Harvard Students: “Widespread Anxiety, Depression, and Loneliness”

The Harvard University administration on July 23, 2020 released the Report of the Task Force on Managing Student Mental Health, which found that Harvard students are experiencing “rising levels of depression and anxiety disorders, and high and widespread levels of anxiety, depression, loneliness, and other conditions.” The report made eight recommendations and 30 sub-recommendations for improving the university’s support for student mental health.

Harvard University

The 46-page report described a toxic campus culture characterized by stressful academic and social competition, overwhelming workloads, unhealthy faculty-student connections, lack of sleep, isolation and loneliness, fear of failure, financial pressures, worries about job prospects, stigma around mental health, and confusion about when, how, and where to seek help with mental health concerns. The report identified shortcomings in clinical support services.

“People in power should demonstrate that they care about mental health, and I think a cultural change within Harvard as a whole would be important,” said an undergraduate student focus group participant quoted in the report.

The report said that undergraduates reported high levels of stress, overwork, concern about measuring up to peers, and inability to maintain healthy coping strategies. It also found that extracurricular activities at Harvard often represented another source of competition and stress.

Graduate and professional students described high levels of isolation, uncertainty about academic and career prospects, and, among those in PhD programs, financial insecurity and concerns about their relation to advisors, the report said.

The task force was convened by Provost Alan M. Garber and co-chaired by sociology professor Mario Small, Arts and Sciences Dean Emma Dench, and psychology professor Matt Nock. It was led by a 13-member steering committee made up of 10 mostly senior Harvard administrators and faculty members, and three external experts. Eight undergraduate and graduate students served on two working groups alongside administrators and faculty members.

The task force examined data on Harvard’s mental health services, analyzed national and campus surveys, and heard from focus groups representing undergraduate, graduate students, professional students, faculty, and staff. The review was conducted from February 2019 to April 2020. As the task force had completed most of its work before the outbreak of the Covid-19 pandemic, the report does not recommend pandemic-specific response actions.

The task force’s eight main recommendations:

  • Create a permanent mental health team to implement recommendations, facilitate cross-campus collaboration, produce an annual report, and distribute information on student mental health to students, faculty, and staff.
  • Launch a one-year campaign focused on mental health awareness and culture change.
  • Institute an annual follow-up messaging program focused on mental health awareness and culture change.
  • Examine making Harvard’s Counseling and Mental Health Services (CAMHS) more accessible to students.
  • Examine addressing mental health, sexual climate, inclusiveness, isolation, and sense of belonging holistically.
  • Address potential service gaps between the Academic Resource Center, which provides academic support, and CAMHS, which provides mental health counseling.
  • Examine how to reduce stress caused by the process of competing for entry into extracurricular activities.
  • Provide clear guidance to faculty and graduate students to ease stress caused by advisor-advisee relationships.

Notable sub-recommendations:

  • Encourage open discussion about mental health conditions and struggles; the report cites imposter syndrome (feelings of inadequacy despite success), duck syndrome (appearing calm despite struggling), and Sleep Olympics (glorifying hard work at the expense of healthy sleep).
  • Frame mental health awareness campaigns in terms of flourishing (through healthy behaviors), not illness, toward achieving a cultural shift.
  • Incorporate strong mental health messaging into course syllabi.
  • Consider student well-being in setting assignment deadlines.
  • Consider instituting regular faculty check-ins with students.
  • Distribute a road map for navigating mental health support options.
  • Organize events and discussions that allow students to discuss their challenges openly with others.
  • Improve clinical wait times for initial consultations and ongoing therapy.
  • Ensure counseling staff diversity.
  • Improve the process for referring students to community mental health providers and assisting with related financial costs.
  • Explore the use of digital clinical assessment and intervention tools.
  • Examine how to address mental health, sexual climate, inclusiveness, isolation, and sense of belonging holistically.
  • Explore providing a broader faculty advising support network for students.
  • Encourage programs and departments to develop formal and transparent “rights and responsibilities” guidelines and workplace expectations.
  • Encourage mentorship training for faculty and examine expanding incorporating mentoring into faculty evaluation.
  • Improve understanding of student financial need and examine ways of signposting resources for students in acute financial need.

In assessing the state of student mental health, the report noted that rates of anxiety, depression, and other mental health conditions are rising nationally among college students and young adults as a whole. The report went on to describe an increasingly bleak outlook for today’s generation of college students:

“Students across the country are facing structural realities dramatically different from those experienced by previous cohorts. The costs of higher education and housing have soared. The planet has warmed dramatically, and the economic, environmental, and social consequences, now too numerous and too frequent to ignore, have dimmed the aspirations of many who will be forced to deal with the repercussions over their lifetimes. The academic labor market has changed, and while the number of PhD’s has risen dramatically, the number of tenure-track job openings in many fields has shrunk. The changing immigration policy landscape in the U.S. and other countries has unsettled many students and their families. And students were facing all these conditions before the world was forced to confront its worst pandemic nearly a century.”

Undergraduate Students

The report said that from 2014 to 2018, Harvard undergraduates reporting that they have or think they may have depression increased from 22 percent to 31 percent; and those reporting that they have or think they may have an anxiety disorder increased from 19 percent to 30 percent.

In a survey of first year students completed in the first week of classes, 62 percent of students scored in the high range on the UCLA loneliness scale and 61 percent reported frequent or intense feelings of being an imposter, according to the task force. “These concerns do not seem to abate over the course of students’ collegiate careers and likely increase (or fail to buffer against) the negative effects of stress,” the report said.

The task force reported that students do not seem to believe they are getting a clear and consistent message about mental health from the university.

Various forms of stigma continue to prevent students from seeking help, the report said. “Students from families or cultures in which mental illness is stigmatized may find it more difficult to recognize when they are struggling, to seek help, and to get either emotional or financial support from their families while in treatment,” the report said. “And for high-achieving students more generally, it can be a challenge to admit when things are not going well.”

According to the report, students cited the possibility of being put on an involuntary leave as a reason not to seek help.

“Students reported hesitation to disclose their mental health challenges to Harvard-employed counselors and others in the administration, fearing the possibility that they would be asked to leave if they were deemed ‘unsafe’ by CAMHS,” the report said. “Students noted that they may censor what they say to a counselor, or avoid CAMHS altogether, if they think they might be placed on a leave of absence. This situation may leave some of the students most at risk fearful of being open about the depth of their problems.”

Graduate and Professional Students

The report found that Harvard graduate and professional students struggled “within a culture that does not appear to prioritize wellness.” And while graduate students across units struggled with many of the same issues, the report said, schools largely worked in isolation to address the mental health issues for their own student populations.

Approximately 23.6 percent of graduate students responding to a depression screening survey exhibited symptoms of moderate to severe depression, the report said. Similarly, approximately 23.1 percent of graduate students who responded to an anxiety screening survey exhibited symptoms of moderate to severe generalized anxiety.

Across campus, graduate students struggled to establish meaningful connections with peers and mentors, grappled with the feeling that they do not measure up to others in their programs, and worried about making ends meet and finding a job after they graduate, the report said.

Task force focus groups conducted with graduate and professional student populations revealed a strong sense of overcommitment, intense workloads, a feeling that self-worth is linked to academic output, and “that sleep and mental health must be sacrificed for academic success.”

