In March, The Wire released an article about the limitations of mental healthcare in Walla Walla. We focused on the ways in which the COVID-19 pandemic has exacerbated an already dire situation as more and more students seek therapy and psychiatric help for chronic issues.
For students with adequate Washington-based insurance, the ability to return home for care, or the money to pay out of pocket fees, there are some clear pathways to receiving mental healthcare. However, students without those resources may face what senior Donna Devereaux (pseudonym) calls “an uphill, impossible battle.”
For Devereaux, access to mental healthcare has “mostly been predicated on the back of whether or not my insurance can cover someone who’s good, or someone who isn’t. And for the most part it’s been unable to cover [medical professionals] who are good. And so I’ve gotten people who aren’t as good.” In other words, without good insurance, you cannot find good care.
Senior Olivia Petrillo (pseudonym) has encountered similar challenges to receiving necessary support.
“Any time somebody sets out a clear path for getting mental health treatment, it’s like ‘cool. I know the steps, but can I afford the steps?’” she said. “Do I even have access to these things you’re telling me to go do? And if I don’t, then what are you going to do instead? Do I just get nothing? Or are you going to do something? Is this just my job to deal with?”
Cost can be an insurmountable barrier to treatment. Students who cannot afford care in town have no choice but to seek treatment through the college, which does not have the resources to meet the demand. Even before the COVID-19 pandemic, not everybody would be able to find someone at the Counseling Center who worked for them, and regular recurring appointments or prescriptions for needed medications were often unavailable.
Associate Dean of Health and Wellness Rae Chresfield explained in an email to The Wire that, “Whitman College is located in a rural section of the state and it does impact mental health resources available to students. The number of clinicians and the diversity of clinicians available to work with Whitman students is small. There are sections of the country where there are few mental health practitioners. Also, there are very few diverse mental health clinicians accepted to psychology and counseling programs.”
Chresfield went on to state that, “Given all of this information, I have worked to change the demographics of the Counseling Center by hiring people with varied identities and the skills to offer a broader range of interventions. I also encouraged the hiring of a Care Manager and that person was hired as the Care Coordinator in the Dean of Students Office to streamline the access process for students.”
Chresfield and her colleagues are providing some students with a valuable mental health resource. For those whose needs can be met by the counseling center, the quality of care is also relatively high.
“I got really lucky to have a really good couple of therapists here at the counseling center, I honestly think that saved my life,” alum Alan Nylund said. “I was seeing them for two years for different types of therapy, and that was very helpful.”
Nylund had a mixed experience of getting mental healthcare through the Welty Health Center, especially during the 2018-2019 school year. “There were professionals there who were very aware of what kind of help people in an emotional crisis need, and others not so much.”
Nylund was able to get their medication rerouted from Comprehensive Healthcare to the health center, which lifted much of the stress related to insurance. The Wire talked more about Comprehensive Healthcare in the article, “The limits of mental healthcare in Walla Walla.”
However, not everyone is able to find the care that they need through Whitman. It is often the most vulnerable who are left with the least amount of options.
For some of these students, Antonia Keithahn, the Director of Academic Resources: Disability Support Services, has proven to be an invaluable and integral resource. Junior Dana Walden explained that without Keithahn’s support, she may have left Whitman.
“Antonia was the first staff member I ever had significant contact with here at Whitman, and I’m pretty sure without her I wouldn’t still be going here,” Walden said. “Disabled students are always an afterthought at this college, but Antonia really works to advocate for students who need accommodations […]Ultimately, Antonia works to set her students up for success, whatever that may look like for them, and prioritizes our needs over the colleges.”
But Keithahn can only support so many students.
“I already have 210 students on my caseload and that’s me, one person, in a one person office,” Keithahn said. “I can’t actually take on that much more … and still be effective.”
It’s not just Keithahn who’s unable to effectively support additional students. The counselors and other staff members are in a similar position.
“I think that [more mental health resources on campus] would make a difference!” Nylund said. And “making sure that people can get the medication and care that they need. I think that the college has a responsibility to do that as … an institution generally charged with providing a healthy learning environment.”
