Mental health at Rice: How the Counseling Center operates and the withdrawal process works

By Farrah Madanay and Nicole Zhao     1/9/13 6:00pm

Online note: The pdf's of the following article are included in this week's news section. The pdf's contain additional information.

By Farrah Madanay

"We should not oversimplify these [sexual assault and mental health] issues or engage in an inappropriate blame game," President David Leebron said in his Dec. 3 email response to Olivia Hansen's opinion piece in the Thresher.

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The article instantly thrust the Rice University Counseling Center, which has a full-time staff of six clinical counselors and one care coordinator, into a negative spotlight. With the burden of allegations, misconceptions and even ire on its shoulders, the staff became a campus villain without saying a word. Hansen critiqued the RCC in her opinion piece, while Dean of Undergraduates John Hutchinson defended the center in his response, culminating in his appearance at the student-organized Rally Against Rice's Treatment of Assault and Mental Illness. Students spoke out for and against the RCC both at the rally and on the various forms of social media, and Leebron presented case statistics from the RCC in his university-wide email response.

"We care so much about confidentiality that we can't comment on the individual cases students brought up," clinical counselor Elizabeth Conaway said. "Hopefully we can speak to some of the misconceptions [about RCC's policies and practices]. My biggest fear is that there could be people who need help who are very scared to seek help because of these misconceptions."

Conaway sat down to talk with the Thresher in hopes of making the RCC's general process and goals more transparent.

The mission of the RCC is to promote positive mental health and help students be successful at Rice, Conaway said.

"I would encourage students to call and ask the questions they have, and if they don't feel comfortable talking to [the RCC], to talk to their masters, their RHAs or RAs," Conaway said. "Students also have many counseling options across the street at the TMC. The important thing is that students should always obtain help when help is needed."

The RCC is located in the student health services building by the Brown masters house. Other mental health resources on campus include the Wellness Center, which offers coaching sessions and other programs, Rice Health Advisers, Rice Emergency Medical Services, and Rice Police, whose officers are trained to handle mental health emergencies.

Jennifer Ding contributed to this article.

 

By Nicole Zhao

Dean of Undergraduates John Hutchinson ultimately makes the decision about whether a student should be withdrawn, but college masters, resident associates, associate deans, Director of Student Development and Retention Kate Noonan and RCC staff advise him on the decision, Hutchinson said.

Of the 455 students who sought psychological counseling during the previous academic year, less than 1 percent were required to withdraw for psychological reasons, according to an email President David Leebron sent to the student body on Dec. 3.

The university may insist on a student's involuntary withdrawal if one or more of the following are true: a student poses a danger to himself other Rice community members; has a medical or psychological condition that he cannot address while enrolled or which the Rice environment may aggravate; behaves in a way that may interfere with the education of other Rice students; or cannot continue to function as a student, according to the General Announcements.

A student may voluntarily withdraw at any time, according to the General Announcements. If the student is in good academic standing at the time of withdrawal, the student can immediately apply for readmission to the Dean of Undergraduates' office with two letters of support and an academic plan approved by the Office of Academic Advising by June 1 for the fall semester or by Nov. 1 for the spring semester.

If students voluntarily withdraw for major medical, psychological or psychiatric reasons, however, they must meet the readmission conditions of an involuntary withdrawal, which requires documentation of treatment received. Students who withdraw within five weeks of the last day of classes of a fall semester cannot apply for readmission until the fall of the following year, the General Announcements state.

Proposing that a student withdraw comes after the university provides support to the student for a long period of time to help the student succeed and remain enrolled, Hutchinson said. This support may come from RCC staff, off-campus assistants and/or college masters. In each case, the university discusses with the student whether withdrawal may be in the student's best interest, and in the majority of cases, the student agrees, according to Hutchinson.

"In a very large number of cases when a student is really struggling with an illness like depression, it is often much more therapeutic for the student to concentrate on their therapy and their recovery from depression without the stresses of trying to handle a demanding course load at Rice," Hutchinson said. "The student may disagree with that, in which case we attempt to put the support structures in place necessary for them to be able to give it their best effort to succeed. In other cases, we know that there are students who are just not going to be able to do that."

Hutchinson said Rice may insist on involuntary withdrawal for students who have ceased to be able to take care of themselves.

