New School students are entitled to 12 counseling sessions each year as part of their health services fee. However, growing demand and insufficient staffing at Student Health Services have left many students without access to these resources.

Forty-four students were on the waitlist for counseling appointments as of Feb. 25. According to data from Student Health Services, the waitlist reached a high of 90 students in the fall 2017 semester. The waitlist for services has grown steadily over the years. It reached 50 students in the 2015-2016 academic year and 75 students in 2016-2017. The number of walk-ins increased more than 35 percent between the 2015-2016 and 2016-2017 academic years.

Tracy Robin, assistant vice president for Student Health and Support Services, started her role in 2000, and has since seen the demand for services grow. The waitlist for appointments “starts happening earlier in the semester than it used to, and it gets larger than it used to,” Robin said. The office is considering alternate ways to meet student demand, such as reducing the number of sessions offered to each student in order to see more students, hiring more counselors, and offering more alternatives to one-on-one counseling sessions, Robin said.

If a student has a flexible schedule, “we usually can assign them [to a counseling session] in three or four weeks. Some people sooner, if they’re high risk,” said Dr. Jerry Finkelstein, director of counseling at Student Health Services.

An estimated 37 percent of New School students screen positive for moderate or severe depression, according to the 2016-2017 Healthy Minds Study, a web-based survey conducted at the University of Michigan used in over 180 colleges and universities in the past decade. Of the 2,062 New School students who were surveyed, 13 percent screened positive for severe anxiety. Of students who screened positive for depression or anxiety, 43 percent had received therapy or counseling in the past twelve months, according to the study.

In 2016, The New School partnered with JED Campus, a mental health advocacy program for colleges. The ongoing four-year partnership began by building a mental health task force of students, staff, and faculty from across the university in order to assess the state of mental health resources at the university.

Working with the task force, JED Campus developed recommendations for The New School. The task force created a report that cited growing demands for counseling. “It is clear that Counseling Services would benefit from more resources to increase staff in order to meet students’ needs,” the 2017 report said.

Aside from personal health insurance, New School undergraduate students who are enrolled in more than six credits pay a $370 Health Services Fee each semester. Since 2013, the fee has increased 21.3 percent. The budget for Student Health Services grew 17.4 percent in the same period.

Students who request counseling services are first seen for brief assessments to evaluate their needs and create a treatment plan. The wait-time for an appointment then depends on the counselor’s assessment of a student’s need, placing a priority on students dealing with life-threatening issues. “We do have to do a little bit of triage with the waitlist,” Robin said.

The university has also looked at potential resources throughout the city, according to Michelle Relyea, senior vice president for Student Success. Some students prefer to find services outside the university, but administration still wants to assist in that process, Relyea said in an interview in November 2017.

But outside referrals are a concern for some people who have been looking at the issue. “The very important interface for a student in crisis needs to be here on campus,” said Cecilia Rubino, chair of the Lang theater department and a member of the mental health task force. For students in crisis or international students unfamiliar with negotiating New York City healthcare, “it could be really rough,” Rubino said.

“Having all students be individuated, so they are known as an individual — that may not be a corporate thing, [but] frankly, I think it needs to be a moral imperative of an educational community,” Rubino said.

“I appreciate that if a student is stressed or a student is not well, that I know that I can trust that I have somewhere I can refer them to where attention will be paid,” she added.

Last year, when the waitlist for counseling shot up to 75 students, the department hired additional therapists to come in for a few hours. “Just to make a dent, because that was getting really way out of control,” Robin said. Funding for those hires was provided through the office of Student Success.

Counseling, as well as Wellness and Health Promotion, offers group counseling sessions and individual mindfulness sessions. Groups and mindfulness sessions “keep [students who are on the waitlist] connected to us,” Finkelstein added. “The further the string stretches, the more it breaks, the more people don’t show up.”

Students who are unable to receive care at school face additional hurdles when they go off-campus. Student Health Services provides referrals to outside therapists or counselors to students who prefer to not join the waitlist, have used their 12 sessions or require specialists not available on-campus.

Being given the option of waitlist or an outside referral “would discourage anyone, regardless of their mental health, but for someone with anxiety or depression or any other mental health concern, that’s like a punch in the face,” said Lang junior Bernie DeVito, a member of the mental health task force.

“There are few practitioners who accept Aetna insurance and often there are long wait lists in community mental health clinics,” according to the mental health task force report.

At the counseling center, advanced Ph.D. students work with licensed staff to care for students. Clinical psychology students at NSSR can apply for externship positions, conducting sessions with up to eight students per week while receiving supervision from counseling staff.

Up until the past two years, counseling had as many as 18 students on staff, said Finkelstein. Those positions allowed the center “to double the amount of services we [could] offer, and it’s all for free. Even with all that, we still [had] difficulty meeting demand.”

This year, there are seven Ph.D. students working in New School counseling. Three students are from NSSR, while four are from Adelphi.

Since externs are only at The New School for one academic year, students often have to see a new counselor each year. “It was difficult to really, first of all, open up. You know, meet someone new, trust them, and have them help you after that, and then they leave,” said Ashton Garcia, a Lang sophomore who has used Student Health Services for counseling and psychiatry.

Relyea said that while the need for counseling is evident, the university is trying to look at other student support systems as well. “How do we balance the need for more counseling with things like homelessness, crisis management, the food pantry, all those things?” she said.

In a typical semester, 25 percent of degree-seeking students use Student Health Services, according to Relyea. Other students express the need for more academic advisors, internship guidance, and residence hall activities, Relyea said. Her job, she said, is to listen to the needs of all students, “and [figure] out what student success should look like in years to come, and what the needs are going to be.”

According to Finkelstein, students struggling with mental health issues often avoid seeking services until “they get to this breaking point, and they come in, and you wish they had come in two months before.”

If a student is put on a waitlist and reached out to after a few weeks, the crisis may have temporarily subsided, and they may avoid services, said Finkelstein. “Had they been seen at that point, maybe the work they did would have prevented them from having another ‘high boil.’”

Finkelstein acknowledged Student Health Services is not the only part of the university under financial constraints.

“As the director of a counseling center, my concern is the people who come in and can’t be seen. I can only see it from that view,” Finkelstein said. “It sort of sometimes feels like you’re in your own world, and you’re not quite sure who out there recognizes what’s going on.”

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Illustration by Ashlie Juarbe