Harvard Is Doing Better

The mental, physical, and emotional wellbeing of the students at Harvard and all of our patients has always been the top priority for Harvard University Health Services. We are continuously working with students and the entire Harvard community to improve the services we offer and increase the quality of care that we provide.

Over the last decade, mental health has been a main focus for HUHS, administrative leaders, and students at the University. In 2000, the Provost’s Committee on Student Mental Health Services established a University-wide Student Health Coordinating Board to encourage collaboration, review standards and goals, and help educate the University community about available resources for students dealing with mental health issues. In 2004, a student mental health task force was created to examine the common and sometimes serious mental health problems faced by students. Undergraduate Council representatives and other students were members of both of these groups. These efforts resulted in the restructuring of our mental health and academic counseling areas to provide an overarching strategic view of these services for students at the University.

The student mental health task force had several other recommendations for the University, many of which have already been implemented, such as the addition of wellness tutors in the Houses, focused specifically on emotional wellbeing. Since that time, HUHS has continued to improve the mental health resources available to students. Some of these efforts include hiring more full-time psychiatrists, increasing the number of visits for mental health treatment through the Student Health Insurance Plan from 12 to 24, and working with over 200 students in the peer counseling and peer education programs. Students, including UC representatives, currently serve on the College/HUHS committee, the Student Health Planning Committee, and the Student Patient Advocate Workgroup.

Harvard has more full-time mental health staff than most other colleges. The national college average counselor to student ratio is 1:1600, and for private universities of our size it is 1:937. Harvard’s ratio is 1:750, not including the counselors at the Bureau of Study Counsel. The national college average of students seen for mental health concerns is 8.6 percent. In contrast, HUHS Student Mental Health Services cares for 15 percent of College students each semester.

In the spring of 2012, we invited three national leaders in student mental health to conduct a comprehensive external review of SMHS. During their visit they met with students, SMHS staff, residential life staff, and College administrators.

They concluded: SMHS is a well-run clinic that maintains health-related confidentiality as a top priority. According to the reviewers, there is a perception that SMHS is not working solely for the administration, so it is not perceived by students, faculty, and staff as having a political agenda. Instead, they continued, the University community trusts that SMHS is there for the care of the students. The review also found that SMHS is well resourced relative to similarly sized institutions and to other Ivy League schools, especially if one includes the BSC’s licensed psychologists and social workers, and that SMHS provides comprehensive individual and group counseling services, which have above average utilization numbers. Many students reported that once they were in the system they felt that they received great care, though it could be hard to get an initial appointment. Students, faculty, and staff all praised SMHS crisis services, and agreed that students were always seen in an emergency.

The external review helped us identify areas to focus on, and in response, SMHS initiated changes to improve access to first appointments for routine visits, and now has two full-time staff positions dedicated to access management and urgent care services. Anyone with an urgent need can usually be seen within 24 hours, and anyone with an emergency can be seen almost immediately.

In addition to these areas that we are working to improve, HUHS already has many well-established services and is accustomed to dealing with the different medical and mental issues that students face. HUHS currently provides a wide range of support and treatment options; in addition to these services, we also offer group and peer counseling and assistance with finding outside providers.

The mental health resources at HUHS are available to all students. All registered students are required to pay the Student Health Fee, which covers mental health and a wide range of other services at HUHS.

Students are also automatically enrolled in the Student Health Insurance Plan, which covers prescription drugs and inpatient and outpatient services outside of HUHS. Students with their own, comparable health insurance may waive enrollment in the Student Health Insurance Plan. However, insurance provided by other carriers may not provide the same level of benefits or access to area providers. We encourage students to carefully review their health plan coverage before deciding to waive enrollment in the Student Health Insurance Plan. Detailed information about coverage and waiving the plan can be found on our website, hushp.harvard.edu.

At HUHS our mission is to ensure that every student receives the care that he or she needs to succeed both personally and academically. As a community, we must work together to create an environment where this is possible through open communication. My door has always been open to discuss students’ concerns and suggestions for improving services, and I encourage students to contact their representatives on the various committees mentioned above or our Patient Advocate when they have concerns about our care.

Paul J. Barreira, M.D., is the Director of Harvard University Health Services.