This is the second installment of a three-part series investigating student mental health at the University of Michigan. The Daily interviewed students on campus, students across the country and prominent leaders of mental health to contribute to this series. In part one, The Daily examined student complaints about Counseling and Psychological Services (CAPS). This part looks at student-led alternatives to CAPS on campus. Part three will discuss how mental health systems work at other universities, such as Michigan State University.
The University of Michigan offers resources to complement services offered by the University’s Counseling and Psychological Services — such as peer-to-peer counseling, Wolverine Wellness and Wolverine Support Network (WSN) — but many students told The Daily they were unaware of these resources.
In response, students rely on a number of efforts to fill in the gaps of CAPS. While these resources are distinct from the professional counseling services, many of them have affiliations with CAPS.
Some students have stepped up to promote positive mental health when they can’t find what they need in University services. Wolverine Support Network, founded by students in 2014 in the wake of two suicides on campus, provides a peer-led alternative to traditional counseling.
More than 30 groups of six to 10 students meet weekly for open-ended discussions on their well-being, facilitated by trained student leaders. As many students struggle to connect with counselors who are decades older than they are, Hannah Connors, executive director of WSN and Public Policy senior, said she sees a clear benefit to the peer-led model.
“People enjoy talking to their peers about their problems because it’s easier to relate to each other,” Connors said. “There’s research that young people turn to their peers first when they’re struggling before going to a professional or a trusted adult just because there’s a lower barrier of entry and it feels comfortable and non-intimidating.”
WSN makes a deliberate effort to be accessible, with group sign-ups open all semester at no cost, Connors said.
“Maybe you tried to get counseling at CAPS and you’re facing an undesirable wait time, WSN can be another piece of your coping,” Connors said. “It provides people at least some outlet to talk about things if they aren’t able to get into counseling right away.”
Other student groups dedicated to mental health promotion include CAPS In Action, Wolverine Wellness PULSE and CAPS Student Advisory Board. These groups actively give feedback to professional University resources.
CAPS Director Todd Sevig met with the CAPS Student Advisory Board in December to gauge student preferences on the time of initial appointments and time in between appointments. The meeting also sought student input on non-traditional clinical options such as placing counselors in “non-clinical” settings and virtual appointments. Sevig says CAPS has received all of the Board’s responses and are going through them all.
Members of Central Student Government are also looking at ways to make mental health care more accessible. In 2017, CSG recommended improvements to University efforts to be implemented within one year, within one to three years and beyond three years.
Many of the goals have been met, including an increased number of CAPS counselors, establishing a first-year wellness course and revamping the CAPS office in the Michigan Union. However, no progress has been made on the long-term recommendation for a complete CAPS office on North Campus.
LSA senior Sulayman Qazi ran for CSG representative to improve the University’s mental health efforts. He said he felt like the resources available on campus were inadequate for transfer students like himself and that they did not take into consideration uninsured students who can’t afford long-term care.
“I ran to direct these resources in the right direction,” Qazi said. “Even if I can’t make big changes, I want to at least have a discussion where people recognize the problems that need to be fixed.”
Since joining CSG, Qazi said he has met challenges, including a possible tradeoff between more funding for mental health services and raising the student health services fee.
“It’s a balancing act,” Qazi said. “You want to have enough money so these services can run perfectly, but at the same time, we don’t want to alienate anybody who might feel they’re putting a lot of money into a system that they’re not using. I’d hope students would look at it from the perspective of the greater community that uses these services.”
Wolverine Wellness, the public health branch of University Health Services, is known for initiatives including free condoms in the residence halls, rapid HIV testing and the Stay in the Blue app. It also offers free Wellness Coaching, one-on-one conversations with a trained graduate student to guide students through common challenges of well-being in college.
According to Director Mary Jo Desprez, Wellness Coaching represents a shift in strategy from specialized appointments in content-specific areas such as alcohol, sexual health and body image issues to a more holistic approach in student well-being.
