Launching Cornell’s Comprehensive Review of Student Mental Health

In the six years that I’ve been at Cornell University, we have seen an unprecedented growth in the need for campus mental health services. While the Cornell administration has been extremely generous in increasing our clinical resources in recent years, it remains a challenge to keep pace with the growing need for care. And we’re not alone: universities across the country are struggling with similar challenges.

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Michael Hogan, leader of External Review Team

Beginning in 2018, I was part of many campus conversations—with students, colleagues, and campus leaders, including President Martha E. Pollack and Vice President Ryan Lombardi—about the need to find new ways to engage our community in addressing the environmental factors contributing to student distress, and to seek new perspectives on the services and resources available to students on campus.

In September 2018, these conversations and others led President Pollack to commit the university to a Comprehensive Review of Student Mental Health, to begin in 2019.

The Campus Health Executive Committee (CHEC) oversaw the development of the review’s scope and planning during the Fall 2018 semester. Feedback was solicited from a wide range of student, staff, and faculty stakeholders, including members of the university-wide Coalition on Mental Health. The consensus was that the comprehensive review should focus on two themes: how to meet the growing clinical needs of students facing mental health problems, and how to improve the campus environment and culture to better support student mental health.

In Spring 2019, CHEC announced the members of the two groups charged with conducting the review: an internal university Mental Health Review Committee tasked with examining Cornell’s academic and social environment, climate, and culture related to mental health, and an External Review Team responsible for reviewing the university’s clinical services and campus-based strategies.

The internal committee, made up of 13 students, faculty, and staff, is led by Marla Love, senior associate dean of students in the Office of the Dean of Students, and Miranda Swanson, associate dean for Student Services in the College of Engineering.  Love and Swanson are seasoned student affairs professionals who are relatively new to Cornell, bringing a fresh perspective to the review process. Love joined Cornell in October 2017 after serving for 15 years at various institutions across the country including Scripps College and Phillips (Andover) Academy, and most recently at Azusa Pacific University. Swanson came to Cornell in December 2017 from the University of Chicago, where she spent 16 years as dean of students in the Physical Sciences Division and working with graduate students in the Humanities Division.

Members of the internal team include Catherine Thrasher-Carroll, mental health promotion program director for Cornell Health’s Skorton Center for Health Initiatives; among the four students in the group is Chelsea Kiely ‘20, of the College of Arts and Sciences, who is president of Cornell Minds Matter, a student mental health promotion organization.

The External Review Team, comprised of three highly respected leaders in the field of mental health, is led by Michael Hogan, who served as mental health commissioner in New York, Connecticut, and Ohio over a span of 25 years. He is a member of the National Action Alliance for Suicide Prevention’s executive committee, and was a developer of the Zero Suicide Model for healthcare. Hogan chaired President George W. Bush’s New Freedom Commission on Mental Health and has served on the board of the Joint Commission, an independent organization that accredits healthcare organizations and programs in the United States.

The other members of the external team are Karen Singleton, associate medical director and chief of Mental Health and Counseling Services at the Massachusetts Institute of Technology’s MIT Medical; and Henry Chung, senior medical director of Behavioral Health Integration Strategy at the Care Management Organization of Montefiore Health System, and professor of psychiatry at the Albert Einstein College of Medicine.

Listening tours and focus groups will be held through the Fall 2019 semester, and the final report of findings and recommendations will be submitted in Spring 2020. Updates about the reviewers’ process and progress—in addition to the final report—will be posted on the Mental Health Review website.

I have also asked the members of both review teams to provide ongoing feedback to Cornell’s leadership as the review proceeds, including recommendations specific to our work at Cornell Health.

It is important for the Cornell community to note that we will not be waiting for the completion of the review to begin implementing important changes to our clinical services. A new counseling appointment model—which will include brief same-day appointments, and more options for follow-up care—will begin in Fall 2019. We look forward to the opportunity to gain valuable feedback and to identify opportunities for improvement.

