By Adam Rubenfire, Daily News Editor
Published April 4, 2012
In light of the recent off-campus deaths of two University students and as finals season fast approaches, mental health professionals from across campus, in interviews with The Michigan Daily, urged students who are struggling to utilize the variety of services offered to students with psychological difficulties.
Where to get help
One of the most visible mental health resources on campus is Counseling and Psychological Services. CAPS provides a wide array of services to students seeking help with psychological and behavioral issues. In addition to CAPS, the University also offers immediate guidance to students at the University Health Service and at the University Hospital through its University of Michigan Health System Psychiatric Emergency Service program.
CAPS aids with preventative and proactive services
CAPS Director Todd Sevig, the campus lead for student mental health, emphasized the role of CAPS in identifying mental health problems in students, faculty and staff.
“We know, the sooner you catch things and the earlier you intervene, you have a better outcome,” Sevig said. “So with mental health care, what we’re talking about is the whole host of wellness services, of online quick things that you can look at … and we know that that prevents things from getting worse.”
Sevig chairs the University’s Mental Health Workgroup — a group of medical professionals, psychiatric and psychological professionals, administrators and an attorney from the Office of the General Counsel who recommend improvements to mental health prevention and treatment services on campus.
CAPS offers scheduled appointments for students who do not require immediate care but would still like to talk with a therapist. Drop-in therapy groups are also available, as well as crisis intervention services.
In addition to scheduled appointments, Sevig said CAPS also offers same-day walk-in care for individuals who require immediate psychological assistance during their business hours.
In addition to CAPS' many proactive education and prevention programs, Sevig said CAPS staff has trained more than 3,000 students, faculty and staff to notice if their peers begin to demonstrate mental health issues through the Question Persuade Refer program. The program educates people on how to respond to situations in which an individual has suicidal thoughts.
Though he encouraged individuals to become trained in QPR, he stressed that those who are not QPR-trained can still follow the general tenets.
“The first thing is to take time to talk with the person and to listen,” Sevig said. “The second thing is to say, ‘Gee, I’m wondering, are you thinking about hurting yourself?’ And then, the third thing is to persuade that person to get help.”
Sevig encouraged friends and professors who are concerned about an individual to personally help them through the process by referring the student to CAPS.
University of Michigan Health System Psychiatric Emergency Service can assist during emergencies
Much like the University Hospital’s emergency room, the University of Michigan Health System Psychiatric Emergency Service serves as an emergency center for individuals experiencing mental health issues that require urgent attention.
Rachel Glick, medical director of the UMHS PES, said the service — which is located near the UMHS medical ER — is staffed with about 70 mental health professionals, including psychiatrists, social workers, nurses and medical assistants and is open 24 hours a day, seven days a week. Glick said patients who initially enter the medical ER are often referred to PES if their symptoms are psychiatric in nature.
Though individuals may be confused as to when they should come to PES as opposed to CAPS or another mental health resource on campus, Glick said those who notice “significant suicidal thinking or behavior” or behavior “that is out of the ordinary, unusual or potentially dangerous” should visit PES for treatment. The service’s 24/7 hours makes it particularly resourceful for individuals who might have walked into CAPS for an urgent appointment during business hours.
Like CAPS, Glick said PES staff members also assess a significant number of individuals who are experiencing a crisis, meaning that they may not have expressed suicidal thoughts, but desire guidance as to what they can do to prevent depression or other disorders from progressing.
When a person enters PES, Glick said they’re immediately triaged by a team of nurses and medical assistants who determine their mental health status. Subsequently, a clinician, usually a social worker, spends time with the patient to assess their history and specific symptoms in order to develop a plan of treatment. Lastly, a psychiatrist briefly discusses drug treatment options with the patient.
PES is one of only a few psychiatric emergency rooms in the state, according to Glick. She said a large number of patients requiring treatment for behavioral issues end up in medical emergency rooms.
“Even if a hospital doesn’t have a dedicated psychiatric emergency service, they’re still getting patients who are having these kinds of emergencies,” Glick said. “They’re just taking care of them in the medical emergency world.”
