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Wednesday, October 21, 2020

Campus

CAPS kickstarts new system to reduce waiting time


Many students are faced with a long waiting list at CAPS.  | Kathryn Lenihan/The Cougar

If you or someone you know are in a crisis and need to speak to someone, please call 911 or contact CAPS at 713.743.5454 to speak with the after-hours counselor. You can also walk into CAPS to learn what services are available and most applicable.

Aidan Potts, a political science sophomore, went to UH Counseling and Psychological Services last summer after struggling to fit in with his co-workers. Potts said his counselor helped him feel less like an outcast at work. He still remembers the first time he cried to his counselor. 

 “I was talking about the time my dad passed away… and (my counselor said), ‘Aidan, your feelings are completely valid,’ ” said Potts, a former SGA College of Liberal Arts and Social Sciences senator. “No one had ever told me that before.” 

One-on-one counseling helped Potts realize how he often bottled up his emotions and avoided talking about upsetting topics. After his CAPS experience, he understood that it is OK to be sad. Individual counseling proved to be effective, healing even, for Potts. But it soon became a waiting game when he tried to use CAPS again the following school year. 

“I had wanted individual counseling, but it would have meant every two weeks or a month, which would have been weird because over the summer I went weekly,” Potts said. “That’s why I did group. Group is weekly, but individual would have been weekly or monthly.”

Many students like Potts are faced with a long waiting list, but CAPS Director Norma Ngo said CAPS is working to navigate the waiting list. Other college counseling centers in Texas are trying to shrink the waiting period and improve turnover rates with programs like online counseling and referrals to outside counseling services, according to The Texas Tribune

In the same way, CAPS has developed a new and creative clinical service model known as the Stepped Care. 

“Stepped care is a best practice model, which prioritizes the most effective but least intensive treatment option,” Ngo said. “It assumes that not every student is comfortable, needs or benefits from traditional individual counseling. Therefore, treatment can be either stepped up or down depending on a client distress, goals, motivation.”

To participate and benefit from the new system, based on the CAPS’ website, students must first walk into CAPS for an unscheduled triage appointment. 

The free first visit triage appointments are open to students from 8:30 a.m. to 4 p.m., Monday through Friday. The appointments take upwards of 30 minutes. This initial screening evaluation helps organizations like CAPS classify whether the student’s case is urgent, according to the American College Counseling Association

During the triage appointment, students will work with CAPS staff to determine what services are most relevant and beneficial. CAPS participants can access many services, ranging from workshops, group therapy and single sessions to more traditional one-on-one counseling services. 

The CAPS three-week essential skills workshop was created to help students manage anxiety and depression, which are the main mental health concerns students face, according to CAPS, or, based on the CCMH 2018 annual report, “continue to be the most common concerns of students.” 

CAPS single session therapy is intended for students who are aware of what issues they are facing but are unsure of how they can resolve it. Similarly, group counseling is a free weekly service that offers students consistent therapy sessions that address common concerns ranging from social isolation to eating disorders. 

The waiting list is the result of growing enrollment rates, more students seeking services at counseling centers and lack of funding, which prevents UH counseling services from meeting every student’s needs. 

The International Association of Counseling Services recommends a staff-to-student ratio of one professional staff member to every 1,000 to 1,500 students. But, according to a 2019 CAPS presentation to the Student Fees Advisory Committee and based on fall 2019 enrollment figures, UH CAPS has a staff-to-student ratio of one staff member to every 2,304 students. 

Based on UH International Student and Scholar Services Enrollment Reports, from Fall 2007 to Fall 2017, the student population jumped to 43,779 from 34,663, marking an upward trend. 

Unbalanced staff-to-student ratios will result in an increased waiting list and trouble helping students with severe mental health issues manage symptoms or progress, according to IACS. It also said high staff-to-student ratios will lead to decreased “support for academic success of students” since many students depend on counseling to help their academic performance. 

College campuses that do not meet IACS recommendations will miss opportunities to educate faculty members or administrators on how to detect and handle at-risk students, according to IACS.

UH-Clear Lake Executive Director of Counseling, Health and Career Services Dr. Cindy Cook said  the UHCL counseling program, like other college campus counseling services in Texas and beyond, struggles with waiting lists due to lack of manpower. 

“We have tried very hard not to have a waiting list, but (2018) was the first time in a really long time we had to implement a short waiting list just because we couldn’t get people in,” said Cook, a licensed psychologist and vice-chair of the IACS Board of Accreditation.

