University of Arizona students struggle to get timely counseling
The Daily Wildcat investigative team decided to look into why it takes so long for students to get an appointment at CAPS, despite the opening of the new CAPS North location. They found a much higher wait time than the national average.
When Allie Schoenike, a University of Arizona student and Associated Students of the University of Arizona College of Public Health Senator studying public health, sought out Campus Health’s Counseling & Psych Services, she found herself waiting six weeks for an appointment.
“When I was trying to use CAPS, I wanted to be seen regularly as a regular patient, and they can only see you like once every six weeks, which is not feasible for somebody who has a chronic mental health issue and needs to be seen weekly or biweekly,” Schoenike said.
Schoenike isn’t the only student who has faced this problem.
UA students have complained of long wait times in the past for follow up CAPS appointments, with estimated wait times similar to Schoenike’s experience. The CAPS website even notes that students may have to wait three to four weeks to see a CAPS provider.
CAPS North opened in August 2019, allowing more staff to be available for students, which cut down wait times, according to Debra Cox-Howard, a clinician at CAPS.
“Wait times for follow-up appointments vary depending upon the time of year, but on average, the wait for a follow-up appointment is one to two weeks,” Cox-Howard said over email. “During times of high demand, this may extend to as much as up to three weeks for non-emergent appointments.”
According to the 2018 Association of University and College Counseling Center Directors Annual Survey, the average wait time for a first appointment after the initial triage for a school with 35,000 students is 12.2 days. The UA is still over that wait time by nearly two weeks.
There were 10,167 total pre-scheduled counseling visits in the 2018/2019 fiscal year, according to the UA public record 2018/2019 fiscal year data bytes.
If CAPS hypothetically distributed each appointment to the 26 mental health professionals equally, they would have had 391 appointments in the 2018/2019 fiscal year. That does not reflect students who sought multiple appointments with the same counselor, which means that number could have possibly been higher for some staff members.
Lee Ryan, a professor and department head of psychology, said access to mental health professionals is a national issue.
“There’s a shortage across the country and there’s certainly a shortage at the UA,” Ryan said. “UA knows that and they’re working hard now to try to address that shortage … but I don’t think anyone would deny that there’s a shortage everywhere.”
The UA has 32 employees within CAPS to serve 38,623 students enrolled on the main campus as of Fall 2019, according to the University Analytics and Institutional Research. Of those 32 employees, there are 17 clinicians, two psychiatrists, three psychologists, three nurse practitioners and one counselor.
Students pay a fee every semester, which goes toward CAPS.
CAPS officials said, “The fee is $425 per year ($300 for students enrolled prior to Fall 2017 who were locked into the tuition guarantee) and Campus Health receives 50.5% of that fee (49.5% goes to Campus Recreation).”
Professor Julie Feldman in the department of psychology said there’s not as much of a stigma around treating mental health, which could explain why there’s more demand.
“The stigma is lowering and that’s part of the problem,” Feldman said. “It’s less stigmatized and people are more willing to say, ‘I’m going to go to CAPS to get some help.’”
Aaron Krasnow, the associate vice president of Arizona State University Counseling Services, said the average wait time is not a good measuring standard of their services.
“If a student comes in and their clinical needs are such that they need to be seen very soon, then we find a way to see them,” Krasnow said. “If their clinical needs are such or their schedule is such then waiting a period of time makes sense, then they are seen at some other time.”
Some students can be seen the next day, while others will not be seen for a few weeks, according to Krasnow.
UA CAPS has a similar system: first-time users of CAPS can be seen the same day during 15-minute triage appointments. The follow-up appointments must then be scheduled, according to their website.
“We offer groups, which students can get into immediately, as well as on-line self-help services such as TAO,” Cox-Howard of CAPS said in an email. “Information on these are provided at the time of triage.”
To keep up with the increased demand ASU has seen for counseling, Krasnow said they prioritize access. ASU did not return public request records regarding the amount of CAPS appointments booked.
“We make sure people can be seen that same day and then we prioritize individualized discussion-making with that student,” he said. “We don’t plug him into a system, nor do we presume that counseling is what they need. We don’t make any of those discussions until we meet them.”