"They really are not getting up in the morning, they're not getting nourishment, they're not interacting with other people, they're definitely not pursuing their coursework," Hutchinson said. "You've got a student who may actually be putting their own physical health at risk, and those are cases where we're going to want to intervene to keep that student safe."

Wiess College senior Heather Olson, who was withdrawn from Rice during the spring of 2012 and was approved for readmission for the spring of 2013, said she thought more transparency about the decision-making process regarding students' cases and the various offices involved would have made the process of withdrawal easier.

Olson said she called the RCC emergency hotline on a weekend night during the spring of 2012 to arrange to be sent to the emergency room because she felt ill.

"The woman I talked to was understanding and helped calm me down," Olson said. "She originally said [Rice University Police Department] would come to my room and escort me off campus, but I asked to walk there myself so it wouldn't make a scene, and she let me do that, so that was good."

Olson said she returned to campus after an overnight stay at the hospital, found an email from the Retention office in her inbox and had to meet with an RCC counselor the next day.

"I wish that in the meeting with the Counseling Center on the following day that the letter [from Retention] could have been explained to me more," Olson said. "I didn't know the Retention office existed. I wasn't clear going into the whole thing about the connection between the dean and the Retention office and the Counseling Center."

Olson said she does not remember her counselor acknowledging the letter from Retention in their meeting the day following her stay at the hospital.

"She never really said, 'Oh, Heather, after the hospitalization, we need to do certain things, and we need to make sure you're OK to stay here or not, ... so I'm going to ask some questions about your overnight stay at the hospital,'" Olson said. "She just kind of went right in. I felt like I was being evaluated and I didn't really know what for, and that freaked me out."

RCC clinical counselor Elizabeth Conaway said unless a student poses a serious threat to himself or other members of the Rice community, information cannot be shared without a signed release even in the event that a student goes to the hospital for a mental health-related reason.

After the meeting with the counselor following her overnight stay at the hospital, Olson said she was hospitalized for 10 days. During the following week, she said she received a letter from Hutchinson notifying her of her withdrawal and then spoke with her college master about steps she had to take. Olson said she did not communicate with anyone from the dean's office prior to leaving Rice. During her time away, she said she communicated with Noonan.

Olson said that withdrawal steps included checking out of her residential college, moving out and having an exit interview with RCC staff. According to Hutchinson, the time limit for withdrawn students to vacate their housing is determined on a case-by-case basis depending on the circumstances.

The General Announcements state that students separated from Rice for any reason must leave campus within 48 hours, though exceptions may be granted, and this time limit is flexible, Hutchinson said.

The notification of withdrawal letter, as provided to the Thresher by Olson, states that the student must sign a release of information to allow RCC to speak with the dean's office as a step in the exit interview. The letter also states that Olson should sign a release of information from her treating professional to the RCC and the dean's office at the time her off-campus treatment begins.

"We normally want to see six months of stability as evidenced by regularly engaging in treatment and by successfully completing work experience, college courses or volunteer activities," the letter states. "We will use all the information available to assess your ability to function as a student, socially and academically, over time."

Olson said she felt she was not treated like a rational individual during her withdrawal process.

"It's just very easy to think that the student experiencing mental illness is totally far gone and will be irrational with everything," Olson said. "Transparency and more of an attitude of respect for people with mental illness would have helped with every aspect of how I was treated in the hospital and at Rice. I felt like my personhood was threatened the entire time. It's like being guilty until proven innocent."

Olson said she wished she had felt more involved in the decision-making process.

"It was obvious at the time I would not be able to actively pursue my school work, and it would have been the smartest thing for me to withdraw anyway, [but] I felt like I was being shepherded around," Olson said. "It's hard to tell looking back what would have been for the best, but I do feel kind of sad about the way it turned out. I'm OK now, but it took a long time to get to where I'm at."

Olson said she hopes students are made more aware of all the different campus offices and structures in place for those with mental illness and that when freshmen are introduced to the RCC during Orientation Week, they are also introduced to the Retention office to understand how these offices come into play with one another.

"If the administration were more upfront about it all and described in what situations [it is] forced to take action, it would show respect for students and increase trust of the student body in the administration," Olson said.

