As students returned to campus this semester, news of changes in the Psychological and Counseling Center (PCC) spread quickly. Both the undergraduate and graduate communities at Vanderbilt shared concerns regarding the impact this would have for students seeking mental health resources. The Hustler met with Dean Mark Bandas and Dr. Adriana Kipper-Smith, Interim Director of the PCC, to discuss the recent changes in PCC services.

Changes in Services

With increasingly high demand for its services, the PCC has shifted to a short-term care model for students seeking mental health services. To reevaluate its practices, the PCC consulted with counseling centers, the Center for Collegiate Mental Health (CCMH) and other universities. Beginning this academic year, the PCC will utilize a clinical review to assess a student’s needs after attending six sessions of counseling.

Comparable models of short-term care can be found at other universities as well. For example, Duke University and Northwestern University both offer counseling and psychological services based on a short-term model.

“In the past several years we’ve been trying to increment shorter therapy,” Kipper-Smith said. “Not a session limit, but short-term.”

The nature of short-term therapy can vary widely on a case-by-case basis. After completing a sixth session at the PCC, students will undergo an assessment to evaluate their progress and may be referred to a community provider. If a student continues to receive services at the PCC, he or she will be reevaluated after the next six sessions.

“The PCC is not turning people away,” Bandas said. “Based on a clinical assessment of their need, they are being referred appropriately to a specialist at Vanderbilt University Medical Center (VUMC), specialty clinics at VUMC, or community providers.”

Despite this change in the type of services provided, the PCC will continue to offer crisis care. This includes immediate care for students who are experiencing crises such as trauma or grief. Unlike many long-term care cases, crisis care does not necessitate a diagnosis. Another aspect of the PCC that remains unchanged is its medical services and ability to prescribe medication.

Student Response

This transition to short-term care has generated backlash, especially among graduate students, who wrote a petition to address their concerns. The petition demands that no student be turned away from receiving services at the PCC. Citing a study from the University of California, Berkeley, the petition states that 47 percent of graduate students suffer from depression due to the high-pressure and competitive environment of graduate school.

“Rather than anger, we graduate students feel deeply disappointed that a service which has been so helpful and necessary for so many may no longer be a resource,” Sabeen Ahmed, the first signatory on the petition, said via email. “Worse is that our institution has either not accounted for this necessity or has chosen to prioritize a short-term ‘cure’ model, knowing that this model is particularly unsuitable for graduate students.”

With obstacles such as transportation and financial burdens, students have expressed concern over the accessibility of receiving mental health care from providers in the Nashville community. Bandas and Kipper-Smith acknowledge these challenges and are still talking through potential solutions. Additionally, every student at Vanderbilt is required to have health insurance, whether that is through the Gallagher student plan or a private plan that meets the same platinum standards.

For several years, many students have expressed concern about the delay from the moment they contact the PCC to the time they are seen. Bandas and Kipper-Smith believe that the transition to short-term care will free up availability for students contacting the center for the first time.

“Eighty-five percent of all requests are seen within seven days,” Kipper-Smith said. “We understand that it is a combination of the times we are offering and a student’s availability. But in order to address those concerns, we created a navigating distress group that is a drop-in group with skills and it’s a very cool idea that it functions as a holding group until they have their first therapy appointment.”

Center for Student Well-Being

The Center for Student Well-Being is another resource on campus that students can utilize for support with a variety of issues such as personal health and stress management. However, the impact of the implementation of short-term services at the PCC will be difficult to measure when it comes to the CSW.

“Right now, because of Health Insurance Portability and Accountability Act (HIPPA) Protections, the CSW doesn’t know if the PCC refers a student there,” Bandas said. “So I think we need to develop a mutual referral system so we can assess the effectiveness of both departments as well as their joint effectiveness.”

Because communication between the two centers is limited, there is no data regarding the caseloads and referrals. With high demand for services and inability to share clients’ information, these two resources experience difficulty with assessing the referral system and its effectiveness.

Looking Forward

Graduate students plan to build on their petition and continue a dialogue with the administration regarding mental health care. In response to the PCC’s new practices, the graduate student union organizing committee intends to pursue policy change.

“The organizing committee is planning to draft a ‘Mental Health Bill of Rights’ which would outline a set of policies that assure students—both undergraduate and graduate alike—that every Vanderbilt student will be guaranteed quality, affordable, professional and comprehensive mental health care, and that financial difficulties will be fully accounted for as needed,” Ahmed said.

As of now, the PCC will continue to operate with a focus on short-term care with the clinical review process in place.

“We cannot afford to offer long-term care to everyone. But we can, and we’re working very hard on offering excellent clinical care,” Kipper-Smith said.

Brandon Jacome-Mendez contributed to this article. 

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Kelly McHale (2020) is a writer for the Campus section of the Vanderbilt Hustler. She is from Fairfax, Virginia but now considers Nashville to be home as well. While she is currently undecided about her major, Kelly is interested in political activism and nonprofit work. Her favorite thing to do in Nashville is explore coffee shops.

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