell me that I would have to go home. That meant that I was forced to formally withdraw from the college, with no guarantee of return. As soon as her decision came down, I was eligible for release into my parents’ custody. Upon my release from the hospital (also not a function of my recovery — but as a result of my expulsion from the College I was even more depressed when I left than when I was admitted, my Yale ID was confiscated, as was my room key. I was given one evening to pack up my entire life.

    My college dean told me I was not even allowed to spend the night in my room in Vanderbilt Hall. I fell asleep on the futon in my suite’s common room at four a.m., breaking the rules, but exhausted and unable to continue putting my things in boxes, dismantling the reality of my college life. I had a chance to say goodbye to a few friends — most of whom I would not hear from during my time away. 18 hours after I walked out of the hospital doors, I was on a plane, headed back to North Carolina in a storm of tears.

    I did what they said was necessary to be a candidate for readmission: therapy, more therapy, two college courses, more therapy. And I healed. Mostly.

    I filled out the paper application for readmission: the usual demographic crap, a three-page personal statement, a transcript of my summer classes, two letters of recommendation, a profile from a therapist and a check for $50. I flew to New Haven for my three interviews — with the dean of my residential college, Dean Pamela George (chair of readmission) and Dr. Siggins.

    As a side note, I might mention that Dr. Siggins was 45 minutes late to my interview. Dean George called me an hour before the scheduled time to cancel, forcing me to interview the following day, two hours before my return flight took off. I answered every question with as much positivity as I could sell. I said: I do not cut, I do not think of killing myself. I am great. Two weeks later, I was readmitted.

    Every morning of my year away from Yale, I woke to the sight of the “Yale” pennant on my bedroom wall — the one they send to accepted freshmen in the big, glorious “Welcome to Yale” packet. “You’re in!” it says. “You’re a treasured asset to our University!” it says. “Come to Bulldog Days and feel the love because we love you and we care about you and we don’t want you to go to any other school because you’re the shit!” it says.

    Thinking back to that welcome packet, there is a conspicuous omission: *We love you and want you and will provide for you and protect you, as long as you don’t get sick.*

    * * *

    I return to a different Yale, though it is I who have changed. After a year spent focusing solely on my health and well-being, I find myself, though not perfectly balanced, resting closer to my ideal center. And, after a year of watching and analyzing every one of my inner ticks, I see external things that were invisible to me before.

    I see that Yale is a fundamentally unhealthy place in one important way. The problem is, everyone is “okay.” I have known friends who have suffered the deaths of siblings, who have been victims of sexual assault or who have fought life-threatening illness, all while navigating their sexuality, while taking five-and-a-half credits, while chairing more organizations and running to more meetings than they can keep track of. I have known friends to do all of this and still profess, at every opportunity, to be “okay,” “fine,” “great.”

    To say something else, to be — in our own minds and in the minds of others — something else, is for some reason not acceptable at Yale. None of us are completely okay. But the pressure to conform to being perfectly functional and happy is a burden that we should neither want nor bear.

    Where does it come from? For most students at Yale, I think the pressure is subconscious, upheld through day-to-day conversation: My classes are amazing. My extracurriculars are dope. My internship this summer is baller. Life is awesome. Are you awesome? No one wants to deviate.

    But I think the source is not, in fact, the students. Those of us who have admitted, at some point or another, that we are legitimately not okay, have learned that there are real and devastating consequences of telling the truth. Because Yale does not want people who are not okay. Yale does not want people who are struggling, who are fighting. Yale, out of concern for its own image, wants them to leave. And Yale makes them.

    With this, I refuse to be okay.

     

  6. Overwhelmed But Not Without Hope: How Students are Attempting to Improve Mental Health at Yale

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    In his address to incoming freshmen on September 13, newly appointed University President Peter Salovey remarked that one of the “last taboos among Yale students” involves talking about socioeconomic status. “When the issue of money comes up, students are often profoundly uncomfortable,” he said. “To the Class of 2017, I encourage you to be sensitive and open to one another. The uncomfortable conversations that you will certainly have represent opportunities for true understanding and true friendship.”

    What Salovey did not mention was mental health. Since becoming University President, the closest he has come to publically addressing this topic was a convocation speech he gave at the Hopkins School — a coeducational institution for grades 7-12 in New Haven — on Nov. 13. Salovey discussed his work as a psychologist, focusing on “emotional intelligence,” a concept he developed with colleagues in the 1990s. In an interview with the News after the speech, Salovey said that he wanted to show how observing emotions provides useful data about people, and that it is important to persist in the face of struggle. (Contacted by email in late October, Salovey wrote that he would be unavailable to comment for this article.)

    As reports issued by Yale undergraduates and their graduate and professional school counterparts have indicated, it is not uncommon for students to struggle with mental health; Yale’s Mental Health and Counseling (MH&C) department sees more than 20 percent of the entire student body each year, and that number only continues to grow. The result has been increased wait-times and variable quality of care at MH&C.

    So far, top University officials have not openly discussed their efforts to reform mental health resources on campus. Besides an email sent by the Office of the Secretary and Vice President in December, which said “discussions and collaborative efforts have been underway at all levels,” campus-wide communications have been slim. The University’s relative silence on this issue has increasingly caused student leaders, masters and deans to take matters into their own hands in making Yale a happier and healthier place.

    Changing the Culture of the Place

    Elizabeth Bradley, Stephen Davis and Jeffrey Brenzel ’75 — of Branford, Pierson and Timothy Dwight Colleges, respectively —are three such masters already working toward this end. Bradley, who is a professor of public health and directs the Yale Global Health Initiative, says she sees part of her role as master as contributing to “a culture of greater balance” among undergraduates. Davis, appointed master this year, says he wants his office to be a “safe space” for students, where they can feel comfortable sharing both their successes and struggles. Brenzel, too, hopes to foster this type of environment within his own college. His former position as Dean of Undergraduate Admissions, however, also allows him to see the systemic causes behind a campus culture where mental health concerns abound.

