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Harvard's Remote Mental Health Services Elicit Mixed Reviews

Harvard University Health Services is located in the Smith Campus Center.
Harvard University Health Services is located in the Smith Campus Center. By Ryan N. Gajarawala
By Fiona K. Brennan, Crimson Staff Writer

After the coronavirus outbreak prompted Harvard’s Counseling and Mental Health Services to transition to solely remote care, some students have voiced appreciation for CAMHS’s continued support, while others raise concerns about the quality of its communication and its care.

CAMHS has been operating virtually since March 18 to limit the potential spread of COVID-19, Harvard University Health Services Director Giang T. Nguyen wrote in an email. CAMHS did not send an email directly to College students about its service changes, however, until this Thursday evening. In the email, Chief of CAMHS Barbara Lewis offered information on available options for individual phone therapy and video therapy sessions, which will become available starting the week of April 13.

Some students, however, say they were unaware of the changes CAMHS has made to its care model. Marcus M. Trenfield ’21 said he has visited CAMHS regularly since the fall of his freshman year, usually meeting with his clinician one to two times per month. But after University President Lawrence S. Bacow announced that students were not to return to campus after spring break, he “assumed” CAMHS would stop providing care.

Trenfield said that because of current social distancing protocols, he did not expect to continue therapy until he returned to campus.

“I just gave up on therapy,” Trenfield said. “I was like, I guess I'm just not doing therapy for the rest of the time until next semester, because people are really avoiding in-person meetings, and I probably wouldn't want to see someone in person.”

Trenfield wrote in an email that, at first, he was unaware that CAMHS had transitioned to phone calls for therapy sessions. He said he was “surprised” when, just days before his previously scheduled appointment, he received a confirmation email from CAMHS.

Though Trenfield said he is “grateful” that CAMHS is continuing to provide care, he expressed concern that students might remain unaware of the changes because of a lack of sustained, effective outreach.

“I do feel like CAMHS is running into issues that it runs into often, where it develops services or changes services, and then isn't outspoken about it and doesn't get the news out to students,” he said. “I don't know why we haven't had one mental health themed email or an important update, where it's just like, here are the different mental health services that you can use.”

Cameron P.G. Clark ’22 reiterated this concern, saying CAMHS has not been “particularly effective” in informing students about changes to its services.

Tania Veltchev ’22 said she believes CAMHS must be “aggressively straightforward” in the information it provides to students so that those who need mental health resources are able to easily access them.

“I think people need to be spoon-fed, step by step, as simply as possible, how to get engaged, get involved, and get themselves help in this case,” she said. “The people who are going to need the help most aren't going to have the focus or the energy to work things out if they come across roadblocks.”

Veltchev said she feels that video and phone calls for therapy are “far from ideal,” particularly because it is hard to read body language online, but that it is better than the alternative of no therapy at all.

Therapy via phone or video call also pose challenges for students who do not have a private place to speak; Trenfield, for example, said he had to sit in his car for privacy during his phone therapy session.

In an interview last week, Lewis said she understands this problem and added that being at home also poses difficulties for clinicians, who may have children to take care of. However, she said, both students and clinicians have been finding ways to adapt to the new situation.

“Some [students] have gone for walks and had sessions doing that. It's not 100 percent private, but I think it's okay to do that way,” she said. “A few [clinicians] have been working outside of our scheduled hours because of those challenges and I'm happy with that just because it's accommodating the students and also just trying to fit it into what they can do from home.”

For international students, meanwhile, phone calls can pose an additional problem — added cost.

Clark, who hails from South Africa, said a phone call for a CAMHS session would be “crazy expensive.”

Nour Abou-Hussein ’22 said that while she understands CAMHS is “constrained” in terms of what it can currently offer, she does not think the needs of international students are adequately taken into account.

“I see that they are definitely constrained and restricted on what they can do and they are doing the best they can,” she said. “But I still don't think there's enough consideration for international students' needs in terms of mental health or CAMHS services.”

Abou-Hussein said that a phone call from Egypt, where she lives, would be costly, and a video call might be difficult because of poor WiFi connection.

Lewis, however, said in an interview that CAMHS has not yet implemented video capability. This also means that most group therapy sessions and workshops are not being held as usual. She wrote in her Thursday email that group therapy sessions will be available over video once clinician training and individual video therapy sessions are “successfully implemented.”

Veltchev said CAMHS should try to get video groups up and running again “ASAP,” adding that she thinks group therapy is especially important while people are being asked to practice social distancing.

“I think that the value of group therapy right now is tenfold,” she said. “Seeing more people when you have pretty limited access to other human beings right now is a massive, massive, massive predictor of maintaining our mental health.”

Lewis added in an interview that, despite the drawbacks, not having group sessions and workshops frees up availability for clinicians. In addition, the absence of athletes on campus opens up additional time for the two CAMHS clinicians usually reserved for those athletes.

Elizabeth A. Denehy ’22 — a student athlete wellness leader with the Crimson Mind and Body Program, which offers mental health support to student-athletes — said CAMHS has continued providing helpful resources to athletes.

“What they've been doing since we've left school is sending out these information sheets with coping skills, reminding us to self care and also reminding us that we can still make appointments with them,” she said.

Despite any frustrations with CAMHS's changes, many students said they appreciated that it has committed to continuing to provide care, albeit remotely.

“I do think they're trying the best they can given the circumstances and given the really small timeframe we had to leave campus and to suddenly change our lives,” Abou-Hussein said.

—Staff writer Fiona K. Brennan can be reached at fiona.brennan@thecrimson.com. Follow her on Twitter @FionaBrennan23.

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