I am grateful to President Pollack and Vice President Lombardi for prioritizing this university-wide review in support of student campus health. And I am confident that the review will result in a healthier and more supportive campus environment with improved support resources and clinical services for our students.

—By Kent Bullis

Kent Bullis, MD, is the executive director of Cornell Health

Photo credit: Suicide Prevention Resource Center (video screenshot)

Winnie, We’ll Miss You!

There’s a Cornell University student who Ithaca will dearly miss when she leaves town and goes out to make the rest of the world a better place. Her name is Winnie Ho.

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Winnie Ho at Cornell University’s 2019 graduation ceremonies

Since arriving from Syosset, Long Island, in 2016, Ho, 22, has worked on the ground with countless community organizations on issues such as mental health, suicide prevention, homelessness, substance use, and science education. She has served as a volunteer with multiple organizations, spearheaded numerous fundraisers and events, and supported students pursuing community engagement as an Engaged Ambassador with the Office of Engagement Initiatives. She has co-delivered the keynote speech at the “2019 What’s Great in Our State” mental health conference hosted by the New York State Office of Mental Health.

We are very grateful for Ho’s indispensable contributions to The Sophie Fund. For example, in her role as vice president of Service and then president of the Alpha Phi Omega (APO) Gamma Chapter, Ho marshaled volunteers from APO as well as numerous other student groups to support The Sophie Fund’s annual cupcake contest and related fundraising.

Besides helping run the mid-October event in the Ithaca Commons, Ho’s army of good Samaritans collected monies that The Sophie Fund passed on to local mental health organizations—more than $500 donated to the Suicide Prevention and Crisis Service in 2017, and $1,300 to the Mental Health Association in Tompkins County in 2018. Ho has also served as a member of The Sophie Fund’s Student Advisory Group, offering endless perspectives and advice on everything the organization does.

The Sophie Fund was proud to learn that Ho was selected to receive The Cornell Tradition Senior Recognition Award at her graduation ceremonies last month. Cornell honored Ho for her many contributions to community service during her undergraduate years. In conjunction with the award, Ho generously donated a $500.00 honorarium to The Sophie Fund.

Ho, was a double major in Biological Sciences (Neurobiology) and Sociology in Cornell’s College of Arts and Sciences; she minored in Inequality Studies and Global Health. For the next two years, she will be pursuing pharmaceutical drug policy research with the Division of Pharmacoepidemiology and Pharmacoeconomics at the Harvard University-affiliated Brigham and Women’s Hospital in Boston, with plans of continuing her advocacy and activism in health inequality everywhere. She hopes to one day pursue a career that combines her passion for service, social justice, and medicine.

Due to her work with Ithaca’s community organizations, Ho will move on not just with a Cornell degree but a profound appreciation for the importance of helping others—and ourselves—when it comes to mental health.

Ho puts it best herself:

“As I look to what lies beyond the ivory tower and beyond Ithaca, I reflect on my experiences here, and realize that one of the most important lessons I learned during my time here is that we all have mental health, and that it is absolutely critical to take care of oneself in the process of chasing our dreams. APO gave me a home like no other to pursue service in the company of the most kindhearted and loving individuals I’ve ever met, and I am so proud to call my fellow peers some of the most devoted advocates and volunteers for mental health I’ve ever seen.

“Change begins when we are willing to support ourselves and those around us. Service to mental health starts by choosing kindness and understanding. Not all big change comes in the form of huge events or big fundraisers or legislation (though these are all critically important). The biggest changes that have occurred during my time here have been the result of everyday people choosing to ask those around them how they are doing as opposed to what they are doing. Mental health intersects with every single aspect of our lives. Whatever comes next, we always have the choice to care for ourselves and each other.”

—By Scott MacLeod

Scott MacLeod is a co-founder of The Sophie Fund

Brief Guide to Student Mental Health Advocacy

Mental disorders, from anxiety and depression to dependency on alcohol and opioids, are an increasing challenge for American society. Today’s college students face a mental health epidemic as they leave home for the first time at an age of life common for the onset of mental illness. Due to concerns about reputation, liability, cost, and other factors, college administrations have broadly failed to meet the growing crisis with a scaled response.