    “We’ve picked people who are extremely intelligent but who are unusual in their expectations for themselves,” Brenzel says. “We have a group of students here whose identity is wrapped around achievement, so when something throws them off it can snowball.”

    Still, all three masters agree that managing students’ expectations about mental health resources on campus could improve negative perceptions of MH&C.

    Michelle Ross ’12* attributes many Yale students’ dissatisfaction with MH&C to a lack of understanding about mental health treatment. Ross began her visits to the center after a suitemate sexually harassed her during her junior year and she became “deeply depressed.” There, a social worker taught her coping skills that were specifically tailored to her situation, but she admits that she had to see multiple clinicians before she felt comfortable.

    “Mental health care is so much about rapport and the therapist-client alliance,” Ross explains. “The times when you’re trying your hardest, you have to keep trying to find someone who’s a better fit for you.”

    Ross adds that few Yale undergrads question the expectations set by themselves and the University’s larger “success-driven” culture. If more professors and administrators were willing to be open about their own mental health struggles, she notes, students might feel less alone. “You never hear administrators speaking about tough times they went through; you only hear that it’s okay to have a tough time,” Ross says. “That’s great, but make it real. Show that you’re human, that these people who are huge successes have struggled also.”

    For some administrators, the constant pressure to succeed is ultimately at the root of students’ mental health concerns, along with their unrealistic expectations of treatment. University Chaplain Sharon Kugler believes students need to learn how to “step off the Yale treadmill” and take care of themselves, asking for help from others when needed. “You’re messaged from day one that you’re tomorrow’s leaders,” she says. “My soapbox speech is: You are tomorrow’s whole people. What you can be is healthy and have a sense of what it means to fail and survive.”

    A Tale of Two Ivies

    Although students groups such as Mind Matters and Walden Peer Counseling are seeking to increase mental health dialogue on campus, there is no student liaison group specifically endorsed by MH&C. Instead, each residential college has a Mental Health Fellow — a trained clinician who can advise students on how to navigate Yale’s peer and institutional resources. The program was created in 2011 as a joint collaboration between YCC and MH&C. Fellows meet incoming freshmen during orientation and can accelerate the treatment process for students who reach out to them in need.

    But few undergrads seem to know that the fellows exist or how they function in the overall scheme of Yale’s mental health resources. “The residential college Mental Health Fellows can and should be on the front lines of getting these messages out,” the YCC report stated. “Right now, however, a lot of confusion exists around the [program]. While some residential college administrators have introduced students to their fellows, most students we surveyed do not know what the fellows do.” There is no information about the Mental Health Fellows on the websites of MH&C, the Dean’s Office or individual residential colleges.

    “Exactly how this program is supposed to work is deeply unclear to me,” Reuben Hendler, one of the YCC report authors, says. “What are the different roles of every party? I don’t have a clear picture of how those parts are supposed to interact.”

    Harvard may offer some lessons about tackling mental health issues in an academically intense environment. Since 2008, Harvard has had a Student Mental Health Liaisons (SMHL) program that was founded by the Department of Behavioral and Academic Counseling at Harvard University Health Services and Harvard students themselves, as part of an ongoing effort to promote emotional well-being on campus.

    According to Angela Lee, a Harvard senior who currently serves as co-president of SMHL, the group has grown to include over 30 students spread across the College’s 13 residential houses, whose job is to raise awareness about mental health issues and resources. Liaisons host mental health workshops for freshmen each year, run a wellness blog on their website and serve to connect peers with the University’s resources, Lee said.

    SMHL also strives to reach students in innovative ways. In August 2012, the group created an online video platform called “Harvard Speaks Up” to address stigma surrounding mental health concerns. Championed by former SMHL co-presidents Seth Cassel ’13 and Meghan Smith ’13, “Harvard Speaks Up” hosts short videos recorded by members of the Harvard community talking about their personal struggles and encouraging others to seek treatment. Those who have given testimonies include Paul Barreira, Director of Harvard University Health Services, Steven Hyman, former Harvard University Provost and former Director of the U.S. National Institute of Mental Health, and renowned Harvard psychology professor Steven Pinker. The videos typically last under five minutes, and the website contains links to both peer and professional mental health resources at Harvard — precisely the type of program that Michelle Ross believes would benefit Yale.

    “What was really surprising to me was professors and administrators opening up about their own experiences and struggles and that they were willing to be vulnerable ,” Lee recalls. “Some students were like, ‘Wow, I had no idea so many people were struggling.’”

    Cassel says the project garnered positive reactions from administrators and students alike, and sparked productive dialogue across Harvard’s campus. “The basis of SMHL is that students respond best to what their peers are saying,” Cassel explains. “Fellow students are more likely to be responsive to the message of getting help if it’s normal that people like them are doing it too.”

    Next Steps

    On November 16, about 30 Yalies met at 17 Hillhouse Ave. to attend an open “Forum on Wellbeing and Campus Culture” organized by the authors of the YCC Report on Mental Health. The choice of venue could not have been more apt — Yale Health was formerly located at 17 Hillhouse before moving to 55 Lock St. in 2010. Refurbished during the summer of 2012, the building now serves as classroom space.

    The attendees came for different reasons; some were leaders of student organizations, while others wished to voice their concerns about Yale Health. At the beginning of the meeting, the authors of the report distributed a “mental health reference sheet” compiled by the YCC, detailing Yale’s institutional and peer resources, as well as a list of student organizations devoted to student wellness. Members of the group broke into small brainstorming sessions structured around mental health publicity, residential college resources, a potential website like “Harvard Speaks Up” and a “Mental Health Week” that would be similar to Yale’s biennial “Sex Week.”

    Hendler notes the meeting was the first of its kind, “at least in recent memory.” Future forums, he continues, will be organized to gauge the progress being made on mental health initiatives, such as workshops, a residential college liaison program and alternative behavioral therapies. Such projects could help reduce the backlog of students at Mental Health and Counseling. In an early January email, Hendler said he and the other authors of the YCC report would contact various student organizations devoted to mental health, in the hopes of forming a coalition that would coordinate projects and communicate with the Yale administration.