Having talked to students, staff and faculty both on and off the record, it is clear that Whitman just doesn’t have enough trained mental healthcare professionals to support the needs of the students. Moreover, as it is in most higher education institutions, the college’s leadership lacks formal training in disability and mental health support.
“I do wish that our leadership had some common training in student development, Disability 101, diversity and inclusion work, and access to unfiltered information about what our student body is actually experiencing when it comes to mental health needs,” Keithahn said.
The big question is, what exactly does a college owe its students in terms of safety nets and resources to protect their mental and physical wellbeing?
Prior to attending college, many students are either unaware of mental health issues or have yet to develop them. As such, they do not research a college’s healthcare limitations until they require those services. Instead, they assume that the school will be able to provide support if the need arises. Unfortunately, this is not always the case.
For Petrillo, her impression of the school’s resources did not match up with her actual experience seeking healthcare here, she said.
“The impression I got is that you could go to the counseling center … as a starting point for any mental health issue you were having. And they would be able to deal with it, or direct you somewhere where they could deal with it,” Petrillo said.
But as she went on to explain, resources are far more limited, leaving her and many others with no real options for effective treatment.
There is some information on the limitations of Whitman’s healthcare systems on the Counseling Center website, but for several students that we interviewed, who did not have a history of (known) mental health issues prior to college, those limitations were not readily apparent during the general admissions process or orientation.
“Unofficial Official” Care
The void left by actual mental health resources is often filled by “unofficial official” networks of care, according to the students and staff interviewed.
Many students go to professors for help. As Keithahn noted, “often, it is the faculty members of color, and, primarily, female-identifying faculty members of color that do become these mental healthcare oases for students, but then that puts them in the space where they don’t necessarily feel supported,” both in their work, or their own mental health.
As a group of female faculty of color stated in We Need to Thrive: A Manifesta, “Compensate us for the additional labor we do mentoring and supporting students of color who vastly outnumber us and often seek us out when they need help. We are counselling students on racism and sexism while experiencing it ourselves.”
Accommodations and mental health support are vital to the wellbeing of students, but the lack of standardization and training for the faculty has created a situation in which, as Keithahn said, “faculty function almost as independent contractors in a lot of ways.”
“Because we are a private institution that has put a lot of agency into the faculty body as a whole and to individual faculty members in making those kinds of choices for their classes,” she explains. “It becomes really difficult to do a big switch and say, ‘we are going to require that you are doing x, y, z.’”
This means that, depending on which professors a student has during a given semester, they may receive entirely different accommodations and levels of understanding.
For Nylund, their experience with faculty has been largely positive, with professors who “advocated for me and kind of like, ran interference vis a vis the administration, making sure that I could get the support that I needed so that I didn’t have to go through a whole series of meetings, I could just say, this is what I already talking about with my professors, can I get this formalized?”
Devereaux has had more mixed experiences.
“It always seems like you can just kind of tell … who’s going to be receptive, and who’s going to look at you like you’re making stuff up to get out of classwork. Those are the two reactions that typically happen. Or the [professors] that when you show up after not being in class because of something, who will give you a hard time about it in front of the whole class … which still happens a lot.”
They continued, “[the intentions of professors] are not often, I feel, extremely negative, it’s just a lack of education, just an ignorance in that field. Which I understand, but at the same time I feel like it’s the institution’s job to educate their faculty on how to deal with that … And I feel like [that hasn’t happened].”
Another issue is that faculty and staff may also lack adequate healthcare and support themselves.
“I can’t imagine what it’s like for the faculty, because as students I don’t think we worry so much about our faculty members, but I know that our faculty members definitely worry about their students,” junior Tricia Ferrer said. “And having to deal with your own work, your own research, your own classes and also worrying on top of that about your students, and how you personally can care for them when the institution that you work for isn’t helping them at all.”
Keithahn hopes that, under new leadership, the college will choose to pursue standardized training for all faculty members regarding mental health.
“I do think that we could probably do more work on the faculty development perspective in creating inclusive content and being more aware,” she said. “Specifically when it comes to mental health, about the types of diagnoses that are happening on campus and how it intersects with the academic environment, and how to [keep] that in mind when creating your course.”
