Counselors Criticize Affiliation With UHS

The 11 full-time counselors of the Bureau of Study Counsel sharply criticized a decision last month that placed them under the control of University Health Services (UHS), arguing in a March 3 letter that the change will “irreparably disrupt and damage” the Bureau’s work.

Two weeks ago, the Bureau began reporting directly to UHS Director Dr. David S. Rosenthal ’59. The change was recommended by the interim report of the Student Mental Health Task Force, released in early March.

The counselors’ four-page letter—which was addressed to Bureau Associate Director and task force member M. Suzanne Renna—said that placing the Bureau under the administration of UHS would render it unable to provide effective non-clinical counseling by effectively integrating it into the University’s clinical mental health system.

UHS Mental Health Services (MHS) currently provides clinical mental health treatment.

“If the Bureau is subsumed within a medical system, its distinct niche within the community will disappear, and, before long, the Bureau and its educational function will disappear with it,” the letter said. “While the Bureau may remain in name and address, its distinctive nature and role will inevitably cease to exist.”

The letter, which was obtained by The Crimson, asked Renna to share the counselors’ concerns with the task force. In particular, the counselors said they worry that unexpected effects of the Bureau’s move to a more clinical setting would detract from its mission to provide advising, counseling and care within an “educational model of fostering learning, growth, and development.”

“We fear that the integration of the Bureau and UHS will irreparably disrupt and damage the intricate ecosystem of Harvard’s community in ways that may be hard for the Administration to anticipate,” the letter said.

The counselors also expressed their concern that the restructuring will “have the paradoxical effect of closing out a large part of the very student population the task force is hoping to better serve,” particularly those students who typically shy away from formal mental health care.

“We are especially concerned about those students who do not conceive of their concerns and struggles as illness,” the letter said. “In particular, international students and minority students are among the many students who typically do not seek counsel in a clinical, medical setting because they do not regard their difficulties as mental health issues.”

Renna declined to comment Wednesday. Bureau Director Charles P. Ducey, who did not sign the letter, also declined to comment Wednesday.

A six-month investigation by The Crimson found that many students view the Bureau as more approachable than UHS, but that its lack of coordination with UHS hinders effective mental health care across the University. The task force emphasized the importance of maintaining a less-stigmatized entry into mental health care in its March report.

Sally T. Weylman, who has chosen to leave her post as a counselor at the Bureau at the end of May, said that she was concerned that placing UHS in charge of the Bureau would undermine the Bureau’s ability to provide effective counseling by compromising its uniqueness.

“We are viewed by students, faculty, and administrators as offering the kind of wise and compassionate services that have become all too rare in this age of fast food and quick answers,” Weylman wrote in an e-mail. “It is our deepest hope that into the future the University will sustain and enhance this unique perspective. Yet we fear otherwise.”

Rosenthal and Task Force Chair Dr. Paul J. Barreira said that the task force has committed to maintaining the Bureau as a separate entity, regardless of the administrative hierarchy.

“This isn’t an integration into UHS—this is a one plus one equals three,” Rosenthal said. “This isn’t really putting everything under one roof.”

University Provost Steven E. Hyman, who convened the task force with Dean of the College Benedict H. Gross ’71, wrote in an e-mail that changes to the Bureau are ongoing and will ultimately make the Bureau more accessible.

“The reorganization enables us to make sure that, wherever students first go for help, they will be able to access easily and smoothly the assistance best suited to their needs,” Hyman wrote. “The Bureau and MHS are being brought together—each continuing to provide its unique services to students, but communicating and working together more effectively under a shared umbrella and a new leader.”

Barreira noted that the Bureau is reporting to Rosenthal only temporarily, until a University mental health leader—an administrator who will oversee all clinical, residential and academic facets of mental health care—is appointed. The University has begun searching to fill the position, and administrators say they hope to have a mental health leader in place by September.

“Part of what seems to get lost in this discussion is that both Mental Health Services at UHS and the Bureau are both reporting to a new person,” Barreira said. “It always sounds like the Bureau is suddenly under UHS. But the task force was careful...there was never any intention or discussion or anything in interim recommendations that suggested the Bureau was going to lose its unique role.”

The letter echoed the task force’s worry about the Bureau’s increasing role in the realm of clinical services.

“We share the concern of the Task Force that the Bureau has fallen into doing active clinical care with severely troubled students,” the letter said. “We want the opportunity to stop providing clinical care and to reaffirm our original mission, which is counseling Harvard students in the service of their learning, growth, and normal development.”

The letter also expressed the counselors’ concerns that the Bureau has not adequately consulted its staff in reaching its conclusions.

“We are concerned that the Task Force has not heard, or perhaps has not fully considered, the case for the University’s maintaining the distinct role of a counseling center,” the letter said.

In the letter, the counselors asked the task force to consider alternatives to integration, and that they be consulted in that process.

But Barreira said that soon after the letter was sent, he met with its signers to address its concerns and explain the task force’s rationale for the Bureau’s new reporting relationship with UHS.

“I think they still wished that the Bureau would remain in a reporting relationship to the dean, but they also understood that that wasn’t going to happen,” Barreira said.

Rosenthal also met individually with most of the counselors and said he attempted to “allay any anxieties” they had about the change. He said that Weylman is the only counselor with whom he has not yet met.

“We are all very anxious to keep their services going, without any change in the access of students to the Bureau,” Rosenthal said.

Weylman wrote that she continued to be concerned about what she said has been an insufficient response to the Bureau counselors’ critiques of the reorganization.

“My leaving is a direct response to the process to which the Bureau has been subjected over the past several years, a process characterized by a profound and consistent lack of sensitivity and wisdom surrounding the choice to move the Bureau from the educational auspices of [the Faculty of Arts and Sciences] into the clinical structure of UHS,” she wrote. “For the past two years, I have witnessed the concerns of my colleagues, all of whom feel passionately about their work with Harvard students, go deliberately and consistently unheeded. This has been profoundly disheartening.”

Another counselor at the Bureau wrote in an e-mail that the “rank and file” of the Bureau’s staff considered the issues noted in the letter of great importance.

“This remarkable grassroots demonstration of unanimity bespeaks the depth of conviction that we individually and collectively feel about the issues we articulated,” wrote the counselor, who asked not to be named.

A source close to the task force said that much of the difference of opinion between members of the task force and Bureau staff was “very much a semantic issue.”

“Their thing is that what they provide is counseling for people that are not mentally ill,” the source said. “They are really resistant to being painted as a place where people who are mentally ill go, because they feel that no one will use the services if they are seen like a place that treats mentally ill people.”

The source said that the task force recognized that people receiving clinical treatment are not necessarily mentally ill.

“There’s no way to not say that if you’re counseling someone about something, then they have a problem about something—whether you call it mental illness or not, it’s just words,” the source said. “People who go [to the Bureau] have some sort of issue that they need help with. They are receiving help from people who can be called clinicians—there’s no way you can’t call that clinical care.”

—Staff writer Katharine A. Kaplan can be reached at kkaplan@fas.harvard.edu.

—Staff writer Stephen M. Marks can be reached at marks@fas.harvard.edu.