UHCL’s counseling program has taken steps to work around the waiting list, lack of funding and personnel. While the program had to consider limiting some services, UHCL expanded the repertoires it offers to efficiently meet the student needs, which Cook said is a “common trend in counseling centers nationally.” 

UHCL has implemented a collaborative care model, which provides students with a variety of services from online self-help therapy to skills groups that help students develop meaningful mental health and coping skills outside of therapy. 

Counseling services at UHCL also had to consider enforcing session limits, which, based on the Center for Collegiate Mental Health 2018 annual report, “can prematurely terminate treatment for students who would have improved with more treatment” or hurt students in the long run. But this is not a thought Cook takes lightly. 

“Even if enrollment doesn’t increase…our demands keep increasing,” said Cook, who has been on UHCL staff since 1999. “Each year the percentage student body we see in our office increases, we may have to set strong session limits…We really hate saying no, and if we had the resources, we wouldn’t.” 

Potts took part in CAPS group therapy. He said better funding, for example, from organizations like SFAC, could help CAPS get more counselors who could then help more students in a personalized way. 

SFAC plays a role in unit fund allocation or how much funding each UH organization receives. Seven students, two faculty members and one non-voting adviser make up SFAC. 

This group recommends how much funding each unit or organization receives for the year to the Vice President for Student Affairs and Enrollment Services and President Renu Khator who determine the final distributions. This recommendation by SFAC comes after intense meetings, group deliberations and reviewing the units’ written requests and presentations to SFAC for the year. 

SFAC presidential faculty representative Nouhad Rizk, a department of computer science faculty member, agrees that CAPS is understaffed and an important UH organization. She added SFAC works hard to make wise decisions based on unit requests. 

“We give the same importance to every unit; we do our best to fulfill every request,” said Rizk, an instructional associate professor. “We don’t come up with (the) budget. We get it. (We) did a good job (concerning funding allocations for CAPS) and spend a lot of time studying and fulfilling requests.”

SFAC increased CAPS 2021 funding to $2,359,406 from $2,167,758 and provided CAPS aditional one-time funding, which is given to organizations to fulfill a specific demand, of $183,533 to help CAPS recruit two psychological counseling positions and two psychologists.

Like SFAC, SGA President Allison Lawrence said she and all of SGA work to ensure that every department is represented adequately and receives what is best for UH. 

Lawrence said SFAC has worked with CAPS to try and improve their resources by hiring new psychologists to better help serve students. But, in the end, it comes down to the funding structure, Lawrence said. Like SFAC, Lawrence said SGA has done its fair share to help support CAPS.

“Something that SGA has done has been advocating for CAPS, get better funding to ensure that their budget is utilized as effectively as possible so that resources are provided to students accordingly within the best time frame as possible,” Lawrence said. 

Last fall semester, SGA demonstrated its support for CAPS and mental health with its annual #EndtheStigma event where SGA members laid out shirts around the fountain in front of the UH M.D. Anderson Library to represent the lives of college students who died by suicide. 

The SGA event was created to bring awareness to the mental health of college students and to end the stigma surrounding mental illness. 

“The University has a lot of priorities, and CAPS is obviously a priority, but there are competing resources, departments,” Lawrence said. “CAPS has to just ration out their resources appropriately. So, going forward, that is the goal of the University to make sure there is an adequate amount of counselors at CAPS. But that is a goal that will take a little bit of time.”

Lawrence said because the University has expanded so much that it will take time before the department is fully supported or able to meet the IASC recommended staff-to-student ratio. She adds that CAPS’ staff-to-student ratio is recognized as a problem people in and out of SGA are actively working on. 

But, ultimately, Lawrence said CAPS’ ratio will remain a challenge and one that will not be fixed in the immediate future. 

In the meantime, students can take advantage of Stepped Care and learn how CAPS can help them.

Potts remembers going to weekly group meetings where, with ten other students and two counselors, he talked about his feelings and the progress he and others made since the last therapy session.

Although group therapy to Potts is “a lot slower” than individual counseling, he said group therapy has helped him personally. He strongly recommends CAPS to other students in need of counseling services.

“It’s better to do it, (to try CAPS) and end up you get something out of it than to never try it,” Potts said. 

If you or someone you know are in a crisis and need to speak to someone, please call 911 or contact CAPS at 713.743.5454 to speak with the after-hours counselor. You can also walk into CAPS to learn what services are available and most applicable.

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