When Meggie Gallina called Counseling and Psychological Services for help during her freshman year, she didn’t expect to wait more than a month for an appointment.

A receptionist answered the phone and scheduled a phone call for later in the day to assess her. Someone on staff said she could either wait several weeks or see someone else in Evanston.

“I felt like I should talk to somebody,” the Communication sophomore said. “I knew I just wanted to talk to a therapist or something. But (CAPS) said that all of the people that they employed were full.”

Gallina never used CAPS’s services. She chose to skip the wait list and see someone in Evanston.

“Fast-forward,” Gallina said, to Fall Quarter of her sophomore year.

“I (went) to the hospital because I felt suicidal,” she said.

After the hospital visit and a talk with her adviser, Gallina went to CAPS to get medical leave forms signed. In early November, she left Northwestern and went home to participate in a program at her local hospital. Gallina returned to campus this Spring Quarter.

Four weeks after her return to campus, CAPS has five students on its wait list.

But Gallina is not alone. Depression remains a common challenge for college students.Suicide is the second leading cause of death among college students, according to the nonprofit website Suicide.org.

This national trend is reflected at NU, where several students have died in apparent suicides. Weinberg sophomore Rebecca Quint was found dead in her Foster-Walker Complex room in March. Last year, Communication freshman Trevor Boehm drowned in Lake Michigan. Yehuda Yudkowsky, a McCormick sophomore, committed suicide on Interstate 94 in 2004, and in 2002 freshman Charles Kim killed himself in his Sargent Hall dorm room.

A spot on the wait list

Executive Director John Dunkle said CAPS makes an effort to keep its wait list to a minimum, and the wait is “usually around two weeks or so” for students on a list.

“We occasionally will have a waiting list,” Dunkle said. “If a student needs to be seen, there’s no wait list for intake or crisis. Once a student has been assessed and they’re waiting to be assigned for ongoing counseling, that’s where occasionally we get into a waiting list situation.”

According to CAPS’s website, a student should normally get an appointment within one week “except during busy times of the year.”

That’s usually from the end of Fall Quarter to the beginning of Winter Quarter, as well as the end of Winter Quarter, Dunkle said.

Weinberg sophomore Kathryn Anderson said when she went to CAPS in February, they referred her to outside services for long-term counseling after an intake and crisis appointment.

“They said they weren’t able to (give me long-term counseling) because there were over 20 people on the wait list,” she said. “Anyone who came in who wasn’t on NU insurance, they referred to someone else.”

Gallina said when she was looking for services at CAPS, she was told there was a wait list for individual and group therapy.

“When they said there was a waiting list even for group therapy, I just thought that was ridiculous,” she said. “I understand that Northwestern students are high-strung and I understand that my situation is not at all unique, but in a school like Northwestern, you need to make sure those resources are available.”

Dunkle said group therapy usually starts at the beginning of each quarter and there are four to five different groups undergoing therapy at any given time.

“Once the group therapy gets started, we can’t bring in new members,” he said. “It would defeat the whole process.”

Some schools have about 100 students on a wait list, Dunkle said. CAPS has a high utilization rate, he said, with 10 to 12 percent of students using the service.

That’s high in comparison to similarly sized schools, but on par with peer institutions such as Cornell University, Dunkle said.

Six students have killed themselves at Cornell this year. The school has both a Counseling and Psychological Services office and a volunteer organization called the Empathy, Assistance and Referral Service which counsels students.

Cornell’s CAPS has a 15 percent utilization rate, said Sharon Dittman, associate director for community relations at Cornell’s Gannett Health Center. Cornell’s CAPS occasionally has a wait list for individual, ongoing therapy, Dittman said.

“Usually (the wait is) under two weeks,” she said. “For a routine appointment, it’s possible that sometimes it’s longer.”

At the University of Chicago, there is never a wait list for counseling, said Linda Tartof, the clinical director of Student Counseling and Resource Service. More than 2,250 students were served last year, Tartof said.

There is no limit on sessions, but most students are only seen five to six times, she said.

“Everything is case by case,” Tartof said.

NU’s CAPS has seen 1,600 students so far this year, and the office saw 1,800 students last year, Dunkle said. CAPS sees undergraduate and graduate students in both Evanston and Chicago.

During Winter Quarter alone, 800 students used CAPS’s services, Dunkle said. That includes students who undergo phone triage, ongoing therapy and intake appointments, but does not include the number of students attending CAPS’s stress clinics or using other services.

Inside CAPS

Students at NU generally come into CAPS stressed out, Dunkle said.

