Yesterday I was flipping through Michel Foucault’s “Abnormal,” which predictably argues psychiatry is but the construct of a suppressive society bent on power and domination. (Tom Cruise has been saying the same thing for years, and he doesn’t have a book in the Memorial Library stacks.)
I thought of how seriously opinions like Foucault’s are taken among intellectuals (some of them on this campus) who should know better – of how sexy it is to believe your problems are not your problems.
I thought of my friends who have been successfully treated for serious mental illnesses. And I wondered where they would all be now had they listened to Foucault. There is a time and a place to be a reductionist, and fighting for your life is not it.
When pondering what to write to incoming freshmen in this mail-home edition, I toyed with the idea of writing something straightforward and political. I hope you see that side of me regularly in the fall. But instead I want to address the 40 percent of you who will, according to research at the American College Health Association, suffer from crippling depression sometime in the next year (along with the untold numbers of others who will be plagued by other significant mental health concerns).
Perhaps you suffered from mental illness in high school and take medication currently. Or maybe you just see a psychiatrist back home and are planning to commute from campus regularly. Or perhaps you are perfectly healthy reading this, with no idea whether you will join the burgeoning ranks of college students with mental illness. Regardless, you need to know the best-kept secret in town: The University of Wisconsin is unable to provide significantly mentally ill students with the consistent and structured care necessary for recovery.
I counted 31 mental health professionals listed as staff on our University Health Services website. Assuming a campus of 40,000 students, that leaves one mental health professional for every 1,290 students. Only four of these individuals are medical doctors, able to prescribe psychiatric drugs. There are eight primary care physicians who in theory can prescribe psychiatric drugs, but given prevailing ideologies it is doubtful this is common.
This invites the most disarming statistic of all: Despite highly significant rates of mental illness among college students, UHS has only one licensed psychiatrist for every 10,000 students. Especially on a campus with the best psychology graduate program in the country, this is the moral equivalent of the Titanic not having enough lifeboats. People are drowning here too, after all.
Yes, we have a mental health crisis hotline. But as anyone with mental illness will tell you, depression and its cronies don’t always express themselves in clich?, melodramatic ways. The mythology of mental illness sometimes imagines that the only truly ill people are walking around in a hysterical, straightjacket-recommending fit. But severe depression can be a slower wipeout; nervous breakdowns are not always apparent to sufferers; people with OCD live in a quiet and nuanced hell; suicides are frequently calm and anticlimactic.
And good luck telling a bipolar patient having a manic episode that they should be realistic enough to call a mental health hotline. No, mental illness is usually a less cinematic animal, and its treatment cannot be reduced to emergency hospitalization during worst-case scenarios.
The UHS website is honest about their own very limited prospects for quality mental health care: “The staff finds that many personal issues can be addressed effectively in a brief period. If you are looking for more extensive services, you have the option of joining group counseling or receiving a referral to an appropriate community resource.”
Terrific. With the scarce psychiatric manpower on campus, this referral process is not quick and succinct. As an experiment, on June 26 I called the UW Psychiatric Clinic (where serious cases at UHS would likely be referred) to set up an appointment with a psychiatrist. I was told the first available opening for my chosen doctor was September 19th. This suggests a UW student suffering from serious depression and needing medication, if they choose to go through UHS, must a) wait several weeks for a pre-screening appointment, b) wait several more weeks for an appointment with an assigned clinician on UHS staff, c) endure cursory and unaggressive counseling before being referred to a more appropriate doctor, and d) wait many months for an appointment with the doctor they should have been seeing all along. Bouts of depression often begin and end in the time period required to get to that final stage. I say, take out the middleman.
Not all of this can be chalked up to lack of resources. There is ideology here too. Staff at UHS is extremely impressed by modest findings by on-campus researchers. Citing questionable UW research, UHS’ prescription for sinus infection is usually a “neti pot” nasal irrigation system. Likewise, counseling priorities at UW appear heavily influenced by the latest fad in our department of psychology: “mindfulness-based” therapy, a quasi-Buddhist approach to the treatment of mental disturbances which de-emphasizes medication, favoring meditation and relaxation skills. Indeed, “yoga and relaxation classes” are the first campus resources listed on the UHS website for controlling stress. And a cheery link inviting guests to “Check out our MP3 relaxation exercises!” is the first item on the general counseling services homepage. Forget about serotonin reuptake problems – give us The Art of Happiness!
This is not the way to treat serious psychiatric problems. “Brief” therapy might work well for the little obstacles in life. But UW-Madison should do a better job educating incoming students and their parents — especially those who have dealt with serious mental illness — about their realistic options for mental health care at the university. I expect this to be the first news you receive about the sorry state of mental health care at UW. But here’s some simple advice, now that you’re informed: If you suspect you might require regular psychiatric visits as a UW student, make an appointment with an off-campus clinician today.
If you’re on medication, come up with an airtight plan for retaining access to medication while in college. Do not be lulled into a self-help-based approach to serious medical conditions. Have a support system already in place the moment you move into your dorm. I have seen college experiences destroyed due to poor planning in this regard. One day, perhaps, our campus itself will summon the resources necessary to fight mental illness. For now, the ball is in your court.
Eric Schmidt (firstname.lastname@example.org) is a senior majoring in political science.
Note: The original version of this article incorrectly attributed to UC-Berkeley research concluding that 40% of college students suffer from crippling depression each year; this true research finding comes from the American College Health Association’s 2003 Mental Health Survey. Additionally, the original article stated that wait times of several months for initial psychiatric appointments are typical for University Health Services; this wait time is typical for the UW Psychiatric Clinic, where UHS patients might be referred, but wait times for comparable services at UHS are typically 1-3 weeks.