|The Thistle||Volume 13, Number 2: Dec., 2000/Jan., 2001.|
The State of Mental Health at MIT
When a student takes their life, everyone in the community is affected. Questions are raised as to what if anything could have been done to prevent such a tragic outcome, or at the very least make it less likely to happen again in the future. While some in the administration fear that a discussion of suicide actually contributes to the likelihood of future suicides, many in the community feel that an open dialogue on this issue is one of many steps needed to improve the overall emotional health of our community.
Even among those who agree that a discussion of depression and self-destructive behavior is needed, there is passionate disagreement about exactly what these discussions should focus on. For example, Veena Thomas complains in MIT’s student branch of the corporate media, The Tech, about students misusing suicide statistics to help promote their “pet” agendas. Clearly thoughtfulness is required, because the people closest to the ones who we have lost deserve as much caring, compassion and support as we can give them. A large part of the silence on the issue of suicide on campus has its origin in the fear that bringing the topic to the surface will reopen painful wounds. Friends and family often blame themselves and wonder what more they could have done to prevent the loss of a loved one by suicide. The “What if’s” are infinite. But it seems that the great feeling of loss makes objectivity or fairness impossible. This is not to advocate self-rationalizations or to claim that we don’t touch each other in myriad ways, but it is to say that life brings forth many challenges to one self and to one’s relationships. So, if someone wants to blame themselves for what could have been better, then in simple fairness, they must also take comfort in all the little things (and large things) that were good. Giving of oneself is never a perfect process- we are all finite, imperfect, limited by our small angle on the truth- but it is nevertheless beautiful and brave to love someone.
While Thomas is right to point out that each number represents a real, irreplaceable human being with particular personal circumstances, viewing these tragedies in isolation also has risks. There are many individual as well as community and societal factors that bring about such a tragic result, and each needs careful consideration. Aggregating cases into statistical groups may seem insensitive, but in doing so we can learn a lot. Consider for a moment the issue of violence against women. Every rape, every abusive relationship has specific individual people and circumstances involved, but only through looking at a statistical pattern does one begin to see that violence against women is both a traumatic personal experience as well as part of a structural and cultural pattern of devaluing women. The only hope of ending this epidemic of violence against women is to learn ways of challenging violence on both the personal and the, possibly more benign seeming at first, structural levels. It is the latter which promotes the tolerance and likelihood of violent incidents being imposed on individual women. Similarly, depression and self-destructive behavior have structural components. None of us is a statistic, completely determined by the environment around us. But equally important is the fact that none of us are as independent from our environment as we might like to believe we are. We are semi-permeable and we cannot always choose what seeps in.
One piece of the problem here at MIT is the culture of how we value ourselves and others. We are not our GPA or our resume or our “intelligence” whatever that means exactly. We are all, every one of us, thinking feeling, inexplicable beings that are inherently worthwhile. All the research and good grades and ideas are just window dressing on the main thing that is wonderful about each of us. We are wonderful because we are, because we exist. Simple as that. The wonder of seeing the snow gently fall, the wonder of feeling hot tea in your hands and your belly on a cold day, the wonder of a friends smile or a good joke, or a twisted dark tree reaching up for the sky, or the feeling of exertion, how it reminds you that you are alive and strong and tied to the earth... and all the MIT science and engineering stuff is just a fun way to think, a bunch of puzzles to work on, a language to build to enable deeper and more interesting puzzles to be solved... but never a measure of a persons worth. We need to keep the pursuit of science in perspective as a fun and interesting past-time while we pass through this incredibly inexplicable thing called life. We need reminders, particularly from our professors, instructors and fellow students, that we are more than a brain. The MIT administration could do more to prioritize the health and well-being of students as well.
MIT Mental Health Services has a huge PR problem, as pointed out by Dr. Peter Reich, director of that department, in a recent article in Technology Review. Some of the PR problem is due to a general skepticism towards mental health treatment as it is practiced in our society, but some of it is well deserved based on the department’s own deficiencies. Complaints include exceedingly long waits for appointments, pressure to go for more inexpensive chemical-based treatments, and being referred off campus only to find the financial support of the health plan too low to make these services available in any meaningful way. Dr. Reich addresses none of these concerns in the article Technology Review article and claims the bad wrap is due to “anecdotal evidence” and an unfair rumor mill. When Thistle members spoke with him, he gave the usual MIT administration lines in response to students who bring up concerns about suicide and depression on campus. These include
-our suicide rate is below that of the normal population,
The Thistle agrees that the complaints against mental health services are anecdotal, but that is because no attempts have been made to study the quality of care and satisfaction of students with services they have received. Absence of evidence is not to be confused with evidence of absence. It makes sense that students who feel concerned about going over to mental health services will ask friends about their experiences. We have heard many reports of students having to wait weeks to get an appointment. Is it possible that such a wait might be too long to be consistent with “good care?” Students are reluctant to deem themselves in an “urgent situation,” even when they are suffering and unable to cope for weeks. From a cost point of view, it is very smart. The student in crisis will either attempt to solve the problem some other way, for example by seeking out friends or family members for support or they will simply lose hope in that avenue of help and not follow through in spite of finding no alternative support system. By making “patients” wait to get care, it might “weed out” the less critical cases from the more severe and keep the caseload down. Or, from a human point of view, it might leave some students feeling left on their own with no clear place to turn.
