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The Campus Treating the Campus
For as long as I've been working in college counseling centers at a variety of institutions, dating back to the mid 1990s, the phrases "more students than ever"  and "greater severity" have been used to describe those seeking counseling center services on campuses across the country.  Like a sinister version of the movie Groundhog Day, in which we wake up to live the same day over and over again, with barely an awareness of the repetition of our words, actions, and reactions, we are still dealing with the "increasing" severity and demand scenario.   Except, today, the scenario is amplified and scattered louder and into the furthermost places by the technology now available to spread information each second and each minute and each hour of each day.  

With this narrative stubbornly in place, the demands remain the same.  We need to add more resources to our campus counseling centers.  We need to increase our response rates to the greater number of students who answer "yes" to questions about whether they feel overwhelmed, seriously consider suicide, or feel sad most or all the time.  Every time a campus becomes the latest profile for a rash of suicides, the urgency becomes deafening again, and we respond by broadcasting the problem louder than the previous decade.  All of this usually translates into hiring more therapists, referring students to off-campus providers they may or may not access, or have them wait for those therapists that are available on campus.

Perhaps, it is time to question the efficiency and efficacy of our approach. While it is painfully cliché to employ the adage that the definition of insanity is repeating the same thing over and over and expecting a different result, it’s particularly ironic that this cliché does seem to apply to the profession responsible for improving sanity on college campuses. 

Outreach has evolved in recent years beyond simply the marketing of the counseling center services. Gatekeeper training programs and screening days and stigma reducing campaigns are promote, each boasting the "evidence-based" credibility that justifies the financial investment in increasingly packaged services. and workshops and programs that help students.  And so much of outreach continues to rely on strategies to ensure that the individual student in distress gets on the path leading to either Intake or Crisis Intervention.  Outreach also has evolved, along with efforts from wellness centers and health promotion units, to introduce skills and practices that help individuals cope with their stress, from mindfulness training and various practices ranging from yoga to exercise and nutrition and sleep hygiene.  Still, efforts are aimed at individuals, whether in the counseling center or out on campus through outreach.

In general, campus mental health is addressed by college counseling centers through 3 familiar processes:  Intake. Crisis Intervention. ​Outreach

The intake is some form of the first therapy session, with some level of assessment of what the needs are.   This is followed by the delivery of some kind of clinical intervention for the student in distress.   The most common intervention remains the individual counseling sessions. There are some promising approaches that reflect some shift away from a complete reliance on individual psychotherapy with the same counselor.  Stepped Care models, for example, consider more efficient assignment to workshops or group interventions for students whose needs are less severe.  However, the orientation to the struggling student remains focused on the struggling individual.   And there are more and more of them seeking counseling center services..   

Crisis intervention is a variation of individual therapy, although given higher priority and more immediate response.  This, too, has evolved to include case management services, students of concern teams, and threat assessment units.  Here, too, the focus remains on the struggling individual.  ​
There are some pervasive norms and mindsets that inform how students enter colleges, move through their academic careers, and segue into the larger world that awaits them. There are repeated mantras on how to earn success, gain status, and navigate an increasingly competitive world.   In fact, there are increasing messages that emphasize a competitive world, forgetting the wisdom associated with one that relies more on collaboration and connection.  How often do we find ourselves and our clients bombarded with messages and norms that involve....

  • An over-emphasis on certainty and control?
  • The worship of the quantified?
  • The banishment of vulnerability?
  • The continued de-valuation of the Feminine (or anything that is not hyper-masculine)?
  • Perpetual distraction from the present?
  • Hurtful marginalization of Other?
  • Over-idealized and un-examined pursuit (or maintenance) of power and social status. 

There are two inevitable consequences of these permeating mindsets, both of which serve to fuel the mindsets in an increasing spiral: a lonely loss of nuance in students’ lives and a pervasive fear of an all-defining failure.  

These pervasive mindsets and their consequences certainly can be (and are) addressed in individual counseling sessions.  However, unlike the common narrations of "mental health" that specify terms like "mental illness" or "depression and anxiety" the language to describe these mindsets can be applied to communities as much as to individuals, and they do not require licensed mental health providers to engage in addressing how to balance such mindsets with life approaches that are more conducive to thriving, healing, and growing..  for individual students AND for campus communities.

Most (if not all) of campus life or student affairs departments will likely find relevance in all of these mindsets and the degree of "scared and lonely" on their campuses, able to engage in exploration of how these issues can be deconstructed regarding their impact on students and communities.  Some departments will likely find particular mindsets to relate more specifically to their mission or to the essence of the work they do.   For example, career services professionals may find that exploring the mindsets related to pursuing power and status as well as the overemphasis on certainty to inform their work with students deciding on majors or identifying career goals.  Offices supporting diversity and inclusion efforts can explore how the mindset of marginalization of other overlaps with the banishment of vulnerability on campus communities that emphasize idealized pursuit of power and status.   Any student organization or department of professional educators can simply review the list of mindsets and brainstorm on how each of these overlaps with others and how they might recognize the impact on how much fear and isolation they promote as they engage in an organic process of identifying and implementing interventions to counter these pervasive and insistent mentalities.

For campuses that have evolved through decades of messages that emphasize referral to "professionals" to deal with issues we narrate as "mental health" concerns, this shift toward a shared responsibility to address those concerns may constitute an overwhelming paradigm shift.  However, such a shift would actually restore more ancient wisdoms that integrated philosophy and theology with psychology more comfortably.   Such a shift would allow for much of what we address as "mental health" issues as actually part of the more intricate landscape of Education issues, re-awakening ideals that call for colleges and universities to be about more than credential-awarding entities in the competitive machinery of the work-force. And, this might also play a role in reducing the number of students seeking services from the campus counseling center, in higher numbers and with increasing severity of problems.   If this can happen, perhaps 20 years from now, counseling centers and mental health providers won’t still be reacting to a crisis that was, largely, self-sustaining...not to mention fulfilling the cliché adage that defines insanity.
Perhaps, it is time to shift away from the emphasis on individuals with diagnoses as a way of describing this crisis toward elaborating on the crisis facing society, often amplified on college campuses.

What if society has the psychological disorder? 
What if we began prioritize our efforts toward treating the community? 

What if we actually moved beyond educating the campus about mental illness and began to actually emphasize the ways we extend the therapy to the campus?