Financial hardship is a major source of stress for many graduate and professional students, the report found. “Students who accumulated debt throughout their graduate studies—in many cases adding to existing debt from undergraduate studies—worried about being able to repay their loans and about the extent to which their loan burden could limit their career choices,” the report said.

Moreover, the task force found, graduate and professional students worried about finding a job after graduation, and many felt pressure to conform to certain expectations about the type of career they will pursue. “Recent years have seen a shrinking of tenure-track positions in many disciplines and fields, causing high levels of stress and anxiety,” the report said.

Students have concerns about displaying weakness or vulnerability in front of both peers and faculty, the task force found. “While student well-being can be bolstered by relationships with faculty that are both personally and professionally supportive, students worry about opening up to faculty who may be in a position to evaluate them either now or in the future,” the report said.

Graduate student surveys revealed a strong correlation between the relationship between a PhD student and their advisor and scores on screening tools for depression, anxiety, self-esteem, and imposter phenomenon, the report said.

In surveys and task force conversations, imposter syndrome emerged as a major factor in graduate students’ mental health, and is likely both a cause and an effect of loneliness, the report said.

Clinical Knowledge, Access and Barriers

CAMHS increased its professional staff by approximately 40 percent since 2015, and as of April 2020 employed 47 mental health clinicians. The CAMHS student to staff ratio is roughly 468 to 1, within the range report by other leading institutions of higher education, according to the report.

Nonetheless, the report said, students who participated in focus groups continued to report difficulty getting a CAMHS appointment in a timely manner, whether for an initial consultation or for ongoing therapy.

Students also cited difficulties when seeking off-campus mental health support. Some reported calling numerous providers only to find that they do not accept insurance, are not taking new patients, or in some cases just do not return the student’s call. “For a student in distress, encountering such hurdles could lead them to give up on finding help,” the report said.

Read: Cornell University Mental Health Review Final Report

Download: Harvard University’s Report of the Task Force on Managing Student Mental Health

Suicide Prevention: A New “Call to Action”

U.S. Surgeon General Jerome Adams on January 19 issued a “Call to Action” report to implement the 2012 National Strategy for Suicide Prevention, a detailed roadmap for preventing suicide in a comprehensive and coordinated way. “Much remains to be done,” the report warned. “Suicide prevention continues to lack the breadth and depth of the coordinated response needed to truly make a difference in reducing suicide.”

The report noted a new urgency behind suicide prevention efforts: the COVID-19 pandemic has now created conditions that may further suicide risk, such as increased social isolation, economic stress, and reduced access to community and religious support. “Problems resulting from the pandemic—including physical illness, loss of loved ones, anxiety, depression, job loss, eviction, and increased poverty—could all contribute to suicide risk,” Adams said.

The report said that in 2019 more than 47,000 Americans died by suicide, and that the national suicide rate increased 32 percent—from 10.5 to 13.9 per 100,000 people—in the 20-year period from 1999 to 2019. The report notes that for every person who dies by suicide, thousands more experience suicidal thoughts or attempt suicide—in a 2019 survey, 1.4 million U.S. adults reported attempting suicide in the past year and 3.5 million adults reported making a suicide plan.

“Although research has identified many strategies that can be effective in preventing suicide, these evidence-informed approaches have not yet been brought to scale,” the report said. Indeed, it added, an assessment of progress toward implementation of the National Strategy showed that few efforts have been comprehensive or strong enough to have a measurable impact on reducing suicidal behavior.

[If you or someone you know feels the need to speak with a mental health professional, you can contact the National Suicide Prevention Lifeline at 1-800-273-8255 or contact the Crisis Text Line by texting HOME to 741-741.]

The report highlights the Zero Suicide Model as one of the key instruments for saving lives. In 2018, the Tompkins County Suicide Prevention Coalition and the Tompkins County Legislature endorsed the model, which incorporates recommendations for “a gold standard of care for people with suicide risk.” The model stresses the need to include suicide prevention as a core component of all health care services, rather than limit it to services provided by mental health specialists, and to improve professional and clinical training and practice for preventing suicides.

The report calls for increased use of a key component of the Zero Suicide Model: a suicide safe care pathway, to ensure that patients at risk for suicide are identified and provided with continuing care tailored to their needs.

“All patients are screened on past and present suicidal behavior, and positive screens are followed by a full assessment. Individuals identified as being at increased risk are entered into a suicide safe care pathway, thus ensuring that they are provided with the attention and support they need to stay safe and recover.

“Components include periodic assessments of suicidality and ongoing follow-up, including contacting patients who fail to show up for an appointment or withdraw from care. The inclusion of family members and other identified support persons in pathway implementation may help support patient engagement.

“Implementation of a suicide safe care pathway requires that protocols and systems be in place to collect and analyze data to track services, ensure patient safety, and assess treatment outcomes. The system should collect data on process measures, such as screening rates, safety planning, and services provided; care outcomes; suicide attempts and deaths; and any other relevant factors, such as sociodemographic characteristics, clinical history, and referrals to other sources of care.

The report noted that in response to the need for a minimum standard of care for individuals at risk for suicide, the National Action Alliance for Suicide Prevention in 2018 developed Recommended Standard Care for People with Suicide Risk: Making Health Care Suicide Safe. It identifies individual recommended practices—such as screening and assessment for suicide risk, collaborative safety planning, treatment of suicidality, and the use of caring contacts—that can be adopted in outpatient mental health and substance misuse settings, emergency departments, and primary care.

Read: What Tompkins County is doing to prevent suicide deaths

The surgeon general’s Call to Action states that while that all 13 goals and 60 objectives of the 2012 National Strategy remain relevant, it is time to focus on six key actions in order to reverse the current upward trend in suicide deaths in the United States.

The Call to Action identifies four strategic directions: Healthy and Empowered Individuals, Families, and Communities; Clinical and Community Preventive Services; Treatment and Support Services; and Surveillance, Research, and Evaluation.

Within those directions, the Call to Action identifies six main actions to pursue:

Activate a broad-based public health response to suicide

Address upstream factors that impact suicide

Ensure lethal means safety

Support adoption of evidence-based care for suicide risk

Enhance crisis care and care transitions

Improve the quality, timeliness, and use of suicide-related data

Download: The Surgeon General’s Call to Action

SUMMARY OF THE CALL TO ACTION REPORT

Action 1. Activate a Broad-Based Public Health Response to Suicide: Inspire and empower everyone to play a role in suicide prevention.

