Waiting for help: Counseling Center offers ‘triage’ appointments as students report long wait times

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The Counseling Center employs one therapist per every 900 students and is currently looking to hire one more full-time psychologist. TALIA WIENER / THE FLAT HAT

Hope Duke ’19 has a big smile that lights up her face. If you met Duke, that bright smile would stick around while she talks about her love for geology club, Pod Save America and her dog, Moose. It would also hide how overwhelmed she has been feeling lately. School work, senior thesis research and the fear of letting her advisor down have continued to pile stress upon Duke. She had resigned herself to powering through until a few weeks ago when she received some news: A friend from home had taken their own life.

Duke spoke with friends and family, and one person suggested she take the leap and make a counseling appointment in honor of her friend’s struggle with their mental health. Thursday, Sept. 20, she walked into the College of William and Mary’s Counseling Center and was told she would have to wait 40 days for the earliest available appointment: Oct. 30.

Nationwide, universities are facing record-high numbers of students seeking campus mental-health resources. The College is no exception — as of Sept. 27, it has seen a 25 percent hike in individual counseling appointments between this fall semester and the 2017 fall semester by the same date. According to the Counseling Center, 10-12 percent of a student population seek campus counseling on average. At the College, 15 percent of students are utilizing Counseling Center resources.

Counseling Center Director Carina Sudarsky-Gleiser traces the increased desire to seek professional mental health help to a variety of factors. According to her, the political climate, stress and an over-reliance on technology are all to blame. At the College, students most often seek counseling for anxiety, depression and relationship concerns, according to Sudarsky-Gleiser.

“We used to talk about how one out of every four people experience mental health issues,” Sudarsky-Gleiser said. “The truth is four out of four.”

“We used to talk about how one out of every four people experience mental health issues,” Sudarsky-Gleiser said. “The truth is four out of four.”

The increased student interest in counseling has led to longer than usual wait times for initial appointments. In the 2014-15 academic year, average wait time for a consultation appointment was six days. In 2015-16, it was nine days. In 2016-17, it was 11 days. In 2017-18, 12 days. According to Sudarsky-Gleiser, the average wait time for the 2018-19 academic year so far is 14 days.

However, students are experiencing wait times much longer than the current average. Duke waited 40 days. Grace Gilbert ’20 called the Counseling Center for an initial appointment Oct. 1 and was told the first open spot was Nov. 12, 42 days later.

The Counseling Center offers three types of initial appointments for students. These appointments are essential to student treatment and include an assessment of the student’s mental state and the creation of a future counseling plan. The first, and most common, is a regular consultation, the type of appointment that found Duke and Gilbert waiting six weeks to be seen. The second is a walk-in or emergency consultation, reserved for students who are in a crisis and are a threat to themselves or others. These consultations ensure that students are able to meet with a professional the same day that they request the appointment.

The third type of appointment, a triage appointment, was created and instituted in September 2018 to help cut down on long wait times for students. The triage appointments serve as an abridged regular consultation and help to create a plan for the student in a more expedited process. These appointments target students who are not in a crisis, but who feel that the wait for a regular consultation is unmanageable.

Once referred to therapy during the initial appointment, students are offered twice-monthly appointments through the end of the semester. However, many students do not end up attending a semester’s worth of appointments.

Olivia Spencer ’20 had a walk-in consultation after her freshman resident assistant and her roommate submitted a care report on her behalf. Spencer’s session was filmed — for counselors still in training, meetings are filmed to be used later as a learning tool for that counselor. The filmed meeting is only seen by the counselor and their instructor, but the interaction left Spencer feeling uncomfortable. She was then paired with a counselor and attended a few appointments. According to Spencer, this counselor strongly encouraged her to join group therapy or to seek outside resources. Unable to afford private counseling, Spencer has since chosen to not seek counseling.

“I ended up repressing whatever I was dealing with because I was like, ‘OK, you guys aren’t going to give me the resources that I need,’” Spencer said. “I’ll just deal with this at a later date.”

“I ended up repressing whatever I was dealing with because I was like, ‘OK, you guys aren’t going to give me the resources that I need,’” Spencer said. “I’ll just deal with this at a later date.”

Many students do seek out private counseling in the greater Williamsburg area, but off-campus options can be expensive and inaccessible. The average price for one appointment in Williamsburg is around $100, and many providers do not accept insurance. Often, students need a referral to get a foot in the door, and it helps to have already identified the specific mental health care they require.

Carlyn LeGrant ’18 connected with her therapist at the Counseling Center and enjoyed her appointments. However, her counselor, still in training, left the College, and LeGrant met with an employee at the Counseling Center to be paired with a new counselor. According to LeGrant, the employee repeatedly encouraged her to seek group therapy, even after she made it clear that she was only interested in individual counseling. LeGrant was frustrated by her experience at the Counseling Center and pursued other options.

“I went to go deal with a very traumatic situation that I had opened up to some friends about, who ultimately were very unhelpful,” LeGrant said. “So to then go to the Counseling Center, seeking help, and have them ignore the severity of my situation, it did make it a lot worse.”

Some students avoid the Counseling Center altogether. For Tommy Rubino ’18, the twice-monthly appointments did not meet his needs. Rubino wanted more frequent appointments and was seeking a diagnosis. Through private counseling from both a therapist and a psychiatrist, Rubino did receive a diagnosis of narcolepsy.

Rubino is satisfied with his choice to seek private counseling and is sympathetic to the Counseling Center’s struggle to meet students’ needs.

“It’s tough to meet the demand of students that have already started therapy, who need to continue and want to continue, and then also support the students that are ready to take on this long-term prospect as well,” Rubino said.

Though Rubino did not seek help from the Counseling Center, he found other resources on campus to help in his mental health journey. He worked with the Center for Student Diversity and Active Minds, a student neurodiversity group through which he now organizes events on campus to spark discussions about mental health.

“Student groups are an awesome opportunity to talk to other people that you feel comfortable talking to,” Rubino said. “You meet people and talk about your experience in a way that’s not like therapy. You’re not going to try to figure out what the problem is; you know there’s a problem.

The International Association of Counseling Services recommends one therapist to every 1,500 students on college campuses. The Counseling Center at the College staffs eight full-time clinicians, one part-time therapist and two therapists who each offer services one day per week. There is one therapist employed per 900 students.

There is currently an opening for one full-time psychologist at the Counseling Center, but according to Sudarsky-Gleiser, the search failed and led to two part-time therapists being hired instead. The position will be re-advertised this November, and Sudarsky-Gleiser hopes this search will result in a hire.

“We don’t want to hire someone who we believe is not going to be the best therapist for our students,” Sudarsky-Gleiser said.

The initial position opening came at a time when the university was not hiring for many other new positions according to Sudarsky-Gleiser. She said the additional funding for a new position at the Counseling Center shows a strong commitment to mental health resources, especially under the College’s new leadership.

“It’s not ‘tell me what you need, and you will get it,’” Sudarsky-Gleiser said. “But for that [new position], I didn’t have to fight.”

For Rubino, the issue of addressing students’ mental health concerns is complicated. He does not see any quick solutions and does not think the Counseling Center will be able to meet the growing student need. But Rubino wants students to have the mental health resources they deserve because getting professional help has made such a large impact on his life.

“It’s tough to think about sadness, obsession in your head, as a sickness when you feel so alone and haven’t spoken with a medical professional who can tell you this is a sickness,” Rubino said. “That legitimacy made a world of difference for me.”