Understaffing. Long wait times. Not enough resources.
On-campus mental health services had a reputation. Because of it, social relations and policy senior Colin Wiebrecht avoided on-campus mental health services when he came to Michigan State.
“I just didn’t want to deal with what I had been told was a broken system,” Wiebrecht said.
More than two years ago, in response to criticism and student demand, discussions on making major structural changes to university student health services began. An action committee of leadership and staff from these services wrote a report calling for an increase in staff, the creation of an integrated health network, the housing of services in one main location and more.
While plans to implement these changes were being made over the years, on-campus mental health services continued to be criticized, and the negative reputation remained. Student groups were formed, petitions were created and forums were held, all demanding the same thing — for mental health to become a priority.
In the fall of 2017, the former MSU Counseling Center and the former Olin Psychiatry Clinic were finally combined into one entity, after a year of planning and restructuring. Until this year, Counseling and Psychiatry Services, or CAPS, was without a director, and some of the initial goals created by the committee, such as increasing staff and fully integrating the two services, still weren’t met.
Now, that’s changing.
“The fact that they’re making strides to reach out to students, to connect with students — I think it really shows that they’re aware of what students thought before,” Wiebrecht said. “They’re trying to figure out the best way to not only fix it internally, but also externally let students know that it’s not going to be a problem going forward.”
With the goal of redesigning CAPS from the perspective of students, Dr. Mark Patishnock, the newly-appointed director of CAPS, already made long-awaited changes to the service, structure and hopefully, its reputation.
“I feel like this is the best opportunity in the country right now, in collegiate mental health care, to provide a transformative experience and to help shape and shift the culture,” Patishnock said. “There’s a moment in time that we’re in, where student mental health is highly being prioritized, and I’ve witnessed that first hand — that Michigan State has invested tremendous financial resources, time and effort into getting this right, and to figuring out what is the best way to serve 50,000 students’ mental health.”
Since June, CAPS expanded its services, redesigned the way students receive these services and helped create a campus-wide coalition of multiple student groups to address issues and raise mental health awareness.
“I think they’re very cognizant of the fact that they had a bad reputation on campus,” Wiebrecht said. “Instead of what the administration has done in certain cases, which is to try to act like nothing’s wrong and move forward, they very much are owning that fact and talking about it.
“Owning up to a problem or admitting there hasn’t been the best care doesn’t mean you’re not able to provide that care, it just means you’re cognizant of the fact you want to do better.”
Finding a director
In April, Patishnock was appointed director of CAPS by Interim President John Engler after a year-long search. Organized by a search committee made up of students, faculty and mental health professionals, Patishnock went through multiple public town halls as well as an open forum presentation.
“It was very helpful to me as a candidate to actually learn what are the real issues, what are people asking,” Patishnock said. “What I walked away with was just how passionate and invested students are about mental health on this campus and that was very refreshing to me.”
The president of the Mental Health Awareness Club, child development senior Alison Miner, attended a few of the town halls on behalf of her organization.
“I wanted to see their point of view,” Miner said. “I thought it was important, especially for the future of CAPS and the future of mental health on Michigan State’s campus.
Expanding staff, locations and services
Kelly Russell is the director of marketing for the MSU Student Health Advisory Council, a branch of campus student health services aiming to promote health education and awareness on campus. She remembers when a psychiatrist from CAPS came to their organization last year and spoke about how they were struggling to bring more psychiatrists on campus.
“Our numbers don’t reflect the support we have,” Patishnock said. “We actually have support to hire lots of more people but it’s really important to hire the right kind of people.”
In June, seven full-time health providers were hired and CAPS is in the process of hiring up to ten more. There are 19 full-time employees and the goal is to be in the high 20s by January.
CAPS also expanded location-wise by opening a satellite office in the MSU Union. It became fully operational Oct. 1, as well as virtually through an app called “MySSP,” where students can chat or talk on the phone at any time with a licensed counselor.
CAPS is also close to hiring two counselors to be placed in South and East neighborhoods.
“The goal is to be able to expose CAPS clinicians to students who might not otherwise walk to a physical setting,” Patishnock said. “In expanding out to the university and expanding virtually with MySSP, we’re hoping to expand from the traditional model of students walking into the clinic — we’re trying to get to them. So whether it’s on their phone, in their residence hall or in the Union, our hope is that we continue to grow.”
Counseling services and psychiatric services merged into one service located on the third floor of Olin Health Building. But, CAPS is still operating on two different medical record systems: One for the former Olin Psychiatry Clinic and one for the former MSU Counseling Center.