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Student advocates play a critical role in improving mental health policies and practices. On the occasion of the 4th Annual Ivy League Mental Health Conference hosted by Cornell University April 26-28, The Sophie Fund presents the Brief Guide to Student Mental Health Advocacy. The guide highlights useful facts and figures, key advocacy goals, resources on student rights, and campus mental health best practices.

Some statistics underlining the urgency of supporting student mental health (Please note that some of the material below in this post may cause distress for some readers.)
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  • 43.8 million American adults—18.5 percent of the population—are experiencing mental illness in a given year, and 75 percent of mental illness cases begin by age 24, according to the National Alliance on Mental Illness.

 

 

  • 46.8 percent of college students surveyed reported that academics have been “traumatic or very difficult to handle,” and 39.3 percent “felt so depressed that it was difficult to function,” according to the 2017 National College Health Assessment; 12.1 percent seriously considered suicide in the last 12 months, and 1.9 percent had attempted suicide.

 

  • 35.8 percent of surveyed college students seeking counseling in the 2017-18 academic year had “seriously considered attempting suicide” (up from 24 percent in the 2010-11 academic year), according to Center for Collegiate Mental Health 2018 Annual Report; 10.3 percent of the students seeking counseling had actually made a suicide attempt.

 

 

  • In a campus-specific study, Cornell University’s 2017 Perceptions of Undergraduate Life and Student Experiences (PULSE) Survey of 5,001 undergraduates reported that 71.6 percent of respondents often or very often felt “overwhelmed,” and 42.9 percent said that they had been unable to function academically for at least a week on one or more occasions due to depression, stress, or anxiety. Nearly 10 percent of respondents reported being unable to function during a week-long period on five or more occasions. Nine percent of the respondents—about 450 students—reported “having seriously considered suicide at least once during the last year,” and about 85 students reported having actually attempted suicide at least once in the last year.

 

Click here to read the Brief Guide to Student Mental Health Advocacy, or click here to download a PDF.

Cornell’s Student Mental Health Review: “Disappointing”

In a letter emailed to Cornell University students on March 20, Ryan Lombardi, vice president for Student and Campus Life, announced long-awaited plans for a “comprehensive review” of student mental health.

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We support all steps to improve student mental health. We sincerely hope these plans will produce significant improvements. But it is with regret that we must express our disappointment with Vice President Lombardi’s announcement.

Nearly two years ago, after looking closely at student mental health policies and practices across the nation as well as at Cornell, we wrote to President Martha E. Pollack to respectfully seek a robust, independent, external-led review of the mental health challenges facing Cornell’s students as well as the university’s policies, programs, and practices to address them.

We wrote that we had observed systemic failure in Cornell mental health policy and practice, topped by a failure by Cornell administrators “to fully and openly recognize the magnitude of the mental health challenges facing Cornell, and to address them with best practices backed by human and financial resources commensurate to the scale.”

Our concerns are based partly on Cornell’s own data. The 2017 Cornell PULSE Survey of 5,001 undergraduates reported that 71.6 percent of respondents often or very often felt “overwhelmed,” and 42.9 percent said that they had been unable to function academically for at least a week on one or more occasions due to depression, stress, or anxiety. Nearly 10 percent of respondents reported being unable to function during a week-long period on five or more occasions. Nine percent of the respondents—about 450 students—reported “having seriously considered suicide at least once during the last year,” and about 85 students reported having actually attempted suicide at least once in the last year.

Vice President Lombardi’s announcement falls very short of what is needed to address Cornell’s mental health crisis and of what the Cornell administration promised when President Pollack announced the decision last September to conduct a review.

In brief, Vice President Lombardi’s announcement said that the review will be handled by two separate entities. One is an “external review team” to look at clinical mental health services—Cornell’s Counseling and Psychological Services (CAPS). The other is a “university committee” comprised of students, faculty and staff to examine “the ways in which the campus environment and culture contribute to mental health challenges at Cornell.” 

