CAPS Schedules 5,000 Appointments in Past Year

By: Anvi Bhate, Atishay Jain, Ashley Jiang, Ellie Ana Sperantsas

Stress is a constant companion for students and faculty at Exeter—but despite the existence of free, one-on-one counseling services offered by Counseling and Psychological Services (CAPS) and student-run mental health advocacy organizations, many Exonians are hesitant to seek support in bettering their mental health.

CAPS is a department on campus dedicated to creating mental health awareness and support for students, offering individual therapy services, psychiatric consultations and educational programming to the Academy community. Since September of this year, the CAPS office has provided nearly 5,000 individual student and consultation appointments. This number has increased significantly from the average of 1800 total appointments per year over the last 10 years.

The CAPS team comprises seven licensed psychologists: Director Szu-Hui Lee, Associate Director Chris Thurber, psychiatrist Marina Vijayakanthan, psychiatrist nurse practitioner Jean Banville and clinicians Johanna Mautz, Kathy Simon and Marco Thompson. Considering student needs, the CAPS office expanded from two full time members and one half-time member in 1999 to its current group.

According to Lee, CAPS counselors are available to meet with all students both individually and when capacity allows, in small skill based group workshops. Students may schedule an appointment with a counselor on a weekly or sporadic basis for individual psychotherapy.

There is regularly a counselor on-call available 24/7 through a call to the Lamont Health and Wellness Center when school is in session. Regular appointments are set up through an email any time to any of the counselors. Students are also able to switch counselors at any point during the process.

Lee noted that there are no costs or limits to the number of sessions a student may attend throughout their tenure PEA, unlike at many colleges and outpatient care. She added that all information shared during counseling sessions remain private and confidential between the student and counselor unless a student speaks about harming themselves or others.

Thompson explained the variety of reasons that students may book an appointment with CAPS. “Anxiety, depression, academic stresses and pressures, relationship problems, or issues with communication. The spectrum of the kinds of topics that we're talking about really range from things that may last only a session or two, because someone is in a particularly tough situation at that time, and we can help them through that situation. But some students also need more longstanding weekly sessions because there's a continual need to meet with someone,” Thompson said.

Lee said, “Something I think is really unique is none of the counselors live on campus, and that's a very deliberate boundary we set. We have an unique relationship with students in order to protect confidentiality and boundaries. You might bump into us in the dining hall, you might bump into us in affinity spaces, or at various events on campus, but we're not in a dorm and rarely in the classroom. We don't have an evaluative or disciplinary role with students.”

Considering the importance of unfettered and free access to mental health services, the CAPS office is also making efforts to reach out to the student body. “We’re working with StuCo [Student Council] to figure out how to not wait for the kids to come to us, but for counselors to get out there in the community and have us be familiar faces,” Lee said. “I chaperoned the coffee house Friday night, and that was really fun, getting to see some people I know and others just stopping by to say hello. It is important for counselors to be out in the community whenever we can so that when students are ready for counseling, we're not such strangers to them, so to speak.”

In the past, CAPS office has promoted awareness of its activities in the community and through dorms, where counselors are typically assigned to dorms as a liaison with dorm faculty. Despite the pandemic, these efforts have continued all year long

When asked about if a stigma persists with the relationship between CAPS and the student body, Thurber said, “No, not at all. Our statistics suggest that the reality is the opposite of stigma. Utilization of CAPS has blossomed, in part because of de-stigmatization. Most of the referrals we get are from a friend, not advisors or deans or parents. Lots of peer referrals and encouragement suggest that meeting with a counselor has little to no stigma attached. That doesn't mean that there are no students who are uncomfortable coming to therapy. Of course, that's the case as well. That'll always be the case, but it's not social stigma that accounts for that discomfort in my estimation.”

Lee added, “I'll say one more thing about the danger of that old narrative, because we have so many students reaching out. If there's still that narrative that there's a gap between CAPS and student body, that might actually negatively impact the people who are already reaching out because they might feel like, ‘Well, wait a minute, I'm going to see a counselor, what is this gap with CAPS I hear? Should I not talk about seeing a counselor with my friends? Will they judge me?’ Then we might be adding to some shame or unnecessary stress. We should actually celebrate when people reach out.”

Thurber agreed. “It's definitely a sign of strength to reach out to anyone for support, whether that's a proctor or student listener, adviser, coach, teacher, custodian, or a counselor,” he said.

