Miller: This is the Winter of Our Discontent

Students and staff fight to help those struggling with mental health issues at Dartmouth, yet critical problems persist.

by Eliana Miller | 2/23/17 12:45am

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by Lucy Li / The Dartmouth

The “WELCOME HOME TWENTIES” sign hanging on Robinson Hall is one of the first things that incoming Dartmouth students see on campus. Cascada’s “Everytime We Touch” and Red Foley’s “Salty Dog Rag” are the first songs that they hear at the beginning of the Dartmouth Outing Club’s First-Year Trips. And Cabot cheese — lots of Cabot cheese — is often the first food that students taste when they arrive in Hanover. But once the busses get back from Moosilauke Ravine Lodge, students begin to hear a different trope, a less upbeat and more serious story of the adversities that lie ahead.

I first noticed this pattern of warnings at an orientation event entitled, “Our Dartmouth: Community Building Through Story-Sharing.” The event was meant to focus on “finding community and places of belonging on Dartmouth’s campus,” according to the First-Year Orientation website, and consisted of a panel of six students who explained how their identities have affected their transitions to Dartmouth. The first-year students heard stories of navigating applications for clubs, managing the 10-week term crunch and international students adjusting to America. It was an informative and honest panel, and the panelists shared an array of stories. But there was one common theme: though Dartmouth can be great, it won’t always be so.

Every student spoke about experiencing tough days on campus, how Dartmouth isn’t always perfect, how difficult daily life can be. But the panelists still loved the College. As I thought about it more, every orientation event relayed this narrative. Upperclassmen would say, Dartmouth pushes students to the limit; they’d tell us that the academic year is not upbeat and dandy like trips or wonder — as seniors — if they really belong here. Even at the Twilight Ceremony, a celebration of the beginning of the incoming class’ time at Dartmouth, the new freshman heard ominous stories about the stressful four years ahead.

So why does this matter? And why might it be good that students hear this eerie warning even before they matriculated?

Because it means that there is talk on campus, starting from day one, about mental health issues. While these conversations should more explicitly reference mental health issues on the whole, students at Dartmouth are open and willing to discuss their days, both good and bad. We may wear crazy flair and dance to loud pop music during the first week of the term, but the student body appears to understand that adversity comes with life and that there is no need to stigmatize these issues in the way that they have been for so many years on college campuses across the U.S.

As assistant health improvement director, Mary Nyhan of the Student Wellness Center faces these issues every day. “There is definitely something to be said for normalizing the challenge and normalizing the struggle,” she told me.

Nyhan added that we need to make it “clear that [struggling is] just something that everybody experiences and sort of turn those moments of adversity into learning opportunities instead of things that really derail us.”

In recent years, Dartmouth has done much to combat the stigmatization of mental health issues beyond Orientation programming. The 2015 Homecoming edition of The Dartmouth provided “a look into the lives, thoughts and feelings of Dartmouth students affected by mental illness.” The edition was titled, “Beneath the Surface” and featured the image of a duck frantically treading water on the front cover, a nod toward the infamous “duck syndrome” of high-achievers. It contained a wide range of testimonies and articles on mental health resources on campus.

More recently, undergraduate advisors have begun to teach first-year students the importance of emotional awareness and well-being through a four-week class. Students are prompted to track their highs and lows via the Dartboard phone app and later discuss what triggers a bad day as well as how to be more cognizant of one’s emotional state throughout the day.

Even professors are increasingly concerned with student well-being. Psychology professor William Hudenko recently partnered with the Digital Arts, Innovation and Leadership Lab to create the app Proxi. The app, which is still in beta testing, connects individuals with a support network of family, friends and a professional clinician while monitoring the user’s risk of suicide.

Orientation warnings and testimonials remind us that despite these initiatives, students believe that there is still much to be done. Dartmouth students continue to face issues of pressure and stress that harm their mental health and can be the catalyst for underlying medical conditions. And in spite of all the best efforts of students and professionals, many students remain reluctant to seek out help, instead preferring to hide their troubles and slap on a smile.

Even those that do reach out for assistance can encounter difficulties in getting help in a timely manner, especially during the all-too-frequent crunch times of the quarter system. That system — and the turnover in student leadership it creates — also makes it hard for student groups to serve as a consistent place of comfort for those in stress.