    “I was initially skeptical of creating yet another organizational structure but have become convinced that this is the best way to accomplish these goals,” Hendler wrote. “Supposing that people sign on, I anticipate a first meeting within the first few weeks of the semester, focused on putting together a mental health week for the spring.”

    Christopher Datsikas ’16, the president of Mind Matters, says he was most intrigued by the prospect of a Mental Health Week, where students could attend panels on a variety of topics and promote conversation on campus. Although Datsikas believes it would be difficult to coordinate the logistics of such an event — including which students would be in charge and how much the University’s administration would be involved — he feels hopeful that a Mental Health Week could be organized within the next two years.

    “It’s not an instant fix; it’s not like we put out the report and suddenly campus culture has changed,” Hendler admits. “But we believe in the good faith of the administration, and we’re trying to engage with them constructively by focusing on common ground.”

    In the waning weeks of the fall semester, meetings about mental health also occurred among the college’s masters and deans. Although these meetings were “confidential,” Brenzel said in a mid-November email that there would be a follow-up by the 12 residential college masters with the YCC. Bradley added that the meetings were “engaged, productive and collaborative” with “a commitment made to try to move ahead wisely.”

    Caroline Posner ’17 represents the next generation of Yale undergrads for whom such discussions may ultimately matter. A freshman in Berkeley College, Posner has lived with an anxiety disorder since the third grade, a condition she wrote about in an October 9 opinion column for the News, “Addressing mental illness.” Given Yale’s tremendous progress on issues such as sexual misconduct, Posner wrote, it’s time for the University to tackle questions of mental health with an equal commitment.

    Today Posner says she is “cautiously optimistic” that Yale’s mental health environment and resources will improve during her time here. She adds that the path to clinical treatment at Yale Health should be made “as clear as possible” and that students themselves should be more open about their struggles.

    “The expectation is that we’re good and functioning all the time,” Posner explains. “I don’t know necessarily why that is. Maybe it’s that Yale is painted as such a happy place where people function on these surreal levels, balancing a job, five classes with Nobel laureates and three extracurricular activities. That’s true sometimes, but that doesn’t mean you’re always in a good place mentally or emotionally.”

    “Somebody needs to say it a little louder.”

     

    *Name has been changed.

  7. Overwhelmed: Why Students Are Unhappy with Yale’s System of Mental Health Care

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    55 Lock Street, commonly known as Yale Health among the University’s students, overlooks New Haven’s Grove Street Cemetery like the Death Star hovered in George Lucas’s night sky.

    Black and jagged, the building was completed in 2010 after three years of construction. According to a newsletter released by Yale Health that fall, the new health center was 60 percent larger than its predecessor, “with more than double the examination rooms, more space in the diagnostic imaging area, and increased space for minor procedures.” The same pamphlet touted the relocation with the headline: “From a ‘hole in the ground’ to ‘wow;’ Yale Health Center continues great service in a new home.”

    The inside of Yale Health suggests a more complicated reality. At the end of a brightly lit hallway on the building’s third floor is the Mental Health and Counseling Department (MH&C), which addresses the psychological concerns of Yale’s almost 12,000 total students. Inside the waiting room, there are 11 brown chairs, a modern-looking coat tree, and a barrier of opaque glass that separates the department from the building’s other facilities.

    More than 50 percent of undergraduates will find themselves in this room during their time at Yale. Lorraine Siggins, the department’s chief psychiatrist, reported in a publically available memo in September that MH&C sees about 20 percent of undergrads each year. (Siggins declined to comment for this article, citing “time constraints” in a November email.)

    The numbers are even higher for Yale’s graduate and professional school students, 25 percent of whom visit MH&C yearly. They are also growing; visits have doubled since 1998, now surpassing 20,000 per year. All Yale students are entitled to 12 individual counseling sessions annually, and a mental health clinician can always be reached for emergencies through the Acute Care Department.

    With the rise in appointments have come longer wait-times and more reports indicating insufficient quality of care at MH&C. Based on more than two dozen interviews with University officials, student leaders and alumni, these concerns about Yale’s mental health services finally seem to be making waves within the administration.

    As pressure mounts to reform MH&C from every level of the student body, the 2013-14 academic year appears to present an opportunity for Yale to more actively address mental health. Still, such reforms may take longer than many students are willing — or able — to wait.

    “Negative Perceptions Are Prevalent”

    On December 12, the Office of the Secretary and Vice President for Student Life, headed by Kimberly Goff-Crews ’83 ’86 LAW, sent an email to all Yale students, which said “discussions and collaborative efforts have been underway at all levels” to improve mental health on campus.

    “Living and working in this type of environment, it is normal for students to feel anxious about academic and social pressures,” the email stated. “However, the culture at Yale seems to discourage acknowledging vulnerability; rather, many students feel additional pressure to be ‘effortlessly excellent’…This expectation is not realistic and not healthy.”

    The email did not specify measures for reform beyond updating the MH&C website with more information about mental health care, nor did it mention students’ most pressing concern of all: meeting patient demand in a reasonable amount of time.

    Yale Health employs 28 mental health clinicians — including social workers, psychologists, and psychiatrists — 22 of whom work full-time. Given Yale’s student population, this means there are approximately 425 to 550 students for every clinician at MH&C. This means Yale has about twice the number of mental health professionals per student than do schools of similar size, based on 2012 data from the Association for University and College Counseling Center Directors (AUCCCD).

    A Yale College Council (YCC) report on mental health published last October revealed that this ratio, while favorable, doesn’t tell the whole story. Authored by three Yale College students, the report compiled data from what it called 50 “structured interviews” with student leaders and administrators, and from a campus-wide, anonymous survey, to which roughly 20 percent of undergrads responded.

