Karen Lin, Staff Photographer

The National Suicide Prevention Lifeline is a hotline for individuals in crisis or for those looking to help someone else. To speak with a certified listener, call 1-800-273-8255.

Crisis Text Line is a texting service for emotional crisis support. To speak with a trained listener, text HELLO to 741741. It is free, available 24/7 and confidential.

To talk with a counselor from Yale Mental Health and Counseling, schedule a session here and also here. On-call counselors are available at any time: call (203) 432-0290. 

The Chaplain’s Office staff are also available: schedule an appointment herewrite directly to any of the staff or call (203) 432-1128 during business hours. Walden Peer Counseling is available from 8 p.m. to 2 a.m. every night. To speak with a trained peer counselor, call (203) 432-8255. To speak with Dr. Eunice Yuen from the Asian American Cultural Center, schedule an appointment here. Good Life Center Woodbridge Fellow Alex Vaghenas offers 30-minute non-clinical wellness chats to support students in coping with stress and anxiety, and to hear about whatever else is on their mind. Email alexa.vaghenas@yale.edu to schedule a one-time session or a recurring time to chat.

Additional resources are available in a guide compiled by the Yale College Council here.

***

On a campus already marked by a stressful academic environment, the pandemic has exacerbated mental health challenges for many Yale students, creating feelings of loneliness, isolation and fear as students cope with a world altered by COVID-19.

And as the Yale community mourns the recent death by suicide of a first-year student, students have engaged in renewed discussion about mental health at the University, including aspects of Yale’s social and academic culture as well as institutional support and mental health services. 

“Yale is not unique in this; college student’s mental health utilization has increased across the country and I expect the pandemic will only add to this trend,” Chief of Mental Health and Counseling Paul Hoffman wrote to the News in an email. “I would encourage any student worried about wait times to reach out [to Yale Mental Health and Counseling], students with urgent situations can receive treatment very quickly and for many it can have a profound effect on their well-being at Yale.”

But he also acknowledged that there is room for improvement. 

The News spoke to 20 students about their experience with Yale Mental Health and Counseling services. All of the students interviewed expressed frustration, disappointment and anger over inadequate mental health resources for students, including weeks-long wait times for appointments and lack of capacity for comprehensive, consistent care. Overall, students expressed feeling like the quality of their support is sacrificed in an MHC effort to get through the long line of student demand. 

“The biggest problem is that there is this common understanding among students that Yale Mental Health and Counseling does not live up to par, and that has the potential to prevent people from even seeking help when they might really, really need it,” a student who requested anonymity for fear of revealing personal health records said. “Aside from students who seek support and do not get it adequately, this is a crisis in and of itself. It already takes a lot for someone with a mental illness to admit to themselves that it is time to get help and then actually ask for it. Yale has to do better to remove the barriers for students who are seeking help to receive adequate help.”

Long waits, short appointments and a lack of comprehensive care

Every student interviewed complained that the chronic understaffing of MHC that has resulted in long wait times for appointments and short therapy sessions to accommodate increased demand — for those who can get appointments in the first place.

Ten students commented on how long it took after their intake appointment — the initial evaluation before a student is connected to a clinician — for them to be assigned a therapist for a first clinical appointment. Two mentioned waiting for up to five weeks.

According to Hoffman, students who seek mental wellness services would start by calling (203) 432-0290 and asking to schedule an intake appointment. During most times of year, students should expect to get that appointment within a week, and during September and early October when the wait for intake appointments is usually longer, some MHC therapists are available for same-day intakes by student request. Based on their intake evaluations, students are assigned a clinician anywhere from within a couple of days “if the situation is urgent” to within a couple of weeks. However, at all times, students can request to see a therapist immediately through the on-call clinician.

MHC currently employs 33 clinicians. That number could increase by nearly 25 percent next year, as MHC plans to add six to eight new positions. Additional staff, Hoffman said, “should help reduce wait times further.”

But as things currently stand, care can be delayed for weeks after students initially seek mental health services.

The anonymous student was diagnosed with anorexia in their first year at Yale. After waiting about two weeks for their intake appointment and then nearly a month after that to be assigned a therapist, the individual was hospitalized due to their declining physical and mental state. After not getting the individualized care, attention and support they felt they needed to be able to recover from their eating disorder, they eventually decided to seek outside care.

