The CAPS Conundrum
Examining the state of mental health care at U-M
—By Mai Tran
“Has anyone actually been helped by CAPS?????,” asked a Reddit post from over 2 years ago on the University of Michigan subreddit, an online forum for all things U of M. This post sparked a debate, with some speaking out on how CAPS has helped them discover temporary solutions, while others claiming it’s better to seek outside resources. With many skeptical students expressing mixed feelings about the state of professional mental health care on campus, it is not unusual for a student to ask, what resources can I rely on?
Universities are meant to offer foundations for knowledge and growth. And yet, the mental health support systems within institutions at large, and at the University of Michigan notably, often leave much to be desired. In the shadows of these doubts and questions, the spotlight shifts to the professionals on campus tasked with providing crucial mental health support.
The harsh landscape
The University of Michigan is not alone in struggling with its mental health care efficacy. A 2021 qualitative study on sentiments from university students on mental health support access indicated that oftentimes, students felt that their problems were both “not severe enough” and “too severe” for the care offered by campus services. They also cast doubt on the quality of care offered, questioning the qualifications of providers. These are only a few of the barriers that keep students from reaching out to the help they need.
This truth doesn’t help, especially given that the conversation on college mental health often gravitates towards the alarming rates of suicide on campuses, coupled with growing diagnoses of stress, anxiety, and depression disorders. According to the annual Healthy Minds survey, there has been a historic rise in the number of students grappling with serious mental illnesses, especially as a consequence of the Covid-19 pandemic. The national statistics also paint a sobering picture: suicide ranks as the second leading cause of death for this demographic, with approximately 1,100 suicides occurring on college campuses each year. Among University of Michigan students alone, 26% have reported some degree of suicidal ideation, with certain at-risk groups experiencing significantly higher rates. For instance, transgender and gender-fluid individuals report a staggering 64% prevalence of suicidal thoughts, while those with disabilities or a self-reported GPA below 2.4 face elevated risks as well. Financial stress, isolation, and academic pressures exacerbate the vulnerability of students to mental health challenges.
We all know CAPS
The Counseling and Psychological Services at the University of Michigan, known as CAPS, is the number one on-campus resource students are referred to when they find themselves in need of support. You can see them plastered on every class syllabus, with professors often suggesting, “If I can’t help you, I would recommend CAPS.” This kind of universal advertising would lead many students to believe that CAPS is the definitive mental health service.
Students and faculty may not be aware that CAPS operates on a temporary counseling system. If you’re looking for support, but it’s not immediate or urgent, you will be placed on a waitlist until the next available counselor is assigned to you for five to seven free counseling sessions. However, if you have been experiencing serious mental health issues or suicidal thoughts, CAPS offers a 24/7 hotline to address immediate support, followed by a consultation and scheduling for a few free sessions.
In theory, this system may work on a busy college campus where students only require a pick-me-up mental health service. However, for those who are looking for more systemic support for long-term problems, this may work out differently. Park (not his real name), a junior at the University who had to take a break from school from severe burnout, shared his feelings about accessing CAPS’ network: “[CAPS] is a hit or miss. I’m sure lots of folks feel the same. You either get someone you really bond with but know that you’ll have to give them up after a few sessions, or they’re not of much help overall.” Speaking more on the support he received, Park shared, “The day after I called their hotline, they kinda just gave me bucket list items to go over when I’m in crisis, and told me they would schedule me in for next term.” His statement seems to be echoed by many other students on campus, if the mixed sentiments on this Reddit post are anything to go by.
A pressing dilemma
A common challenge for CAPS service providers seems to be reducing the stigma around receiving care for students. Addressing this matter, Todd Sevig, the Director of CAPS, said: “Stigma in accessing care or acknowledging mental health problems exists in some groups and tends to be higher for some populations, including international students, students of color, men, and LGBTQ+ communities, among others.” This perspective poses an interesting juxtaposition to what students think may be a barrier to their access to care. Perhaps it’s true that in addition to the long wait and limited availability of care, students are also hindered by their own perception of what constitutes therapeutic services and what CAPS can offer them. CAPS within the microcosm of the University may also reflect the state of mental health care throughout the state, or even the country. Sevig notes, “Data show that even when students want a referral for off-campus care, they often do not follow through due to barriers of wait time, cost, not wanting to use insurance, location, or scheduling constraints.”
