The quality of care extended to students through Counseling and Psychological Services at Duke recently has been called into question by some on campus.
Recognizing that confidentiality and students' right to privacy prevent or inhibit most from talking openly about their positive experiences with CAPS, we feel obligated to share facts vital to a complete, balanced and accurate understanding of the care students receive.
The truth is most students who use CAPS services report having a very positive experience.
Twice annually, students in our care evaluate our services. For the past five years, they rated them as quite to extremely satisfactory (6.2 overall on a seven-point scale). This past semester, our clinical support staff received the highest evaluations to date-a 6.6 score.
Similar results are seen in the pre-and post-test assessments of "treatment outcomes" for CAPS clients. The vast majority of our clients showed improvements that were statistically significant, with symptoms reduced substantially following counseling.
Student interaction with CAPS isn't limited to office visits. Last year our outreach programs reached more than 9,200 participants, totaling more than 21,500 "contact hours." They included peer education programs, such as through RAs or with other Student Affairs units.
Duke considers mental health issues a top priority-in part because it, like universities across the country, is facing a growing demand for services on issues ranging from stress and anxiety to eating disorders. CAPS, which provides both crisis intervention and time-limited services, continues to provide more services to more students with more serious concerns. In fact, at Duke the demand has increased by a third over the past five years. CAPS has responded by making organizational changes to ensure we're available to all students who might need our services. That's our commitment.
As with all health agencies, students may experience a short wait prior to a first appointment. However, if they tell our front desk staff that their concern is urgent, they will get to speak to a staff consultant the same day.
Last year, the maximum wait time for a student to see a CAPS therapist after an initial assessment meeting was two weeks. Students with emergency needs always receive immediate treatment through CAPS or within the greater community.
We work with students to provide treatment that works for them. If their needs are extensive or require long-term therapy, we may refer them to a specialist in the local community. Our psychiatrists only prescribe medications after fully evaluating a student's needs, and prescriptions are never issued without a follow-up plan. Our staff always discusses symptoms, possible side effects of medication and non-medication treatment options. When students need ongoing care, we help arrange for it.
This care involves thousands of personal interactions.
As some students have noted, the "match" doesn't always work between a student and someone on our clinical staff, which has diverse backgrounds, theoretical orientations aand areas of specialization. If students feel after an initial appointment that they'd prefer a different therapist, they can discuss this with their "intake counselor."
Our goal is the same as theirs. We want the process to work for them.
This is my first year leading CAPS at Duke. When I was recruited from Northwestern University, I was impressed by how seriously the leadership of Student Affairs and the university is thinking about mental health issues facing students. Since I arrived last summer, we've embarked together on a strategic planning process and have begun increasing our resources and expanding our facilities. CAPS recently completed some initial space renovations and will address other facilities challenges as funds allow.
In addition, we are working on increasing our clinical resources for both individual and group therapy, and we are expanding our approach to developmental programming.
We welcome the attention that has been given to this issue by students and others, since it affects so many Duke students in challenging ways. I am glad to speak with any student, individually or in groups, about their concerns. We don't want anyone feeling reluctant to seek treatment due to myths or misunderstandings.
If you are a student and think you need help, I want you to know: We're here for you.
Kathy Hollingsworth, Ph.D., is the executive director of Counseling and Psychological Services.
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