Melanie Cole (Host): Welcome to Conversations with MIT Health. I'm Melanie Cole. Today we’re talking about MIT’s Student Mental Health and Counseling Service, my guest is Dr. Anthony Van Niel, he’s a psychiatrist with MIT Health. Dr. Van Niel, the mental health and counseling service can help students who are stressed out, depressed. Tell us a little bit about this service and who it’s for. 

Dr. Anthony Van Niel (Guest): The MIT Mental Health Service has been around for many years, but I would say for the last five to ten years we’ve made a big effort to reach out to undergraduate and graduate students to let them know about our availability. The service is free to all registered students, and although occasionally we may refer students out for longer term treatment, the initial consultation and visits are free and hopefully accessible, given our hours, for any student who’s registered on campus.

Host: Well let’s talk about some of the treatment services available, Dr. Van Niel because student stress is very unique, and especially at an institution like MIT, I’m sure it’s two-fold or ten-fold. So they’ve got relationship issues and sleep issues and stress and studying and finals, how do you help them, and what are some of the common treatments that you might look to?

Dr. Van Niel: Well you raise an interesting question because this is a unique time in the lives of many students. I would say our common age range is from 17 to the early 30s and that’s a time of great transition in the lives of all of these people. We offer a variety of services. I think our most common approach is basically to sit and talk with someone about what’s going on in their lives and help them make sense of it. Sometimes we have some specific remedies such as medication, we offer group therapy, and we have unique services directed towards minority students as well as those having issues around gender identify.

Host: Speak about some of the common myths. Dr. Van Neil, sometimes kids, they hear you talking about how it’s free and how you are open to helping students with these issues, but sometimes people don’t want to go to mental health and counseling because there’s a bit of stigma still there, so speak about some of the common myths or misconceptions associated with that and ways that you want them to know that this is not the case and that you’re very welcoming and that you want them to come see you.

Dr. Van Niel: Melanie that’s an interesting question because it appears that not just on our campus but throughout the country, there has been more awareness and acceptance of mental health treatment than I think has been the case for generations. Many students recognize that they’re dealing with issues that are complex and beyond their day to day experience and seeking professional advice seems much less stigmatized than it has been in the past. One of the biggest concerns is about confidentiality and we make great efforts to ensure that the conversations that we have with students remain private. In fact, our medical records are distinct from those of the medical department as a whole and require only special permission to access by non-mental health providers. We are not allowed to release these records to anyone on campus without the permission of the patient and consequently it’s one of the few places on campus where students are absolutely ensured that they can speak freely without any recrimination. I think that among the campus we have given many talks and have a vigorous outreach to tell people about our services and hopefully we are well received. This is born out by the number of students who visit us. Any one year, we will see about 20% of the undergraduate student body, and over the four years that students generally spend at MIT, almost 40% of the student population has visited us about once or more.

Host: Wow, you know that’s great to hear because it’s such an important part of keeping students really centered while they’re working so hard as you say in this transitional time. What’s the usual process for scheduling a first time appointment?

Dr. Van Niel: Well we’ve tried to make that as convenient as possible but the biggest request is that we actually ask the students to call us. The number that they can call is 617-253-2916, or if you’re on campus, just 32916 and that will get you to our desk where the secretaries will pick up your call. We are trying to return those calls as promptly as possible, and in that initial call we’ll try to get a sense of what’s going on and whether it’s something that needs to be seen immediately, in which case we have same day walk in services, or whether we can schedule an appointment with one of our providers. Having that initial phone call allows us to triage the services most efficiently, and if it is necessary that someone be seen right away, we do have walk in hours throughout the day from 9 to 5 and psychiatrists available every afternoon from 2 to 4 if there are questions regarding medication.

Host: What should a student do who feel that they’re in urgent distress or urgent need of help?

Dr. Van Niel: Well we’re not the only resource on campus. Many students are connected with faculty, advisors, professors, deans, housing administrators, and so there are many places where students can go to talk about what they’re experiencing. If they feel that they want to connect with mental health, they should immediately give us a call. We do have clinicians on call after hours 24 hours a day and we can talk with them and help them figure out what the best approach is to what they’re dealing with.

