Mental health articles

The Mental Health Service and the Community
In calmer times, college mental health services had to justify their existence
within the academic community. Th e public relations challenge was explaining
why an institution of higher learning should bother funding a fringe activity
like psychological treatment. In today’s climate of acting-out students and the
negative publicity and lawsuits that follow suicides (Franke, 2004), the need
for psychological assistance is no longer in question. Now college services have
a diff erent selling job: proving that their interventions work. More precisely,
their task is to demonstrate eff ectiveness in curbing disruptions and averting
tragedies.
But how, exactly? Th e normal activity of therapy, conducted invisibly behind
closed doors, doesn’t exactly project a robust image. To impress the community,
the pressure is on clinicians to fl ex their muscles—to hospitalize, initiate
contact with others around safety planning, check up on shaky students
between sessions, contact parents, and yes, remove students from school. And
so, despite their expertise, clinicians may fi nd themselves bowing to external
and self-imposed pressures and responding overaggressively to troubled students.
Treatment decisions may be infl uenced by public relations and political
considerations.
Th e irony, of course, is that aggressive measures initiated in response to
community fears are no assurance of protecting the community. Sensing clinical
overreactions, current patients may lose trust and be turned off to treatment.
Other students, hearing about questionable hospitalizations and enforced
leaves, may hesitate about coming forward for treatment. Ill-considered interventions
may drive away the very students the community is most concerned
about reaching.
Even in the absence of blatant overreactions, therapists who are distracted
by community anxieties may be prone to clinical tone-deafness, lapses in empathy,
and understanding. It takes one’s full clinical powers to sit with suicidal,
eating-disordered, substance-abusing, and self-cutting students. You have to
be able to assess and tolerate risk and explore the motives behind the risky
behaviors. You need faith in students’ ability to eventually overcome their selfdestructive
patterns. But this mindset is incompatible with a mandate to keep
the campus safe at all costs. You can’t listen with the third ear while community
anxieties are ringing in your head.

Tags: Mental health