Managing the effects of the COVID-19 pandemic on MUSC’s students has been compared with riding the twists and turns of a mental health roller coaster that can bring about elevated feelings of anxiety, uncertainty and fear in addition to feelings of depression, unworthiness and grief. In response, students, faculty and staff have worked together to provide a more supportive academic experience.
In 2020, with the campus closed to students and all classes immediately shifted to online learning, the troubles were just beginning. Not only did students struggle with uncertainty and changing public health guidelines connected with the coronavirus, many first- and second-year students voiced that they were struggling with home confinement, personal isolation and loss of interpersonal connectivity and interaction with their professors, mentors and peers – cutting short students’ school expectations and experiences.
Throughout this time, one valuable resource that has been readily available for students is MUSC’s Counseling and Psychological Services (CAPS), an on-campus program that provides students with a variety of quality, confidential and evidence-based mental health services and support.
Gigi Smith, Ph.D., R.N., associate provost for Education Innovation and Student Life, supports CAPS’ mission to assist all MUSC students, especially during the pandemic period.
“The pandemic came unexpectedly for all of us,” said Smith. “We made a commitment to students when they were admitted to MUSC that we will provide the services and resources that they need to become the individuals they want to be. It’s what we do.”
CAPS services
For more than two decades, the CAPS team has provided MUSC students with high-quality mental health services that are problem focused, offering a variety of evidence-based treatments. The team consists of 14 mental health care professionals, including a licensed clinical psychologist, professional counselors, doctoral-level psychiatric nurse practitioners, attending psychiatrists, part-time psychiatry residents and support staff to assist students in every step of their health care educational journey. These professionals are prepared to evaluate and treat anxiety, depression, substance use and other mental health concerns and crises. From the pandemic’s beginnings, they also managed other issues, such as struggles with remote learning, quarantining, home confinement, fear of contracting COVID-19, social isolation and grief.
Students can self-refer or can be referred by a staff or faculty member. Students begin with an initial evaluation with a CAPS team provider and work with the provider to develop a comprehensive treatment plan in the context of a therapeutic alliance. CAPS provides individual mental health services; couples counseling; psychopharmacological management for problems like anxiety, depression, mood and eating disorders and insomnia; substance use treatment; suicide prevention; and other consultations. Students work with counselors of diverse backgrounds. Early in 2021, CAPS expanded their team to include two doctoral-level psychiatric nurse practitioners and now provides extended hours for student appointments.
“Our goal has always been to provide a tailored approach to care for each individual based on specific identified needs. It is not a one-size-fits-all approach,” said Alice Libet, Ph.D., licensed clinical psychologist and director. “Not every student needs mental health care, but it is a helpful resource for many of our students. MUSC’s mental health services, like at other colleges and institutions in the country, were especially tested during the pandemic. Our team rose to the occasion and used confidential web-based resources to meet student needs, turning ‘on a dime’ and working from home, in closets and at kitchen tables to provide students with professional mental health services without interruption. I am exceptionally proud of the work, resiliency and dedication of this team.”
According to Libet, the team responded to more than 1,195 unique students, providing 8,692 appointments during the pandemic, from spring of 2020 to today.
Prioritizing mental health for students
At MUSC and campuses across the country, student services leaders like Smith and Libet, along with college faculties and staffs, were reviewing mental health policies and practices for students and hosting frank discussions about the growing mental health crisis spurred on by the pandemic. They searched for solutions that would address the students’ well-being as much as their learning and academic success. According to Libet, these health care students will someday be a significant part of health and wellness journeys for their own patients. For this reason, it is essential that students learn to prioritize their own physical and mental health.
CAPS licensed professional counselor Amy Horner and her CAPS colleagues also emphasized the value of providing campuswide mental health services and reducing the stigma that may sometimes make students reluctant to seek therapy.
Pandemic-related issues, such as isolation and vaccine efficacy, the team has addressed student issues like self-doubt and imposter syndrome – the feeling of not being worthy or not having the having the knowledge or skills to work in a career for which they are training.
“Mental health services for students are needed today more than ever. With MUSC’s level of high-caliber students who are studying to become health care professionals, students struggle with recognizing their own self-care and being human. They are saying, ‘How am I supposed to help my patients if am not able to help myself.’ It is so important to recognize that helpers can need help too. Mental health problems do not discriminate,” said Horner.
The CAPS team responds to self-referrals by students as well as referrals from college faculty, administrators, preceptors, staff and fellow students if they sense a student is in distress. The CAPS team also works closely with the campus’ Behavioral Support and Intervention Team, a group composed of faculty representatives from each college who work to identify and assist students in distress and intervene when needed to help to maintain a safe campus for everyone. They receive reports of students in distress and encourage others to recognize, respond, refer and report.
CAPS is an especially valuable service for the colleges and their student affairs teams navigating help for their students. Since the spring of 2020, there has been a marked increase in student appointments and consultations, especially due to the pandemic and unsettling world events.
Pandemic needs
Cathy Worrall, Pharm.D., associate dean for admissions and student affairs in the College of Pharmacy, oversees four cohort classes – approximately 350 pharmacy students – and is acutely aware of the stress that pharmacy students have endured during the pandemic, from managing tough didactic course work while transitioning to remote learning to coping with challenges during clinical rotations and managing patients’ fears and pandemic anxieties.
“Students’ mental health issues seemed to have exploded beyond typical issues, especially early on in the COVID pandemic and afterward. Students came forward with their needs, and it was easy to refer them to the CAPS team for help and support. CAPS did a great job pivoting to be able to offer their services virtually for students who needed to meet with them. All of our students were able to get the support they needed at the time,” said Worrall.
She was most impressed with CAPS’ proactive approach during the pandemic as leaders created more programming that addressed self-care topics on mental health and mindfulness practices and coping strategies and exercises, plus they offered professional wellness resources that students could access and practice 24/7.
Another helpful tool introduced by CAPS and the Behavioral Support and Intervention Team is the Red Folder – an icon on the University home page that provides information for faculty, staff and students regarding behaviors and symptoms of concern and provides a list of resources to help. This tool urges the MUSC community to “See Something. Say Something. Do Something,” and the page offers information, resources, appropriate referrals and campus phone numbers to help users.
Perhaps one of the toughest times during the pandemic, according to Worrall, was when the students transitioned back into the classroom last fall. CAPS responded with educational presentations on time management, stress reduction, sleep disorders and other valuable subject matter.
“It is the University and our college’s goals for students to focus on self-care and well-being and scheduling time to manage and prioritize that,” Worrall said. “All of us are hoping that now that students have experienced a year of transition back to in-person activities, we will see improvements. I am hoping that with all these things in place, our students are now in a better place today to move forward.”
During the summer, members of the CAPS team met with Worrall and other college leaders to assess students’ needs and obtain their feedback. In August, the team returned to presenting in person at new student orientations for all six colleges. The team now plans to continue with its monthly educational presentations on various topics and include a licensed therapy dog – a sheepadoodle named Atlas, who belongs to psychiatric nurse practitioner Akeya Harrold, DNP – in some upcoming CAPS events.
“Of course, CAPS could not be successful without support from Smith and the Provost’s Office,” said CAPS counselor Horner. “They helped us recognize and evaluate our needs, expand services and recruit our needed practitioners. All this has been great recognition of the importance of mental health to our student population and supportive of our goal of providing excellent services to MUSC students.”
For information, visit MUSC’s CAPS or call 843-792-4930.
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