Resident advisors (RAs) are another “unofficial official” group that support student mental health.
Kazi Joshua, the Dean of Students, explained that the purpose of residence life is, first and foremost, to help create community.
“RAs are a very crucial part of the student experience and community building at Whitman,” Joshua said. “They welcome students to their home away from home, help them connect with others, give them information about academics and social life on campus and community. In short they are guides to first and second year students. They also function as trusted allies and invaluable support systems in the absence of family.”
“My RA my first semester was like a life saver, she was the reason I made it through that semester,” Devereaux said. “[She was an] extremely amazing well of emotional support and just, an incredible human being in all ways. And absolutely the reason I was able to be… kind of successful that semester.”
While the work that RA’s do is invaluable, the extra work that they take on can be detrimental to their own wellbeing and mental health, especially when the lack of professional mental health resources forces them to act not only as “guide,” but also as a major, or even only source of support. While RAs are trained to support their residents in a variety of capacities, they are not trained to act in place of mental health professionals.
As Andrew Johnson, the Associate Director of Residence Life and Housing, stated in an email to The Wire, “[We try] to make clear that RAs are not therapists and should not be primary supports for students dealing with mental health struggles. RAs are students first and need to be focusing on their own wellness, and we try to provide them with the tools to be setting appropriate boundaries … If a student is really struggling with a mental health challenge, we help to get them to professional resources … In these cases, their role is really more to support and refer students to other resources.”
Kazi Joshua, the Dean of Students, similarly stated that RAs are not expected to act as mental health professionals.
“They are students first and foremost […]” Joshua said. “We see the role of Residence Life staff as a resource to help students identify and connect with the support they need whether that be from a trusted mentor or friend or a counselor on campus or off campus. In emergencies there is an on-call counselor, as well as a 24/7 call service that assists and provides for specific guidance during a crisis.”
Interviews with RAs, however, revealed a dichotomy between administrative expectation and the reality experienced by students. Because of the lack of professional resources available, and the counseling center being particularly overburdened due to the pandemic, RA’s are inevitably expected to take on the mental health of their peers, despite how the administration might envision their role.
Chresfield explained in an interview from March that was featured in “The limits of mental healthcare in Walla Walla,” that “[the Counseling Center] entered the semester with a waitlist of about 30 people. It started like that. And we were able to schedule folks pretty quickly. The issue became that over time the list got longer and longer, because we were trying to figure out how to see all the folks who are waiting to be seen; and at one point, [the wait] was about a month, maybe a month and a half. Then it was about three weeks. Now it’s about a week.”
The difficulty, Chresfield explained, is that there are only six counselors, and “we had to do a lot of…critical evaluation of clinical skills, to say, who needs to meet every week? Who can meet every other week? Who can meet once a month? Then we had to go even deeper and say, who has health insurance that they would be able to utilize? That’s not what we wanted to do, but knowing that each of us were at capacity ourselves, and there was still a list, we had to reach out to students to say, we are only offering Telehealth, so we will help you connect with your health insurance, So we have done all that we can think of given that there are only six of us.”
Therefore, immediate responses to mental health crises, as well as some long term support, continue to fall on the shoulders of RAs, and students struggling with mental health feel that they have nowhere else to turn.
For Petrillo, who worked as an RA in 2019 and was dealing with her own mental health issues, “It was so hard to manage everything because [the administration] would always say, you’re a person first and a student second and an RA third, but I felt like there was so much pressure to do RA stuff. I guess that I didn’t have enough time to be a student or an RA to the extent that I needed to, and that’s not even counting being a person because I was a husk of a human being the whole time. I was not taking adequate care of myself at all.”
This sentiment was echoed by Walden who, while not an RA herself, has several friends who worked as RAs.
“They’re being told how to handle emergency situations and many of them are already naturally emotional caretakers,” Walden said. “But they’re not being trained [to be unofficial mental healthcare providers].”
According to Johnson (Residence Life Office), RAs are only meant to serve as a first point of contact for students struggling with mental illness, after which they should contact their resident director (RD) or they are “encouraged to reach out to the Counseling Center, the Health Center, the Dean of Students Office … and in some situations other offices like the Intercultural Center or the Financial Aid Office.”