The often heard reply that MIT’s suicide rate is in line with the average (if we include grad students) is not a satisfactory response to the energy and concern that students are willing to give to the issue in the hope of preventing further needless loss of life. Clearly the student concern is demonstrated very concretely by the efforts of the purely voluntary student night-line staff, which currently has around 20 members who volunteer 12 hour shifts at a time. (And they are good folks, students should definitely call or join them if they can.) Of course, again, this is voluntary, so quite a bargain service for the Institute balance sheet. Even if we were well below “average”, and students were willing to work to make it even a bit less of a risk, why discourage that? Why deflect? There are also many faculty and administrators who would be willing to pitch in on this effort. Should we tell them that for this one issue, we are content to be average? How about a new slogan for MIT medical: “At MIT, we do things pretty much like everybody else.”
Hopefully the newly formed UA task force on mental health issues will be able to affect some change. The fact that Chancelor Backow made it clear that the task force should be led by the professionals, such as Dr. Reich, and not “a small group of students with a special agenda” gives cause for concern. Could that “special agenda” mean striving to reduce incidents of suicide and other self-destructive behaviors. If that is what he meant, he will find that many students have such an agenda. And if Backow is concerned about the purse strings, then we can see why he would want to keep the Professionals, who also just happen to be employees, in charge of things.
Whatever the result of the task force, there are things we can try in the meanwhile. Tod Rodger lost his son, Douglas, in June of 1991. (See letter at end of doc) He said, “I would like to see more personal contact with adults” for students in fraternities and living groups and, “I would encourage more talking about, and more education about this issue.”
The Thistle interviewed Associate Dean Randolph on Tuesday December 5th. The following is an excerpt from that interview:
Q: What could we be doing better as a community to provide more support for people suffering with depression or contemplating suicide?
A: There was a question this fall about how to distribute a letter from a father who lost his son to suicide the previous semester. Speaking of this controversy Dean Randolf stated that “Risking in this community is difficult. People are always ready to point fingers and criticize. But we have to be ready to talk and learn from each other. If we are going to become the kind of community we want to be, then we need to learn from each others’ successes as well as failings.” It is better to talk about these issues, in as incomplete a way as it may be, then to say nothing while we search for the “perfect” way to address these things. We may never get consensus on the “perfect” way, but meanwhile we need to try and initiate the dialogue.
Q: Students have many concerns about the state of mental health on campus. For example, many students complain about 3 week long waits to get a visit at the med center mental health department, which is very frustrating when you are in the midst of a personal crisis of some sort. Others feel they are given only very limited in-house care and then are offered referral. And while off-campus care may be excellent, the $35 per visit allocation from the student insurance plan leaves undergrads deciding between disclosing their situation to parents or stopping treatment and graduate students choosing between treatment and rent. Despite the increase of this allowance to $50 dollars per visit next year. The cost factor tends to pressure students towards the cheaper medication option, which may be the right choice for some, but would hopefully be made based on medical considerations and not financial ones. Are you aware of these concerns?
A: There is a question as to whether walk-in hours work or not. I have been here for 20 years, and the question of referring out vs. in-house care has been around forever. And there is a concern about the trend of drugs being used over talk therapy. It is a concern for me as well. There are many students who feel like people are trying to get them to take meds and they do not want to take medication. Who does?. That makes it harder to reach some students. The goal is to communicate what it means to live in a healthy fashion.
Q: How do we change a culture that students sum up with the mantra, “Friends, work, sleep: choose two?”
A: “MIT by nature is a problem solving kind of place. Some problems don’t have simplistic or mechanistic solutions. In terms of improving technical education, a lot of people feel that ‘If it ain’t broke, don’t fix it.” But we need to look at the more complex normative, value-laden questions. Is it good? Is it right? Could it be better? Can we do better? These are the very reasons I have been such a strong supporter of the work of the Technology and Culture Forum, because they do try to broaden the set of questions.”
Q. MIT has a capital campaign and a lot of enthusiasm about building labs and gentrifying Cambridge. Could we have a campaign to pay for more human contact hours for students with mental health services?
A: “That is a very appropriate question to be asked, what is the division of resources. I am optimistic about the newly created task force on mental health issues. And I think it is important to not overlook the easy questions. If we are asking the right questions, we could find some solutions.”
|The Thistle||Volume 13, Number 3: Dec., 2000/Jan., 2001.|