CaPS does vital work, services must expand
I have never had a particularly easy time falling asleep. Even when I was a child, I remember staying up until the clock hit 9, then 10, then hours no little kid should ever be awake for until I either slipped into a short nap or morning came. The problem never eased up as I got older, but as I started to reach adulthood it shifted from silent waiting to a series of uncomfortable thoughts to an internal screaming match just trying to get my brain to calm down for just one minute and let me sleep. From there it only escalated. It’s hard to remember when each shift happened, but eventually this was no longer just a bedtime scourge. My whole day became a fight with myself. Over time it shifted into an internal fight with someone else. It made me angry, but I never really felt anything amiss until the middle of a final last year.
I sat taking a test in a class I was taking pass/fail, needing merely a 20 percent to slip by. As I sat in the room and tried to focus, this voice became loud and angrier than normal. As I stumbled through the first problem on the exam, it began to taunt me. It began to get more and more aggressive until, for the first time, it threatened me.
I was confused and panicked. I handed in my exam with just the one problem finished and looked for the nearest empty spot. That happened to be the stairs between the Morewood Parking Lot and WQED. I pulled out my phone and called the campus mental health emergency number, lying that I had just had a panic attack. I don’t quite remember what the person on the other line said, but I managed to get all the way to my apartment before I began crying hysterically.
I decided I needed some sort of company. The voice in my head kept taunting me that I had somehow managed to miss such a meager goal on that final, and I just needed something else to focus on. I somehow never managed to contact anyone and wound up at home assembling IKEA furniture for six hours that felt like months. Eventually I did manage to find my phone to ask someone to come help build a coffee table, but I never quite recovered.
I still have a nightmare of a time just sitting down and doing homework for extended periods of time. Getting to class in the morning is a nightmare, and I often fall really far behind in terms of material. Carnegie Mellon’s Disability Services are extremely helpful for these symptoms, but getting myself to class in the morning would be a more personally meaningful step then having free access to copy machines for notes and flexible testing hours.
I eventually sought help — I had to, there was no way around it — through Carnegie Mellon’s Counseling and Psychological Services, or CaPS, which sent me “into the community” as they always do with people with problems they are not designed to handle. That’s probably the best solution, but there are three hurdles involved in seeking the necessary care in that situation.
First, a lack of motivation is among the most common symptoms of any mental illness. While CaPS is right on campus and not far removed from most people’s daily activities, places like UPMC’s Services for the Treatment of Early Psychosis (STEP) are comparatively far away and, when in the wrong mindset, can be explained away by anything from the weather to the bus taking too long to just plain not wanting to go.
Second, mental health treatment can be exorbitantly expensive. Copayments at each visit if not in a set program mean that six weeks of therapy can cost $250. That’s not within the budget of most people, especially college students.
Third, white coat syndrome can be a serious concern. Every time I go into STEP and am asked what the voice sounds like or what it says, I’m met with loud resistance inside my head to saying anything specific. Despite being able to talk about it freely in other situations, I’ve never been able to describe the problem when I’m actually inside a medical institution. White coat syndrome is very common and probably plays a large role. The on-campus environment of CaPS could be better for sharing information that needs to be shared.
Pittsburgh is an excellent city in terms of mental health care. Most places don’t have something close to an equivalent for STEP and don’t have the abundance of mental health care resources. CaPS itself is also a program ideal for a university; it is designed to deal with the mental health problems that may come up for college students. An intuitive solution seems to be to have Carnegie Mellon contract professionals who could help students with less common problems through CaPS, but there are probably obstacles to that I could not think of. I don’t have the knowledge to provide a solution, just to start a conversation in hopes that someone else does.