Lack of urgency; lack of a holistic approach; lack of independence, transparency, and accountability; lack of full mandate, scope, and goals; such aspects of the announcement highlight our concerns about the strength of the Cornell administration’s commitment to student mental health.

Lack of Urgency

Some background puts the March 20 announcement in perspective. President Pollack announced in September 2018 that Cornell would undertake a “comprehensive review” of student mental health. It was then only last week, seven months into the academic year, that the Cornell administration finally outlined plans for the review in a late-night, mid-week, out-of-the-blue email to students.

It may also be noted that after we first wrote to the Cornell President seeking a review of student mental health, it took 10 months for the administration to respond with a clear answer, and President Pollack’s answer at that time was “No.”

In that January 2018 response, President Pollack pointed instead to an “external assessment” then being conducted by The JED Foundation, JED’s on-site visit to the Cornell campus in the summer of 2017, and Cornell’s “ongoing engagement with the foundation to ensure we are providing holistic support.”

We wrote to President Pollack again in August 2018, arguing that the JED review was “plainly insufficient.” We noted that the review (or the parts of it that Cornell had chosen to make public) included no findings, and that its recommendations had not addressed 1) CAPS services; 2) Cornell’s suicide prevention policy; 3) community mental health provider services to Cornell students; 4) academic workloads; 5) or faculty and staff handling of students in distress.

Throughout 2018, two student organizations—the undergraduate Cornell Mental Health Task Force and Cornell Graduate Students United—made extraordinary efforts to seek an independent review and to advocate for specific improvements for student mental health.

With the March 20 announcement, the Cornell administration seems to have lost an entire academic year of time for a comprehensive review. Cornell’s 10-day spring break starts this week, and then only five weeks are left until the last day of spring semester classes.

Lack of a Holistic Approach

Vice President Lombardi’s announcement suggests that the Cornell administration has decided against going forward with a true comprehensive review; the announcement indicates a preference instead for a review that is modest and incremental.

The plans outlined on March 20 fragment the review into at least two compartments, rather than establishing a centralized task force to review all Cornell mental health matters in their “comprehensive” entirety. This is at odds with President Pollack’s statements that Cornell would undertake a “comprehensive” and a “holistic” review of student mental health.

We along with others have called for a task force to conduct a comprehensive review due to the interconnectedness and complexity of student mental health challenges. The challenges deal strongly with CAPS clinical services but hardly with CAPS alone; the scope of a comprehensive review must examine university policies, administration commitment, academic culture, campus climate, community mental health services—and the intersection of all these areas.

Lack of Independence, Transparency, and Accountability

The March 20 plans lack a structure or mechanism to ensure the independence of the review, such as the appointment of a recognized external expert as task force chair (or co-chair), who would oversee all elements of the review and report directly and only to the Cornell President; the Cornell administration, rather, seems intent on a review with ambiguous lines of authority and accountability that is guided and closely controlled by the administration itself.

The March 20 announcement said nothing about the charge that the review teams have been given; about who authorized the fragmented review plans; about who appointed the members of the two entities that will conduct the review; or about which university authority the review teams will report to, and by what deadline.

The announcement also failed to identify all but two members of the review teams—nothing was said about the appointment of specific external mental health experts, student leaders, or Ithaca community stakeholders. This lack of transparency (or efficiency) suggests the absence of a strong mandate.

Vice President Lombardi did announce the appointment of co-chairs for the campus environment committee—two associate deans who are both new to Cornell and to Ithaca. Typically, university officials at the vice president and vice provost levels have been assigned leadership roles on mental health task forces at peer institutions.

The March 20 announcement made no commitment to transparently releasing all reports related to the review.

Lack of Full Mandate, Scope, and Goals

The March 20 announcement said nothing about the mandate, scope, and goals given to the clinical mental health services external review team and the campus environment committee. The announcement makes no mention of mandating the two review entities to report findings or make recommendations.