    The report included findings about Yale’s campus culture and resources surrounding mental health. Of students who completed the survey, 39 percent said they had sought the services of Mental Health and Counseling — the reasons for their visits ranged from depression and anxiety to eating disorders and academic stress.

    “We do acknowledge the limitations of the data we’ve collected,” Reuben Hendler, one of the YCC report’s authors, says, referring to sampling biases in the survey and interviews. “But that in no way means we can’t learn a lot from it.”

    The report also contained data on students’ perceptions of the quality of care offered at Yale Health, with 31 percent of students rating their experiences as “poor” or “very poor.” Moreover, over half of respondents said they would be “unlikely,” “very unlikely,” or “unsure” about approaching MH&C if they wanted professional counseling.

    “Negative perceptions of MH&C are prevalent,” the report stated. “Some students fall through the cracks.”

    Paul Genecin, director of Yale Health since 1997, acknowledges that students’ experiences of MH&C vary, but says Yale Health has quality control measures in place, such as an annual review of clinicians, a member services department, and yearly accreditation by the Joint Commission — a non-profit organization that certifies roughly 20,000 health care programs in the United States.

    “It is a fact of student health across the land: If you ask students what they think, you will find a number of people exercising their critical faculties,” Genecin says. “You can trade out us and put in ‘Athletics,’ ‘Dining,’ ‘Libraries’ — there’s always a seeming disconnect between how people look at a service versus how it actually is.”

    In order to assuage students’ expressed concerns, the YCC report outlined three major recommendations for MH&C: communicating more effectively about appointments, expectations, feedback, and mental health education; hiring additional therapists; and possibly referring certain students to outside clinicians.

    Specific measures included allowing students to schedule appointments over email, instituting mandatory telephone check-ins with students who miss an appointment or wait more than a week to be assigned a therapist and creating “an accessible, well-publicized way for students to provide feedback.” Hendler, one of the authors, says he is confident the report will be given “serious consideration” by the University.

    Genecin states the YCC report did “a good job” of addressing some of the misinformation among students about MH&C’s services. He admits Yale Health should do more public outreach, but adds that his staff is primarily dedicated to patient care, and so cannot focus on outreach as much as they would like. When asked about the long wait times some students experience, Genecin responded that “no health care system can have perfect access to resources” and that doctors must prioritize patients based on the severity of their conditions.

    “I’m much more concerned with treating students who need serious intervention,” he explains. “The question is not what percentage of students did you see in x number of days, it’s what percentage of students did you see who really needed help.”

    But such an approach has led to a dissatisfaction with MH&C that extends well beyond the College: on the same day the YCC released its report, Yale’s Graduate Student Assembly (GSA) and Graduate and Professional Student Senate (GPSS) released their own mental health report, according to which 32 percent of participants in an annual GPSS survey said they were “somewhat dissatisfied or worse” with the University’s mental health services. Ultimately, this was “the strongest student concern with the Yale Health Plan” in 2013.

    Yale: “A Rough Place To Be Sometimes”

    For Julie Botnick ‘14, scheduling an appointment at Mental Health and Counseling was a daunting task. In an October 21 Yale Daily News opinion column, “Don’t neglect us,” Botnick wrote that she sought treatment at MH&C during her sophomore year for a chronic mental disorder.

    Botnick became frustrated, however, when she waited over a month to be assigned a permanent clinician after her “intake” appointment — an hour-long evaluation session typically made within three days of a student contacting MH&C.

    When Botnick finally saw someone, the clinician was a social worker and not a psychiatrist as she had requested, whom she said seemed “bored and unresponsive.” She stopped visiting MH&C after “two or three sessions,” and was never contacted afterwards to see if her condition had improved.

    “It was a waste of my time,” Botnick remembers. “I can’t believe they had never been so busy before and didn’t know what volume of people to expect. They need to meet the demand, no excuses.”

    Multiple factors may explain why students like Botnick experience long wait times and variable quality of care at MH&C. Notably, Yale Health’s triage system prioritizes students who feel they are in dire straits and can articulate it. According to Genecin, those who express suicidal thoughts or the intention to harm themselves are “seen immediately,” which necessarily delays other appointments.

    Nonetheless, as Genecin himself acknowledges, these are rare cases; most students present with an “extremely broad” range of concerns that do not require emergency treatment.

    After intake, each patient is given the contact information of a MH&C clinician, and a schedule is created that is reviewed within five weeks, Siggins, the head of the department, stated in the September memo. Students on medication are scheduled a check-in appointment after four to five weeks of treatment, and Siggins reported that only “about 10 percent” of patients wait longer than two or three weeks to see a clinician.

    Additionally, in her September presentation to the Yale Health Member Advisory Committee — a feedback group composed of about 20 undergraduate, graduate and professional school students, and Yale Health staff — Siggins said her department offers group therapy to students waiting for individual appointments, with about a dozen groups currently running.

    But Genecin concedes that many students are uncomfortable with group treatment because they would prefer confidential, one-on-one therapy. Moreover, students can only join groups in which they do not know anyone else. While in line with clinical best practices, this requirement poses significant logistical problems for a student body as well connected as Yale’s.

    Anna North ’13, a first-year student at Yale’s School of Public Health and a former Freshman Counselor (FroCo) in Silliman College, says although she was offered group therapy after her individual appointments ran out as an undergrad, she was ultimately disappointed with her experience.

    “Hardly anybody will be able to benefit from [group therapy] because they start at a random time and are really disorganized,” North says. “Last year, I tried to join a group, finally got into one, and then found out one of my friends was in it so I wasn’t allowed to join.”

    However, Stephanie Tubiolo ’14, a current FroCo in Silliman College, believes group therapy helped her cope with depression and an eating disorder, which developed after her work supervisor, John Miller MUS ’07, a School of Music employee, committed suicide in 2011. Tubiolo says everyone in her therapy group received the attention they needed, adding that the counselor in charge facilitated discussions without interfering with the group dynamic.

