Better Isn't Good Enough

I was deeply touched by the anonymous op-ed of the student suffering from schizophrenia. Published earlier this semeser, “In Sight, Out of Mind” was not just a rallying cry, but also undeniable evidence that Harvard must do more for its students all along the mental health spectrum. That’s why I was shocked to read the response by Paul J. Barreira, the director of Harvard University Health Services (who is a Board-certified psychiatrist specializing in depression, anxiety, and bipolar disorders). Instead of addressing the issues posed, he insisted simply that Harvard is “doing better.” This shows not only complacency toward Harvard’s mental health crisis, but also insulting dismissal.

I applaud the progress made by the University, especially the efforts to hire more full-time psychiatrists and increasing the number of visits covered by insurance. But none of this, nor pointing out that Harvard has more mental health staff than“most other colleges,” means that HUHS is doing enough.

Barreira cites that many students felt like they received “great care” but notes that “it could be hard to get an initial appointment.” That the latter was mere afterthought demonstrates the disconnect between students and a defensive and complacent administration. For most students, the difficulty of attaining an initial appointment isn’t an inconvenience—it is the very roadblock that leads them not to bother navigating HUHS’s bureaucracy.

According to the 2012 senior survey, 36 percent of graduating seniors “sought help” for mental health. I wonder, though, how many were truly helped. This inquiry is based not only on anecdotal evidence and that of the anonymous author, but also on my own experiences. My sophomore year, I struggled with depression. After finally getting an appointment, the therapist asked a few basic questions (Did I have thoughts of hurting myself or others?), and after a brief talk, nodded sympathetically and asked if I had ever tried an anti-depressant. After a 30-minute visit, I walked out with a prescription for Wellbutrin—which I never took, since I had just written the obituary of a classmate who committed suicide while on that very medication and whose parents sued Harvard for negligence. I didn’t connect with that therapist and was told by peers that, like dating, it can take some tries to find the right one. But I feared that by the time I had found the right doctor, I would run out of allotted appointments—not to mention that each visit would require “getting in the system again.” I gave up and white-knuckled it through the semester.

That a student is placated with anti-depressants after 30 minutes is indicative of HUHS’s pharmaceutical-heavy approach. After all, real care is more expensive—and requires more licensed psychologists than Harvard currently employs.

Junior year, the same darkness descended after a particularly hard break-up. I didn’t understand how what other students could bounce back from could leave me in tears for months. Once again, I went to HUHS. This time, I was prescribed sertraline and strongly urged to take a semester off.  I can still remember my disbelief. Didn’t they understand that I had left my room for the first time in two weeks precisely because I didn’t want to leave Harvard? That I wanted to know how to live my life on campus? How could an institution that had invested so much in my mind, in the form of full financial aid and a wonderland of academic opportunities, not ensure that it was healthy enough to take advantage?

I now wish that I had done more to address my issues then because in the real world, the difficult becomes impossible. In New York, most good therapists charge $300 to $500 per session, none of which is covered by insurance. Insurance provides only for nurse practitioners, qualified to hand out pills. Even if one had the money, most therapists work weekdays from nine to six—when, of course, you do, too.

College is the ideal time to address mental health, which is why HUHS must take it upon itself to ensure that students do not leave campus without a healthy state of mind. Students have flexible schedules and are surrounded by loving friends. My boss at The Crimson, to his credit, was always accommodating when I needed to change my schedule because depression hit. Meanwhile, alumni find themselves isolated, fearful of telling their offices that they are struggling; while the stigma may be dying on college campuses, it is still alive and kicking in the corporate world.

I hope that Harvard realizes how it is preventing its best and brightest from reaching their full potential. Yes, the solution might be expensive: lifting the limit on therapy from 24 sessions to once a week, for however long is needed; hiring enough psychiatrists to meet demand, such that students can schedule appointments with ease and so those professionals know they can do more than hand out prescriptions.

Mental health care is one of the best investments that Harvard can make in its students—and not the least, in its own future. Only healthy alumni have the strong careers that allow them to give back. While HUHS may believe that it is doing better, for many students and recent alumni, better is not close to good enough.

Nan Ni ’10, a former Crimson news editor, is a Stanford University M.B.A. candidate, class of 2015.