Host: What if you’re concerned about a friend or an acquaintance, Dr. Van Niel, how should you respond and what advice would you have for someone like that in trying to convince the person that they care about to go see someone and get the help they might need?

Dr. Van Niel: That is a common call that we get, not just from students but from administrators and faculty around campus regarding someone that they’re concerned about. We are experienced in walking people through the various options, ranging from talking with the person to getting other people involved and maybe even the family at times. Those situations are all unique in their own way, but calling us and talking on the phone or coming in and discussing it is something that we encourage students to do anytime day or night. Obviously, if they can make an appointment to come in, they will be ensured to have time to talk through something in great detail and come up with a plan that makes sense for them.

Host: And now a little advice, Dr. Van Niel, if you would share for parents of kids – I’m a mother and my son is in college, so I know the stress that I hear on the phone when I speak to him, what do you want parents to know who might be concerned about the stress level that their student might be experiencing and how they can help their child while they’re at MIT?

Dr. Van Niel: Well Melanie, if I had the answer to that, I’d probably be running the country I tell you. That’s very difficult because this is a time when these young people both need to and want to be independent, but at the same time, they want to use the supports that they’ve had before, and the interplay between being dependent and independent is very difficult to negotiate and one of the things that we can help the students with. As far as the parents go, I would say the best thing is to have an open communication with your child before they come to MIT so that when something comes up, you feel that there is a basis of trust and discussion that have given them permission to engage with you when they’re under stress. If you feel that they are reluctant to talk with you or there are things that you feel you’re not hearing, I would suggest that the student talk with people that they feel comfortable with. That could be someone in the house that they’re living with, perhaps one of the academic deans who helped them negotiate academic issues, sometimes faculty or staff that they know, but also they can come to mental health and establish a connection here too. If you’re concerned about your child and you feel that they’re not reaching out in the way you think they should, then you can call us at the same number that I mentioned before and talk with one of us and we can help guide you through that process.

Host: That’s wonderful to hear, and Dr. Van Niel thank you for that answer. Please wrap it up for us. What you would like students at MIT to know about the mental health and counseling services available at MIT Health and the treatments that you can provide for whether they’re under stress or having sleep issues, or they’re worried, whatever their situation is, what you can do for them, and your best advice for them.

Dr. Van Niel: Well that covers a lot of ground, but I’m going to address why people should come to mental health and what they can expect out of it, and let me preface this by saying that the transitions that students are facing during these years are immense. People are discovering who they are as a person, they’re discovering their sense of intimacy with other people and what that involves for them, establishing close relationships, sometimes romantic relationships, trying to identify a sense of what they want to do professionally and their competency as a student, which is often questioned at a place as difficult as MIT. All of these are huge decisions and understandings, which can often take an emotional toll on people and add to the stress that they feel. It’s not just exams and problem sets that cause people stress, in fact usually by the time people get here, they’re used to doing those kinds of things, it’s these issues about growing up and finding your own place in the world that are often very difficult to negotiate. Sometimes having a place where you can talk this through where no one is judging you or expecting certain things is a great relief, and I think at MIT where people are so competent in their academic work, the idea that they may need help sorting out these emotional transitions and adjustments is something that I think is well received and understood, but we hope that we can provide that service to students when they come. Often our treatment involves just talking through what’s going on and helping someone make sense of it. Occasionally there will be something that requires medication such as problems with sleeping, anxiety, or depression but that’s not really our main focus, and although we provide those services, even those who prescribe medication, are mostly interested in getting to know the student and understanding what they’re going through so that together we can make a plan about what makes sense, whether it involves further counseling or other accommodations.

Host: It’s great information, Dr. Van Niel, and thank you so much for coming on and sharing your expertise and explaining so very well the student mental health and counseling services available for MIT students. Listeners can visit Health.mit.edu for more information and to get connected to one of our providers. That concludes this episode of Conversations with MIT Health. Please remember to subscribe, rate and review this podcast and all the other MIT Health podcasts. . I'm Melanie Cole. Thanks so much for joining us today.