Content warning: This article mentions suicide.

A 2018 report from the American College Health Association found that over 40% of U.S. college students had “felt so depressed they had difficulty functioning.” A Reuters Health report found that suicidal thinking, self-harm and extreme depression more than doubled between 2007 and 2018.

As students struggle to meet the next deadline while applying for summer internships and working part-time jobs, a proverbial straw often breaks the camel’s back before we finally decide to seek help for our mental health. Because many of us have never been taught that taking care of our mental health is a priority, we invariably arrive at lines that should never be crossed: a realization, a breakdown, days spent immobile in bed, terrible thoughts.

For rising LSA junior Abigail Li, which is a pseudonym to preserve her anonymity, that line came in the form of a panic attack she experienced as a freshman while walking down a street in the fall of 2019. “I couldn’t breathe,” she recalls. “I felt my heart just racing through my chest… So I was like, ‘Maybe I should go talk to someone about being so anxious all the time and being randomly just sad and having no motivation to do things.’”

We often feel we have to trudge on, until we can’t anymore. And, while it is always important to be proactive about one’s mental health, it then becomes absolutely necessary to ask for help. 

But when Li initially approached the University of Michigan’s Counseling and Psychological Services shortly after her panic attack, she was placed on a waitlist and didn’t get to speak with a CAPS counselor until two months after she had initially sought help. “(CAPS) didn’t provide me help when I needed it,” Li says. “And I was left alone to face that situation on my own.”

CAPS counseling is not a long-term solution to mental health issues, nor is it intended to be. While there is no set amount of times a student can see a CAPS counselor, clients attend 3.5 sessions on average and they can only attend more than five sessions under certain, mitigating circumstances. As a result, CAPS’s purpose during sessions is to provide students with mental health resources they can use in the future, like breathing exercises and therapist databases.

“It was CAPS that told me that they wouldn’t be able to help, which is, I guess, very, very counterintuitive, compared to how they advertise for CAPS,” Li says. “People say, ‘Oh, if you need help, go to CAPS,’ and CAPS, in turn, told me, ‘Oh, we can’t help you.’”

During the last winter semester, Li underwent hospitalization for a mental health-related concern and because the hospital was required to provide patient aftercare, Li was obliged to schedule an appointment with CAPS. She alleges that during the subsequent appointment, she was told explicitly that CAPS could not help her because it does not offer long-term care, but it could instead offer her a list of mental health resources, which she requested. CAPS never followed up with the list.

Li doesn’t share her experience in order to discourage students from seeking help from CAPS, but rather to emphasize that CAPS is a “first step” — not the solution — in a U-M student’s mental health journey. Many students at the University who seek mental health help share this same, frustratingly familiar story. You go into CAPS and there’s the wait time. Or the disappointing lack of resources. Or even the “ghosting,” which Li experienced.

There are, however, alternative resources to CAPS for mental health help on campus, including several which are also cost-free.

One of these resources is hEARt Listens, which is free and completely anonymous. To use hEARt Listens, students can download the Google Voice application and text the hEARt Line at 734-292-8006. Within 24 hours, the student will be connected to one of the dozens of hEARt supporters with training in skills like “active listening, smart referral, and crisis management.” hEARt supporters are fellow U-M students “who understand the feelings of frustration and helplessness prevalent in the population right now, and … hope to help their fellow peers as best they can.” 

The 10-week training program for hEARt supporters consists of different weekly topics related to mental health such as food insecurity and loneliness. After the training, candidates take a practical and written assessment to become supporters.

Lilli Arbetter, a rising LSA sophomore and the incoming marketing manager of hEARt Listens, believes that peer support is beneficial because students may feel comfortable around people in a similar life stage. Diane Yu, a rising LSA senior and the outreach director of hEARt Listens, adds that in addition to these benefits, there is no “barrier of formality” that one might feel when talking to a mental health professional. Additionally, mental health resources are often cost-prohibitive: There is a direct correlation between higher rates of psychiatric issues and those who can’t afford treatment for them. Another benefit of using hEARt Listens is user anonymity, which encourages students to discuss issues they may normally feel uncomfortable being forthcoming about. 