    “It was a really rewarding experience to say I had this issue and someone else would say, ‘That happens to me all the time,’” Tubiolo explains. “Especially at Yale where so few people are willing to show their weaknesses. It’s a rough place to be sometimes.”

    Tubiolo also speaks highly of individual counseling sessions, which she says taught her to “pick [herself] up” on difficult days and now seem like “one of the best decisions [she has] ever made.”

    She says she was surprised by the YCC report’s findings about variable quality of care at MH&C, but admits that not everyone feels immediately comfortable with their clinician because of therapy’s subjective nature.

    Siggins reported that 25 percent of students start to feel better after three or four visits to MH&C. But inevitably each year, the department sees busy times, such as between Thanksgiving and winter breaks, when the stress of final exams and papers may negatively affect students’ mental health.

    “I feel like it’s gotten a bit worse in recent years,” University Chaplain Sharon Kugler maintains. “Students are now stressing two weeks into the semester rather than six. Then we get into Reading Week and everything goes to black.”

    Addressing the Information Gap

    Administrators like Kugler play an important role in getting certain students to receive treatment at Mental Health and Counseling. In an environment with a high demand for services and a limited supply of clinicians, residential college masters, deans, freshmen counselors and chaplains can significantly accelerate the intake process by advocating for students.

    “If something gets to a level where day-to-day support from deans, administrators, and friends is not going to help, then we contact MH&C,” Jeffrey Brenzel, Master of Timothy Dwight College, says.

    Many undergraduates do not know where to go until they face an acute situation. As the YCC report outlined, students may be “confused about how to navigate [Yale’s] extensive network of resources.

    Such confusion is unsurprising: Yale resources include everything from student organizations like Walden Peer Counseling, Queer Peers, Peer Liaisons (PLs), Communication and Consent Educators (CCEs), Freshman Counselors (FroCos) and Mind Matters — a mental health awareness group — to institutional resources like MH&C, the Sexual Harassment and Assault Response & Education (SHARE) Center, the Chaplain’s Office, the Resource Office on Disabilities, the Office of LGBTQ Resources and the four cultural centers. Currently, comprehensive information about campus resources is not centralized.

    “I felt like FroCo training was the first time where I fully knew about Yale’s mental health resources because it was my job to know,” Margaret Coons ’14, a Silliman FroCo, recalls. “People going through emergency situations might not have the luxury to wait.”

    Five current FroCos said freshman orientation should include more information about Yale’s mental health resources and campus culture. Although every FroCo must meet with the staff of MH&C and participate in mental health role-plays before freshmen arrive on campus, Michael Sherman ’14, a FroCo in Pierson College, says he was disappointed with this year’s training.

    “When we did the role-plays,” — simulations of students approaching FroCos with mental health concerns — “the professionals who were there gave almost no feedback and left it up to the group,” he says. Sherman added that a mandatory tour of Yale Health was part of orientation, but because it was scheduled on Labor Day, there were no officials present to greet and guide freshmen. “We quickly realized we were the tour guides and we didn’t know the adequate information.”

    Anna North ‘13, the alumna at the School of Public Health and former FroCo, agrees with Coons’s assessment of the information gap, adding that she was “extremely nervous” the first time she visited MH&C during her sophomore year because she didn’t know what to expect. North, who was experiencing regular anxiety attacks, only approached MH&C once she felt she was on the verge of leaving Yale if nothing changed.

    The result of general ignorance about MH&C is that rumors circulate among undergrads regarding the consequences of receiving treatment, North claims, which may deter some students from seeking help. Such rumors include being sent to the Yale-New Haven Psychiatric Hospital, where treatment could become expensive, and being asked by the University to take a medical leave of absence, which could threaten a student’s chances of graduating on time.

    It’s no wonder then that for many students, a certain deal of anxiety surrounds scheduling an appointment at MH&C. Robert Peck ’15, a former staff reporter for the News, had a Kafkaesque experience there during his sophomore year, when he had to wait over three months to be seen by a permanent clinician.

    Now a YCC representative on the Yale Health Member Advisory Committee, Peck says he was told he would get to see a clinician within a month of his intake appointment in November 2012. When that did not happen and he returned home for winter break, Peck emailed his intake counselor but received no response. And when he called MH&C in early January, he was simply told that December was always a busy time.

    It was not until his dean called MH&C several weeks into the spring semester that he had an official appointment scheduled for February.

    “You would think that was the end of it, but then the therapist I was assigned decided not to show up for work on the day of my appointment,” Peck remembers. “I was so thoroughly poisoned by the experience that I left and didn’t go back.”

    Peck admits his condition was not as severe as those of others he has spoken with, but says it would be unacceptable for Yale Health to define success only in terms of treating its most pressing patients.

    “Of course Yale Health is probably better than many [university health care] programs in the country, but that doesn’t get them off the hook for not fully helping the student population here,” he asserts. “If we’re to have faith in our university, for a service we pay for through tuition, there has to be some legitimate reason they can’t meet demand in a timely fashion. So far, I haven’t heard what that is.”

    “A Legitimate Reason”?

    A potential answer to Peck’s question may involve how the University determines Yale Health’s annual budget, which Stephanie Spangler, deputy provost for health affairs and academic integrity, currently oversees. She previously served as Director of Yale University Health Services from 1990 to 1995.

    In November, Spangler declined to comment on the magnitude or percentage that Yale Health’s expenses make up of the University’s overall budget, but said Yale Health’s four biggest costs are medication, staffing, hospital expenses and those to outside providers and delivery systems.

    Genecin and Lorraine Siggins are the two people primarily responsible for managing the budget for mental health, Spangler said. Although Genecin declined to provide specific budgetary figures, which total in “the millions of dollars,” he notes that a significant amount of MH&C’s funding comes from the endowment, through donors who specifically want to support Yale’s mental health services.

