Last December, Yale Law School’s Mental Health Alliance, of which I am a member, released the first-ever large-scale survey of the law school student body’s experiences with mental health and health care. The survey, “Falling Through the Cracks,” identified a wide variety of issues related to Yale’s mental health culture, institutional policies and treatment options. But what stood out for many were its stark findings about mental health care at Yale Health.
The survey found that while the vast majority of law students who experienced mental health challenges during law school considered seeking treatment, only about half of the respondents did so. Those who did not seek treatment routinely cited wait times and concerns about the quality of Yale Health’s services as reasons for not utilizing existing resources.
Meanwhile, nearly half of the law students who did seek treatment reported being dissatisfied or strongly dissatisfied with their Yale Health experience. Students faced a median wait time of one to two weeks for an intake appointment, and then another three weeks to two months after that to be paired with a regular therapist. Many reported that these long wait times impaired their academic performance and personal relationships. And if they did not get along with their therapists once matched, students did not know where to turn. Even if they did establish good relationships, these were limited, as Yale Health appeared to have an unwritten rule capping sessions at around 12 per year. And, of course, students lacked coverage for mental health treatment while they were away from New Haven during the three-to-four-month summer break.
The reforms that were announced to the undergraduate student body on Thursday, and to graduate and professional students on Friday, represent an important first step in addressing some of these concerns. To the extent that hiring more mental health professionals helps reduce wait times, it is a much-needed fix, and one that MHA supports wholeheartedly. Creating a transparent process for changing therapists is also a major improvement, although it needs to be paired with a reassurance that students will be able to receive new therapist assignments in a timely manner.
Yet the impact of some of the other reforms is less clear. For example, Yale Health is right to focus on the transition between the intake and the first appointment. As is, students wait weeks just for an intake appointment. At the intake appointment, they describe the struggles they have been facing, which for many is a deeply painful process. Then they wait again, for weeks or even months, before being paired with a therapist. For many students, this delay may signal that their problems are not important — a perception that Yale Health’s leaders have reinforced in some of their public comments. Yale Health has promised to “streamline the transition” from the intake to the first appointment, but unless this means providing shorter wait times and more active support in the interim, it is not enough.
The reforms also leave unaddressed some of the student body’s most pressing concerns. First, the apparent rule that most students can access only around 12 therapy sessions a year forces students to ration therapy based on when they think they may need it most.
Second, Yale Health must do something to address the gaping hole in coverage that students face when they leave New Haven for the summer. Unless they are physically in New Haven, students must travel back for therapy as well as for access to some controlled medications, which is an unreasonable and often impossible burden. Every other law school in Connecticut — as well as every other top five law school in the country — provides students with access to a number of off-campus therapy visits per year, which allows students flexibility in their plans over breaks.
Third, the University as a whole must reconsider policies that may exacerbate student mental health issues. For Yale College, this means revisiting withdrawal policies that punish students for addressing ongoing mental concerns and encourage students to avoid seeking treatment. For the graduate schools, whose policies are often different, this means increased transparency about the processes for taking leave.
Time will tell if the reforms promised in Director of Yale Health Paul Genecin’s announcement will become realities. We are hopeful that they will mark the beginning of real and desperately needed change at Yale Health, and that this process of change will involve graduate students as well as the undergraduate community. In the meantime, MHA stands ready to work with students, Yale Health and the University administration to ensure that all students have meaningful access to quality mental health care.
Rachel Dempsey is a third-year student at the Law School and a 2009 graduate of Yale College. She is a founding member of the Mental Health Alliance. Contact her at email@example.com.