The game of chance was supposed to end with Harvard's letter of admission. But for students coping with personal problems--from dealing with a breakup to suffering from serious mental illness--the University's resources benefit only the "aggressive" or those who are lucky enough to find a tutor who cares, a teaching fellow who notices or a therapist who is available.

Each year, one or two students commit suicide at the College, and although that matches the national average, friends and classmates are left wondering how no one noticed.

But while the 1995 Dunster House murder-suicide may have prompted some reforms of an unwieldy counseling system, some tutors and health professionals say the House advising system remains deeply flawed, relying on a premise the College knows is unreliable: that students in trouble generally route themselves toward help.

Harvard may tout itself as a breeding ground for independence, but coping with mental health is not effective as an exercise in self-reliance.

Please Hold

It may take weeks to get an appointment at University Health Services (UHS), and when students do, they may find themselves alienated by UHS's version of managed care.

Dean of Students Archie C. Epps III, while not officially a resource in the University's mental health care network, says students and parents sometimes turn to him when they are not making progress within the system.

"They need an advocate because the system is not working well," says Epps, who likens himself to a shepherd. Student in tow, Epps often bypasses "the complicated bureaucracy" that impedes access to UHS therapists. With Epps' help, students can often see "the best care in Boston" without waiting up to three weeks for an appointment.

"Ideally, I shouldn't have to do that," he says.

Dr. David S. Rosenthal '59, director of UHS, says Epps' intervention is not necessary.

"When students call, they get right in," emphasizes Rosenthal, adding that "aggressive" students can secure "same day emergency visits."

But such a system assumes students can conduct a self-diagnosis, and that students-- many of whom have already taken great stridesin simply calling for help--will be willing tocharacterize their situations as requiring"urgent" care.

Dr. Randolph Catlin Jr., outgoing chief ofmental health services at UHS, says his departmenttries to train receptionists to ask studentswhether they need help immediately, or whether thehelp can wait. Catlin admits that this is not afoolproof plan, as the system relies on thestudents to take the initiative.

Even if a student does take that next step andsolicits urgent attention, Nadja B. Gould, aclinical social worker at UHS, says appointmentscan be limited.

Mental health services offers urgent care foran hour at 9:30 a.m., 12:30 p.m. and 3:30 p.m.While students can see a therapist on a walk-inbasis at these times, they are not assured a fullhour appointment, Gould says, because otherstudents might be waiting.

Patients can schedule a follow-up appointmentfor further treatment, but that sets them on theroller-coaster ride of UHS managed care: busytherapists and an emphasis on diagnosis.