“In general it seems like there is kind of a disconnect between what the admin is doing and what the RAs are doing,” Petrillo said. “And it’s sometimes hard to know if the admin is doing anything at all, or what they’re doing, or if it’s enough. Because you just have the initial contact with the resident and report it up the chain and you don’t have any more contact from there unless a student tells you. Yeah, I don’t know what they’ve done, but some of my residents have struggled and I’m not sure they are really getting the help that they need.”
She added that, “I feel like [the admin] are aware that RAs do talk to their residents about this, and I feel like they sort of use us as tools to initiate mental healthcare when a resident needs it.”
Nylund said that in their experience, “[RAs] are keeping this institution functional.”
Johnson also admitted that, “I do worry about the pressure that RAs are under, and I think colleges nationwide need to be thinking about how we best prepare and support these valuable and impressive student leaders in these positions.”
It is also important to note that some RAs, especially First Generation/ Working Class (FGWC) students, rely on the room and board that comes with being an RA in order to continue their education. This effectively means that RAs must take on the mental wellbeing of others as yet another prerequisite for graduation, while, at the same time, leaving their own mental health untreated.
“I was interested in being an RA because I was just interested in being an RA, but I don’t know if I would have been able to afford to stay [at Whitman] if I hadn’t been,” said Petrillo, who is an FGWC student. “I rely pretty heavily on the room and board compensation from being an RA, and it was definitely kind of frustrating to feel like this was my only option, and so I was sort-of being forced to take on other peoples issues and I was willing to because I signed up to do it […] but towards the end [I felt like I] was kind of forced into it by Whitman, and it was a lot.”
At the same time, “I didn’t have access to mental healthcare and even if maybe I did I was too nervous about the potential cost,” Petrillo said. “And being at Whitman you feel like you don’t really belong here and they don’t really want you here because they don’t give you the support that you need.”
What is the administration doing?
Whitman has worked towards matching the mental healthcare services offered by other small liberal arts colleges, but those programs have failed to account for Whitman’s unique situation and location.
It’s difficult to make any meaningful comparison between Whitman and other institutions when it comes to mental healthcare resources, Keithahn explained.
“You’d… have to think about ‘what is a reasonable comparison school?’” Keithahn said. “Let’s say [you compare Whitman to] Reed College [which is part of] the Panel of 13 [but is located] in Portland with a lot more health and mental healthcare resources. Is that a comparison school that is actually apt, or should we only be comparing against other institutions that are more rural and smaller schools? … what kind of comparison can you draw?”
If a school like Reed was unable to offer adequate support to a student, they could go into Portland and likely find a professional who accepts their insurance. At Whitman, this is often not an option. And for BIPOC and queer students who may not feel safe in this part of Washington, there are additional challenges. Comparing Whitman to other liberal arts institutions without considering the isolated location does not provide an accurate measure of what resources Whitman needs to be providing for its students.
It is often the most marginalized members of Whitman’s community that face these challenges, but their needs have not always been a financial priority for the college.
Ferrer argues, “It’s a matter of priorities, really. I don’t think anyone would really buy a lack of financial resources on the college’s end to fund healthcare on campus. Like, I don’t think anyones gonna say, “how are we going to pay for it?” Because they know that we are paying for things that we probably shouldn’t be paying for in the first place!” In other words, “if the college really cared about their students’ health, they’d find the money for it.”
So, what is a priority for the college?
Watching over Residence Life and other structures at Whitman is the Coordination Assessment Response Education (CARE) Team, a group of administrators tasked with keeping an eye on students’ wellbeing.
According to Keithahn, the CARE team is Whitman’s version of a Behavioral Intervention Team (BIT), which were first adopted by many institutions after the Virginia Tech shooting in 2007.
These teams were initially designed to prevent large-scale tragedies, but have since broadened their scope to be, as Keithahn said, more “inclusive of lower-level (but still acutely needed) mental health interventions.”
