UHS Mental Health Services Director Dr. Richard D. Kadison says UHS does its best to accommodate students despite limited resources.

Elizabeth A. Whitman ’05-’06, who suffers from an eating disorder and depression, refilled her University Health Services (UHS) Zoloft prescription over the phone for eight months.

She never saw any mental health professional during that time.

After the eating disorder she battled throughout high school recurred during her freshman year, Whitman made an appointment at UHS Mental Health Services.

She was referred to a nurse practitioner with prescribing ability and began taking Zoloft, an anti-depressant. She also began seeing a UHS psychologist every other week.

After a semester of appointments, Whitman told her psychologist that she wanted to stop therapy.

Whitman then continued taking Zoloft for eight months, getting refills from UHS without ever seeing the nurse practitioner—or any other clinician.

“Then I started getting depressed again, worse than before,” says Whitman, whose family has a history of depression.

That fall, she returned to UHS, where another nurse practitioner switched her to the anti-depressant Lexapro, telling her “everything will be fine.”

Whitman said she wanted to restart therapy with her old psychologist, who no longer worked at UHS.

“I had to see someone else, the drug wasn’t working, and I started to have suicidal thoughts,” she says. She started cutting herself and bought a bottle of sleeping pills. Her roommates told her to return to UHS and she did. She informed her UHS psychologist that she was thinking about suicide.

But Whitman says her new psychologist told her she didn’t think Whitman was a danger to herself—and that she should “just try and focus on other things.”

Finally, after a year of start-and-stop care with four different UHS clinicians, she decided to take a semester off and try to get more consistent, professional help at home.

Like other students who have sought help at UHS, Whitman faced a treatment system that patients and medical experts say focuses more on the bottom line than on the mental well-being of its students.

The Crimson’s six-month investigation into mental health at Harvard has found that UHS is coping with rising costs and increased demand for treatment by shuffling students through a confusing system of multiple clinicians and then nudging them out to stay under budget.

Under UHS’s “split care” system, students are usually assigned to two care providers—one for medication and one for therapy—rather than to one psychiatrist.