“I remember the weeks between steps [in MHC’s care timeline] were grueling, and not knowing when the wait was going to be up took an even harder toll on me mentally,” they said. 

On the other hand, Camden Rider ’23 shared with the News that following an experience last November that put him in the hospital for 24 hours, MHC followed up nearly immediately. He expressed his utmost gratitude for having been in touch with a clinician so quickly, but he also acknowledged that the circumstances of his situation likely contributed to the speed in which he was contacted.

Hoffman told the News that MHC understands that the wait times are often discouraging to students and has been working hard to reduce them. He stated that major increases in students seeking treatment are one of the main causes of the waits. Around 70 percent more students now seek treatment at MHC than five to six years ago.

Leila Iskandarani ’22 also told the News about her history with MHC. Last semester, she sought counseling for anxiety, and after a two-week wait for an intake appointment and another two-week wait after that to be assigned a therapist, she was able to get appointments each week for approximately 30 to 45 minutes. 

However, when she returned to campus this semester, MHC told her that because of increased demand, she could only make an appointment every other week for half an hour. 

“I can’t imagine that a half hour every other week would be enough time to be helpful for anyone,” Iskandarani told the News. “It sometimes feels as if they’re seeing us to say they’ve seen us, but not really investing enough time in each of us to address the issue.”

Hoffman told the News that MHC sees around 800 students each week. Because of what Hoffman described as “a change in how students are utilizing mental health services during the pandemic,” clinicians are spacing out therapy appointments since students are staying in therapy for longer periods of time than ever before. 

Currently, the length of time between sessions is not based on a standardized policy but on an assessment of students’ needs. Some students may be seen weekly and others biweekly; some for 30 minutes and others for 45.

“Many students and therapists have found 30-minute appointments are better suited to teletherapy,” Hoffman wrote in an email to the News.

Despite feeling as if the 30-minute appointment every other week was not actively helping her, Iskandarani clarified that it was not harming her either. 

Natalie Troy ’22 expressed similar sentiments. She sought help last year at MHC when she began experiencing symptoms of anxiety, and she explained that it took her over a year to find a therapist who was a good fit for her. She currently sees a therapist “every few weeks or so” and is content with the services. 

However, she feels frustrated that it took so much time for her to get the help she needed and believes that MHC would benefit from hiring more therapists to help reduce burdensome wait times and to ensure that students get consistent, meaningful time with their providers. 

For three students, the thought of further overburdening the system has prevented them from seeking more care. One of them, Ian Homsy ’22, explained to the News how he went from years of therapy and three weeks of inpatient and outpatient care prior to coming to Yale to his current routine of five-minute phone calls with a psychiatrist every few months. 

“I felt that because I thought I was doing better than I used to, going to Yale Mental Health and Counseling would help back-up a system that is already so incredibly understaffed,” Homsy wrote to the News.

Josephine Holubkov ’24 — who was originally in the class of 2023 but took a gap year — saw a therapist through MHC “semi-regularly” throughout her first year at Yale. She recalled trying to see her therapist every week or two, but that her therapist would frequently cancel her appointments and fail to reach out to reschedule.

She does not believe that this was intentional; rather, she feels she may have just “slipped through the cracks” since her therapist had “such a huge number of patients.”

“While I learned a lot from my sessions, I did to some extent feel like a cog in a machine and not a valued individual or patient,” Holubkov wrote in an email to the News. “I don’t think I would feel comfortable reaching out to my Yale health therapist if I had been genuinely in crisis, and I wouldn’t trust Yale Health to handle my friend’s mental health crisis either, which I find sobering and dangerous.”

Dean of Yale College Marvin Chun told the News that MHC realizes that many students who “are in less acute states feel that there is a wait and too long of a wait” for appointments, and that MHC continually works to find ways to improve response times.

Seeking outside care

A second trend among interviewees was the feeling of privilege for those who could access mental wellness care outside of Yale. 

One undergraduate, who requested anonymity for fear of revealing private medical issues, told the News that they initially sought help at MHC for their already-diagnosed depression and anxiety. But after being told to expect more than a month’s wait time for an appointment and that they could not be guaranteed a female provider — a provision that they felt would be more comfortable — they decided to seek support outside of the University. 