Gustavo Silva ’20 and Makisa Bronson ’20 are the two Dartmouth liaisons for the Second Annual Ivy League Mental Health Conference being held at Brown University at the end of this month.

Silva said that when students with “unhealthy behaviors, [who] are not mentally well” are considered, “it’s a very big proportion [of the student body].”

“It’s a small proportion of students that say ‘Yeah, I sleep well. Yeah, I am not over-stressed. Yeah, I do not feel anxious about midterms, papers or whatever,’” he added.

Bronson echoed this sentiment, saying that especially at Dartmouth and its peer institutions, “there’s just this sense of having to put on a happy face and having to present yourself in a way that seems like you know what you’re doing all the time, you have your act together, you are getting enough sleep and you’re healthy, even if none of those things are true.”

The conference aims to discuss mental health policies on college campuses and teach delegates how to “actually promote change and talk to the administration [about policy issues],” Silva said.

Both liaisons said they hope that in time their work will help bring about change on Dartmouth’s campus.

For some, like Amara Ihionu ’17, this change is long overdue. Ihionu wrote an article in the 2015 Homecoming edition of The Dartmouth explaining her concerns with mental health resources on campus. “I am lucky to have had decent experiences with Counseling and Human Development at Dick’s House — but, unfortunately, I know many who have not,” Ihionu wrote. “Mental health is not just a personal issue — it is a campus issue, and Dartmouth needs to do a better job of addressing it.”

Our affinity for flair does not hide our emotional dilemmas.

When I spoke with her this year, Ihionu said many students continue to feel alone on campus and that counseling services have not improved over the past two years. In 2015, she particularly took offense with the policy that restricted free counseling at Dick’s House to 10 appointments per academic year.

Though the policy has evolved and is now more lenient, some concerns remain.

Now, each case is treated individually, and clinicians and their patients determine the number of counseling appointments needed. However, long-term treatment is not offered. According to its website, the “CHD utilizes a short-term therapy model” and will refer students to a therapist in the area “if longer term counseling is needed.”

This model severely disadvantages students with ongoing mental health concerns, such as Ihionu, who said that finding a therapist nearby, especially one that takes a specific insurance plan, can feel like a nightmare.

In an email, CHD director Heather Earle told me that the CHD sees 20 to 25 percent of all Dartmouth students annually. However, a survey conducted by The Dartmouth in 2015 found that 44 percent of students reported feeling “hopeless, despondent, uninterested in activities [that they] typically enjoy or [feeling] lethargic” on at least some days in the past month.

While we cannot assume that everyone who has had a few difficult days in the past month believes they need counseling, there is almost definitely a demand for counseling that is not being met. CHD has nine counselors and a full- and part-time psychiatrist on staff attempting to treat the over 6,000 undergraduate and graduate students. This discrepancy manifests in long wait times and difficulties scheduling appointments.

Earle informed me that according to a recent survey, the average wait time for a routine counseling first appointment at Dick’s House was 3.88 business days in the 2015-2016 academic year.

While this is not an exorbitant amount of time, it is too long for some already pressing mental health conditions and can cause issues to worsen to more extreme conditions. According to the National Alliance on Mental Illness’ website, the “earlier [one accesses mental health services and support], the better.”

Luckily, there is 24-hour crisis counseling for students. This hotline is for students who have suicidal, life-threatening or self-harming thoughts or have been physically or sexually assaulted. Though extremely important and necessary, this resource does not account for students with less extreme though still pressing issues.

The truth of the matter is that the average wait time of 3.88 business days at Dick’s House is just that: an average. I have checked weekly to see what wait times are. The first week of the term, it is easy to get an appointment on the day someone calls or the next. Meanwhile, during week four — a week in which many students are swamped with midterms — wait times can be up to 10 days. It only increases as the weeks go by.

CHD is aware of the wait time issue.

“With increasing academic demands, the second half of the term is busier than the first few weeks,” Earle wrote. “We are working to open more intake [and] consultation appointments for the end of each term.”

