Report Finds Mental Health Services Lacking

Mental health services at Harvard are understaffed and inefficiently coordinated--though improving--according to a report to be released today by a special committee organized by University Provost Harvey V. Fineberg '67.

The committee's findings come after eight-months of interviews with about 75 students and administrators and an examination of mental health resources across Harvard's nine faculties.

The 10-member group concluded that Harvard must do more to train its faculty and residential staff and to build stronger communication between mental health providers across campus.

"The mental health service is understaffed, especially considering its multiple constituencies, locations and its complex obligations to a diverse student community," the report reads.

The report represents the first comprehensive look at mental health care across the University and was headed by Fineberg, Harvard's point-person for inter-faculty initiatives and a former dean of the School of Public Health.

The report cites patients' frustrations with long waits for appointments and their difficulty in getting care after-hours as among the most pressing student concerns.

These findings support a survey of students released in October about University Health Services (UHS), in which 36 percent of those surveyed said they viewed UHS' mental health services unfavorably.

The provost's mental health committee brought together a number of prominent campus administrators and the University's lead mental health professionals.

"We had a vehicle through this committee to bring people together," said Committee Chair Paul Summergrad, associate professor of psychiatry at Harvard Medical School.

According to Summergrad, it was difficult for the committee to conclude that mental health services are in fact understaffed.

Although UHS, Harvard's largest mental health care provider, employs 13.37 clinicians for 21,000 visits every year, there are no industry-wide standards for how many clinicians universities should provide.

"There are no great benchmarks for this," Summergrad said. "Given that, we had to make a judgement call."

Among the committee's recommendations was the creation of an 11-member Student Health Coordinating Board to help compile information about health services at Harvard.

That board, which will include a group of clinicians and administrators--who have already been selected--will begin meeting monthly in January to discuss implementation of the report's other recommendations. It will also help coordinate increased training for all faculty and staff who come into frequent contact with students.

Yesterday, Summergrad called for a "core curriculum" of basic mental health care knowledge for all those who work with students--not just mental health professionals but faculty members, administrators and House staff.

The report also recommends improving access to mental health services--efforts that UHS Director David S. Rosenthal '59 said his organization has already begun to implement.

"There have been a lot of perceptions about long waits in the past," Rosenthal said. "If you look over the last year, there have been very few waits."

Rosenthal said UHS has also tried to make its operating hours better match student schedules, to establish UHS liaisons in the Houses and increase staff during points of the year that are traditionally more stressful for students.

The report also recommends better coordination among all the different counseling and advising services available to undergraduates, graduate students and staff.

For example, undergraduates can turn to their House tutors, the Bureau of Study Counsel, peer counseling groups or UHS when they have a problem.

"[The current system is] both confusing and potentially helpful. We think the system needs to be more transparent to students," Summergrad said. "We think it's important that there not be only one portal for care."

The report addresses what a number of administrators have long acknowledged as problems.

Yesterday, Dean of the College Harry R. Lewis '68 applauded the committee's work--and said he would support further mental health training for tutors and further student input.

"It has always seemed to me odd that proctors are systematically evaluated before reappointment, and even faculty are evaluated, through CUE questionnaires, before they are promoted, but there is no requirement that student opinions be solicited before a tutor is reappointed," Lewis wrote in an e-mail message.

Lewis and Fineberg yesterday said they hoped the report would lead to ever better health care on campus.

"The most significant element of this report is putting the student needs first," Fineberg said.

--Gregory S. Krauss and Daniel D. Springer contributed to the reporting of this story.