Students seeking mental health support from Columbia’s Counseling and Psychological Services can face weeks-long waits just to meet with a clinician.
One in two Columbia College and School of Engineering and Applied Science students will visit CPS at least once during their four years on campus, and this number is only rising—27 percent more students went to CPS this academic year than in the 2013-2014 academic year, according to data provided by CPS. The office will serve a total of 5,327 students this year, 55 percent of whom are students of color.
Following a series of student suicides on campus this year, the urgency of prevention and mental health awareness remains at an all-time high and is the focus of an ongoing evaluation of Columbia’s mental health resources by the JED Foundation. Improving mental health at Columbia, where students face unique levels of stress, has been a perennial concern on campus.
But over a dozen students interviewed by Spectator said it took them anywhere from two to four weeks to meet with a clinician, and they voiced concerns about the barriers raised by Columbia’s multi-step triage process. While similar processes have been emulated at several peer institutions, not all boast wait times nearly as long as Columbia—some universities promise wait times that average less than a week.
Additionally, CPS is currently only open on weekdays, when classes are scheduled—another obstacle that can contribute to longer wait times and can limit the number of accessible appointment slots for students seeking counseling.
CPS director Richard Eichler was not made available for an interview, but acknowledged the possibility of weeks-long wait times in a statement to Spectator. He added that the current triage system was developed with input from undergraduate councils. According to a University spokesperson, data for averages and distribution breakdowns of wait times could not be reported by CPS because each case is variable and is prioritized based on urgency.
However, the spokesperson added that CPS’s internal surveys report a greater than 97 percent satisfaction rate with quality of care for students who are able to see a clinician, and its staff-to-student ratio exceeds standards put forth by the International Association of Counseling Services. But across Columbia’s campus, student perception of the office is largely negative, and despite recent costly expansions to the office’s staff, students continue to point to the difficulty of scheduling an appointment.
Handled through a phone triage system, the first step in the process of setting up an appointment is a preliminary phone call conducted by a clinician in which the student’s level of risk is assessed. According to CPS, students “in acute distress” receive priority care. For other students, an appointment is set up following the phone call, sometimes for a date two to four weeks away.
Determining such criteria, however, depends on students’ self-report of their level of distress, and research has shown that, while generally reliable, self-reporting symptoms of mental illness can be flawed in some cases.
“One problem is that they ask you to rank how severe your problem is on a scale of 0 to 10,” Mental Health Task Force member Jeff Solazzi, GS ’18, said. “I think that can cause people to underrate the severity of their problem, because they’re worried about taking time away from somebody else that might need it.”
This can be further complicated by the fact that students are not always comfortable expressing their symptoms or personal concerns over the phone.
“When you’re depressed, the last thing you want is someone grilling you about your depression,” Liza Libes, CC ’19, said.
Although severe cases receive immediate attention, cases deemed “non-urgent” can take from two weeks to a month before the student is seen—an experience shared by nine different students interviewed by Spectator.
“I first called CPS the first week of freshman year because I was feeling so overwhelmed, and I really wanted to see someone just to talk it all out because I didn’t really have anyone on campus to talk to at that point,” Libes said. “The semester hadn’t really started because it was just NSOP, but it still took me like three weeks before I could get an appointment, which I thought was ridiculous.”
This problem remains even for students who require counseling on a recurring basis, as the weeks-long wait time can still apply between subsequent appointments.
“I had insufferable pain and I told the therapist that, and I told him I was having suicidal thoughts again,” Jacqueline Basulto, CC ’17, said. “And he said, ‘OK, well, can you come back in two weeks at the same time?’ And I was like, ‘I need help right now, I can’t wait anymore.’”
To meet this growing need, CPS’s staff has grown by 45 percent since 2014. Adding new staff, however, is costly, especially given CPS’s efforts to hire a diverse range of clinicians in response to student calls for a staff that reflects student demographics. Further increasing the number of clinicians would likely require a fundraising campaign or an increase in student health fees—when CPS hired six new clinicians in 2015, the student health fee rose 7.5 percent.
While Columbia is not alone in its multi-step triage system and high demand for counseling, not all peer institutions feature weeks-long wait times. Princeton and the University of Chicago both claim average wait times of one to two days and less than a week, respectively, and neither school uses the multi-step phone triage system at Columbia that some students find discouraging when seeking help.
“It was super easy to get an appointment with a psychologist here, which I did in the fall a few times,” a Princeton first-year told Spectator. “I could probably get an appointment tomorrow if I needed to.”
Students seeking a more temporary solution to long wait times for appointments can meet with a clinician at a CPS “drop-in” appointment. Situated in eight different on-campus buildings, drop-in locations can accommodate about 50 hours of appointment times, according to Eichler.
To address the high need for appointments, Eichler said CPS will aim to expand these drop-in hours in the fall.
Many students believe that the high-stress culture of Columbia creates an overarching empathy problem that poses a threat to mental health across campus. Without more available, more accessible mental health care, students will continue to have to deal with the obstacles that contribute to this perennial problem.
“The fact that it’s so impersonal here [on campus] makes everything a lot worse,” Libes said. “There should really be some feeling of empathy on campus, and that’s what’s lacking, and that’s why we have such big problems with CPS.”