Additionally, Earle noted that 81 percent of students surveyed agreed with the statement “upon contacting CHD, I was offered an initial appointment within a reasonable amount of time.” However, the survey was sent out to around 200 students and had a 32 percent return rate, meaning that the statistics come from only 64 students.

Yet upon graduating, 48 percent of the Class of 2016 reported feeling “very satisfied or generally satisfied” with psychological counseling services according to the 2016 Dartmouth College Senior Survey. This survey had a 44 percent response rate, with 464 total responses. Looking at sample size, this research is more reflective of the student body than that of the CHD survey. In 2010, 74 percent of graduating seniors were satisfiied with CHD services.

While CHD research is not necessarily inaccurate, it may not reflect the views of the entire student body and can be misleading. The Senior Survey shows that there has been an increase in satisfaction with psychological counseling services, but only slightly as the satisfaction rating has risen by only one percentage point since 2014.

The issue of higher counseling demands during the second half of a term should come as no surprise to Dartmouth students. The College is a stressful place, and the D-Plan, as I was warned during week one, can compound students’ stress by packing lots of work into a fast-paced 10-week period. Aside from compounding stress, the structure of the D-Plan can affect access to mental health resources.

Active Minds, a student group focused on mental health awareness, suffered from the constant turnover in leadership that the D-Plan generates. As students move on- and off-campus, it can be difficult to have consistent membership, causing peaks and valleys in any group’s momentum and focus.

While Active Minds took a break in the fall and has yet to hold a meeting this term, the new co-presidents, Molly Carpenter ’19 and Charlene Browne ’19, are “excited to revitalize the club and get a larger presence on campus in the future,” according to Browne.

Active Minds hopes to “shift [its] goal more toward resources and awareness rather than being a place where personal experiences are shared,” Carpenter told me.

“While we hope to be a safe space for those experiences to be shared, we would really like to gear [the club] more towards raising awareness for problems that we have on campus and becoming a network for social support for students,” she added.

So what’s to be done? The D-Plan is an integral part of Dartmouth, and while it causes issues with mental health resources on campus, it is not going anywhere. A more stressful second half of the term is common. CHD strives to increase the number of appointments available during this time, but the College could certainly assist them by providing additional funding for the hiring of more clinicians and therapists. Decreasing wait times year round would greatly improve our resources and help students in need of counseling.

The issue of student turnover in groups due to the D-Plan is more difficult to address. However, clubs could benefit from greater collaboration. Some clubs, such as Dartmouth on Purpose — a group focused on mindfulness, wellness and self-care — interact with other organizations on campus and support one another by co-sponsoring events. But others, such as Active Minds, exist in isolation. Other groups such as the recently created Student Assembly Wellness Committee also seek to promote general student health and well-being.

Josue Guerrero ’18, a Student Assembly representative from East Wheelock House and co-chair of the Wellness Committee, told me about the Mental Health Awareness Week that the Committee is planning beginning on Feb. 27. This week will hopefully bring together student organizations and raise awareness for mental health issues on campus.

“They’re actually people here willing to help you if you just reach out,” Guerrero said. “I just don’t think students are willing to look for that or they might not know that it’s there.”

Increased solidarity between clubs would help magnify their presence on campus and allow students to realize how many resources are available at Dartmouth. Perhaps these resources should be better advertised at Orientation programming and later at clubs fairs.

What can we, the average Dartmouth students do? First, we can join clubs and student groups that promote self-care and wellness. We can support our peers with a hug and ourselves by making counseling appointments at CHD. We can advocate for increased funding for mental health resources throughout the term by writing letters to the deans and to College President Phil Hanlon. We can participate in workshops sponsored by CHD and the Wellness Center, as well as events run by student groups such as the coming Mental Health Awareness Week.

We must be aware that simply discussing these issues can be a double-edged sword. Orientation prepares students for the more difficult moments of their Dartmouth career, but that does not absolve the College from its duty to keep students healthy. Simply being aware of stress does not make it go away, and it is easy to become complacent once an issue is out in the open.

To be satisfied with the “things will be hard” narrative is to give up on improvement. The conversation around mental health does not end after Orientation week and should be more than a conversation. Mental health resources must continue to improve, for the wellbeing of the current students and the students to come.