Patishnock noticed this challenge right away, and said he is working to change it by integrating CAPS clinically and culturally, as well as establishing “collaborative care.”
“The first challenge that I found myself in was to truly help fulfill the mission of the integration of CAPS as a new entity, as a new idea,” Patishnock said.
Meeting the unique needs of every student
One of Patishnock’s first initiatives as director was to form a “Student Mental Health Coalition.”
He invited a large number of different student groups to their first — and so far only — meeting on Sept. 18 where they established goals of working together on campus mental health awareness initiatives, reducing stigma and promoting education and dialogue.
“My goal was to actually design a model, design a center, design a system that really helps the entire university to play a role in the creation of holistic student mental health and wellness,” Patishnock said.
Patishnock also hopes the coalition will be a way for him to receive feedback from the community on how CAPS can improve.
“I really saw a lot of improvement already just by going to the Student Mental Health Coalition meeting,” Miner said. “He just seemed to be very interested and empathetic toward mental health.”
CAPS also redesigned their clinical intake system. This is intended to decrease the time students spend in the center while waiting for their first appointment and to establish tailored screening appointments.
Students are given paper forms with several different options on it, and CAPS responds clinically based on how these forms are filled out.
“A lot of that comes from students sharing that they really want to spend less time in our waiting room,” Patishnock said. “They want to come in and see someone more tailored, and they want to tell their story to the same person. So we’ve designed a system to allow for that.”
Students are also asked upfront if they’re in a crisis, and if they are, their forms are shorter so they can get help as soon as possible. They’re also asked if they want to talk to someone from the MSU Sexual Assault Program or from MSU Safe Place. If they mark yes, offices are in CAPS specifically for them to go to.
CAPS also made sure students seeking out their services are assigned to the appropriate clinician based on gender, race and other demographic factors, Patishnock said. Another new expectation is that if students want to follow up, it will be with the same clinician from their previous appointments.
“Some people feel more comfortable speaking to a counselor that shares one of their identities,” Wiebrecht said. “You want to speak with someone who essentially understands or is going to be able to empathize a little bit more.”
Reaching out to help the community
CAPS aims to serve more students than ever before, Patishnock said.
Before becoming the director, he said the utilization rate of counseling and psychiatric services was around five percent. The average for student mental health services provided by Big Ten universities is around 10 percent.
In the past month, Patishnock ran a report which showed data from Aug. 20 to Oct. 1, revealing a 22 percent increase in students utilizing services.
Unlike Wiebrecht, Director Russell turned to the university when seeking help for her mental health struggles. She participated in a walk-in appointment and spoke with a clinician immediately.
“I hope we will make CAPS seem more approachable at MSU,” Russell said. “On college campuses, (we) as students are more likely to acknowledge when times are bad or when you’re struggling with a problem … but people are still very hesitant to seek help. Even I was.
“I sit here and say I want to tell people that it’s OK, but even I still had a lot of hesitation about seeking help when I needed to. But because I was surrounded by this community, it made it less scary for me.”
Shedding the reputation
Russell heard concerns about CAPS before using its services and said her personal experience was different than the negative things people said.
“I think as a campus, there’s a curse over Olin and the Counseling and Psychiatric Services, where even if people have never been, just from word of mouth, they hear that it’s poor quality,” Russell said. “Sometimes people are afraid to go to these places.”
Though Miner saw positive changes made to CAPS, she still thinks the reputation is the same from years ago.
“Overall there’s still a negative perspective of CAPS,” Miner said. “A lot of students actually don’t know about CAPS still, however if they do know about CAPS I feel they have a negative perspective.”
Wiebrecht said his opinion of CAPS changed, and unlike before, he feels comfortable with recommending students to use its services.
Patishnock said it’s too soon to tell if the view of CAPS changed.
“If we’re thinking about reputation, one of the things I heard was just students felt that they needed more support,” Patishnock said.
Patishnock already published a small report on how CAPS is doing, and hopes to continue being transparent.
These future reports will include data on utilization, demographics, what struggles students are facing and more.
“I’m very public about that,” Patishnock said. “I think it’s very important to be transparent with students who are paying for our services through general funds, to help them understand what the picture has been.”
As the year progresses, Patishnock said more changes will be made to CAPS.
“My number one goal is to try to enhance the student experience, to make sure students get in here, they have reduced wait times, and that essentially they have a better experience than ever before,” Patishnock said.