“Students come to us as a beautiful combination of lots of those issues,” Desprez said. “They will come see me and say, ‘I don’t know if I used a condom last night because I was so drunk,’ or ‘I’m saving all my calories for the bar.’”
Previously feeling isolated as an out-of-state student and a freshman living on North Campus, LSA sophomore Delaney Walsh went to Wolverine Wellness last year and had a positive experience with Wellness Coaching.
“I think it feels like specific care, maybe because there are less people,” Walsh said. “I’ve never been to CAPS but it seems like it’s more quantity over quality there. Wolverine Wellness is nice because it’s smaller and their questions are easily answerable.”
According to a Wolverine Wellness report obtained by The Daily, 464 students utilized Wellness Coaching over the past two academic years, but the resource is still not as widely utilized as CAPS, which took in more than 4,500 new clients in just one year. Out of 11 University students interviewed for this story, only one mentioned Wolverine Wellness when asked about mental health resources on campus.
However, Lindsay Mortenson, UHS medical director, said UHS services are still a significant part of the available mental health resources on campus.
"We see thousands of students annually for mental health visits in our Primary Care, Psychiatry, and Eating & Body Image Concerns clinic," Mortenson wrote. "Our Care Managers also do brief mental helath interventions in those clinics."
While Desprez emphasized that Wolverine Wellness does not offer clinical psychological services like CAPS or UHS, she said the program is looking at a number of avenues to reach students more effectively.
“I would say our partnership with Housing is a big one,” Desprez said. “We try to reach out to RAs a lot, and also partnerships with all of our other colleagues. CAPS can refer students and rec sports can refer students. One of the things I’m hopeful for is the syllabus statement. Wolverine Wellness and all the well-being resources on campus will be in it, so if you sign up for four classes and see that syllabus statement four times you’ll hopefully be saying, ‘All right already, I get it that Wolverine Wellness is a thing.’”
In the CAPS 2018-2019 annual report, 36 percent of students said they heard about CAPS from a friend. That is a 12-percent increase from the second-largest category, which is the CAPS website. Sevig told The Daily that students encouraging each other to focus on mental health will increase the usage of all the resources available.
“The number one is a friend,” Sevig said. “It’s not (an) email from me. It’s not communications from communications. It’s not our website. It’s not a faculty. It’s a friend. It’s a great recurrence on our campus and it’s different from other campuses. That means two things. One, that there is an increased comfortability among students to actually talk and address mental health. Two, it also means that there’s a huge increase in student energy and advocacy.”
Even though Music, Theatre & Dance sophomore Helen LaGrand has never used CAPS, she said she has referred her friends to the service. She recognizes that not all students come to the University knowing the benefits of mental health counseling and that peers are often the link between struggling students and available resources.
“I have a pretty good support system outside of school. I’m really close to my family and my parents are really supportive of my mental health,” LaGrand said. “But I have friends who don’t have that support system and it’s really hard for them going to college and not really knowing where to turn to.”
In light of the number of students turning to CAPS on the basis of peer referrals, Sevig told The Daily he would like to see more peer collaborations within CAPS.
“Another thing is that I would love to see a huge increase and inclusion in peer support and peer counseling,” Sevig said. “I would like to see the possibility of some peer individual counseling, peer programming, workshops, peer education around mental health.”
Group therapy is one example of the peer collaborations within CAPS — there are other groups such as #Anxietytoolbox, #Blackgirlmagic and Graduate Women’s Group. CAPS currently runs these programs every semester, developing new ones each year. Sevig said he encourages these group sessions because it encompasses the vision he sees for peer support within CAPS.
“The idea for group therapy, support groups and workshops is that you get support from other people, not just the professionals,” Sevig said. “It actually normalizes it.”
CAPS created a faculty toolkit explaining how to respond to different situations of students struggling with mental health issues. This toolkit provides negative and positive example scenarios when introducing CAPS in the syllabus, confidentiality and creating an inclusive classroom community, among other topics. Students told The Daily they had experienced both types of situations.