1.1 Broaden perceptions of suicide, who is affected, and the many factors that can affect suicide risk.

1.2 Empower every individual and organization to play a role in suicide prevention.

1.3 Engage people with lived experience in all aspects of suicide prevention.

1.4 Use effective communications to engage diverse sectors in suicide prevention.

Action 1: Priorities for Action

  • State government and public health entities should implement the Suicide Prevention Resource Center’s Recommendations for State Suicide Prevention Infrastructure to support comprehensive (i.e., multi- component) suicide prevention in communities.
  • Prevention leaders from the public and private sectors, at all levels (national, state, tribal, and local), should align and evaluate their efforts consistent with the Centers for Disease Control and Prevention (CDC) resource Preventing Suicide: A Technical Package of Policy, Programs, and Practices, to expand the adoption of suicide prevention strategies that are based on the best available evidence.
  • Federal agencies and state, tribal, local, and county governments and coalitions should strengthen their prevention efforts by developing strategic suicide prevention plans based on available public health data. Mechanisms for the prompt sharing of innovations and best practices should be developed and supported.
  • State and local suicide prevention coalitions and health systems should actively reach out to organizations serving populations at high risk for suicide; these systems should also reach out to individuals with lived experience in order to learn from them and engage them in designing prevention efforts.
  • The public and private sectors should invest in patient-centered research and include people with lived experience in research design and implementation.
  • Federal agencies, mental health and suicide prevention non-governmental organizations, and others conducting communication efforts should ensure that suicide prevention communications campaigns (1) are strategic, (2) include clear aims for behavior changes that support broader suicide prevention efforts, and (3) measure their impact.
  • The federal government (Congress) should expand and sustain support for states, territories, communities, and tribes to implement comprehensive suicide prevention initiatives similar to the Comprehensive Suicide Prevention Program, funded by CDC, and the Garrett Lee Smith youth suicide prevention grants, funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), which have been shown to reduce suicide in participating counties, particularly in rural areas. Funding targeting substance use disorder should be broad enough in scope to allow for interventions that address suicide prevention and related workforce and infrastructure needs.

Action 2. Address Upstream Factors that Impact Suicide: Focus on ways to prevent everyone from suicide.

2.1 Promote and enhance social connectedness and opportunities to contribute.

2.2 Strengthen economic supports.

2.3 Engage and support high-risk and underserved groups.

2.4 Dedicate resources to the development, implementation, and evaluation of interventions aimed at preventing suicidal behaviors.

Action 2: Priorities for Action

  • Private companies and workplaces should leverage their health care benefits purchasing power to enhance employee mental health (e.g., invest in benefits and programs to prevent and treat behavioral health problems) and work to shape worksite values and culture to promote mental health by providing access to crisis support, support to employees following a suicide, and ongoing mental health wellness programming.
  • Suicide prevention leads in federal, state, tribal, and local public health and behavioral health agencies should partner with their counterparts in labor and workforce, housing, health care, and other public assistance agencies to collaborate on strengthening economic supports for families and communities.
  • Foundations and other philanthropic organizations that support early intervention programs— particularly those targeting (1) social determinants of health (e.g., reducing poverty and exposure to trauma, improving access to good education and health care, improving health equity) and/or (2) enhanced social interactions (e.g., improved parenting skills) and problem-solving and coping skills— should ensure that these programs include outcomes related to suicide (e.g., ideation, plans, attempts) and evaluation of those programs for suicide-related outcomes.
  • Federal government and private sector research funders should support the analysis of existing data sets of longitudinal studies to determine the impact of various interventions (e.g., home visitation, preschool programs, substance misuse, child trauma) on suicidal ideation, plans, and attempts, and on deaths by suicide. This could include such projects as the CDC’s efforts to assess and prevent adverse childhood experiences and examine their effect on suicide-related problems, and National Institutes of Health (NIH) initiatives that focus on aggregating prevention trial data sets to better understand the long-term and cross-over effects of prevention interventions on mental health outcomes, including suicide risk,88 and to address suicide research gaps.

Action 3. Ensure Lethal Means Safety: Keep people safe while they are in crisis.

3.1 Empower communities to implement proven approaches.

3.2 Increase the use of lethal means safety counseling

3.3 Dedicate resources to the development, implementation, and evaluation of interventions aimed at addressing the role of lethal means safety in suicide and suicide prevention.

Action 3: Priorities for Action

  • The federal government and private sector entities can support efforts to ensure that updated information on lethal means safety policies, programs, and practices (e.g., ERPOs, firearm owner and retailer education, bridge barriers, medication packaging, carbon monoxide shut-off sensors in vehicles) is incorporated into existing national clearinghouses and resource centers so that local municipalities, states, and tribes can adopt and evaluate them for their prevention benefits.
  • States, communities, and tribes should collaborate with the private sector to increase awareness of and take action to reduce access to firearms and other lethal means of suicide, including opioids and other medications, alcohol and other substances or poisons, and community locations (e.g., railways, bridges, parking garages) where suicidal behaviors have occurred. This urgent multi-sector effort is key to saving lives by reducing access to lethal means for individuals in crisis.
  • Health systems and payers should leverage their existing training and resources and collaborate on a national initiative to train general and specialty health care providers and care teams on safety planning and lethal means counseling.
  • SAMHSA and the VA should coordinate to ensure that lethal means safety assessment and counseling are incorporated into the assessment and intervention procedures of the National Suicide Prevention Lifeline and Veterans Crisis Line call centers, particularly in preparation for the national launch of 988.
  • The federal government can prioritize and fund research and program evaluation analyzing community and clinical lethal means safety interventions (e.g., ERPOs, firearm owner and retailer education, bridge barriers, medication packaging, carbon monoxide shut-off sensors in vehicles) at the population level.
  • State and federal governments should collaborate with the private sector on a synchronized public health communication campaign addressing lethal means safety in the context of suicide prevention, which should then be evaluated to determine prevention benefits and inform future communication efforts.

Action 4. Support Adoption of Evidence-Based Care for Suicide Risk: Ensure safe and effective care for all.

4.1 Increase clinical training in evidence-based care for suicide risk.

4.2 Improve suicide risk identification in health care settings.

4.3 Conduct safety planning with all patients who screen positive for suicide risk.

4.4 Increase the use of suicide safe care pathways in health care systems for individuals at risk.

4.5 Increase the use of caring contacts in diverse settings.

Action 4: Priorities for Action

  • The federal government, professional associations, and accrediting bodies should collaborate to address barriers to adopting the Action Alliance’s Suicide Prevention and the Clinical Workforce: Guidelines for Training to ensure increased clinical training in evidence-based care for suicide risk during graduate education and post-graduate training.
  • State behavioral health licensing boards should add continuing education requirements for suicide prevention in order for clinicians to maintain licensure or certification.
  • Payers from the public and private sectors should incentivize the delivery of evidence-based care via existing levers in contracting and reimbursement.
  • Federal and state policymakers and commercial payers and health systems should take specific steps to improve outcomes for individuals with mental health and substance misuse conditions in primary care by using effective methods (e.g., CoCM) to integrate mental health and substance misuse treatment into primary care.
  • To enhance workflows for suicide safe care, health systems should collaborate with EHR vendors to develop options for integrating screening, suicide safe care pathways, and safety planning into their EHR systems.

Action 5. Enhance Crisis Care and Care Transitions: Ensure that crisis services are available to anyone, anywhere, at any time.

