Cost Issues
Both University officials and students must decide whether increased mental health care is worth the fiscal costs, according to Brendan A. Maher, Henderson professor of psychology of personality.
"All of us ought to probably think through dispassionately what are the range of things in a student's life...in which the University has a duty to deal," Maher says.
Maher sees a need to "divide genuine mental health from the normal ups and downs of life." He says this division can be made through "a definable index of improvement."
Like Harvard, Boston University treats students solely on a short-term care basis.
"A crisis doesn't last a year," says Leah Fygetakis, the director of B.U.'s counseling center. "You would be amazed at how much work can be done in a short period of time. Most students get the result by the time they end [and] where we think [short-term care] might not be beneficial, we explain to the student."
But Maher says there is a danger to therapists telling patients that further care is not necessary.
"The diagnosis could be used as an excuse for avoiding responsibility," he says.
For his part, Berlin believes mental health is key to education and should be provided at all costs.
"I don't see any reason why a large institution can't take on those responsibilities," he says. "I think it is a commitment to students."
Visibility
Catlin says mental health services depend on word-of-mouth, and, at Harvard, such services suffer from a lack of visibility.
Because of the health service's lack of visibility, Catlin says he doesn't really know how many students the mental health unit should be serving.
Repetto says few students know when they first approach a health professional that they need long-term care.
"How would you know that you want to talk to somebody for four years when you first walk in?" she says.
But Berlin says short-term care is often endorsed by therapists who are constrained by fiscal decisions.
"Most of the [short-term care] come[s] out of bureaucratic necessity and not clinical mandate," Berlin says. "There is just not enough time."