Yu and Arbetter are aware of the limitations of the organization. They are not licensed mental health professionals, but when they encounter concerns they’re not equipped to deal with, they know the next resource to refer the user to. hEARt Listens also provides a help resource guide on its website, which includes a directory of resources catered to specific health issues. 

While CAPS is often overcrowded and bogged down by wait times, hEARt Listens has 50 to 60 supporters, but only a small few students employ their service every week. Arbetter says, “(hEARt Listens is) here for students. We have so many supporters that are willing and want to help other students and … we want to get the notification that someone wants to talk to us. We’re not just a hotline for when it gets to that point where you really need help.” Yu emphasizes that students can reach out for help before their situations become big problems. “If you just had a bad day, if you bombed a test and really need to talk to someone about it … if you need advice on choosing a major and you’re really stressed about it,” they encourage students to make a quick call, Yu expresses. “A lot of little things can lead to bigger problems,” Yu says. “Reaching out for help before then is a really important step that sometimes people overlook.”

Another University resource is the Wolverine Support Network, an organization aimed at promoting student mental health through peer-led support groups across campus and community-building events, like game nights, trivia nights, meditation and yoga sessions. Nicholas Brdar, who has been a member since his freshman year, is a rising LSA senior and the incoming executive director of WSN. He says these support groups are unstructured and have no agenda.

WSN was founded in 2014 by a group of students in collaboration with CAPS and in the aftermath of two student suicides. The founders’ hope was that peer-led support groups would feel less intimidating than seeking professional help. WSN’s goal today, in Brdar’s words, is “to empower students to both create an inclusive community on campus and also learn how to support each other’s mental well-being, identities and … their day-to-day lives.” 

For the coming fall semester, Brdar is cautiously optimistic that WSN will provide some in-person activities, along with hybrid and virtual options. And in the long-term future, he hopes to diversify the predominantly white population of WSN through ensuring that leaders are prepared to discuss different identities on campus and by outreaching to diverse student communities.

In addition to hEARt Listens and WSN, the University offers other free resources for mental health aid. The Sexual Assault Prevention and Awareness Center holds its own weekly peer-led support groups, including one that is solely dedicated to students of color. The Spectrum Center aims to provide support and assistance with specific focuses on gender and sexuality in order to serve the LGBTQ+ student community. Its services include peer groups, peer mentorship and information on transgender care at University Health Service, among other programs. Wolverine Wellness offers individual and group wellness coaching and recovery support for addiction, eating and body image issues, sleep and other issues. There are also cost-free mental health resources outside of the University. Apps like Headspace, Moodfit and Happify are gradually demystifying meditation and self-care practices, through their low price margins, anonymity and accessibility from the comfort of one’s home. 

Despite increased dialogue surrounding the field of mental health, the stigma of seeking help persists. Consequently, accessible and effective aid is extremely challenging to come by. “Everyone in the mental health field means well,” Brdar says. “But it’s just that sometimes there are limitations that you just can’t get around and not even institution-wise, (but) society-wise, we’re just not at a place where (mental health workers) can support everyone’s mental health to the fullest extent.” Unfortunately, every mental health resource has its limitations — especially the ones which are free of charge. 

Therapy is an important solution for mental health, but it admittedly has drawbacks for many students. Meetings with a registered counselor or psychologist are often expensive, even with insurance coverage. Even then, some students who are on their families’ insurance plans may not want their loved ones to know that they are seeking help for their mental health. However, while therapy can’t always provide the right solutions, those who can and do access it often find it to be very helpful.

The database Psychology Today makes it easy to find licensed therapists who specifically work in the Ann Arbor area, and search results can be filtered based on accepted insurance networks, mental health concerns, sexualities, languages, faiths and ethnicities.

Rising LSA junior Jennifer Kim has been attending individual therapy since the summer of 2020. She acknowledges her privilege to be able to afford health insurance and to attend long-term therapy, which, in her experience, has been beneficial for her mental health. For anyone who has the means, she says, “I would strongly recommend (therapy), even for people who don’t think they need (it), because I think it’s examining yourself from another point of view and then laying out your deepest thoughts, your darkest thoughts. (You’re) essentially breaking (them) down and saying this thought process, this cycle of saying you’re not good enough, or whatever thought it is, actually doesn’t make sense.”