5.1 Increase the development and use of statewide or regional crisis service hubs.

5.2 Increase the use of mobile crisis teams.

5.3 Increase the use of crisis receiving and stabilization facilities.

5.4 Ensure safe care transitions for patients at risk.

5.5 Ensure adequate crisis infrastructure to support implementation of the national 988 number.

Action 5: Priorities for Action

  • The federal government and the private sector should address gaps, opportunities, and resource needs to achieve standardization among crisis centers in interventional approaches and quality assurance in preparation for the launch of 988.
  • The federal government, states, and the private sector should work together to optimize system design, system operations, and system financing for 988 as the hub of an enhanced, coordinated crisis system, and enhance coordination between Lifeline 988 centers and 911 centers to reduce overreliance on 911 services and ED boarding (the practice of keeping admitted patients on stretchers in hallways due to crowding).
  • The federal government should fund the necessary infrastructure to support crisis care (e.g., Congressional support for the 5 percent SAMHSA Mental Health Block Grant set-aside; core services identified in SAMHSA’s National Guidelines for Behavioral Health Crisis Care) and should provide technical assistance to states looking to evolve crisis systems of care.
  • The federal government and foundations should support research to identify effective models of mental health crisis response (e.g., coordinated efforts among mental health specialists, peers, and law enforcement) to improve short- and long-term effects on communities of color and other marginalized populations.
  • The federal government and private sector payers should support the use of follow-up phone calls or texts within 24 hours of discharge from psychiatric hospitalization or emergency room discharge to check in with the patient, provide support, and maintain contact until the person’s first outpatient appointment.
  • The federal government should establish universally recognized coding for behavioral health crisis services, and public and private sector partners should collaborate with payers and health systems to increase adoption of the new coding.
  • The federal government should support the development of an essential benefits designation that will encourage health care insurers to provide reimbursement for crisis services, thus reducing the financial burden on state and local governments to pay for those services, delivered within a structure that supports the justice system and ED diversion.

Action 6. Improve the Quality, Timeliness, and Use of Suicide-Related Data: Know who is impacted and how to best respond.

6.1 Increase access to near real-time data related to suicide.

6.2 Improve the quality of data on causes of death.

6.3 Expand the accessibility and use of existing federal data systems that include data on suicide attempts and ideation.

6.4 Improve coordination and sharing of suicide-related data across the federal, state, and local levels.

6.5 Use multiple data sources to identify groups at risk and to inform action.

Action 6: Priorities for Action

  • The federal government should support near real-time collection of data on deaths by suicide and nonfatal suicide attempts in a group of sentinel states to develop the framework for a national early warning system for suicidal behavior in the U.S. The system would create a central database that links multiple data sources and would build state and local capacity to translate data trends into prevention efforts in a timely manner. In addition, the federal government should expand ED SNSRO to monitor nonfatal suicide-related outcomes, track spikes and potential clusters in suicide attempts, and identify patterns, all of which can then inform prevention activities.
  • The public and private sectors should collaborate on a near real-time suicide dashboard that pulls data from existing national, state, tribal, and community databases to make data on deaths by suicide and suicide attempts timelier and more accessible, thus linking the dashboard to prevention actions on the ground.
  • The federal government should implement Recommendation 1.8 of the Interagency Serious Mental Illness Coordinating Committee, which calls on public and private health care systems to routinely link mortality data for serious mental illness (SMI) and serious emotional disturbance (SED) populations, and supports the standardization of similar data gathering across state and local systems for SMI and SED populations within the justice system.
  • Professional organizations connected to coroners and medical examiners at the state and national levels should release guidance on and support wide-scale implementation of coding sexual orientation and gender identity in death investigations.
  • The federal government should implement the PREVENTS Executive Order recommendation for the U.S. Department of Health and Human Services and the VA to propose legislative changes that mandate a standardized process for uniform ED data reporting across the United States specific to the external cause of injury (e.g., suicide attempt).
  • Health care systems should work with public sector agencies to support the linkage of mortality data with health record, social, geographic, education, and criminal justice data systems to strengthen data quality and increase accountability for patient outcomes across key systems.
  • State suicide prevention coordinators and community suicide prevention leaders should routinely monitor available data to identify trends and evaluate their own efforts.

College Counseling in a Pandemic

This is not what Brian Petersen imagined when he came to Ithaca College to become director of the Center for Counseling and Psychological Services in the fall of 2019. His old boss at Pace University told him that he won’t really know a school until he’s worked there for at least an academic year. Petersen set out to experience Ithaca’s ebb and flow through the changing seasons, but then the Covid-19 coronavirus pandemic forced the school to close the campus and move to online instruction.

Brian Petersen, director of the Center for Counseling and Psychological Services at Ithaca College

Yet, Petersen stresses, Ithaca College’s counseling services have remained open for business. Not only that, he adds, due to increased staffing and reduced demand on campus, CAPS has not maintained a waiting list for appointments since fall 2019.

“I think the pandemic has forced everybody to assess how well we do in taking care of ourselves,” Petersen said. “And some students may have discovered that they’re more resilient than they thought they were.”

Due to the campus closure, everything from individual therapy sessions to drop-in groups have operated virtually through Zoom teleconference meetings.

The 12-person CAPS clinical staff will extend its telehealth services into the Spring 2021 semester even as the campus reopens to practice social distancing as a means of reducing exposure to coronavirus. A CAPS counselor will be present on campus at all times for crisis interventions.

While demand for services is expected to increase as students return to campus, during the pandemic new client intakes at CAPS have been down approximately 20 percent. Petersen said this was probably partly due to students utilizing hometown support services rather than relying on CAPS. The decreased demand, however, has enabled CAPS counselors to work with students individually for longer periods of time.

Utilization of Let’s Talk, a virtual drop-in service that offers confidential consultations with a CAPS counselor without an appointment, fell off 50 percent. The pandemic also saw a fall in demand for Toolbox support groups; utilization dropped by around 20 percent for the Anxiety Toolbox group, and a toolbox for social skills and communication was not utilized at all. Due to reduced demand CAPS scaled back the number of groups focused on body image and eating issues from two to one.

CAPS responded to the campus closure with an innovation called Connection & Health Through Text Support (CHATTS), where students connect to a counselor on Zoom but with video and audio turned off and only the chat function enabled. Each session of this group service sees an average of six to eight people.

The CAPS website also provides a self-reporting mental health screening tool call MindWise that allows students do their own check-ins and receive immediate feedback. Nancy Reynolds, director of the Health Promotion Center Program, has posted apps on the website to help students with sleep and nutritional needs.

Additionally, the CAPS website has a wealth of resources. It includes contact information so that students can reach the people of CAPS. Brandi Riker and Brittany McCown, the front desk administrators, remain available by phone to guide students through the process and explain the levels of services that CAPS offers.

CAPS experienced some difficulty reaching those students who remained outside New York State with remote counseling due to geographical restrictions imposed by counseling licensing. Initially, many states allowed services across state lines with little problem or paperwork. But starting with the fall semester, many states rescinded permissions.

CAPS holds a handful of licenses in other states, including California, Connecticut, Maine, and Massachusetts. For others, the CAPS team has kept up with databases managed by other schools such as the University of Texas at Austin to obtain temporary licenses whenever possible. CAPS will always provide crisis intervention services for Ithaca College students wherever they may be.

“If a student wants counseling from us and they’re in a state where we’re just not able to get the licensing that’s needed, then we can provide consultation services and then help them find local providers in their area,” Petersen said. “But one thing I want to be clear about is that no matter what state a student is in, we can still provide consultation services. So we can do an initial assessment. We can do the Let’s Talk and the Toolbox groups because those aren’t considered clinical groups.”

CAPS expanded its outreach efforts by building more connections than ever before across the campus community. It has created relationships with the departments of Athletics and Recreational Athletics, Housing and Residential Life, the Center of Ideas, and the five schools of Ithaca College, among others.

The CAPS team wants faculty members in every department and major to have direct access to someone in the counseling center. That enables them to bring in CAPS representatives for informational class presentations and to consult someone about students who made need CAPS services. Every CAPS counselor has been assigned two or three liaison relationships on campus, Petersen said.