“I am fortunate enough that I have insurance outside of Yale,” they told the News. “I just felt like I couldn’t deal with the wait — I needed help immediately — so I started looking for support outside of Yale but in Connecticut. I realize that is an extreme privilege, and a lot of other students do not have that possibility which is why this conversation is so important.”

Iskandarani similarly commented on how she decided to pay for private therapy between semesters since she was not located in the state of Connecticut and would not be able to receive counseling through Yale. 

According to Hoffman, any student, regardless of location, can call to set up an initial appointment or call the on-call clinician. However, if a student is located outside of Connecticut and has Yale Hospitalization and Specialty coverage, they will be referred to a clinician in their home state and MHC will cover the cost of treatment. For students who have waived the specialty coverage — which is an option only for those who have outside insurance — MHC would consult with them on how to utilize their alternative insurance to access treatment. 

Per Hoffman, clinicians at MHC cannot see students for treatment outside of Connecticut because of state licensure laws. When students were sent home in March, MHC continued to treat out-of-state students when possible under many states’ then-relaxed licensure laws. Students not living in states with relaxed laws were referred to mental health providers in their states and Yale covered the cost.

Iskandarani ultimately opted to utilize Yale’s free counseling when she returned to campus this semester because “it just made more sense” since private therapy is expensive and Yale offers free services under the basic health coverage plan that every Yale student receives. 

“I feel like the institution contributing to my mental health issues should pay for my therapy, so I am at least glad that the services I do get are free,” she said. 

While some students have given up on trying to utilize MHC services, other people, such as Mel Adams ’24, continue to use the MHC services in order to get access to the prescribed medication that is covered under the student health plan. But in addition to this, Adams supplements the care with outside therapy to ensure they get the time with a provider that they need. Adams similarly posed the rhetorical question of whether they are “in a bad enough situation” or “worthy of treatment” given MHC’s strained resources.

But for many students, MHC is the only mental wellness support they have access to or is the only feasible option, creating a divide between the students who can afford to outsource mental health support and those who cannot.

And because only enrolled students get health coverage from Yale, students on leaves of absence are not able to access mental wellness resources through the University.  Students have criticized the implications of this policy, which they say imposes an additional burden on low-income students.

Community calls to action

Over the past several days, students have taken to social media to share new frustrations and long-standing grievances with Yale’s mental wellness resources.

Students shared on Twitter many personal experiences with MHC — from describing negative interactions with MHC to saying how Yale’s failure to dedicate more resources towards mental health is indicative of “how little prestigious institutions value the well-being of their students.

In addition to individual students’ concerns, several student groups on campus are also engaging in advocacy for better mental health resources on campus, as well as providing those services themselves. 

Three members of Students Unite Now — a group fighting for full financial aid and mental health care for students— spoke to the News about their work advocating for better mental health resources at Yale. 

SUN’s primary demand is reducing the wait time for counseling appointments to a maximum of two weeks. In their August 2020 report, they emphasized the need for Yale to strengthen its mental health resources.

“Hundreds of students spend their ‘bright college years’ in pain and feeling alone, while Yale has the resources and the ability to care for them,” SUN organizer Danielle Collins ’21 wrote to the News in an email. “We need a mental health system that is equipped to help the most vulnerable rather than abandon the liability. I am calling for more therapists in general, but especially therapists of color and LGBTQ affirming therapists because mental health issues are exacerbated by oppressive structures and marginalized groups also receive worse quality of care.”

Another organization, Walden Peer Counseling, provides an anonymous and confidential peer counseling service for undergraduates. The counselors are fellow Yale undergrads who are trained by the Mental Health and Counseling and other specialists on mental health issues at Yale, and they provide “non directive and non-judgmental counseling.”

One of the co-directors of Walden Peer Counseling, who asked not to be named since Walden is an organization that runs on the premise of anonymity for both counselors and counselees, expressed their belief that Walden Peer Counseling can serve as a “short-term alternative to MHC” for students who seek immediate counseling, but that Walden Peer Counseling is not a substitute for professional mental health care.

Yale Mental Health and Counseling is located within Yale Health at 55 Lock St.

Julia Bialek | julia.bialek@yale.edu

Correction, Mar. 25: An earlier version of this story referred to Adams with she/her pronouns. In fact, Adams uses they/them pronouns. The News sincerely regrets the error. The story has been updated.