We read Eric Schmidt’s recent opinion article regarding the mental health services at University Health Services with great interest. The staff at UHS is interested in providing effective, evidenced-based treatment in a timely fashion and welcome feedback that will assist in providing the highest quality of care possible. Genuine and constructive feedback is the foundation for improvement in any endeavor, but we are concerned that Mr. Schmidt’s article contains information that is inaccurate and does not accurately reflect the services provided at UHS. We would like to correct any misinformation which may prevent students from seeking treatment.
The Counseling and Consultation Service is a division of the UHS which is nationally accredited. C&CS provides over 17,000 outpatient visits per year to approximately 10 percent of the UW student population. On average, over 100 students per week are seen for an initial evaluation to assess their concerns and determine what resources best meet their needs. This may include treatment at C&CS or assistance in finding treatment options in the community.
Suicide prevention and crisis intervention are major priorities for University Health Services. Twenty-four-hour crisis intervention services are available to UW-Madison students or others concerned about a student seven days a week, including holidays and semester breaks, by calling UHS’ main number (265-5600) and selecting option 9 on the phone menu. Contrary to the article’s assertions, a great many students with very serious mental health concerns and others who are concerned about a student’s mental health do, in fact, regularly avail themselves of our after-hours telephone-based crisis services. In 2008, UHS responded to over 300 crisis calls after-hours.
Caller concerns included suicidal urges, suicide attempts, self-injury, severe anxiety, depression, mood disorders, domestic violence, sexual assault, psychotic symptoms, substance abuse, eating disorders and stalking in addition to situational crises related to academic performance, relationships, transition and other difficulties. For many student callers, these after-hours crisis services have literally been a lifeline. During business hours, same day face-to-face crisis appointments are available every week day and are regularly used by students with serious mental health concerns. In 2008, more than 500 UW-Madison students were seen in crisis appointments.
While college students do have an increasing and disconcerting burden of psychological problems, 40 percent do not suffer from “crippling depression” as suggested in the article. A recent article in the “Archives of General Psychiatry” documented a 10 percent prevalence of major depression in college students over a 12-month period. To meet the psychiatric needs of students at UW-Madison, UHS has both four psychiatrists and three advanced practice nurse prescribers along with 20+ professional counseling staff. While the editorial notes that this ratio is inadequate, UW-Madison in fact has the highest ratio of psychiatric prescribers to students among the Big 10 and is within the range recommended for adequate provision of mental health services. Our overall ratio of one mental health professional to 1,290 students also meets the national standards for mental health provider to student ratios as determined by the International Association of Counseling Services that is an accrediting agency for university counseling services.
We also want to refute the two statements that students have to 1) “endure cursory and unaggressive counseling before being referred to a more appropriate doctor” and 2) “must wait months for an appointment with one of the four university psychiatrists.” As part of our internal quality process, UHS closely monitors time to access for all of our services. During the past 12 months, we have consistently been at or below our goal time of an initial psychiatric appointment of 2 weeks. That is in comparison to a community standard to six to 12 weeks. As previously mentioned, a lengthy wait for an appointment is not at all typical and we are in fact puzzled by this assertion. In addition, strong research evidence supports that psychotherapy is an empirically-based treatment option for depression and for many people can be as effective as medication.
The vast majority (approximately 90 percent) of students who seek services at UHS are accepted for care. When circumstances are such that UHS is unable to meet the needs of a student, the professional counseling staff members strive to assist that student in finding appropriate resources in the community. We offer a wide variety of proven treatment options and provide care for a wide variety of mental health concerns ranging from serious psychiatric disorders to personal growth, adjustment, academic performance and wellness support.
All students or parents who have concerns or questions regarding this article or any of our services are invited to seek information directly from University Heath Services.
Eric Heiligenstein, MD
Clinical Director, Psychiatry
Dennis Christofferson, PsyD, LCSW, CACD III
Clinical Director, Crisis Services
Sarah Van Orman, MD
Executive Director