    However much money is allocated to MH&C, the University’s limited finances and budget priorities may impede changes to Yale Health for some time. As of June 2013, Yale faced a $39 million budget deficit, which University President Peter Salovey and Provost Benjamin Polak announced in mid-November would need to be reduced through cuts to administrative departments. At the time, Genecin told the News that Yale Health is always looking for ways to contain costs, and that budget pressures fluctuate throughout the year.

    Reuben Hendler, one of the YCC report authors, admits that hiring extra clinicians at MH&C would cost more than other reforms, but says it would be “the silver bullet” to lowering student wait times. In turn, Hendler explains, undergrads would have more positive perceptions of Yale Health. “It’s simple: If there are more therapists, then people can be seen more quickly,” he says. “Obviously that takes resources. We think those resources are well spent.”

    “Barring unforeseen circumstances, I expect we’ll be talking about adding more staff as the new residential colleges are built,” Genecin says. The two new colleges are scheduled to be completed in August 2017, which will allow Yale to admit roughly 15 percent more students each year, bringing total undergraduate enrollment to more than 6,000.

    Genecin declined to speculate as to whether the ratio of mental health clinicians to students would also change.

    Ernest Baskin GRD ‘16, chair of the Yale Health Member Advisory Committee, says he is optimistic that mental health resources on campus will improve, but maintains that it will take “broad student initiatives” to make the Yale Corporation aware that mental health is such an important issue. “It needs to be heard by the trustees who control the purse strings and can influence the allocation of funds, at the very highest level of decision-making,” he asserts.

    For now, at least, those hopes may not be far off.

    “One thing in the [YCC] report that concerned me was the observation that students could be unhappy here and feel they have to hide it,” Spangler says. “We have a great opportunity to change that.”

  8. Hard to Swallow

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    A few weeks ago, the mental health group Mind Matters tabled on Cross Campus. Volunteers offered information about mental health resources at Yale in the form of flyers and conversation. If people were willing, they could write their thoughts about mental health on colored sticky notes and place them on a cardboard display for others to ponder.

    “Sometimes I skip lunch on purpose.”

    This light blue sticky note in the center of the board — a quiet admission of skipped meals, written in a neat hand — was surround by confessions of depression, anxiety, fear, loneliness and porn addiction.  The sentence seemed so simple; many can admit to accidentally skipping meals, and a pattern of missed lunches would be easy to overlook. But the note’s author was admitting to something intentional, a problem below the surface.

    Had they confided in anything other than a sticky note? Had they spoken the written words aloud?

    Start to talk about eating disorders at Yale, and a familiar, simplified narrative soon emerges: Yale is an intense place, and in our collective scramble to reach the top, students find solace in control — be it academic or nutritional. Disordered eating, especially anorexic tendencies, follow from this competitive nature, as the outgrowth of an overworked and self-critical student body.

    Some of this may true — and students’ intensity (both in the classroom and out) does translate to a heightened frequency of disordered eating. While a widely accepted statistic is difficult to find, given that many of those suffering are left undiagnosed, according to the National Association of Anorexia Nervosa and Associated Disorders, roughly 1% of the population suffers from eating disorders. In a recent survey conducted by the News, sent to 500 students with 141 responses, 8% of respondents self-reported that they had been diagnosed with an eating disorder.

    Perhaps because of this markedly higher prevalence, 59% of students surveyed also said they thought “disordered eating” is an issue on campus. But though many believe these unhealthy habits develop on campus, few observed a satisfactory level of awareness. When asked to rate on a scale of one to five — one being “not at all” and five being “often or always spoken” — how often discussions of eating disorders occur, respondents rated campus conversation at a low 1.92.

    For those diagnosed with eating disorders, or suffering from potentially harmful eating habits, this silence only fuels the problem. Those with disorders have few opportunities to articulate their problems to friends, administrators or even themselves. And, according to many who have suffered in secret, beginning to talk is the first step to a solution.

     

    BURNT TOAST

    Find the smallest piece of bread and burn it. Each day of her freshman year, Skyler* served herself the same breakfast, sometimes adding a cup of black coffee. The first meal of the day had always been her favorite, but most of Yale’s offerings — eggs, pancakes, bagels — scared her with the possibility of consuming fattening oil and calories. So she stuck to the one option she deemed “safe”: the tiniest piece of black toast.

    “Burning toast makes it harder to chew, so I would have to chew longer to finish a piece,” she explained.

    With classes throughout the day, skipping lunch was easy. All it meant was a strategic swipe at Bass Café for an iced coffee and a pack of gum – “in case I really needed something to chew on.” Dinner was a plate of raw spinach and tomatoes with a dash of mustard, a combination admired by Skyler’s friends, who complimented her apparent healthiness.

    By the end of her freshman year, Skyler was struggling with a full-blown case of ED-NOS, “eating disorder not otherwise specified.” This meant that, according to a nutritionist, she did not meet the strict physical definition of anorexia but had severely harmful eating patterns with a strong psychological component.

    Skyler’s habits fit into the clinical definition of “disordered eating.” According to the Mayo Clinic, “disordered eating” includes both psychological and physical symptoms, like cycles of severe restriction or binging, excessive feelings of guilt when eating, or defining self-worth based on eating habits.

    When given this definition of “disordered eating,” 59% of respondents to the News’ survey reported that they have noticed habits that fit this definition among their friends.

    Skyler said she recognizes them “everywhere” at Yale, hidden behind a veil of health-consciousness. She mentioned that many students associate dieting with health, and added that many count the ability to balance physical fitness, academics and extracurriculars as a badge of honor.

    “It’s just another stretch for perfection. Yale is filled with all these perfectionists ready to do anything to be the ideal person,” she said.

    Katie Chockley ’14 has struggled with an eating disorder since high school. She shared Skyler’s estimation that more people suffer than one might expect. Though, in Chockley’s experience, these habits dominate some groups at Yale more than others.

    Chockley has participated in several athletic teams while at Yale and said that for athletes, weight affects performance. Certain sports, like long-distance running, benefit those who weigh less.

