Having the bureau as a more approachable option for mental health care provides another entry point for students to get help.“We hear and see how hard it is to take the leap, to seek services in the first place,” Ducey says. “I think it’s fairly clever that Harvard offers two portals to enter into mental health services.”

Mission Creep

But Hyman and Dean of the College Benedict H. Gross ’71 believe that the bureau has strayed too far from it’s original mission.

Founded in 1946 by William G. Perry ’35, a professor at the School of Education, the bureau was originally a service mainly to help students with academic and adjustment issues.

But as the number of students with mental health problems increased over the years, the bureau began to treat students with more serious concerns.

“I think that the bureau has moved in to treat some of this demand,” Gross writes in an e-mail. “This was a departure from its original mission of tutoring and counseling for the usual problems of adolescence and adjusting to college.”

Hyman calls this shift “mission creep.”

“The bureau had its mission increased,” Hyman says. “It sort of started to creep to help people who had more and more serious illness.”

But Hyman says that the bureau should not be treating students with clinical mental illnesses.

“While a lot of students like what [bureau clinicians] do when they show up with depression or other issues, we feel that on balance, students should be getting the agreed-upon best treatments,” Hyman says. “And the people trained to do that are in UHS.”

None of the clinicians at the bureau can prescribe medicine. There are no psychiatrists on staff.

“The broad world has reached a consensus on how to treat depression,” Hyman says. “That’s really what we owe people—the best-tested therapy set that we know, the best-tested treatment.”

He says that for mild to moderate depression, patients should have the choice of either a specific kind of short-term therapy, called cognitive-behavioral therapy, a selective serotonin reuptake inhibitor (SSRI) medication, or sometimes both. This is the type of treatment offered at UHS, he says.

Hyman says he would like to see the bureau continue its work with academic counseling, and refer students with clinical mental problems to UHS.

The catch, Hyman says, is that many students really like the bureau. There is an “enormous amount of consumer satisfaction,” he says.