Centralizing Mental Healthcare

Harvard has a mental health problem. Surveys have shown it, Crimson articles have investigated it and undergraduates in need continue to suffer from it. The current system of care is rife with problems—from a lack of centralization and file sharing to a troubling dearth of funds. But it is the first problem that is most pressing; right now, students are prone to get lost between disparate campus organizations providing everything from counseling to medical attention, and many choose to avoid the confusing web of institutions altogether. The College’s mental health task force, created last December to address the rising number of concerns on campus, must make effective centralization of the system the starting point for any plan to improve mental healthcare on campus.

The Harvard mental health system has two main branches—the Bureau of Study Counsel and University Health Services (UHS)—which both serve undergraduates. Though there is some question among administrators about the mission of the bureau and its role treating students with mental problems, 931 students from the College received psychotherapy there last year. UHS, on the other hand, provides students more serious medical treatment for mental health problems, including prescribing drugs.

Unsurprisingly, the bureau and UHS have problems with coordination. Many students do not even realize that the bureau is a resource for mental issues, and when they do, students are often confused by the decentralized manner of care. The two organizations did try to launch a “coordination of care” system last year, which allows students to release their medical information to be shared between the bureau and UHS. But there is no central location for files, and a student seeking treatment with their non-primary caregiver could be left with doctors who have no record of the student’s previous problems, a great danger especially when prescribing drugs is involved.

One solution might be an electronic file sharing system. The mental health task force is investigating this possibility. If this can be instituted legally and efficiently, it should be put in place as soon as possible. And even if a computer centralized database is unfeasible, the bureau and UHS should both keep treatment records for all students who signed the release. Constant communication is also essential to update the files each organization keeps.

But sharing student files won’t solve the whole problem. Harvard’s is a unique predicament—most schools have just one healthcare provider in charge of mental health treatment. Harvard’s bifurcated structure demands some kind of central management to make sure the two parts are cooperating. Right now, the only overseer of both parts is University President Lawrence H. Summers. The University needs to appoint someone else to supervise mental healthcare on campus, replete with a central office available to direct students to the proper organization and assist in coordination. This should not be difficult to do; the University already created a similar central office last spring—the Office of Sexual Assault Prevention and Response. There are many reasons students avoid seeking treatment, such as the stigma attached to it and the difficulty in recognizing mental problems. Harvard should not let bureaucratic incompetence give its students another reason to avoid treatment. Centralize the system first. Then move on to less fundamental problems.