Maggie Neal

Student expectations, reality of counseling services often different

Part two of a three-part series on the challenges of campus mental health

Just under 10 percent of the students at USC use counseling services in a year. Of those roughly 3,200 students, most choose to return for a second session. But there’s a fundamental conflict, said Director of Counseling and Psychiatry Warrenetta Mann, between the expectations of students and the services the university provides.

“Making it go away immediately isn’t necessarily the goal of counseling,” Mann said. “And I think that’s hard because what we’re used to is what happens when we go to the doctor and they, you know, say, ‘Here’s the diagnosis, here's what’s wrong, here’s what we’re going to give you, and if you take all these pills in about seven days this should go away.’ And mental health isn’t like that.”

But mental health services on campus are a lot broader than traditional counseling, from student initiatives to online programs.

On a Wednesday evening in the Office of Multicultural Affairs, a small group of students has congregated in the Intersection Lounge. Mostly peer listeners from the new Gamecock Reach group on campus, there are also a few supporters and a few people just checking out the free coffee during the Stigma Free USC Week meet-and-greet. Katie Cohen, the Student Government secretary of health and wellness, started the group last year. The peer listening group aims to help students struggling with anything from relationship problems to severe depression. Cohen sees it as a more approachable alternative to formal counseling.

“Gamecock Reach is there for students who just want to vent and who don’t necessarily feel like a counselor would understand,” she said. “It’s for students who don’t necessarily want to be counseled by an adult and would rather have someone their age there to just vent to.”

While the program is still small, with just 11 peer listeners, Cohen said that she hopes it’ll expand as more people come. This is its first full semester of operation and it offers only four hours once a week, but she wants to expand to more days as the service gains steam. College of Charleston started a peer listening program a few years ago that originally struggled to bring in any students but now has good engagement, something Cohen said she hopes to see with Gamecock Reach. At the moment, though, she's still trying to get people aware it even exists.

For students who still want a professional but still don’t feel comfortable meeting face-to-face, there’s another new service: Therapist Assisted Online. Through TAO, students learn about the mental disorder they’re dealing with, video conference with a USC counselor and complete daily exercises that take just a few minutes. Although just 56 students used TAO last year during the pilot program, this year it’s available to anyone through the Student Health website.

Second-year marketing and management student Sharon Maguire started using TAO this semester on a referral from another counselor. She especially appreciated the educational aspect of the service and uses it in addition to traditional in-person counseling.

“If we're already paying for it, we might as well take advantage of it,” she said. 

When she started having anxiety in high school, Maguire's parents didn’t understand how someone so outgoing could have anxiety. She took the initiative to seek out therapy on her own. While originally she kept her struggles to herself, she’s opened up in college.

“I think I’ve proven my worth in so many other ways that I don’t find it to be a weakness anymore,” Maguire said. She got into painting around the same time she started having anxiety and now runs a business selling her work. She started seeing a counselor preventatively as soon as she arrived on campus as a freshman, which benefited her later in the year when she began to quickly spiral and already had a relationship with her therapist.

“I don’t think I’ve ever met anyone who did go to counseling and left feeling as worse as they did going in," she said.

Not all students have had that experience, however. Several students said that they wouldn’t go to USC’s counseling service because they’ve heard bad things from friends. With thousands of students a year going to at least one counseling appointment, there’s inevitably a big range of experiences.

Mann said that some negative experiences are inevitable but that students should request a different counselor instead of never returning. Most students — 76 percent — fall between two and 10 sessions, the maximum included for free. And overall, about two percent more students at USC seek out counseling than the national average. USC doesn't have higher instances of mental health conditions, according to the National College Health Assessment, but USC students diagnosed with mental health conditions have higher rates of treatment. A typical student-to-counselor ratio is 1 to 2,500, and USC's is 1 to 1,750.

“I see those numbers being higher not as a bad thing, that we have more mental illness, but that our counselors are working very hard to make sure they get around to every student that needs it and that we have put systems in place so that they can address those needs,” Mann said.

But even with more counselors than the national average, wait times are inevitable — especially with the triage process. Students seeking counseling must attend an appointment first to determine which services best fit their needs, resulting in wait times up to two weeks before seeing a counselor in person. Mann defended the triage process, saying it was necessary when dealing with large numbers of students and helped match services with needs. 

She attributes much of the negative feedback to a misconception about what the services are for. She said that students who come in looking for a quick fix or to feel instantaneously better are bound to be disappointed.

"I think the biggest challenge for campus mental health right now is the expectation that when you come to college, while we can provide a number of incredible resources to support students, that somehow everything you need in your whole life will happen here on campus," Mann said.

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