Petersen noted a decrease in the number of first year students utilizing CAPS services compared to a typical semester. “A lot of first student first year students use CAPS, because they’re dealing with adjustment issues like homesickness, social anxiety, and adapting to being in college,” he said. “And because we didn’t have them on campus this year, those adjustment issues have sort of been pushed off. I anticipate [this] semester we’ll see more because they’ll be here.”

As a consequence of CAPS counseling services have been mainly utilized by upperclassmen, notably seniors experiencing anxiety about jobs and graduation.

“Covid has really impacted people’s confidence about what comes next,” said Petersen. “And so, juniors that are looking for internships for senior year and seniors that are looking to step out into a job have a higher than normal level of anxiety about what comes next, and how they’re going to negotiate it. And the other impact of all of this, besides the job anxiety, is the lack of social connectedness and the idea that you want to leave college with some good solid social connections. We’ve all been remote for so long now that it’s harder to feel that way.”

—By Nicole Brokaw

Nicole Brokaw is a senior at Ithaca College majoring in Cinematography and Photography and in Writing

Cornell’s Mental Health Review: Final Report

The Cornell University administration on October 22 released the Final Report of a nearly year-long Mental Health Review that contains 60 recommendations comprehensively calling for improvements in mental health and medical services, academic life, student well-being, and mental health awareness and proactive support.

Download: Cornell University’s Mental Health Review Final Report

The administration at the same time announced the formation of a high-level Executive Accountability Committee, led by senior academic officials as well as senior administrators overseeing student affairs and Cornell Health, to evaluate and prioritize the recommendations.

The 34-page report’s recommendations include a mix of specific suggestions and identification of areas for further review. The report cited a need for upgrading psychological counseling services, but also strongly argued that fully supporting student mental health requires significant changes in academic policies and practices.

“Cornell, like its peer schools, must rethink what it means for students to strive for excellence, and design an enhanced version of excellence, which has as its foundation a healthy educational environment,” the report stated.

“While treatment offered by counseling centers can benefit students directly through symptom relief, increased levels of academic and social functioning, and increased retention and graduation rates, improving mental health requires a degree of culture change, which must be a university wide effort,” the report said.

“Students maintain a culture of competition in the curricular, co-curricular, and social spheres, which normalizes course and extra-curricular overloads that can become a detriment to physical and mental health,” the report’s authors wrote. “We have observed that the culture of competition may take on an unhealthy cycle of expectation and behavior that can reach traumatizing levels for students, faculty, and staff.”

The report expressed concern about the health and well-being of faculty and staff, and about the impact that increasing expectations has on their well-being and on their ability to support students. The report said the issue warrants continued attention but noted it was outside the scope of the review that was focused on student mental health.

The review was conducted during the 2019–20 academic year by a task force appointed in mid-2019 that included three experts from outside the university as well as faculty, staff, and students from the campus community. The task force submitted its Final Report in April just as the Covid-19 (coronavirus) pandemic was disrupting education at Cornell and on campuses across the country.

The review examined challenges affecting Cornell’s undergraduate student population as well as its graduate and professional students (numbering 14,743, 6,239, and 2,638, respectively, in Fall 2020). It included two campus surveys, 37 focus groups, five Telling Stories workshops, six World Café large-group dialogues, and meetings with undergraduate and graduate students, deans and faculty members, senior staff members, and campus healthcare providers. Additionally, the task force met with off-campus therapists and community mental health organizations. The task force also reviewed Cornell Health data, and examined mental health reviews conducted at other colleges and more than 70 student well-being programs and initiatives.

The 13-member internal Mental Health Review Committee, which included five students, was headed by Marla Love, senior associate dean of students, and Miranda Swanson, associate dean for student services in the College of Engineering. The External Review Team consisted of Michael Hogan, a former commissioner of mental health for New York State, Ohio, and Connecticut (chair); Karen Singleton, chief of Mental Health and Counseling Services at the Massachusetts Institute of Technology’s MIT Medical; and Henry Chung, senior medical director of care management organization at Montefiore Medical Center in New York.

The report highlighted one “overarching recommendation” to sustain the complex challenge of improving student mental health: “Creation of a widely representative permanent committee on mental health to ensure the implementation of immediate recommendations, and to monitor progress and conduct further review of those recommendations that will require more time and resources to enact.”

The External Review Team members stressed the importance of establishing a permanent committee on mental health “to act as a steward of this cause” in an April 15 report transmittal letter to Vice President for Student and Campus Life Ryan Lombardi. “An issue like mental health, which touches so many and is affected by every aspect of university life, requires consistent attention and a centralized effort across the university,” they wrote.

Hogan, Singleton, and Chung also cited the “distinctive role” the Cornell administration must play in implementing the recommendations. “Mental health must be championed at the highest levels of leadership in order for students, faculty, and staff to have the confidence to act,” they wrote.

The plea echoed the report’s introduction, which stated in part: “The recommendations that emerged from this process must be addressed and ongoing change led at an institutional level to ensure that mental health and wellbeing is valued and embedded in the culture of the university.”

Medical and Mental Health Services

In its assessments and recommendations, the report recognized Cornell’s history in the collegiate mental health field, and commended Cornell for providing “whole person,” or “integrated,” mental health care through Counseling and Psychological Services (CAPS) and Cornell Health’s primary care services.

The report noted “significant recent changes” to improve access to mental health services. These included the hiring of additional staff—according to the report, the number of budgeted fulltime CAPS therapists increased from about 28 in 2018 to about 38 in 2020.

The changes also included the adoption of a new service-delivery model in Fall 2019, which enabled 25-minute initial outpatient sessions virtually on demand, and offers students greater flexibility in choosing their therapists and scheduling appointments. “The approach has already led to increased utilization, significant reductions in wait times, and decreased referral to community therapists,” the report said.

With the recent changes, there is not currently a need for significant staff increases or expanded access to services, the report said. Yet, if access and quality of care cannot be sustained, the report added, future increases in CAPS clinical staff may be required.

The report said that student feedback indicated a strong preference for long-term, weekly 50-minute psychotherapy sessions at CAPS. However, the review concluded that such a practice was not justified based on research evidence about the effectiveness of specific psychotherapies as well as current practices in insurance coverage.

“This is not to say that there is no benefit to long term counseling,” the report explained. “Clinics and insurance plans encourage individuals desiring such care to seek and pay for it on their own, so that available resources are used to benefit the entire community, and can be focused especially on those with immediate and serious concerns.”

Nonetheless, the report stated that “continued improvements in the professional medical and mental health services at Cornell are necessary… [involving] a continuing, long-term quality improvement process, not a quick fix.”

The report called for continued efforts to balance increased demand for mental health services as well as medical services with “finite resources.” The report urged improvement efforts including measuring outcomes, working with data, sustaining staff quality, and measuring patient satisfaction and concerns.

The report specifically recommended that Cornell require annual professional development training for all clinical staff on topics including suicidal patients, risk management, and multicultural competency and threat assessment; create a patient advocate/ombudsman for students to register complaints and positive feedback; utilize the Zero Suicide Model self-study to determine needed improvements in suicide prevention; utilize best practices tools to provide optimal care for underserved populations such as LGBTQ+ students; develop a framework for mental health patient access and continuity of care; improve integrated mental health care; consider refocusing the “Let’s Talk” mental health outreach service on underserved students; consider consultation with the International Accreditation of Counseling Services to benchmark against other collegiate mental health services; and consider hiring a sports psychologist to address the particular needs of student athletes.