On the bright side, it seems that CAPS is taking this issue into account. Many CAPS staff members emphasize their rigorous process of collecting feedback from students who receive service. Determined to improve upon past lackluster reviews, they now work closely with several student groups, including the Student Health Advisory Council, the CAPS Student Advisory Board, and student government organizations. “We regularly ask for student feedback, including weekly patient satisfaction surveys, an all-student survey from a consulting firm in Winter 2023, and other surveys for randomly selected samples of students…. We look over all results carefully and often incorporate feedback into our plans and outreach,” said Lindsey Mortenson, the Executive Director of University Health and Counseling (UHC) — a brand new unit integrating University Health Services (UHS) and CAPS, aimed to centralize health care resources on campus and strengthen access from beginning to end, reflecting her promise.
Continuous community efforts
To combat this concern and the rising number of students who need support, CAPS has been initiating efforts to provide us with many options. Speaking on this commitment, Mortenson said, “We have more resources than ever before to support our students’ mental health. This includes not just the long-standing offerings through CAPS, Wolverine Wellness, or UHS, but also through the continuum of care and the important addition of Uwill. Uwill offers free virtual counseling for our students after hours, with diverse providers, and in all 50 states and many countries around the world. We know that having choices about care options is key in mental health.” Moreover, following a 2021 pilot program, CAPS has now been incorporating individual peer counseling as one of its services.
CAPS providers also urge students to engage with additional student organizations on campus to reduce the stigma as well as form communities to support each other. Wolverine Support Network (WSN) and the U of M chapter of Active Minds (AMUM) are some of the student-led mental health care advocacy and service-providing groups for students on campus. Speaking on the virtue of WSN, Paige Bost, a junior at the University of Michigan and one of WSN’s peer leaders, said, “[Community-based care] is a space I’ve always wanted to be in. [WSN] really gave me experience with supporting my peers in a controlled environment but also being the point for people to kind of wind down after a difficult day of classes. I know how busy it can get around here, being able to be a part of making someone’s day better is just very valuable, and I find a lot of students also sought and found value from what we do.”
It seems that these student-led initiatives have taken roots on campus. When asked why she thinks this might be the case, Lois Kim, a graduate student at the University of Michigan who previously represented AMUM, highlighted that these student-led initiatives are often aimed at destigmatizing mental illness, promoting campus-wide dialogue, and making self-care more accessible to the general student population. However, there are also important areas where institutional support could be enhanced to better meet the diverse needs of the student body. “We don’t have enough funding or expertise to talk about [mental health challenges and how to overcome them] at length. We can provide a little wind-down as a student org, but at the end of the day, if the foundation of [the school’s support system] is not strong, there isn’t much else we can do in terms of providing care and advocating for an organization that can’t promise much.”
Echoing Kim’s central statement, while initiatives like CAPS demonstrate the University’s commitment to supporting student mental health, challenges persist. Long wait times for counseling appointments, limited session availability, and the need for more comprehensive support beyond temporary solutions all highlight areas where improvements are needed. As we navigate these complexities, it’s crucial to recognize the importance of collaboration between university resources and external providers, as well as the invaluable role of student-led organizations in fostering a supportive campus community. Voices from other campuses have made valuable additions to the discourse. An article in the Daily Tar Heel, a student publication at the University of North Carolina-Chapel Hill, voiced the same concern on the adequacy of on-campus mental health support, highlighting the lack of space for students to unwind. Surfing Reddit again, I found public discourse from the perspective of mental health care providers, offering their thoughts on working for an on-campus mental health care service. Among the responses, what stood out most to me was the emphasis on long hours-little pay, short-term services, service rationing, and many other institutional limitations.
This is, and has always been, an institutional issue. We must call out those who systematize these services. There is a stark need for mental health care resources distribution, as reflected in a recent Michigan Daily editorial. However, it is also important for us to highlight the efforts that have been put in place given institutional limitations by passionate healthcare workers at CAPS, working tirelessly against the grain. Said Sevig, “Staff at CAPS are deeply knowledgeable and passionate about college student mental health, and students can meet with them for no out-of-pocket costs. We know that having choices about care options is key in mental health.” Moving forward, the University must continue to prioritize mental health support, addressing systemic factors contributing to student stress and ensuring accessible, comprehensive care for all.
If you or someone you know is in need of mental health support, please reach out for help. If someone is in immediate danger, call 911. Get connected to the National Suicide Prevention Lifeline by dialing 988. Get 24/7 help from the Crisis Text Line.
For University of Michigan students, here are some on-campus resources:
Counseling and Psychological Services (CAPS)
CAPS Individual Peer Counseling
Sexual Assault Prevention and Awareness Center (SAPAC)
University Health Services (UHS) Psychiatry Clinic
University Health and Counseling (UHC)
Feature Photo: “Seeing the beautiful brain today,” by Alina Grubnyak on Unsplash