Lee acknowledged the worries that come with seeking help. “I hear a lot of kids who will say, ‘Is my problem bad enough? Is this big enough? Maybe I can just deal with it myself.’ I believe if there's any question that you might just want to run by somebody, that's enough to come to counseling. You don't have to have a diagnosed mental health disorder to come and talk to a counselor. Like Mr. Thompson said, we talk about anything. It could be relationship issues, roommate conflict, time management, stress reduction, and it goes from there. So when in doubt, absolutely come and speak with us, and give counseling a try.”

Thurber said, “I think that everybody on the planet needs a confidant.”

Simon also brought up the flexibility of the role CAPS can take. “I’m open in my idea of what counseling is. I think of it as simply a way to understand yourself, the world, mental health, your family, your history, etc. And with that definition, it’s something that many students could benefit from.”

Thompson said, “My philosophy is, the only way you can get out of your own head is to let somebody else in. And sometimes the conversations that we have in our own head are challenging or obscure, or at times even unreasonable. So if you just need some assistance in sorting that out, counseling can be a place, a nonjudgmental space of self-reflection."

“Often we are asked to make difficult decisions and we want to have some feedback on whether or not we're making the right ones. And it can be as simple as just having someone here to assist you with that,” Thompson added.

Student organizations, such as the Mental Health Committee of Student Council and Active Minds, are working to bridge this perceived gap between the administration and the student body.

Mental Health Committee co-head and senior Sonny Fiteni discussed progress made thus far. “Unique to this year, Mental Health Committee has made dramatic strides to build our relationship with CAPS. We began working closely with Dr. Lee as our first point of contact—discussing objectives in bi-weekly meetings and running initiatives by her office—and as our relationship has evolved, she’s become a close faculty advisor and mentor for us,” Fiteni said.

Fiteni was also no stranger to the symbiotic nature of the CAPS partnership. “Dr. Lee’s expertise has allowed us to develop projects on two fronts—as teenagers, we understand the student perspective, and Dr. Lee offers us valuable insight into how we can apply this perspective effectively from the perspective of a mental health professional,” Fiteni said. “Our discussions with her have also helped the student voice percolate impactfully into private, administrative conversations.”

Fiteni continued. “We focus on three things in particular: destigmatizing mental health by fostering dialogue, organizing events, and establishing a cultural presence in the student body; igniting policy change via student task forces and an increasingly pointed appeal towards the Upper Admin to support student mental health; and internally, reevaluating big picture questions about what forces touch the student experience, and where we can change them,” Fiteni said. “Through student interviews, initiatives like Words of Encouragement, and events like the ones coming up for Mental Health Awareness Month this May, we have worked hard through this year to support students despite the challenges that COVID-19 has presented us.”

Fiteni offered advice for other student groups hoping to tackle complex issues, like mental health, at the Academy. “I’d encourage more student groups to seek coalition with faculty. Our teachers spend so much time trying to articulate the student perspective–help them find it,” Fiteni said.

Students who went to CAPS in the past shared their thoughts and experiences with The Exonian.

Senior Yulian Ye emphasized that CAPS has been a major support system for him throughout his time at the Academy. “I’ve been part of the CAPS program for about three years now. I’ve been primarily working with Dr. Lee, and for me, it started because I was dealing with depression, anxiety, addiction and other things going on. CAPS has saved my life more than once,” Ye said. “With the support that I’m always able to get no matter where I am or what time it is, I feel like there’s somebody that I can always turn to, which is really important to me. Even at home with a private psychologist, it wouldn’t be as readily available.”

Ye’s relationship with CAPS has also grown to be more casual while still maintaining the same consistency. “Now, my relationship with Dr. Lee evolved over the years to more of a check-in thing where it’s less so a life or death kind of thing, but more so a really helpful check-in every week where I could talk about the highs and lows of my week and get everything off my chest that I wouldn’t otherwise be able to with other people,” Ye said.

Similarly, senior Emilio Abelmann, who has gone to CAPS for the past three years, noted that his relationship with Thurber has played an important role in his growth. “I initially went to CAPS for anxiety but that went away quickly and now I go for the fun, intellectual benefit. I’ve always found it super helpful and have now built a meaningful relationship with Dr. Thurber. I’ve continued going just because it's enjoyable,” Abelmann said.

