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.