Should You See Your Local Shrink?

IS YOUR twelve o'clock just too early in the day? Is that last exam just one too many? Is your roommate blowing your skull? Are you getting more sleep now and enjoying it ever so much? Have you noticed a tensiontic in your left eye? Are you crawling the walls? Ever thought of ending it all?

If this is your bag, the chances are that during your four-year sojourn at Harvard you will be tempted to call for help!

But where will you turn? Perhaps to a Cliffie with an absorbant shoulder or you'll make a quick phone call to the familial fold. You can have a long chat with a college chum or get unsolicited advice from your Freshman proctor. All these solutions have their advantages, but no friend in need has the skills of your local shrink.

Many a lost lad, however, has second thoughts about going to the University Health Service psychiatrists. They fear, and with some justification, that a record of their weak moments will work against them when applying to graduate school and for future jobs. Graham Blaine, Chief Psychiatrist at UHS, admits that many students are discouraged from using the Psychiatric facilities because they know that they will be questioned about any treatment they have received. Blaine, however, maintains that the fault is with the grad school and job application questionnaires and not with the confidentiality of the psychiatric records.

"We never give out a student's record to anyone until he has signed a release," Blaine said. But students are put under not-so-subtle pressure to sign the release. First the applicant will be asked if he has ever been to see a psychiatrist. If he says yes, he is asked to sign a release. If he refuses to sign a release, it will probably be assumed that he is hiding something.

Blaine explains that if the student involved has just been treated for some relatively minor problem, there is usually no problem in describing it as such. If a student has been "seriously ill," however, the UHS is obliged to describe the full extent of his disturbance. "In order to give the student his choice." Blaine continues, "we read him the text of our evaluation before sending it off." There is, of course, always the option of lying when asked whether you have ever been to see a psychiatrist-but on all of the government forms for either employment or grants, the small print at the bottom advises the applicant of the heavy jail term for falsification.

In spite of these discouragements, the number of students, faculty and employees who visited psychiatrists at the UHS last year increased nine percent over the previous year. Nine percent of the Harvard undergraduate body (441 students) and a little over 14 percent of Radcliffe (169 girls) saw UHS psychiatrists last year--on the average. Cliffies had twice as many appointments as Harvard students.

In order to cope with the increase, a walk-in clinic was established where students could come in with their problems between nine and twelve on week-days and be seen by a senior psychiatrist. The psychiatrist quickly weights the case and decides whether the student could wait for a regular appointment or should be treated immediately. Before the clinic was established. Blaine explained, this important decision was often made by a secretary. After regular hours, there is always at least one psychiatrist on emergency call.

Although Blaine feels that the facilities are adequate in general, he admits that "we are always pressed for therapy time." A number of students are farmed out to private doctors to complete their treatment so that UHS psychiatrists can hold a certain number of hours week open for new patients.

Numerous students complain that although the walk-in clinic looks efficient enough, once you have had your initial interview, it often takes weeks before an appointment slot is open. One student recounted how when he went to UHS and asked for a psychiatrist, he was immediately shuttled off into a little room where a doctor asked him if he had ever contemplated suicide. Once having convinced the doctor that he was not suicidal, he was issued three tranquilizers and sent away. After waiting two weeks for an appointment he found a private psychiatrist outside of the Health Center.

Another undergraduate who asked for treatment was told that the UHS didn't take students for long term analysis and that he would have to find a private doctor. Later that year, he attempted suicide--the psychiatrists changed their mind and took him in.

There is no doubt that the increasing number of people using the UHS psychiatrists reflects a greater awareness among the faculty and employees of the college that the service is available. But the disturbing figure is the number of students who have to be sent to mental hospitals for extensive treatment. There were "more than 30" such cases last year: a record high. Blaine says that the increase may reflect the inability of students to take a year off without being drafted--and these are the students who are apt to feel that they are under pressure and need a change of scenery.

Since 1958 the suicide rate at Harvard has remained fairly constant at two or three a year; somewhat below the national average. This figure represents a decline of some fifty percent from the preceding decade. Although this would appear a victory for UHS, the number of attempted suicides still remains at an incredibly high 10 to 25 a year indicating that suicide continues to be a problem at Harvard.

While the UHS may avert a number of suicides through therapy, it rarely gets to see the students who do commit suicide. "The student who successfully attempts suicide has usually never had any contact with our Psychiatric Service," Blaine said. Thus the UHS has yet to attract some of the most disturbed students on campus.

UHS psychiatrists also come in contact with a number of student drug users. If a student comes to UHS with a drug problem he will be treated discreetly (both with antidote and counseling). He will neither be reported to the police nor to University authorities. "We like to feel," Blaine said, "that anyone can come to us with their problems without fear of implication." In terms of statistics, Blaine continued, the number of LSD cases had dropped dramatically from last year's total, but that "there seems to be more talk of marijuana."

Perhaps the greatest problem that the Psychiatric Service will face in coming years is the ability to communicate with the wide variety of students who go to Harvard. The most common complaint among students who have rejected the counseling they found at UHS is that it is narrow minded. Although not all of them use exactly this phrase, most of the dissatisfied feel that the Establishment doesn't understand them and thus is incapable of helping them.

For example students who take drugs at the University know that they will be received with open arms at the Health Center, but they may have heard stories about psychiatrists lecturing students on the "problem of pot." Most drug-users don't consider pot a problem, but rather feel that the society which sees pot as a problem is sick.

Since 1958 the suicide rate at Harvard has remained fairly constant at two or three a year... the number of attempted suicides still remains at an incredibly high 10 to 25 annually.

Many of these students are not "far-out heads" but perfectly normal people who have a different value orientation from the doctors they meet at UHS. And it is not only drugs which separate these students from their doctors--many have ideological and moral differences which cut them off from psychiatric help.

Outside Advice

As a result most of these students either don't go to UHS or else quickly abandon the psychiatrist they have been assigned. Some of these students--popularly considered the alienated fringe but probably closer to the norm at Harvard than elsewhere--find sympathetic listeners in the Soc Rel Department; others have talked with Robert M. Coles, research psychiatrist to UHS.

If UHS psychiatrists are going to cater to all of Harvard, they will have to learn to be more open minded; they will have to make their definition of sickness a little more elastic. They will, in effect, have to become a little more hip