In contrast, ASU’s counseling system has 47 employees, 36 of which can treat students. Those 36 consist of 11 psychologists, 15 counselors, four social workers, and three therapists working between four counseling centers and six health clinics across their Downtown Phoenix, Polytechnic, Tempe and West Campus to serve their 72,709 students enrolled as of 2018.
Krasnow also said their approach to counseling is different than other treatment systems. In a traditional system, most people who seek counseling are immediately put into a treatment system; ASU’s Counseling Services uses an individualized approach to determine whether someone needs continuous counseling or if their source of stress can be addressed through alternative routes.
“If a student comes in because there are experiencing financial distress … we don’t presume that what that person needs is counseling,” Krasnow said. “We take that individualized approach with every single person that comes in.”
Schoenike said the one thing she wants to see improved with CAPS is wait times.
“When I was a freshman, my mom passed away,” Schoenike said. “As I’m going through obvious college issues as well as the grief of losing a parent and then dealing with the aftermath … Just dealing with things, someone like me, I need to be seen on a more regular basis than six weeks.”
Schoenike said she still uses CAPS for psychiatry, but she outsourced her counseling.
“Sometimes it’s a bit unorganized. I remember one time I waited six weeks to see a counselor and I showed up and they were like, ‘Oh, she’s actually out today,’ and I was like, ‘You have got to be kidding me,’” Schoenike said.
Another issue students face when trying to seek mental health support on campus is finding long-term counseling solutions, which CAPS does not offer.
“[For] someone with a chronic mental illness, CAPS is not the right place to go,” Schoenike said. “I think the reason they don’t necessarily broadcast themselves as like a short-term solution is because, if someone is struggling with mental health, they don’t want to go somewhere that’s going to tell them to go somewhere else.”
CAPS provides resources for students who want to seek counseling or other psychological services outside of the university, such as Psychology Today, a website that can find specific counselors for an individual’s specific needs.
“In the case of students needing long term counseling services, we have Clinical Care Coordinators that work with the student to attain services in the Tucson community, off campus,” Cox-Howard said in an email.
Krasnow said ASU’s Counseling Services are also not intended to be long-term counseling solutions.
“Typically when the student identifies for themselves or we recommend something that is longer term than what our resources or our model could provide, we help them find a clinician in the community,” Krasnow said.
Ryan said CAPS should only be one part of the approach to addressing mental health on campus.
“There needs to be a multi-layered approach to providing support for students and employees at the university,” Ryan said. “If any student goes to CAPS, they will be seen. It might take several hours before they’re seen, but they can only provide short-term interventions. For students who need more long-term help, we need to be able to connect them with those kinds of services too. It’s going to take everything from counseling and advising up to CAPS and psychiatry, the whole thing. There’s not a simple solution.”
The Student Health Advocacy Committee has their own ideas to engage the student community outside of CAPS. SHAC is a student-led organization within the student government and focuses on mental and sexual health.
“The [UA] is actually part of this program called the Healthiest Campus Coalition, and the HCC focuses on mental health and brain health,” said Kaylah Scharf, co-director of SHAC. “They’re planning this huge thing called Brain Week in the spring and SHAC is hopefully going to be a part of that.”
According to Scharf, Brain Week will bring mental health awareness and resources for students.
“Basically, there’s going to be a presentation and programming and speakers, games for an entire week focusing on mental health and the different ways de-stigmatize it and other ways to cope with the fact that mental health and mental illness plague a lot of students,” Scharf said.
Schoenike is spearheading a committee on mental health in ASUA to address the matter on campus.
She said ASUA is trying to come up with their own solutions for the CAPS problem on campus. ASUA Senate wants to create either a mental health week on campus or a resource fair for students. She thinks that if the UA creates a mental health week on campus, it will be easier for students to identify if they need help.
“It takes a lot to admit that to yourself and to admit that to someone else,” Schoenike said. “I think if you could bring mental health one step closer and kind of take the fog and mirrors out of it, make it so that it’s not this big scary [thing].”
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