Access to mental health services varies by students' degree

Because she was nearing the university’s limit on counseling sessions, Ella Strei chose to stop using University Health Services for mental health care. Out of therapy for more than five months, Strei said this gap in care led to what she called “nightmare” withdrawals after her prescription ended.

She wouldn’t have had to make that decision if she was studying medicine or engineering instead of wildlife ecology.

UW-Madison students have different access to UHS mental health care depending on major or school. Students in the College of Engineering or the School of Medicine and Public Health (SMPH) have no limit on appointments and a shorter wait time.

SMPH’s Director of Student Services Chris Stillwell described this as “enhanced access.”

Andrea Lawson, interim co-director of UHS’ Mental Health Services, agreed with Stillwell, saying it’s accurate for students to note that there is different access.

This means most students can see counselors less often, and their visits take longer to schedule than those in the SMPH or the College of Engineering. Most students can see a counselor 10 times in a calendar year, and a total of 20 times while at UW-Madison. Wait times vary, but 17 business days is the average time before an initial counseling session, according to Lawson.

Strei called the discrepancies in care “blatantly unfair.”

Several explanations for why these two schools need more access were given, but people consistently asserted that it is due to these students’ different academic workloads and tough schedules.

Strei strongly disagreed, saying those reasons don’t “really add up.”

“I don’t really think their reasonings for why [those students] don’t have that 10-session cap really apply,” Strei said. “It just doesn’t really make sense to me.”

For students in the SMPH, the increased access has led to greater use than the general population.

One out of five SMPH students using UHS go past the 10-session limit imposed on other students, according to Lawson. There is not a similar report for engineering students.

As a student with limitations, Strei said the cap was a “haunting deadline” for her, as it was always on her mind when scheduling an appointment or finishing a visit.

When she finally quit, Strei said she regressed mentally.

“Stopping going to UHS because of the 10-session cap did set me back because I was out of therapy for like five months then,” Strei said. “The way I had to stop then, I was kind of weaning myself off of it. I definitely got weird withdrawal effects.”

Because of how she left, Strei said she felt like she couldn’t even go back to UHS to check in to see what she should be doing.

Students in the SMPH, on average, visit UHS 5.8 times a year, which is more than 20 percent higher than the general student population’s rate of 4.8 visits.

However, there is no significant increase in use for engineering students. Engineering students have a similar amount of average visits per student as the general population does (4.7 visits for engineering students and 4.8 visits for the general population, according to Lawson).

The increase in access comes from the additional money the colleges pay to UHS.The College of Engineering pays for half a full-time UHS employee (about $50,000) a year, while the SMPH pays for one full-time employee (about $100,000) a year. Stillwell said this money does not come from any additional fee for students and is just built into the college’s budget.

For the SMPH, this puts the counselor-to-student ratio at one to roughly 750, significantly better than the one to 1,733 ratio for the general student population. Lawson said this is the reason SMPH students can come in and see someone sooner than other students.

Both of these schools likely came to UHS for the partnership, which has now been around for about 15 years, according to Lawson.

There is a written contract between UHS and the SMPH, though it is vague in additional services provided; there exists only a verbal agreement between the College of Engineering and UHS. Both agreements are renewed automatically every year.

Lawson still said that neither the students in the SMPH or the College of Engineering have their needs fully met, but said the additional money is a step towards that goal.

“If students need ongoing, long-term care for mental health concerns, we’re still not going to be the place for that to happen best,” Lawson said, explaining that this is due to a lack of funding.

She said UHS is still trying to increase general funding to improve access to mental health services for all students, regardless of major or college.

“That’s part of why we’ve gone with a general student fee to increase our resourcing so that we can better serve the rest of the population,” Lawson said. “Instead of having different parts buy into us, our hope is to have a seamless and cohesive unit.”