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A year and a half after a Crimson investigation found that mental health services at the College were inadequate and poorly integrated, and over a year after a Student Mental Health Task Force released a set of recommendations to address this crisis, major changes are underway at the newly-created Department of Behavioral Health & Academic Counseling.

The effects of these changes, which include structural modifications, increased coordination between offices, and several new appointments, are just beginning to take shape.

And Dr. Paul J. Barreira, appointed last May as director of university counseling, academic support and mental health services, is optimistic about the eventual impact of these steps.

“The idea of this model is that people aren’t sitting in their offices waiting for you to come see them to get medication, or to come and ask for counseling. This model aims at getting out there quickly and engaging the community,” he said.

Last year’s Crimson investigation found that many students seeking mental health care got lost in a system that sometimes hurriedly medicated and then discharged them.

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A lack of collaboration between University Health Services (UHS) and the Bureau of Study Counsel (BSC)—which offered services unknown to many students to begin with—along with inadequately trained professors and residential tutors also hampered efforts to provide students with coordinated treatment, the investigation reported.

The report of the Task Force, formed prior to the publication of the Crimson report, led to the appointment of Barreira to his current post—directly overseeing all mental health-related services including the BSC, UHS Mental Health Services (MHS), the Office of Sexual Assault Prevention and Response, and the newly created Alcohol/Substance Abuse Services (ASAS).

Now that the BSC and MHS are under the same structure, both incorporated under UHS, the two offices can better communicate with one another to coordinate student care, said Barreira. Barreira noted that the two offices now share a computer server, so that they can share information about students’ treatment. Staff members at each organization have also begun regularly attending each other’s team meetings.

BSC clinicians expressed concern in a March 2004 letter that the structural change would “irreparably disrupt and damage” its work, transforming the BSC’s unintimidating atmosphere into a colder one.

But Judith Z. Herbstman ’07, co-chair of the Mental Health Awareness and Advocacy Group (MHAAG) said, “I think the Bureau has retained its flavor. Just because it’s more organized doesn’t mean it’s sterile.”

Barreira said that many students make use of the unique services at both MHS and the BSC—this fall, approximately 595 students used MHS, 359 used the BSC, and of these, 107 used both.

Barreira also said that both offices have made efforts to reduce the time students must wait for a follow-up appointment to a week or less, if needed. If a student misses an appointment, Barreira said that now they are usually contacted by e-mail.

Barreira also expects to appoint a leader for recently-formed ASAS by the beginning of the fall term, following the October report of the Committee to Address Alcohol and Health at Harvard.

“This is someone whom the entire community can call on for assistance,” Barreira said. “It’s pretty shameful that we didn’t have one before.”

He added that the primary goal of the administrator will be to ensure students’ safety. “One near-death experience with excessive drinking is too many,” he said. “We know students are going to drink....What we’re figuring out is how to communicate with them: ‘If you’re going to drink, for God’s sake don’t get yourself to the point where you get beaten up or raped or pass out.’”

The House Wellness Tutor program, piloted this year in Adams, Currier, and Dunster Houses, will be expanded into several other Houses next year.

UHS Center for Wellness and Health Communication Manager Keli M. Ballinger, who is also the Dunster wellness tutor, wrote in an e-mail that over the year, she provided students with personal assistance in navigating mental health resources at Harvard as well as providing general information to the House community.

Herbstman noted that overall, the changes have had a positive impact for students. “I feel like everybody gets the sense that things at Harvard are being shaken up and examined, and that the changes that have been made are in students’ best interest.”

Still, according to both Ballinger and Herbstman, the greatest challenge lies in changing students’ perceptions about mental health. “It’s not the resources. It’s the stigma about accessing those resources that needs to be addressed,” Herbstman said.

MHAAG co-chair Daniel J. Foti ’06 added that the “next step for MHS is a major publicity campaign.”

—Staff writer Anna M. Friedman can be reached at amfriedm@fas.harvard.edu.

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