Counseling offices aim to overcome student hesitance

You may have seen posters for the Furman Counseling Center around the Barnard campus, or stumbled upon Counseling & Psychological Services when the elevator doors opened on the eighth floor of Lerner Hall.

But while most students know of the counseling offices at Columbia and Barnard—CPS and Furman, respectively—far fewer choose to utilize the services offered to them.

“There’s still a problem that people who could be served and may be suffering are not coming in,” Mary Commerford, director of Furman, said.

In 2008, Furman saw 24 percent of the Barnard student body of about 2,300, and CPS saw a combined 4,000 students from the 25,000 attending all schools within Columbia, both undergraduate and graduate—about 16 percent of the student body. Because Columbia is home to more graduate students than undergraduates, CPS saw more graduate students overall, including those seen over the summer when most undergraduates are away, but Richard Eichler, director of CPS, noted that undergraduates come “disproportionate to their numbers.”

Commerford also noted that, nationwide, a larger proportion of students at smaller schools tend to utilize counseling services than at larger schools—a trend seen in the disparity between turnout at CPS and Furman.

More than 300 Columbia and Barnard students responded to a survey distributed by Spectator, and while many reported experiencing depression, anxiety, or other mental health concerns, a large percentage said they chose not to seek treatment on campus. But those who did reported doing so for many reasons.

“I had gone to counseling at home, and so I wanted to follow up,” said Becky Davies, CC ’10, who went to CPS shortly after transferring to Columbia in fall 2007. “I’d gone for a while to treat depression, and I’d basically gotten over it at that point, but I was still taking medication and wanted to consult with someone about that.”

Davies said she was upset when she had to wait for three weeks after calling CPS to get an appointment. “I wasn’t in serious trouble or anything, but for someone who may be, that seems like an unusually long time to make them wait.”

Though she was asked if she had an emergency, she said, “I feel like that’s also a hard question for someone who really felt they needed to come in but didn’t feel they were really the worst. It’s the kind of thing that’s hard to judge for yourself sometimes.”

For several years, CPS has utilized a “rapid access” system, which puts all students in touch with a counselor for an initial phone session within 24 hours of calling. Students talk about their concerns and are assessed for urgency before being set up for an in-person appointment.

Furman has a somewhat different process. When students call, “we ask them when they need to be seen,” Commerford said. “If they indicate it’s urgent, we will see them that day. We get people in pretty promptly. Occasionally if a student says, ‘I want to see so-and-so,’ who is booked solid, then they have to wait.” Next fall, Furman plans to implement a phone triage system similar to CPS’s to more accurately determine how soon a student needs to see a counselor.

Kevin, CC ’08, whose name has been changed because of his concerns about privacy and stigma, said he visited CPS’s Lerner offices during his first two years at Columbia, and visited one of CPS’s residence-hall offices in the fall of his senior year.

Kevin sought counseling in high school, he said, because he had “a real problem making friends.” At Columbia, his relationships improved when he got more involved on campus, but he said he sought out CPS in order to work through persisting feelings of loneliness as well as family issues.

Kevin said that while his experience with CPS was less than ideal, he did not believe that reflected on the quality of the resource.

“It wasn’t helpful because I never really gave it the effort that it needed. I dropped in for 40 minutes [the residence hall visit] before going home for three weeks [winter break] and spending time with my family,” he said. “I don’t know that I necessarily believed that my issues in college were serious enough to warrant a ‘real’ visit.”

Feeling like a problem isn’t serious enough is a common concern among students who consider scheduling an appointment with a counselor—one of the misperceptions that officials at both schools want to challenge.

“There’s no problem too large or too small,” Commerford said.

For students who may not feel comfortable with one-on-one therapy, CPS and Furman also offer a number of other venues for students to address psychological concerns of any severity, including support groups and workshops.

Furman offers a stress management class every Wednesday, and while turnout is generally low, Commerford emphasized the importance of regularity.

“Every Wednesday they [Barnard students] can show up—they don’t have to sign up,” Commerford said. “If you just have something consistently offered, people will come or not, but eventually they’ll know it’s there and they’ll make use of it more.”

Because both offices must deal with the challenges of outreach that stem from stigma and misinformation, they also work with primary care and residential services at both schools, aiming to reach students through more frequented venues.

“A lot of times students come into the medical side of things if they’re reluctant to come into the counseling side,” said Calvin Chin, assistant director of outreach and community clinical services at CPS. “Even if a student doesn’t want to come into counseling services, there are ways we can make sure they get treatment in primary care as well.”

With that in mind, CPS implemented a new program in September in which students who come to primary care medical services are given a brief depression screening. The initial screening consists of two questions, and students whose responses indicate possible mental health concerns are asked eight additional questions.

“There’s no better place, if you think about it, to reach students,” said Eichler, adding that almost triple the number of students visit primary care than CPS. “It’s hard to go a year without getting a cold or needing birth control pills or spraining a wrist.”

Student response to the screening—known as the Patient Health Questionnaire, or PHQ-9—has been largely positive.

“It’s innocuous. It sounds like a whole big thing, but it’s two questions,” Eichler said. “It uses a gateway approach, so we’re not belaboring you—we’re not spending a lot of time in these primary care visits asking needless questions.”

Outreach at Furman operates on three levels: primary prevention, which raises awareness of mental health issues throughout the community; secondary prevention, which targets groups deemed to be at-risk—such as the LGBT community; and third, simply working with students who are already in treatment.

“One level of outreach [primary prevention] is just to broadly teach people about situations in the hopes that raising everybody’s consciousness will help,” Commerford said.

Furman also maintains a number of initiatives to identify at-risk students and encourage them to seek help, including residential and faculty training.

“We work with the people who are called the ‘gatekeepers,’ who are on the front lines, so they know what to look for,” she said.

While counseling services on campus may be doing enough to reach out to students, the problem of underutilized services may lie with the students themselves.

“I never felt like there was a problem with promotion,” Kevin, the Columbia College graduate, said, noting that he was always aware of the services available to him, but found it difficult on his end to consistently follow up. “It was never an issue of trying to enter—a much more substantial issue was staying in after that.”

Maggie Astor can be reached at maggie.astor@columbiaspectator.com