ABOUT 600 undergraduates visit psychiatrists at the health services each year. Many of these are given psychological tests, but the tests are not always effective in pointing out which students are most in need of help. Eight of the students interviewed went to the health services; five were tested; only two of those tested were said to need psychiatric help. But none of those initially discharged with a clean bill of health--who later spent over a year in hospitals and saw 11 psychiatrists--said he "withheld a great deal" on the tests and in talking to his doctor.

For most of the students, some dramatic incident precipitated going to the hospital--a Cliffie screamed at her roommates for ten minutes, another student refused to take his exams, a third begged his roommate to hold his hand so he could go to sleep. By the time they got to McLean, their feelings were violent enough that their perceptions of the hospital could not be objective. In describing it in the interviews, several said that the place was minor compared to the experiences they had.

But the ones who noticed said they could not have asked for a better setting. The scattered buildings of the century-old hospital sit atop a wooded hill, and its prep-school-like appearance is in marked contrast to the dingy institutional air of Massachusetts Mental Health, the other Harvard-staffed hospital where some students go. At McLean, new patients go through a month of "work-up"--sessions with a doctor in which the patient's case history is reconstructed in minute detail. After that, a therapist is carefully selected and the patient sees him several times a week.

Slumming

Several students interviewed said they were not as disturbed as most of the patients at McClean, and all but one of them stayed there less than a year. Arriving at the hospital was a shock for some. "I couldn't believe that I was actually in a mental institution," one boy said. "It was as if you had been slumming and suddenly found yourself living in a tenement."

These students were reserved and withdrawn for the first few weeks. "I was almost ashamed to talk to anyone there," the same boy said. "It would have been an admission that I was one of them." "I was too wrapped up in myself, too full of self-pity to realize that there were other people around," another said.

Psychotherapy was intimidating. "First you discover that throughout your whole life you had been in the process of getting sick," one of the girls said. "Every move you made and every feeling you had had helped make you what you were now--unacceptable to the world." Another Cliffie described her therapy as "a steel claw tearing open my scabs . . . . During each session my hands shook and I could taste snot in my mouth." For some there was an irritating sense of disconnection, a feeling that while their pasts were being microscopically examined, they were wasting their present lives and shortchanging their futures. "Once someone gave me a CRIMSON," one boy said, "and I was panic-stricken at the thought of all the time I was losing and all the things I was missing."

Spook Stories

The greatest frustration was the nagging uncertainty about when they would leave. "It would be even more anxiety-inducing for the doctors to tell you when you were expected to leave," one student said, "since that would become an obsession, but the fact that they left it hanging in the air made you pretty angry sometimes." Otherwise, there were no criticisms of McLean as an institution, with one exception. The student who spent the most time in hospitals and whose mind made the most harrowing trips complained that he was "vegetablized" by tranquilizers. But his experiences elsewhere suggest that his objections with McLean were primarily reflections of his state of mind at the time.

Some time after he left McLean, he said, he once more became unable to cope with Harvard and was sent at his request--"Because I knew I could leave it anytime I wanted"--to Boston State Hospital, an institution in which extremely disturbed and chronic patients are kept in custody. "I was put in a bedroom with 16 other men," he said, "screaming and urinating all over the place. I stayed in the hall and told the black attendant spook stories. . . ." He became more and more excited and finally was put in the "box," an empty room "with cement all over, small windows with bars and an iron door. I was told to take off all my clothes . . . it was cold. I was not allowed to have water. I was given one blanket. There was nothing to urinate in. I screamed all night . . . ." He left after a week and went to another hospital.

Tale Tellers

His was the extreme case. For the rest of the students interviewed, the stay in the hospital was a slow journey into the recesses of the mind. Some of them felt a massive relief on entering McLean. "Before I got to the hospital," one said, "I was constantly confronted with the accusation that I was losing my mind. The people around me could not understand actions that seemed perfectly rational to me. They wanted me to be like them, but I couldn't. I was split in two by an insoluble conflict, and I became suspicious of everyone. I always had to conceal myself. When I came to McLean, I found people who accepted everything and who were trying to help me. The attacks [of hysterical laughter] I had been having went away."

These students made friends with other patients and participated in the hospital's social life. They became part of the community that Erving Goffman describes in his book Asylums. One student still tells anecdotes about the people he met. Another said, "You could have great times there. People sat around reading I Never Promised You a Rose Garden and One Flew Over the Cuckoo's Nest. There were some great tall-tale tellers."

BUT THERE was one reservation. Students said that the patients never talked about each other's problems, no matter how close their friendships. "It was not that it was an unwritten law," one boy said. "You just didn't. It was irrelevant. It was the given." People could ask each other about what hospitals they had been in, or how long, but not why. "It would have destroyed a basic trust," another student said. "It would have taken away the acceptance that people need to pull themeslves together."

Despite this one barrier, the same girl said, bonds do form between patients and among groups of patients, and this phenomenon can aggravate a terrific problem in mental institutions--getting patients who have recuperated enough to be able to manage on the outside to leave the community where they feel secure and important. For Harvard students, however, there is usually a less stark contrast between a threatening outside world and a home-like hospital than that many patients face. As one boy explained, "Harvard students want to leave the hospital because they have a solid social structure to return to. In my case," he went on, "I was initially given to understand that I would stay about a year. But I left within three months. There were people I loved in Cambridge, and getting back to them was a tremendous incentive for me to get well."