PES also operates a 24-hour crisis line — featuring psychiatric evaluation and treatment recommendations according to the PES website — which can be reached at (734) 996-4747.
Glick said PES is just one part of a large network of mental health facilities on campus.
“I see us as sort of an integral part of a whole system to support our whole community,” Glick said.
University Health Service also offers an array of mental health services
The University Health Service also offers several psychological and psychiatric services. Robert Winfield, the University’s chief health officer and director of UHS, said if a student, staff or faculty member is certain they are in psychological distress, they should first look to facilities such as CAPS or the PES ER, whose primary mission is to treat students for psychological issues. However, he emphasized that if a person in distress does come to UHS, the clinic’s staff is capable of assisting them.
Winfield said without an appointment, an individual in distress may be seen by a UHS nurse practitioner, who will assess their needs and direct them toward the appropriate services, whether that be a referral to CAPS, UHS’s part-time psychiatrist or the UMHS PES.
Winfield added that if UHS providers can prescribe psychiatric medication if they deem it appropriate, such as when a student has run out of medication or believes that a medication will resolve his or her problem. If a person’s mental health issues are not severe, Winfield said UHS clinicians may even be able to treat the patient in-house.
“Health Service is one resource, but not the first resource for people that are very depressed,” Winfield said.
He added: “It’s an alternative resource, which will typically not have the level of expertise for somebody who is severely depressed, but can help people who have less severe difficulties.”
What might be most noticeable to students who visit UHS is the implementation of two patient questionnaires that were launched in August. Individuals who visit the UHS walk-in clinic are now asked to fill out the PHQ-9 questionnaire, a widely used test that assesses an individual’s level of depression, in addition to an audit that screens for alcohol abuse.
If an individual scores high on either the 27-point depression questionnaire or the alcohol audit, Winfield said UHS staff members work directly with the patient to provide them with the necessary resources to resolve possible problems.
“We are very pleased with the work we’ve been doing on this because we have identified a good number of students who had not come in just to seek help just for psychological or alcohol issues, but we were able to identify these and reach out to them,” Winfield said.
Between Aug. 22, 2011 and Nov. 22, 2011, Winfield said about 6,000 patients took the PHQ-9 questionnaire. He said 0.6 percent of the patients were deemed to be severely depressed, 1.5 percent were suspected to have moderately severe depression, 4 percent scored as moderately depressed and 11 percent scored as mildly depressed. If a patient scores as moderately severe or severe, UHS social workers aid the individual in gaining access to the necessary resources to treat their depression.
Website serves as portal for information on mental health issues
The University also hosts a website that specifically helps students with ongoing health disorders called Campus Mind Works.
Stephanie Salazar, project coordinator for Campus Mind Works, said the site is a portal of information for students on how to manage their disorder while studying at the University.
“Everything on there is really focused on that student with the ongoing health disorder and how to navigate through the University,” Salazar said. “And we also have information about what to do if you’re hospitalized, and what the process is to get back into school and what resources are available to you.”
According to Salazar, the site also works with the College of Engineering and the University’s Psychological Clinic to provide free education and support groups for students on campus.
Salazar said prevention and education are crucial in proactively monitoring the campus community for mental health issues.
“Obviously, prevention is important when we’re talking about mental health because it’s so much easier to tackle a problem before it gets really bad,” Salazar said.
She added that when the site was being developed, many students surveyed were unaware of the options they had in taking a semester leave, dropping classes or reducing their workload. According to the academic section of the website, students with certain mental health disorders can request a waiver from the University’s Services for Students Disabilities, which will state that they are taking a reduced course load but should still be recognized as a full-time student.
Campus Mind Works also has resources for parents who may be concerned about their student’s mental health. Salazar said the information is intended to give parents an overview of how they can effectively support their children.
“(There is) some information about what parents can do to support their student’s mental health because I know a lot of parents have trouble sort of navigating both being supportive but not overbearing especially if their student is away from home,” Salazar said.