LSA sophomore Noelle Seward said she had negative experiences with her professors, emphasizing their lack of empathy when she reached out to them for support.
“So many professors go into the beginning of the semester preaching that they’re so understanding about mental health and they think that all these things they have in their syllabus are enough,” Seward said. “I feel like my professors were preaching how they’re understanding and that they get it. But when you actually could use some help, they’re like, ‘That sucks for you.’ It’s very crushing. I feel like there are resources, but they’re not accessible to students.”
LSA freshman Ishita Shukla did not have trouble with her rigorous classes in high school, but she struggled to adjust when she started her courses on campus. As a result, she said her exam grades faltered and she started to experience exam anxiety. Once she recognized her situation, Shukla said she reached out for help.
“I was taking Bio 171 this year and I felt like exam anxiety was getting in the way,” Shukla said. “The course coordinator met with me and she sent me her own list of exam anxiety strategies. I followed it and I did a lot better on my final exam than I did on my other exams.”
LaGrand said she saw a lack of community in the large classes she took in LSA. She said she believes that strong social ties in academic settings are important to students’ mental health.
“A lot of mental health stuff for me comes from being connected to people. If I don’t feel mentally good, it’s because I don’t feel connected to people,” LaGrand said. “I feel like ways to facilitate more connections in class (is having) professors or GSIs encouraging more conversation between people in classes. This is such a huge school and you’re on the run all the time so you don’t necessarily see the same people all the time.”
During the Union’s 20-month renovation, CAPS relocated to the Tappan Auxiliary Building. Now that the Union has reopened, Sevig said he anticipates CAPS’ return to its original location will make their office more accessible.
“The Michigan Union, symbolically and concretely, is the center of student life,” Sevig said. “We’d also like being in a building where you can come in for many different reasons because while there is drastically less stigma, some students still do have stigma. We’re also not (on the) first floor where there is so much activity. We’re on the fourth floor next to SAPAC and that’s one of the biggest new things that we’ve never had.”
A new wellness zone is now open next to the CAPS office in the Union. The wellness zone offers massage chairs, yoga and meditation tools, seasonal affective disorder light therapy and many more resources focused on improving wellness among the student body. Sevig said that he was hesitant about creating a larger wellness zone in space that could have been used for additional CAPS offices, but the positive response to the existing wellness zone on North Campus convinced him to expand it.
“That’s why we built the wellness zone. We could have used the space for two or maybe three more small offices for individual work,” Sevig said. “Based on student input and feedback, we tried the wellness zone. I was a little nervous because if students don’t come to it or they don’t use it, that’s when quantity started to increase but students said this a good idea.”
Sevig told The Daily that CAPS has made advertising efforts for its own services through orientation, emails, website and paper material given to RAs. A list of additional CAPS-related resources is online for reference when counseling appointments are not immediately available.
“What’s cool is that a lot of students who have had some mental health challenges in high school, they find us right away and they seek it out,” Sevig said. “(But) the reality is until you need it at a certain time, it might go in one ear and out the other.”
Sevig told The Daily that CAPS was involved with orientation through the Educational Theatre Company and gave a presentation at the Parent Orientation. However, the ETC does not perform at transfer student orientation.
Qazi transferred to Michigan from a community college in Illinois. When Qazi attended transfer student orientation, he did not hear anything about CAPS and did not know where to go when he was seeking help.
“As a transfer student, in the orientation, I didn’t know about CAPS and all those things because orientation was four hours long,” Qazi said. “So when I was having all these issues, I did not go to CAPS at all. I actually went directly to UHS services and through UHS they would end up referring me to someone else. But initially, before I transferred to Michigan, I would always just go to my Illinois doctors. But at Michigan, it was really confusing and I didn’t know where to go.”
This article has been updated to include a quote from UHS Medical Director Lindsey Mortenson.