Vice President Lombardi said that the clinical mental health services external review team will “evaluate our services.” With such a vague and narrow mandate, the team may not be empowered to review the many budgetary and other policies that affect the services, or the services provided to Cornell students on referral off campus by community providers.

Vice President Lombardi said that the campus environment committee “will gather information” about the environment and culture at Cornell. With such a meager mandate, the committee may not be empowered to examine the plethora of policies and practices related to mental health (suicide prevention, student disabilities, academic pressure, alcohol and other drug services, residential life, sexual assault, hazing, vulnerable population groups, education and awareness, emergency response)—and their interconnectedness—with the required rigor and vigor.

Lack of Resolve

All this leads us to worry about a lack of resolve in addressing student mental health at Cornell. We continue to have concerns about “an institutional mindset reflecting complacency and defensiveness,” as we wrote to President Pollack nearly two years ago.

We are disappointed by the President’s hesitation and delays in moving forward with a comprehensive review. We were surprised when she declined our request in 2017 to meet with us to discuss our concerns and suggestions. In December, Robert S. Harrison, chairman of the Cornell University Board of Trustees, also declined our request to address the board on student mental health at its meeting in Ithaca scheduled for March 22.

Last fall, we welcomed President Pollack’s announcement that Cornell would conduct a comprehensive review of student mental health. What we said then remains our belief—and our hope:

“There is a mounting mental health crisis facing our young people today, and the goal of the comprehensive review should be not merely to tinker with the existing system but to create a gold standard for supporting student mental health in the years to come. As one of the world’s leading research institutions, Cornell should expect no less of itself.

“We continue to stress the importance of a truly independent, robust, and transparent review, led by an external expert—a recognized public health authority with a strong background in mental health and without any current or previous ties to Cornell. This is vital, both to ensure the best possible outcome and to win the confidence of Cornell students and the wider campus and Ithaca communities that the university administration is doing its utmost to support student mental health.”

—By Scott MacLeod and Susan Hack

Scott MacLeod and Susan Hack are co-founders of The Sophie Fund, a non-profit organization supporting mental health initiatives aiding young people in the greater Ithaca community. The Sophie Fund was established in memory of their daughter, Sophie, a Cornell fine arts student who died by suicide in 2016 while on a health leave of absence.

UPDATE 4/1/19

Cornell Health posted further information about the mental health review on its website:

Cornell’s comprehensive review of mental health

In September of 2018, the Office of the President announced that the university would be conducting a comprehensive review of student mental health, stating that “Cornell Health will work with the campus community during the fall 2018 semester to determine the appropriate scope for a comprehensive review of student mental health at Cornell, anticipating that such a review could potentially begin in early 2019.”

Over the course of fall 2018, feedback was solicited from a wide range of student, staff, and faculty stakeholders, including the university-wide Coalition on Mental Health.The consensus was that the comprehensive review should include two broad themes:

Exploring how best to meet the growing clinical needs of students facing mental health problems

Identifying ways in which the campus environment / campus culture might change to better support student mental health

Cornell’s comprehensive review will be conducted by two different groups working in concert with each other:

A university Mental Health Review Committee composed of staff, students (undergraduate, graduate, and professional), and faculty
An external team of expert evaluators (members to be announced soon)

Upcoming timeline:

This spring 2019, the university is in the process of finalizing membership in the Mental Health Review Committee, and will convene the committee and refine questions to explore with key stakeholders. The committee co-chairs (Miranda Swanson, Associate Dean for Student Services in the College of Engineering and Marla Love, Senior Associate Dean for Diversity and Equity in the Dean of Students Office) will also develop a plan for gathering campus input and collaborate with external reviewers to plan site visits. Between Fall 2019 and Spring 2020, the Mental Health Review Committee will conduct a ‘Listening Tour’ of campus; the external reviewers will conduct their site visits, and submit a written report.

More details will be added to this page soon.