Abelmann continued, adding that CAPS doesn’t only have to be about getting help for serious issues. “[CAPS] has just been a way for me to talk about the things that I have no one else to talk to about,” Abelmann said. “It helps me become a clearer thinker and understand my emotions, my thoughts, and how they interplay with the things that I experience in my day to day life.”

Prep Finn Tronnes shared his own experience with CAPS and the extra layer of comfort and support that it provides him. “It’s helped me a lot. I think also having the option so readily available does make people feel less alone,” Tronnes said.

However, many students believe their struggles are not serious enough to require professional help. “I've expressed multiple times that I'm worried my problems aren't 'big enough' to warrant CAPS’ time,” upper Anne Chen said. “But I've always been discouraged from this line of thought. I've learned to trust myself and my feelings, and to value my problems as worthy of time and attention.”

Tronnes shared similar thoughts. “People tend to downplay their own problems in their mind. A lot of people don’t think of their mental health problems as big enough to get help, even when they could benefit from it,” Tronnes said.

Another concern for some students considering reaching out to CAPS is confidentiality. “The general conception people have of CAPS is that they are not to be trusted,” senior Caleb Richmond said. “If one would want to talk about certain issues that they have, in which school rules were violated, they feel as if they don't have confidentiality to discuss all the issues that are facing, which might keep them from going to CAPS in the first place.”

A challenge Ye faced before going to CAPS was the idea of being vulnerable with an unfamiliar person. “When I was a lower, and I began dealing with depression, anxiety and addiction, I was hesitant to reach out despite seniors and proctors encouraging me to go, just because I thought it was weird to talk about such personal and intimate things with someone who is otherwise a total stranger,” Ye said. “The idea of [talking to a counselor] just didn’t seem natural to me. I think this is where the stigma arises, where people who have this idea of what they’re dealing with and this idea of who they’re going to be talking to don’t really match.”

Lower Lydia Osei pointed to the difficulty in facing one’s emotions that surrounds counseling. “There's a lot of paranoia involved in seeking help—feeling as though they don't want to confront the emotions they already have, but would further be confirmed by a trained professional,” Osei said.

Lower Cassie Perez suggested the formation of additional support structures, such as mental health affinity groups, to provide space for students to support each other. “Yes, we need one-on-one help. With individuals, however, most students don't speak out about their mental illness because they don't know that other people are struggling. They don't know that their friends are struggling. If there was an affinity group, that students could go to share their problems. Or even if they don't want to say anything, if they just want to sit there and be like, I'm not alone in this like that. For me, that would have been awesome,” Perez said.

Osei, resident of Langdell Hall, added that although dorm culture is an additional source of support for many, some still struggle with feeling isolated. “Within my own dorm, we have a pretty solid culture and I can talk to anyone about anything. But I also see people who don't feel as though they're comfortable enough with other people inside of their dorm to talk about anything that they're going through. So, they end up feeling isolated with a lot of their issues,” Osei said.

Prep Natalie Welling added that the idea of reaching out for help is sometimes associated with weakness and not “being able to deal with your own problems.” “I think it's normalized for people to have bad mental health or get no sleep. I feel like people think they'll be judged if they did reach out for help,” Welling said.

Upper Nick Talleri emphasised that CAPS provides support rather than helping to solve one’s struggles directly. “I think CAPS supports students and does it’s job very well. Therapy doesn’t fight your battles for you, it just teaches you how to actually fight,” Talleri said. “Unfortunately, a counselor can’t just help you solve your problems, rather, in the end, you’re being forced to think and approach your thoughts in new ways to progress to overcoming any issues you might be facing on your own.”

Talleri continued and noted that having a major crisis is not a requirement to go to CAPS. “Getting mental health help is sometimes viewed as the last action that people take before more serious issues occur. You don’t have to be in the middle of a breakdown to start going to CAPS and getting help. It’s important to speak with someone to get things off your mind before getting help becomes a necessity,” Talleri said.

Ye urged students who are facing struggles to reach out to CAPS for support. “Talking to somebody and being that vulnerable is scary, really, because you go in thinking, how could this person possibly understand who I am and what I'm going through? More importantly, how could they possibly care about that? But they do. They really really do. It goes beyond CAPS counselors doing their jobs. They do it because they care about kids. It’s always really hard to take that first step forward, but I just want to say that if you’re struggling and if you’re having a hard time with anything, your struggle has validity to it,” Ye said. “Taking that first step and trying to get help is the best thing you’ll ever do for yourself.”