Healthy Educational Environment

Noting there is “much to celebrate” about Cornell’s educational environment, the Mental Health Review nonetheless made significant recommendations for addressing the “toxic effects” that Cornell’s academic and social culture can have on student well-being and achievement.

“Multiple measures indicate that the mental health needs of students have increased significantly in recent years,” the report stated. It cited Cornell PULSE/CUE surveys indicating that the proportion of undergraduates who reported that they were unable to function academically—missing classes, unable to study or complete homework, etc.—for at least a week in the past year due to depression, stress, or anxiety increased from 33 percent in 2015 to 42 percent in 2019. From Fall 2015 to Fall 2018, individual CAPS therapy encounters increased by 19 percent, the report added.

The report broadly pointed to pedagogical innovations that could play a role in decreasing student stress and anxiety, such as multiple and varied means of grading and evaluation, academic credit limits, and flexible timing in exam administration. The report recommended approaches to “foster community, collaboration, and autonomy” in academic and co-curricular life. The report also identified the need for increased “multicultural competency and fluency” and financial aid solutions addressing inequities to reduce stressors across Cornell’s changing racial, ethic, socioeconomic, and gender demographics. The report cited a need to address student stress over career prospects and graduate school admission.

The report specifically recommended that Cornell create a centralized mechanism for institutional oversight of academic policies and practices that negatively affect student mental health. It called for the mechanism to work closely with college/school leadership and faculty across Cornell to examine eight issues: grading on a curve; Pass/Fail grading for first-year students and certain types of classes for all students; academic work during scheduled breaks; credit limits; attendance policies, especially as related to mental health; workload outside of class; pre-enrollment syllabi availability; and mandatory meetings with advisors.

Cornell should address problems around prelim [mid-term exam] scheduling, raise the profile of advising as a critical component of student success, launch a uniform course feedback instrument, and encourage academic departments to conduct self-studies to identify key stressors for students and mitigation strategies for them, the report said.

The report called for mandatory mental health training for every faculty member and staff member at least once every two years, and said Cornell should encourage faculty to model and discuss behaviors that promote mental health in their course orientation lectures and initial meetings.

The report singled out Cornell’s graduate students, who play dual roles as students as well as teaching assistants (TAs), for requiring special attention. “Graduate students feel particularly vulnerable within Cornell’s rigorous yet loosely structured academic environment,” the report said. “Financial independence, loneliness and isolation, power differentials with faculty and mentors, work-life balance, and ambiguity and vulnerability in advisor/advisee relationships, seem to intensify stress in the graduate student experience.”

The report said that graduate students as well as professional students face special challenges related to social connectedness, work-life balance, and resilience. Classes, research, employment, and job searches limit the time they have to engage in activities that reduce stress, the report said. Moreover, it added, they tend to have few social connections outside of peers in their labs or programs, with whom they are often in competition for jobs and resources.

The report listed five proposals for addressing concerns raised by graduate students: train TAs in mental health and resilience so they can support their undergraduate students as well as self-manage their own well-being; create clear and consistent standards for PhD degree completion; develop a mechanism for reporting and acting on problematic thesis advisors; develop a template for documenting expectations when selecting an advising committee chair; and train new faculty advisors and graduate students in developing positive mentor/mentee relationships.

Social Connectedness and Resilience

Acknowledging benefits like diverse academic offerings, research opportunities, and a beautiful campus, the report nonetheless argued that “Cornell’s competitive environment, complex structure, and physical layout compound feelings of isolation… [C]ompetition and a culture of achievement at all costs pervade the academic and social environments and hinder social connections.”

The report cited factors such as a campus social life that is heavily dominated by fraternities and sororities, where hazing, sexual assault, and alcohol abuse are perennial problems; competitive application processes for club membership and leadership positions; lack of free and convenient fitness facilities; and Ithaca’s long, cold winters.

The report called for a centralized, campus-wide strategy, with substantial, personal, and sustained support from Cornell leaders, to live up to Cornell’s “Caring Community” slogan and promote messages and means for social connectedness and mutual support.

According to the report, the university has undertaken a series of substantive reforms to address hazing, sexual assault, and alcohol misuse in the Greek Letter community; the report said the review team members “strongly endorse these important and challenging steps as key aspects of supporting campus wide mental health.”

The report specifically recommended that Cornell establish a high-level task force to develop a campus-wide strategy for student well-being; foster stronger competence in new students for managing college transition; explore mental health training for campus housing Residence Assistants (RAs); expand outreach support to international students, transfer students, first generation students, veterans, and other vulnerable populations; expand opportunities for physical fitness and prioritize fundraising for fitness facilities; regulate application-based student organizations; incentivize student organizations to offer well-being programming; improve sense of belonging for students in campus housing; promote alcohol-free activities and night programming; expand campus and off-campus spaces for programming and social interaction; and establish a task force to promote Cornell pride and create new traditions.

Help-Seeking Behavior and People in Need of Care

Student demand for mental health services at Cornell exceeds expected use, according to the report. Yet, it said, students still express reluctance to seek mental health care. Among the reasons cited by students were lack of time, cultural aversion to help-seeking, negative experiences with help-seeking, confidentiality concerns, perceptions that their symptoms were “not bad enough,” and that “everyone is stressed” at Cornell.

The report said that while it is critical that all members of the university community play a part in recognizing and responding to students in distress and to those who could benefit from proactive intervention, faculty, staff, and students all expressed uncertainty about their roles and abilities to do so.

The report made 10 recommendations for promoting help-seeking behaviors. Among them: develop a single comprehensive source of information about health, mental health, and well-being; ensure all new students receive information about recognizing mental illness and support resources; use orientation materials to equip parents to recognize signs of distress, reduce stigma, and encourage help-seeking behavior; create a pre-departure guide for international students with information about arrival logistics, finances, the academic system, and mental health; implement a mental health awareness campaign; create a social media platform where faculty, staff, and students can model help-seeking behavior through sharing personal experiences; develop a comprehensive strategy for mitigating the intersection of mental health and alcohol use; and establish a protocol for students to notify faculty of health or well-being issues that affect attendance or work completion.

For identifying and supporting students in need the report made seven specific recommendations, including: improve the experience for students taking, being on, and returning from Health Leaves of Absence; increase the number of sexual victim advocates; improve the system for handling “Students of Concern”; develop a “Big Red Folder” as a quick reference guide for all faculty, staff, TAs, and RAs to assist students in distress; and increase staff resources at the Skorton Center for Health Initiatives to offer enhanced mental health training for faculty and staff.

Executive Accountability Committee

According to the Cornell Chronicle, the seven-member Executive Accountability Committee will oversee three teams focused on “implementing efforts in key areas – academic community, campus community and clinical services.” The committee is being led by Vice President Ryan Lombardi; Kathryn Boor, dean of the Cornell Graduate School and vice provost for graduate education; Lisa Nishii, vice provost for undergraduate education; and Sharon McMullen, assistant vice president of student and campus life for health and well-being.

“Moving forward to implement change will require careful reevaluation of our university priorities as well as changes within our policies and systems,” Boor said in an October 22 article in the Chronicle. “Implementing key recommendations will help to improve the well-being of our community, and more specifically, the well-being of our undergraduate, graduate and professional students.”