    But after joining the Yale club rugby team, Chockley said she has found a more supportive environment and that she admires the body-positive attitude of her teammates.

    “If someone makes a comment about some food as ‘good’ or ‘bad,’ they’re immediately shut down,” she said.

    But while acute in certain areas, some social pressures are constant. For those who already have an unstable relationship with food, there are many stressors built into day-to-day life.

    Andrea* has struggled with cycles of severe restriction and binging at Yale. At an interview in Bass Café one afternoon, she was energetic and smiling. She looked healthy, but that hasn’t always been the case.

    Andrea said restricted dining hall hours teach students to eat at specific times, not necessarily when they are hungry. Often, she said, emphasis is placed on the “comfort” of foods over their nutritional value. She added that these complaints are not unique to Yale, but endemic to most college environments.

    “The dining hall situation is interesting, because it can go both ways. [Buffets make it] easy to binge or restrict. And if you don’t want to eat, you just avoid the dining hall,” she said.

    As someone also in recovery during her time at Yale, Chockley added that she felt uncomfortable with the social aspect of food in college, even outside the dining hall.

    While students often joke that free food is everywhere on campus — and a hallmark of club meetings — Chockley said these events can be intimidating. Many of these feature unhealthy foods like Claire’s cake and pizza, which are “scary” to those who are over-aware of what they consume.

    “There’s this voice in your head that says, ‘Do I have to eat cake for them to think I’m normal?’” she said.

     

    MIND OVER FORK

    By their nature, eating disorders have an element of voyeurism that escapes most mental disease. In its most extreme form, these diseases manifest as nearly skeletal: bones jutting out, pencil-thin wrists and countable ribs. But for all their visibility — for all their Hollywood connotations — every eating disorder begins immaterially, as a psychological problem. They derive from an impulse to use food, not for nutrition and fuel, but as a way to gain control.

    “Eating is one of those things that we can control in this world,” Andrea said, associating these kinds of disorders with competitive environments. “When things get really stressful, that’s what people can turn to.”

    For Andrea, Yale, academically and socially, was that competitive environment. Though Skyler located this pressure not just in classes and clubs, but in a feature specific to Yale: the unspoken expectation of happiness among its students.

    Because Yale students pride themselves on a sense of self-control, she said, cracks in the façade are not welcome. The result is an atmosphere in which issues with food can snowball quickly, as students often avoid tough conversations about disordered eating. Skyler exhibited symptoms of ED-NOS before she recognized them as part of a disorder.

    “There’s so much more happening than what you decide to eat and not-eat,” Skyler said.

    She added that her situation was especially risky because she was at a healthy weight and seemed visibly unaffected. Those with ED-NOS still experience detrimental physical symptoms such as hair loss and dizziness, she explained, but they do not attract the same attention of those who are visibly emaciated.

    And so the answer doesn’t lie in judging healthiness by appearance. Skyler said the root of the problem lies in someone’s habits, which are harder to discern, but still noticeable if you pay attention.

    “You shouldn’t look at every skinny person on the street and ask if they’re anorexic. But I think if people were more sensitive, it wouldn’t be that difficult to glean who is having problems. There’s an air that’s almost tangible,” she said.

     

    OUT OF CONTROL

    We met Eric* at Blue State on York, so crowded with students and businessmen that the collective body heat was making us sweat. Two students sat at a table only a few inches away, discussing a summer program in the Southwest. Concerned that Eric might feel uneasy discussing a personal, sensitive topic in such a crowded place, we suggested a move to somewhere more private. He waved off the idea and said it was no problem. His confidence was astounding, especially for someone who had lived through what many consider a worst-case scenario.

    Eric took a year off from Yale mid-semester the fall of his sophomore year after struggling with severe disordered eating habits and mental health issues. His disordered eating habits started second semester freshman year. Like the 51% of Yale undergraduates surveyed who listed that they felt a need to lose weight, Eric felt uncomfortable with his weight and body image.

    But the catalysts for his descent into disordered eating were emotional: He struggled with relationships with friends, his sexuality and concerns about his academic future. With all of these things seemingly out of his control, Eric turned to food for stability.

    His habits began as an interest in healthy eating. He dubbed himself a “foodie,” and soon became a vegetarian.

    “For me, that decision was an excuse to just eat vegetables all the time and not much else,” Eric said.

    As time passed, Eric became increasingly restrictive and obsessed with planning meals — what he was he going to eat, and who he was going to eat with. All it took was a cancelled dinner date or an unexpected change in a dining hall’s menu to send him spiraling into anxiety, feeling that he had lost control.

    The malnourishment caused by his restriction led to cycles of binging and purging — the body responds to starvation by seeking calorie-dense foods for survival. But after each binge, Eric felt a need to compensate for overeating. If he didn’t purge by vomiting, he ran eight miles to rid his body of excess calories and to ease his obsessive mind.

    “[It] was funny, because I felt like I wasn’t really deciding to do those things, but it was just happening,” Eric said. “Deep down I knew it wasn’t going to help and wasn’t what I wanted.”

    Eventually Eric realized that he needed to take control, and that meant taking a year off to recover at home, where he saw a therapist on a weekly basis. He said the time away made all the difference for his recovery.

    According to Eric, that time off doesn’t seem like an acceptable option to many Yalies. Time away from campus, he said, only feels justifiable if you’re doing something career-focused; otherwise it gives the impression that you simply can’t handle Yale.

    But the world doesn’t end if you can’t get everything done in four years, Eric said, though breaking that perception can feel like yet another difficult step on the path to getting better. He found that taking time to recuperate was one of the best things he could have done for his well being, and added that those of his friends who have also spent time away agree that the experience is beneficial.

    “The time off was really, really awesome, I learned a ton about myself … I came back with 10 times more confidence than I had previously,” Eric said, smiling.

    Unfortunately, Yale does not make the reapplication process to return from time off due to mental concerns easy, Eric said. Instead, this impediment makes the prospect of taking time off even less appealing.