Cornell Health also posted information about “Upcoming changes to Cornell Health’s counseling services”:

Cornell Health is planning changes to student mental health services to provide more rapid access to care. These changes are in response to student feedback and a growing demand for services, and were first announced in a message to the student body on March 20, 2019.

We are adapting a model of care currently in place at Brown University that has proven successful in supporting seamless and rapid access to mental health services.

Beginning in Fall 2019:

Students can have access to same-day counseling appointments (or next-day appointments, if they contact us in the afternoon)
Students will have flexibility in who they see: they can select a therapist based on convenience (i.e., whomever has an opening on a given day at a specific time), or wait to see a therapist of their choosing
Students who are interested in continued counseling will be able to select half-hour or hour-long appointments (students’ counselors will partner with them in determining the frequency and length of appointments that will meet their needs)
Students will have increased access to psychotropic medication management services

How we plan to accommodate these changes:

Beginning fall 2019, every therapist’s day will include time slots for same-day appointments. These same-day appointments will be focused on addressing immediate needs and problem-solving. We will gain much of this time in the schedule by converting the “brief assessment” telephone screenings and the traditional “CAPS intake” appointments into times that can be scheduled to directly address the student’s concern.

Additionally, we will offer half-hour counseling appointments along with the traditional hour-long appointments to increase the number of appointments available each day. We anticipate the rapid access and the flexibility built into this new model will be a welcome change for students.

More details will be added to this page soon.

Thank You, Cornell Student-Athletes!

Cornell University’s Student-Athlete Advisory Committee (SAAC) this week announced that its “Spike for Sophie” mental health fundraising event in December collected $909.00 in donations to The Sophie Fund.

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Sophie Jones of The Sophie Fund (center) with SAAC members at “Spike for Sophie”

“The event was a huge success!” said Morgan Chall ’19, a varsity gymnast, who is SAAC co-president and the NCAA Ivy League SAAC representative. “We had an awesome turnout with a little over 100 student-athletes, administrators, non-student-athletes and strength coaches rolling through throughout the event. Aside from everyone coming together to support a worthy cause, it was a really fun event that brought together the Cornell community through a shared love of sports.”

The “Spike for Sophie” spikeball tournament and related “Bench Press for Sophie” took place on December 5 at Cornell campus sports facilities. The event was co-sponsored by SAAC, Cornell Minds Matter, the Spikeball Club, Athlete Ally (LGBTQ+ inclusion in sports), and the Red Key Athlete Honors Society. The event stemmed from an NCAA Division 1 SAAC focus on mental health awareness in athletics during 2018.

“We chose The Sophie Fund because it allowed us the opportunity to give back to a local Ithaca organization fighting a cause our athletic community cares deeply about,” said Chall, a student in Global and Public Health Sciences. “Not only was it a fun and exciting afternoon, but the event was a huge success, by uniting students, student-athletes, faculty and athletic administrators over an important public health issue.”

Chall said that the event highlighted SAAC’s #Don’tBearItAlone campaign “by reminding every member of the athletic community the importance of taking care of your mental health.” She added: “’Spike for Sophie’ showed the Cornell and Ithaca community that decreasing the stigma against mental health and improving resources especially within the athletic community is an important issue we all take very seriously. The wide range of support from faculty to students showed just that.”

Scott MacLeod, a co-founder of The Sophie Fund, said the organization was grateful to receive the donation, noting that it would help support mental health initiatives aiding young people in the greater Ithaca community. “The Sophie Fund expresses its truly heartfelt thanks to the Cornell Student-Athlete Advisory Committee and other student groups for spreading awareness and knowledge about mental health and providing hope to fellow students who may be struggling. Cornell students continue to be champions for mental health both on campus and off campus.”

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Brandon Womack ’19 and Eli Bienstock ’17, and Cornell University Athletic Director Andy Noel at “Spike for Sophie”

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Photo Credits: Courtesy Sophie Jones and the Student-Athlete Advisory Committee