In September 2018, the Office of President Martha E. Pollack published a plan for a comprehensive review of student mental health services. Lombardi shared the decision in an email to students; and, in an email to the Cornell Daily Sun,said it “reflects the University’s commitment to promoting health and well-being as a foundation for academic and personal success.”

Throughout 2018, undergraduate students and graduate students separately formed task forces to lobby the university administration for improved mental health support and services.

In an April 2017 letter, Scott MacLeod and Susan Hack, who founded The Sophie Fund after their daughter Sophie, a Cornell student, died by suicide in 2016, called on the Cornell president to “establish an independent, external-led task force on student mental health without delay to review and assess the mental health challenges for Cornell students and the university’s policies, programs, and practices to address them, and to make recommendations to the Cornell president to ensure that the university is adopting and implementing current best practices.” They repeated the request in August 2018.

Responding in a letter on September 20, 2018, Pollack said that Cornell would conduct a “comprehensive review” and thanked MacLeod and Hack “for your advocacy for providing the best possible environment to support the mental health of Cornell students.”

The Sophie Fund gave a presentation with 22 recommendations last January 15 to the Mental Health Review teams.

DOWNLOAD: THE CORNELL UNIVERSITY MENTAL HEALTH REVIEW FINAL REPORT RECOMMENDATIONS AT A GLANCE

Download: Cornell University’s Mental Health Review Final Report

A Mother’s Movement Against Bullying

Jane Clementi is the founder of the Tyler Clementi Foundation, which works to end online and offline bullying in schools, workplaces, and faith communities. She started the advocacy organization in 2011 to honor her son, Tyler. He died by suicide at age 18 in the first month of his freshman year at Rutgers University. Among the foundation’s programs is the Million Upstander Movement, in which enlistees pledge to stand up to bullying and treat others with kindness, respect, and compassion. The Sophie Fund’s Anna Moura spoke to Jane Clementi via Zoom on October 28, 2020.

Tyler and Jane Clementi [Courtesy Jane Clementi]

THE SOPHIE FUND: What drove you to create the Tyler Clementi Foundation?

JANE CLEMENTI: It was in the wake of my son’s death. He died by suicide in the fall of 2010 after he had been just started his freshman year. His roommate live-streamed him in a sexual encounter with another man. And then, as he read the comments and quotes on social media, his reality became twisted and distorted, and he made that permanent decision to a very temporary situation, and he died by suicide. It was to honor his legacy.

There were several high-profile deaths in the fall of 2010, but Tyler’s seemed to rise even up to the top of those and his story held national headlines for several weeks after that. Several noted celebrities continued to talk about Tyler over the course of time. As my fog lifted from the extreme distress that I was in after Tyler’s death, I realized that there was a lot of good positive conversation that was happening, and that those conversations were helping to create change, to make life better for other LGBTQ youth as well as just other marginalized youth that were being targeted.

I wanted to make sure that the world knew more about Tyler and the kind, caring, resourceful young man that he actually was. I also have come in years since to realize how distressed he truly was as well. I recently moved, within the last six months, and I came across more writings that Tyler had documented some of his pain and sadness and anger. It was someone I didn’t even recognize. I had no idea. So not everyone exhibits symptoms of their pain.

THE SOPHIE FUND: How do you define the problem of bullying?

JANE CLEMENTI: I think it’s a complex issue with a complex array of solutions. I think it’s helpful for us to share our stories so that people are aware of the great consequences and harm that can be caused from bullying behavior. I like to make sure people know that not all bullying situations end in the same devastating way that Tyler’s story ended. But with that said, all bullying hurts when it is happening, and it often leaves lifelong scars, whether physical or emotional, psychological scars.

I also think it is an issue that needs our constant attention and immediate attention. I don’t think it’s “kids just being kids.” I don’t think it magically disappears when someone turns 18. It’s behavior that goes on uncorrected and unchallenged. We have to identify that behavior early—the earlier, the better—to make change. Legislation is important, but I think it’s just a small component of creating change. I think most legislation sets the boundaries, which I think is key and important, but after that once the boundaries are crossed, it is very punitive. It mostly deals with punishment or suspension. I don’t think that that changes the behavior. I think we need to implement more behavior modification, and maybe reward positive behavior and call out positive behavior as part of the solution.

We are working preventing bullying online and off, as well as in schools, workplaces, and faith communities. Because I think it happens not only to youth, and not only in schools, but also through legislative inequalities as well as religious dogma that targets especially those in the LGBTQ community. We can go further down to the root of the cause and that will help prevent it for other people.

THE SOPHIE FUND: What can we really do to make an impact on bullying behavior?

JANE CLEMENTI: We have a few initiatives ourselves with the Tyler Clementi Foundation that we think will impact that behavior. First of all, we think it’s important to realize that there’s more than just the target and the aggressor in a bullying situation. But there are bystanders. Almost all situations have bystanders, people who see what’s happening. And those are bystanders because they’re passive and remain silent. That is like condoning and supporting the aggressive behavior. So, we want to empower those bystanders, and we call them “upstanders” once they become empowered. We think that there are many ways to do that.

You can intervene and interrupt a situation if you feel comfortable and if you know the people involved. Because we never ever want anyone else to come into harm’s way. Sometimes it’s as easy as, if you know the people and maybe think they are using racial slurs or homophobic slurs as jest or some type of humor—which they are not—and calling it out and saying that this isn’t funny.

It might even be as simple as coming beside the person being targeted and calling them away and pulling them physically out of the situation, saying, “Come with me, I want to show you something I saw outside, or down the hall,” or whatever.

If you don’t feel comfortable in that situation, or if the behavior doesn’t get changed, it’s about reporting it to a trusted adult or a youth. Or reporting it to the proper people if it’s happening in the workplace, up your ladder, your chain of command, your human resources department, something to that effect.

If you have someone’s best interest at heart, it is not tattling, or telling on someone. It’s about finding them the right support, which takes us to the third easiest way. That is to reach out to the target. I think that that is important. I think if someone had reached out to Tyler, it would have made all the difference for him. Making sure they know where their resources are. Tyler had resources at Rutgers, and he had resources at home. But no one made sure he knew how to reach out. And when you’re in a really dark place, and I learned personally, you don’t often see your resources. You just see the pain and the bleakness. So reaching out to the target, making sure, sometimes it’s just about making sure they know you’re there, you’re a friend. I think those are key elements of being an upstander.

We also believe that its more than just a one-on-one but about creating safe communities as well. We believe that someone, if they say on a first day of a group meeting together, whether it’s a sports team, or a club, or a classroom, or an entire school, having a person of authority set the boundaries, and say that we value everyone here, we will not accept anybody being targeted or humiliated for any reason. And then calling out and enumerating the reasons. Such as body shape and size, or abilities, or what language they speak at home, or their sexual orientation, or their gender identity, or whatever else makes somebody special and precious.

We do think people are targeted because of their differences, and we need to enumerate those differences so people understand that, and then get an acknowledgement back from the group that, yes, they understand. It is not a magic wand. The aggressor needs to hear where the boundaries are sometimes. It is also a huge message for someone who is marginalized to hear, to know that they are welcome and included in this space regardless of whatever makes them special.

THE SOPHIE FUND: Tell us about the “Upstander Pledge”?