    In order to gain readmittance into Yale College, Eric was required to get passing grades in two courses he had to complete during his time off, write an application essay and convince his college dean, Mental Health and Counseling chief psychiatrist Lorraine Siggins and an assistant dean of students that he could be “a real student again.”

    He didn’t find out that he was readmitted until mid-August, just weeks before he would have to return.

     

    GETTING HELP

    Yale Health now employs one nutritionist. Under the student health plan, Andrea met with that one nutritionist, Lisa Kimmel, twice over a six-month period last year — a process she describes as cathartic and crucial to her recovery process.

    But help isn’t consistently available. This year Kimmel works as part of Yale’s “Mind Matters” initiative and no longer provides nutrition counseling. Andrea said adjusting to Kimmel’s replacement, Marita Holl, has been difficult. When she returned to school this semester and called to make an appointment with Holl in late October, she was asked if she could plan to come in January. When she explained the urgency of her need for counseling, she got an appointment at the end of November. After the fact, she described that meeting as “disappointing.”

    To those with a history of disordered eating, “recovery” is a process, not a cure, and it is one that does not only depend on professional help. Andrea observed that students, and not just administrators, could do more to encourage a better environment for recovery.

    “The only way someone with an eating disorder will decide to get better is with support and education,” she said, adding that we should “at least make it a discussion on campus — it’s just not discussed, along with most mental health issues.”

    Chockley, too, said other students influence the dialogue surrounding food. She pointed out that issues with eating habits are a lot more prevalent than most assume, and that those who do not suffer from them unwittingly make the problem worse.

    If someone observed that she was “eating healthy” when Chockley was restricting, she felt a pressure to continue. If they commented that she had “a lot” of food when she felt stable, this instilled a sense of guilt and defeat, often leading to more intensely restrictive behaviors.

    Skyler echoed Chockley’s concern about the ignorance of the student body, but added that Yale’s administration could better foster student dialogue on this issue. She drew a parallel to the University’s bystander intervention seminars.

    “Yale focuses so much on teaching us how to intervene when your friend is about to get raped, but they teach us nothing about how to help a friend who is on [another] really bad path,” she said.

    And so the people who could make the most difference — close friends and suitemates — often don’t know how to act.

    When he first started to restrict his diet, Eric’s friends recognized that he had lost a lot of weight over a relatively short period of time. For a while, they didn’t address his weight loss or personality changes any further, only mentioning his problems obliquely, and saying that they never see him anymore. Eric could not share his burden with anyone else.

    Eventually, his friends took action. They decided to confront him about his weight loss and depression, but only after Eric’s life had been unraveling for months. Looking back, he said it would have been better for him if his friends had spoken up sooner, though he recognized blame on both sides of the conversation.

    “On the one hand it was my unwillingness to involve people, and on the other it was people’s either unwillingness or inability to get involved,” Eric said.

    But even those that have experience with these psychological conditions find it hard to balance respect for someone’s independence and concern for their well-being.

    Lydia was diagnosed with anorexia at the beginning of her sophomore year of high school and came to Yale after being in recovery for two years. But she said even now, she does not feel equipped to intervene when she sees classmates that exhibit disordered eating patterns.

    “We’re friends with these people — the dynamic is different. Parents can intervene … but that’s not part of the job description for friends,” she said. “This is the time when people are supposed to start living independent lives, so how can you say to someone, ‘I don’t trust you completely to feed yourself?’”

     

    FIRST WORDS

    Eric and Skyler still relapse under stress, but now that those around them are aware of the nature of their issues, they feel more able to face them. Still, to obtain the support of friends and family, they had to divulge one of their most personal secrets.

    Before he took time off, Eric believed that most of his friends would subscribe to the common perception that eating disorders are image-driven and simply about starvation. He feared responses that would only address the physical aspects of his problem, such as “go eat some more ice cream.”

    The best way to propagate an awareness of the complexities of the issue is to engage in more discussion about disordered eating, Eric said. He called on others who have struggled with similar unhealthy approaches to food to share their experiences with friends, if they’re comfortable enough to do so.

    “[Be] willing to be part of the conversation,” he said.

    Ten minutes after Eric left our little table at Blue State, a girl who had sat at a neighboring table for the duration of the interview approached us. She asked what the interview was for, and the conversation soon turned to the silence surrounding eating disorders at Yale. Then, she admitted casually what many feel a need to hide.

    “I had an eating disorder.”

     

    *name changed for anonymity

  9. Harvard students rally for mental health reform

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    More than 150 Harvard students rallied for mental health reform last Friday afternoon, chanting “Harvard, we are mad” and urging administrators to take a closer look at the university’s mental health services.

    The protesters gathered just one day after The Harvard Crimson — the campus newspaper — published an anonymous op-ed by a student with schizophrenia, who described his experiences with Harvard’s mental health services and perceived flaws in the system.

    Friday’s rally quickly drew the attention of administrators, including Assistant Dean for Student Life Emelyn A. dela Peña, who approached the group and invited them to continue their discussion indoors. The offer was declined. Although dela Peña told The Crimson that Harvard administrators are willing to provide all necessary services, the anonymous op-ed claimed that the administration is “hostile” toward mental health issues.

    Standing in a circle, protestors echoed the arguments put forth by the op-ed: Students who seek treatment for a mental health issue should have immediate access to a therapist, and antipsychotic or antidepressant medications should be free for students on financial aid. Most importantly, the protestors argued that students should not have to choose between an education and mental sanity.

    The protest has extended beyond campus boundaries. Students launched the “Coalition to Reform Mental Health Services at Harvard” on Friday evening after the rally and began posting to Facebook, Twitter and other social media websites. In response, Undergraduate Health Services representative Lindsey Baker released a statement assuring that mental health is a “top priority” for the administration.

    The administration has yet to announce changes to mental health policy, but pressure continues to build as the coalition amasses new members. As of Saturday afternoon, 110 students had joined.