Does CAPS' referral system work?

Whenever first-year Eleanor Murray made a mistake, she felt she had to make up for it in some grandiose way. 

In November, Murray sought out the guidance of an online advice group. When one person commented that this sounded like anxiety, Murray began a mental health journey that continued with research and a visit to Counseling and Psychological Services.

“That was kind of like the first (time) I was really exposed to any idea of me not being neurotypical, having any kind of mental health disorder, because in school, I wasn't really taught, ‘Here’s the identifying signs,’” Murray said. “I was more taught essentially like, 'Here's what to do if one of your friends has depression,' or something like that. It was never really about yourself.”

Once at CAPS, Murray met with an intern and discussed her concerns. The intern gave her three options, which included meeting with a low-commitment anxiety support group, beginning short-term therapy with CAPS up to six sessions or finding long-term therapy by referral elsewhere. 

Murray chose the referral option. She believes her CAPS experience was positive overall, but some students question if CAPS would better serve students by allowing students to come back for more sessions before being referred elsewhere. 

Junior Katie Clark, who used CAPS to find a new therapist for her anxiety, said she was only able to go for six sessions before being referred to an outside provider.

“For me, (CAPS) wasn’t the most helpful because they started out saying, 'You know, this is very temporary,' so they started out saying we can’t conquer the issues you want to talk about,” Clark said. “This is very temporary.”

Although Murray said CAPS’ referral process allowed her to narrow down her long-term therapist search by cost, location, gender and style of therapy, she said it is a concern that CAPS cannot serve students who do not want a referral and would like to continue their sessions on campus.

“The idea that, if they feel like they can't help someone, they just refer it to someone else, I wouldn't say (is) degrading, but I think it can be a little de-motivating for that person because if you work up the courage to go get help, the people who are supposed to help you kind of push that problem to something else,” Murray said. “While they're still there to support you, it doesn't completely feel like they’re supportive.”

CAPS Director Dr. Allen O’Barr said CAPS’ inability to provide long-term psychotherapy is one of the biggest complaints the institution receives. O’Barr said CAPS cannot operate that way because of limited resources.

“I can tell you that every therapist here would love that if we could do that,” O’Barr said. “The problem is, is that long-term therapy can go on for years and years and years, and so when you’re looking at not only the undergraduate population, but also the graduate and professional population, that would be the possibility of somebody having weekly psychotherapy for sometimes up to 10 years. So then you begin to look at the amount of numbers of therapists that that would actually require, and I’m not sure that we would really ever be able to meet that demand.”

O’Barr said University mental health task forces, led by student body president Savannah Putnam and Executive Vice Chancellor and Provost Bob Blouin, work to address the mental health needs of the entire University by focusing on mental health as a community responsibility infused into curriculum. 

Clark was impressed by how friendly and accommodating the employees at CAPS were, but there were moments during her therapy sessions when she was not able to talk about an issue because of the short-term nature of the therapy.

“I remember in my sessions my therapist saying this is something you should talk about with someone outside, like we can't focus on that right now,” Clark said. “I wonder if maybe they could give people a few more sessions honestly.”

One area of improvement Murray thinks CAPS could work on is its engagement of student feedback.

“The amount of people who when I told them I went to CAPS, they were kind of like, 'Oh, were they actually good? Did you actually like them?'” Murray said. “I think it creates this negative stigma where if you're not letting people tell you how much you enjoyed it or if you actually found it helpful, you're not creating that opening environment to where you can give honest feedback. I think it's going to prevent students in the future from maybe always relying on CAPS all the time.”

As CAPS continues to see a higher number of students in need of services, O'Barr said he hopes UNC develops a more "community-focused" way of dealing with mental health.

But for now, O'Barr said the CAPS website offers students a chance to provide feedback, and he personally invites students in to discuss issues. O’Barr said when the issue of cost emerges in their referral coordination, CAPS staff attempt to problem-solve with students the best they can with financially feasible options, such as the UNC Department of Psychology Community Clinic and the UNC Department of Psychiatry training clinic.

“This is a really highly competent staff and a staff that really cares about students. I’ve been working here for 21 years, and I’ve never seen a staff this good," O'Barr said. "This staff is competent, well-trained and just full of heart, and they really are trying to do the best they can."

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