JANE CLEMENTI: We started it several years ago. We wanted to reach a million people with our upstander pledge by October of 2020, and I’m pleased to say that we did just reach a million people. We’re really thrilled about that announcement, but we also know that a million people sounds like a lot, but it still needs to reach more. So we are going to continue our message.  It is also a message that needs to be heard over and over again.

Every time you are faced with a situation, it’s not like, “Oh, I signed the pledge, I’m good.” You have to really think about it. One of the things I’ve learned is that there is something called the bystander phenomenon. The more people that see an incident happening the less likely that somebody is to stand up to that incident. That’s why we need to have it fresh on our mind: “Wait a minute, nobody is saying anything. That’s me. I need to be that person that stands in the gap. I need to be the person to be empowered enough, and to have the courage enough, to stand up here.” And then hopefully you’ll be the leader to create a wave of people that will stand up to that.

THE SOPHIE FUND: How does the foundation’s work specifically impact LGBTQ youth?

JANE CLEMENTI: Our mission is broad in that it speaks to anyone’s difference. With that said, I think that allows us to speak specifically where we go and where we are invited in to talk. We are not quite as problematic for some schools or for some businesses that might not be able to or want to invite, say, GLSEN, or GLAAD, or HRC. And yet, for us, that is a huge focus of our work because that is part of Tyler’s story. Tyler was a gay youth, so we can speak to that. We have a gentle way of bringing that conversation to the organization that we are speaking in.

THE SOPHIE FUND: How do you view the problem of cyberbullying?

JANE CLEMENTI: With Covid we are spending so much more of our time in the digital cyber world, so the incidences of cyber-attack or bullying are so much greater. We have to be sure and think about the words that we’re using, and say the words that are building other people up and not attacking their character. I think it’s important that we see the humanity behind something and being willing to back up whatever we say by saying it to someone’s face, not saying it just through words on a screen.

THE SOPHIE FUND: Can you talk about the Tyler Clementi Higher Education Anti-Harassment Act?

JANE CLEMENTI: A little history. It was created and introduced into the Senate initially by the New Jersey’s senator at the time, which was Senator Frank Lautenberg. He realized a truth which I still see today, that there is no federal anti-bullying legislation at all. Since Tyler was a college student, he initiated the bill to speak to colleges and universities, higher education institutions, to create policies and programs to protect all their students.

In 2010, in the fall, there were very few state laws for anti-bullying. I think New Jersey instituted one of the first. New Jersey’s law is called HIB—Harassment, Intimidation, and Bullying. That passed shortly after Tyler’s death. At this point, all 50 states have some form of anti-bullying legislation. Which also means each state has a different definition of what bullying is. There are 50 different definitions out there. And so I do think we do need a federal law.

There are several that are out there. The two that are most known are the Safe Schools Act, which would be K-12, and that is supported by the Human Rights Campaign, and several other organizations. And then there’s theTyler Clementi Higher Education Anti-Harassment Act. That is also supported by HRC and a few less organizations than the Safe Schools Act. But it does not seem to get passed legislatively. Maybe with the new Congress we can get that moving forward.

THE SOPHIE FUND: What do you think is needed specifically in higher education?

JANE CLEMENTI: One of the things with LGBTQ support is that many colleges and higher education institutions do not have a resource person or an LGBTQ center on their college campuses. Out of 6,000 institutions, only less than 10 percent had a resource person, one FTE employee who was in charge of the resource center. So, I think that there needs to be more resource availability available through a center through a place where people can gather together and receive the support that they need.

Most institutions also need policies in place to protect all students and calling out and enumerating classes including LGBTQI+ students as well. With those policies they should have trainings for staff as well as for students. Those are components of Tyler’s bill also. Having not only policies in place but trainings for staff and students.

THE SOPHIE FUND: Can you talk a little bit about the Tyler Clementi Center at Rutgers University?

JANE CLEMENTI: We have a Memorandum of Understanding with Rutgers that created the Tyler Clementi Center at Rutgers. It falls under the inclusion and diversity chancellor. They are working towards having research and symposiums. For all marginalized students, but the last two symposiums have been specific to LGBTQ, creating safe LGBTQ spaces on the college campus. They just did a web conference, the topic was “Out of The Closet.” It was discussing the safety aspect of being in the closet against the harm of being in the closet, which usually outweighs the safety. It was about not forcing people to come out before they were ready to come out. But how to rather encourage people to see the positive aspect of being out, and the better emotional mental health of it.

The Clementi Family at Tyler’s high school graduation 2010 [Courtesy Jane Clementi]

THE SOPHIE FUND: How do you view bullying in the context of today’s divisive political scene?

JANE CLEMENTI: We never will agree with everyone completely on solutions. But I do think it is key that we learn how to have those conversations respectfully and to talk about the issues and solutions to the problems without attacking someone’s character or the person. I think that’s one of the things that we haven’t achieved very well in our political system right now. As a nonprofit, we don’t endorse any candidate at all, but we certainly need leaders that will exemplify and model good behavior for us and not call out and target and attack a person’s character but have those respectful conversations.

 Until we do, I think it definitely affects youth today. You might dismiss it, but there was a research project out of the University of Virginia that talked about the last political campaign for the last election. It showed that bullying behavior increased among youth after certain political leaders exhibited it on the television screen or their news media screen, and visualizing someone calling out news reporters for their disabilities, or calling out other people and attacking their personality.

THE SOPHIE FUND: Why did the foundation reach out to the 2020 presidential candidates to take the upstander pledge?

JANE CLEMENTI: They were going to occupy so much of our time through news, we thought it was important that the candidates, all of the candidates, would take our pledge and to live out our pledge in their campaign. We reached out in a bipartisan way to everyone running at the time, and we posted them on our website.

It is multi-faceted the answer as to why some people did not take the pledge. Obviously, it was interesting to me that all the candidates were from the Democratic Party that did sign our pledge. But even within that Democratic Party, there were some that did not take it. Some responded that they don’t sign pledges, and they don’t put their name to things that they don’t have control over. And I accept that. But we got most of the top contenders who were running which I think speaks volumes. If someone actually engages in bullying behavior, I would imagine that they wouldn’t want to sign the pledge.

THE SOPHIE FUND: How do you assess the “Be Best” initiative of First Lady Melania Trump? People have accused President Trump of engaging in bullying and not setting a “Be Best” example.

JANE CLEMENTI: I concur. I don’t think he would be the best example. I don’t think her initiative is as robust as it should be either. I see very little about it. Maybe I’m just missing it in my news area. I do know that she had one conference and I know some people who attended the conference. I didn’t even know that it was happening until after the fact. I think it was shallow at best, and I think she could have had a larger and stronger voice in this area. Although it’s very difficult when you are trying to reap change for good and one of the people involved on the other side and is occupying so much media attention is actually being the aggressor in many situations. and being the aggressor without knowing that he even is the aggressor. I have to have a good view of everyone. I can’t imagine someone wants to be an aggressor or wants to inflict cruel pain on someone else. I think sometimes it is just not even in their consciousness that they are being that type of an aggressor.

—By Anna Moura

Anna Moura, an intern at The Sophie Fund, is a Class of 2021 Writing major and Psychology minor at Ithaca College

[To learn more, check out local, state, and national resources on bullying at https://thesophiefund.org/bullying]