Brown College senior Raquel Perez, who said she has taken both a voluntary and involuntary withdrawal during her time at Rice, said the criteria for what information the RCC could share without consent is vague to her.

Perez also said she felt she was treated without compassion during her involuntary withdrawal process. In the fall of 2009, during which she was receiving counseling at the RCC, Perez went to the emergency room and agreed to stay at a mental health institution.

"I realized I was in such a rut and things had become such a mess,'" Perez said. "It was just getting really bad, like how I was handling my life. I wasn't going to class. I couldn't get out of bed."

While at the hospital, Perez's college masters gave her a letter stating she was temporarily suspended while Rice evaluated whether she should return to campus, she said. She met with Noonan, then an assistant dean, twice to discuss her thoughts and plans if withdrawn or if let back on campus.

Perez said she felt very upset to receive the letter, and greater awareness of mental health issues among everyone would have helped her better cope with the experience.

"If [my masters had] said like four students had been kicked off this year or in the past this many students have been kicked off and come back, that would have made me feel better," Perez said. "I felt so isolated, like I was the only person going through it. Those kinds of mental health facts and figures would have helped a lot."

After Perez left the hospital, she received Rice's decision to withdraw her for the spring semester of 2010, she said. After taking classes and receiving counseling in her hometown, she was accepted for readmission for the spring of 2011.

Perez said it is difficult now to determine whether her withdrawal was the right move, but she feels the university could treat those about to be withdrawn better.

"I know my masters cared, but at the same time, my masters, the administration made me feel like a criminal ... like I was the worst person in the world, that I was hurting my roommates," Perez said. "I was doing the best that I could. I know it must have been really hard for [my roommates] because they didn't know what to do. In that sense, I could understand that I might be a 'burden to my peers,' ... but you should have support from the administration [at that time], yet it felt like they were ruthless."

Perez said the national stigma against people with mental illness is a pervasive attitude among Rice students as well.

"Having to tell someone you are taking time off from school for mental health issues or that 'Rice kicked me out,' Rice students typically look down on that so much," Perez said. "It's the culture at Rice, it's like people don't have a lot of compassion for that and it may just stem from not a lot of people knowing what mental health is and how it works."

When a student is readmitted after a medical withdrawal, the student must first find treatment professionals in Houston and meet with the Retention office to keep releases of information open with Houston treating professionals, allowing them to communicate with Hutchinson's staff, including Retention and the RCC, according to a readmission letter provided to the Thresher by Olson.

Brown sophomore Karina Farias said she has only had positive experiences with the RCC, where she saw a counselor monthly for five months and then weekly for a month and a half.

"They're really nice and helpful, and I didn't ever feel pressured to say or do anything," Farias said. "It made me think that I wasn't really certain with what I wanted to do [with my life]. Mostly it was just through talking to [my counselor] that I was able to open up and figure that out."

Farias is not at Rice for the semester, but she said RCC had nothing to do with her leave, which was not an involuntary withdrawal.

"I'm actually pretty confident that none of [my information] was given anywhere," Farias said. "[My counselor] didn't even tell the [on-campus] psychiatrist anything about my situation."

Brown Master Steve Cox said he believes the university's withdrawal protocol is humane and while withdrawals are suggested for the student's well-being, they also do minimal damage to a student's academic record, with grades appearing as "W's" rather than "F's."

"Above and beyond the issue of safety, a lot of the withdrawals were very forward-looking in a sense that a high-performing student, for whatever reason, has stopped performing to their previous level," Cox, a professor of computational and applied mathematics, said. "The hands-off approach of letting them continue their course would lead to suspension, [which is] difficult to remove from a record."

Cox said he does not personally know of a single example that he would consider unfair to the student involved. Cox said he never saw a student coerced into taking a given course of action but that greater transparency may be needed.

"[Perhaps students] weren't really aware at the time of the severity of their remarks or their state, in the sense that it could potentially lead to withdrawal, and didn't feel sufficiently consulted in that process," Cox said. "Something we can get to is transparency about the situations that may lead to voluntary or involuntary withdrawal."

Hutchinson said he is proud of the processes Rice uses and the staff involved.

"I believe as students learn more about our staff and our processes and our resources, they'll actually be quite happy with them, while also agreeing with us that we can always continue to do more, continue to innovate and expand," Hutchinson said.

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