On the Whitman website, the CARE Team defines itself as “a group of staff members who meet regularly to discuss issues relating to the academic, emotional and physical health and safety of our students and campus community. This group works together to assess reported behaviors of concern and provide resources and support to students who may need it.”
It is composed of nine staff members including Keithahn, and is chaired by the Dean of Students Kazi Joshua. While Keithahn was unable to speak to the selection process, she did explain that it was based on recommendations made by representatives from the National Association of Behavioral Intervention and Threat Assessment (NABITA). These recommendations include the Dean of Students, Security, DEI, Athletics, Disability Support, Health, Counseling and Residence Life.
However, Keithahn commented that the CARE Team is not at its most effective because much of the community is unaware of its existence and purpose, a sentiment echoed by the students interviewed for this article.
“Prior to the start of the pandemic, there was going to be some sort of rollout of ‘this is what the CARE Team does’ or ‘this is who they are’ or ‘these are the types of information that would be helpful to pass along’ in order to build a community of care,” she said. “That, of course, didn’t really happen, so it seems like a weird shadowy group doing who knows what in a corner of Memorial Hall somewhere.”
Keithahn hopes that “now that Whitman has committed to an in-person and relatively normal fall 2021 semester there may be a renewed effort” to publicly establish the CARE Team as an important resource for students, staff and faculty.
During weekly meetings, they go through a series of cases and try to determine the most appropriate ways in which to address a situation or follow up with a student who has been brought to the attention of the CARE Team by their peers, faculty or staff members.
Donna Devereaux, in her experience with the administration, has found that the way things are now, “the systems that are in place, […] often they are kind of predicated on you making the first move, and then when it is them making the first move, they act like you’re going to kill yourself.”
She continues, “on one hand I think they are trying to make sure people are safe, but on the other hand it very much feels like, oops, uh, and like let’s try to manage this situation as well as we can because we don’t want to lose a student because that would look bad for us.”
The way that the CARE team functions (as a mechanism to prevent tragedy), while important, often leaves students to fend for themselves until their issues are considered serious enough for administrative intervention, according to some students who have had dealings with the Dean of Students office.
The CARE team may prove more successful with broader student awareness and outreach, but even so, it should not be confused with mental healthcare.
As demonstrated by the sudden surge in students being seen by the Counseling Center or seeking support from Keithahn’s office, mental health issues are a very real and persistent threat to student wellbeing. According to several of the students interviewed by The Wire, chronic mental health is not a new issue at Whitman, it has simply been rendered invisible to those who have not experienced it because of the duality of the Whitman experience.
As Keithahn puts it, the story of mental health at Whitman is a “the tale of two Whitties.” On one hand there are those who can access the treatment that they need with the barebones frameworks in place, and on the other are those who cannot. While the COVID-19 pandemic has exacerbated mental health issues across the entire campus, it is as always, the most marginalized students that are continuing to go untreated while the standards for care are being set by the needs of a predominately white, healthy and wealthy majority.
Keithahn explains, “We have two Whitmans’ in a lot of ways, and here I’m going to be the admin person that talks about why this is a societal problem, it can come down to these massive financial differences with accessing education [and healthcare], and that’s not an easy thing to solve for.”
While these issues are complicated, finding an innovative solution needs to become a greater financial priority for the college, according to students interviewed.
“I feel like we sometimes fall into the trap of only moving forward with an idea if it is a norm in our comparison institutions,” Keithahn said. “So, rather than pushing for transformative change, we instead conform to a perceived standard that doesn’t represent the unique needs of our student population.”
She continued, “So, some of it just takes vision with leadership, and that’s something we’ve lost out on in the Kathy Murray era. I really hope we take the opportunity with this new leadership decision… that there is more of a focus on true inclusivity and justice when it comes to our student body and what we can do.”
The administration’s favorite phrase is, “your business here is to learn,” but we have yet to address the question, how can students learn if they are also being left untreated for valid health concerns?
“Every time they say, your business here is to learn it implies that if you aren’t being productive you’re a failure of a student and they don’t want you,” Senior Olivia Petrillo reflected. “Sometimes I feel like your business here is to treat me like a person, and not hurt me all the time with your pressure to be productive! And you’re not doing a very good job with that.”