Both Kim and Li feel that their cultural backgrounds as women of East Asian descent had deterred them from seeking help for their mental health. From Kim’s previous experience of living in East Asia, she believes that although there are greater conversations about mental health now, the topic remains taboo, especially among older generations. When Kim was growing up she often felt that those around her believed “you can pray away your sadness… it will just pass and it’s just a temporary thing.” Entering college gave Kim greater independence to make her own decisions, including taking care of her own mental health.

Only 8.6% of Asian Americans seek mental health care, as opposed to the 17.9% of the general population which seeks it. Cultural stigma and shame surrounding mental health issues in Asia then transfer to immigrant and diasporic groups, preventing Asian diasporic people from seeking help for issues related to mental health. Language barriers in immigrant populations, concerns over immigration status and inadequate health insurance coverage are also obstacles in receiving sufficient care. 

Asian Americans are often perceived as a monolithic group that does not struggle with mental health problems; however, this stereotype does not reflect the community’s reality. A wide variety of issues that are often overlooked can damage individual Asian Americans’ mental health. For instance, individuals who resettle in America as a result of war or instability in their homeland carry generational trauma, not just from witnessing such turmoil, but also from subsequent legacies of poor education rates and high rates of poverty and incarceration; many of these families arrived in America as a result of inequitable U.S. government relocation programs which purposefully placed them in areas with high concentrations of poverty, gangs and violence. According to the National Alliance on Mental Illness, suicide is the ninth leading cause of death among white Americans, but it is the fifth leading cause of death for Asian Americans.

All communities of color in predominantly white nations — not just Asian Americans — bear the brunt of systems of racist oppression which pose additional threats to their mental health. They also often have different views of mental health and treatment from their white counterparts. Cultural upbringings bear a heavy influence on how people navigate their mental health, but because these differences in heritage are often overlooked, there are few mental health resources specifically dedicated to marginalized communities. As a result, it becomes even more difficult for people of color to seek help for their mental health. Additionally, health care workers sometimes provide inaccurate diagnoses to people of color based on racial prejudices: Black people, for instance, are overdiagnosed with schizophrenia and underdiagnosed with mood disorders.

Li states that her cultural upbringing made it difficult for her to accept that she needed help. “It is so… looked down upon that people just assume you’re lazy if you’re depressed. They don’t care if you’re going crazy. They don’t care if you’re extremely sad, Li says. “Your mental health is nonexistent, especially in comparison to your physical health and your accomplishments.”

Currently, while living on campus, Li practices regular breathing exercises and methods from cognitive behavior therapy and dialectical behavior therapy. She also takes medication and hormone treats daily as prescribed to her by her psychiatrist. When her alarm goes off reminding her to medicate, she intentionally remembers the reasons she needs her medication, and uses the time as an opportunity to reflect on how she’s feeling and to practice self-care. The key, in her words, is to know yourself: “Ask yourself, ‘Am I doing okay? Am I pushing myself so hard that I might break apart Sunday?’ … It’s just so important to constantly check in with yourself or have someone else check in on you.”

Students play a monumental role in their fellow peers’ mental health. Empathizing with others and letting people know you’re there for them can make a huge difference in somebody’s well-being. 

The University must also provide more efficient, helpful and cost-free resources, and take steps to mitigate the stress that the University itself directly inflicts on students. Any verbal commitments to uplifting the community’s spirit feel hollow in lieu of the University’s administrative actions in just the past year, including the implementation of two feeblewell-being break” days and an attempt to hike tuition during a global pandemic.

In the meantime, the U-M administration should make awareness of alternative mental health resources a high priority — and students shouldn’t feel they have to wait until they can no longer breathe to be proactive with their mental health. It’s vital that students try a variety of care options because there is no one-size-fits-all solution; different treatments work for different people.

Brdar’s message for students struggling with their mental health is that these problems are “normal and valid and okay, and not something to be ashamed of.” He encourages those who are comfortable doing so to reach out to people around them and talk about their concerns. “Sometimes all it takes is taking a leap to join WSN or make an appointment with a psychiatrist or therapist,” Brdar says. “And it can be scary… and it’s so worth it in the end.”

Senior MiC Editor Jessica Kwon can be reached at jesskwon@umich.edu.