Suffering from a recent anxiety attack and plagued by suicidal thoughts, a Dartmouth student sought help at Dick's House about two weeks ago, hoping to speak with a counselor and receive anti-depressant medication.
Upon checking in at the front desk at Dick's House, the student was directed to a waiting room. She waited for two hours to meet with the on-call doctor, who she was told was on a lunch break and had an appointment scheduled afterwards, the student said in an interview with The Dartmouth. The student wished to remain anonymous due to the sensitivity of the issue.
The average Dartmouth student waits five days to meet with a Dick's House counselor barring emergency situations, according to Heather Earle, associate director of counseling and human development at Dick's House.
If a student comes to Dick's House in need of urgent counseling, the student is directed to the front desk where the receptionist will determine if the student is capable of filling out a pre-evaluation form, Earle explained. This form is intended to make the patient think introspectively about his or her mental state.
In the case of an emergency after hours or on weekends, in-patient admissions nurses are trained to help students until the on-call counselor arrives.
"If a student is having fleeting suicidal thoughts but says she can wait and that she will be okay, then we will have her wait," Earle said. "We try to see students as soon as possible and we do an assessment with them quickly. We sometimes get backed up with on-calls and then it's sort of the emergency room protocol, not who walks in first but the level of the emergency."
Earle acknowledged that some students feel great emotional stress when seeking counseling.
"I want to make us the most helpful to students, especially to those who walk in because it's hard to do that," Earle added. "We are always improving to get to them as soon as possible."
With a staff of five psychologists, two psychiatrists, two social workers and an additional psychologist who works part-time, Dick's House sees 1,000 students for counseling each year, in a total of 6,000 visits, according to Earle.
The number of students seeking counseling at Dick's House increases as the term progresses, but the number of patients seen each term is consistent, Earle said.
"It's about the same between terms," Earle explained. "Fall's an adjustment time, winter's hard, and spring is when students are graduating, and they don't know what they want to do [after Dartmouth]."
The number of Dartmouth students seeking counseling from Dick's House has grown over the years, a trend also reflected in the general population. Reasons for the increase include a decreased stigma of going to therapy and advancements in psychotropic medications that can help people afflicted with mental health issues live regular lives, Earle said.
There is a greater number of people struggling with mental health issues today, according to Janet Sims, a psychologist in Norwich, Vt. People are also in poorer health than they have been in the past, she added.
Two of Sims' four Dartmouth student patients were referred to her by Dick's House.
While roughly 20 percent of Dartmouth students seek counseling from Dick's House each year versus 14 percent at Cornell University, as reported by the Cornell Daily Sun, the statistics do not necessarily mean that Dartmouth students are more prone to mental illness, local counselor Caroline Lee said. She explained that it takes courage and maturity to seek the resources offered.
While Dick's House does provide a strong service to the school, their ability to help students would improve with more counselors and funding, Allison Baker '09, a member of the Dartmouth chapter of Active Minds, said.
The anonymous student described earlier agreed.
"The structure of the organization is the issue more than the people," she said. "They really want to help people. There is a lack of resources and just not enough people."
Students are allotted eight to 12 free counseling visits at Dick's House per year, according to Earle. Students who seek long-term counseling are often paired with local therapists such as Sims and Lee. Each full-time Dick's House counselor can meet with six to seven regular clients if the students are on the Dartmouth Student Group Health Plan.
"We want to make sure all students have access to Dick's House," Earle said. "If we were to see every student long-term, there would be a very long waiting line."
Some students contend that Dick's House is troubled by greater shortcomings than a lack of resources. When Matt McDonald '09 sought therapy from Dick's House, he rotated through three counselors and felt that they were too focused on his feelings as opposed to diagnosing a medical condition.
"They didn't tell you anything you couldn't learn on your own," McDonald said. "I am paying you, and you are supposed to have all these degrees. I want to hear actual medical terms."
Students sometimes place blame on Dick's House to provide an excuse for why they are still facing mental health issues after counseling, Baker said.
"Criticizing Dick's House is an easy way to seek some valid reasons as to why they're struggling," said Baker, who has experienced mental illness in her immediate family. "A lot of people at Dick's House are extremely talented, but it's really an intensive process."
To recover from their mental health disorders, students need to be engaged and not assume that counseling and medication will act as a cure-all, Baker added.
"Your mental health issues are you," she explained. "Medication only works when you're an active participant in your own recovery. A lot of people aren't willing to take that active role."
As the College cannot monitor the mental health of the entire student body, it relies on students to seek help on their own and to voice concern over other students, according to Kari Jo Grant, coordinator of health education programs, responsible for overseeing student groups such as Sexperts and Active Minds
"We're not a Big Brother institution. We want students to identify themselves or to share their concerns," she said.
Dick's House depends on the greater Dartmouth community to ensure students' mental health, Earle said.
"One of the things I really value about Dartmouth is the working relations between coaches, [Office of Residential Life], [Office of Pluralism and Leadership], the Dean's Office, other students, parents and our office," Earle said. "It's not uncommon for a professor to tell us they're worried about students."
When counselors are notified about a concern for a student, they are not permitted to contact the student unless the student poses a threat to himself or others. In this case, Safety and Security will bring the student to Dick's House for immediate counseling, Earle explained.
For students who do not require immediate assistance, Earle recommends that concerned peers speak with their deans or community directors.
"There's a lot of different resources when it's below the safety-check level," she said.
Dick's House is working to broaden its outreach programs to provide students who have not come in for counseling with mental health information, Earle said. Much of the work is focused on forming closer relationships with other organizations such as ORL, faith-based groups and sports teams.
-- Staff reporter Amita Kulkarni contributed to this article.