“What students present with are stress and anxiety as a top concern-broadly, broadly defined,” he said.

Stress may include anything ranging from a bad breakup or family problems to sleep issues and academic problems, he said.

Each full-time student at NU “may be eligible” for up to 12 ongoing therapy sessions, according to CAPS’s website. That’s a number Dunkle said he would like to raise.

“That’s something that I’m trying to work on strategically to address by looking at our resources, to be able to possibly raise our session limits,” he said. “But obviously that would involve staff issues.”

He said he has a long-term plan to increase staff and said the office is “absolutely” supported by the administration.

CAPS employs the equivalent of 11 full-time licensed professionals, Dunkle said. In addition to the licensed staff, the office has a training program that includes two post-doctoral fellows and three pre-doctoral interns who meet with students.

These unlicensed staff members are closely supervised, Dunkle said, and all sessions they conduct with students are recorded. CAPS is looking to hire one more professional to occupy the associated director for developmental programming and outreach position, which will be vacant this Friday, and another to fill a newly created “Alcohol and Other Drug” specialist position.

When a student calls CAPS, the receptionist schedules what is called a “phone triage appointment,” usually the same day, where a staffer assesses the student and determines the next step, Dunkle said.

In a crisis situation, the student gets a same-day appointment, he said. Alternatively, they may be scheduled for a longer assessment called an intake before beginning therapy or being directed to other services.

“Part of the assessment is, we have to determine if (the student is) appropriate for a 12-session model,” Dunkle said. “For individuals whose issues would require more than 12 sessions, we have to help them find other types of services, which we do a lot of.”

Anderson said she had to wait one day longer than she would have liked for her first CAPS appointment and was later scheduled for a crisis appointment.

A presence on campus

CAPS doesn’t only schedule therapy with students, Dunkle said. For the past four or five years, it has had a formal stress clinic. Over the past year, use of the clinic has doubled on both campuses, he said.

“We do a fair amount of outreach,” he said. “We do a lot of diff
erent programs based on the data we collect (from students who use CAPS).”

Regardless of its outreach, Gallina said most of her friends avoid CAPS.

“I have so many friends that don’t go to CAPS for problems because they’re afraid that it’ll affect their study abroad applications or because they’ve heard about someone who went to CAPS and was brushed away or got no help or got the wrong help,” she said.

CAPS follows state law regarding student privacy, Dunkle said, and would never share information with any other NU department unless a student signed a release.

One student study found many NU students did not realize CAPS offered programming other than counseling or had little awareness of CAPS at all.

SESP junior Emmaline Pohnl said she worked on a group project for her global health class last quarter to analyze a public health problem at NU. Her group chose to look at depression.

Though Pohnl’s group was unable to interview directly with CAPS, they performed an informal survey of 253 students for data analysis. Pohnl acknowledged the small sample size, and according to the group’s report, most respondents were female.

“The main two things we found out about CAPS from our survey is people didn’t know about it, so awareness, and accessibility,” Pohnl said. “A lot of people mentioned that getting an appointment in a timely manner was difficult.”

The students also found that CAPS’s current, temporary location reduced its accessibility on campus, Pohnl said.

“A lot of people mentioned, ‘Why is it in the bottom of Plex?'” she said.

Weinberg sophomore Ismini Mouzakitis said although she had never used CAPS, she thinks most students are reluctant to take advantage of it.

“It’s always hard to ask for help,” she said. “And then CAPS is just this very large thing, and no one really knows what it is or where it is. It’s a strange, far place.”

One of Dunkle’s long-term goals is to expand CAPS’s outreach, he said. He said it may increase outreach when hiring a new assistant director for developmental programming and outreach.

“Whoever fills that will be able to think strategically about how to increase our programming, especially our developmental programming area,” he said.

When CAPS moves back to Searle Hall, the department plans to increase the number of stress clinics, Dunkle said.

“That’s the number one issue students present with,” he said.

Construction on Searle is expected to be completed by fall 2010.

CAPS needs more experienced staff, Gallina said.

“Campus mental health centers like CAPS in general just suffer from not having people that are experienced enough,” she said. “I’m sure there’s people there that are incredible and wonderful, but I’m sure there’s also grad students and … people working there because they need a job. And selfishly, when I feel like my well-being is in someone else’s hands, I want to feel like I’m their first priority.”

Dunkle said CAPS has relationships with every residential hall and actively participates in community assistant orientation. He also said he hopes to continue relieving the stigma associated with mental health issues.

“I would say in general, Northwestern students, they seek our services,” he said. “Ten to 12 percent utilization is pretty darn good.”[email protected]