When asked to think about a mental health resource, society has filled in that schematic category with some kind of institutionalized, specialized, well-educated expert. We are told that there are people out there who know about this kind of thing, who will intervene and help us out. In grade school, you would make your way down to the front office, explain yourself to gatekeeper of student affairs (the secretary) and you would be referred someone who would take charge in the matter, like the nurse or school counselor. To a child with any confusion or problem: reach out, talk to someone, “go tell an adult.”

Now we grow up and mature and stray away from adult answers in adolescence by finding our own voice, our alternative answers and seeking contact and support from our friends and romantic partners. Life opens its arms, age invites freedom and the struggles are balanced by novelty and excitement. For the most part, we figure out ways to cope and process the strange or painful, and eventually previous troubles lessen their grip on our spirit and become part of our unique personal history. We look forward.

Until the next challenge hits like a tidal wave and shakes us to our core. In a world where social contact is morphing in shape and frequency, our generation is confronted with entirely new challenges in day to day modern culture. Where the majority of individuals now have a cyber-persona in addition to their physical selves, where reality marches on in one’s waking hours and also snatched and frozen in pieces of immortality by photographs, videos, social networking sites, blogs, – and not to mention all the collected and saved data as well as internet history – we are in a constant-transient state.

With such a rapidly connected and changing reality, novelty is the norm. The brain is filtering sensory stimuli at a faster and faster rate, far surpassing the information that is received, transmitted and processed. Naturally reactionary struggles ensue. External forces push internal drives to produce oscillating shifts of power. The individual takes on characters and social roles throughout development to meet basic needs, responsibilities and important connections with others. Every culture in the world, from the island warriors of Papua New Guinea to the sadhus of India to the soft civilians of industrialized Florida, there exists madness or some kind of manifestation of mental pain. Within every cultural context there is a unique expression of mental pain and suffering, linguistically, artistically, superficially or spiritually. Physical pain has its remedy, however mental pain’s remedy is often placed in the hands of authority figures, of politically structured engines of knowledge that will point the finger to causal reassurance.

When mental fragmentation occurs, when reality breaks down and is replaced by emotional pain, internal voices, severe paranoia, repetitive thoughts and negativity, the self is no longer whole. As social beings, one must reach out and hold onto reality in order to sustain life. A mental health resource is a socially acceptable term for something or someone to hold onto in this time, to grasp and acquire new knowledge to make meaning of current existence and ideally, to bring about change. Resources can be a simple google or library search of psychological literature, picking up a good book or a paint brush, talking to a close friend or simply petting a friendly animal.

However often reality does not meet with the ideal social influence and advice, friends cannot be bothered or burdened, and communication and expression of mental distress may be incredibly difficult. An individual may not even know what is happening let alone how to explain what is going on with them. College men and women face very different social expectations of how to express themselves, in joy, grief, excitement, love, health and sickness. Compounded by cultural differences in expressing mental state of mind, a students’ mental health may be further burdened with troubles with family, finances, childhood trauma or political or social discrimination. Family may not be the optimal support system, as autonomy and future goals become more important for the young American adult.

Student life at the University of Miami is dynamic and about as diverse as any college experience. Although not much of a college town, UM offers a wide variety of campus experiences, classes, clubs, athletics, creative outlets and social interactions. The microcosm of campus life is abound with opportunities but the semester’s grind can be relentless, professors pile on work, exams, papers and it often, and understandably, becomes overwhelming. Mounting stress may create a state of crisis, and for struggling students in need of help. So where does a struggling student go in a time of crisis? In such a situation, the go-to place they tell you since day one of freshman orientation is the Counseling Center. As large and well-funded as the University of Miami is, the UM Counseling Center is tucked away on the bottom floor of one of the old buildings across from Eaton Residential College marked by a small sign. I visited on a hot, sticky Wednesday afternoon to meet with Kirk McClellan, the Assistant Director to talk about their services, stigma, and the student body.

Having heard largely negativity associated with the Counseling Center, I sat in the waiting room staring at the confetti of paper pamphlets on every imaginable “mental illness” with great apprehension. Mr. McClellan arrived within five minutes, dressed professionally, with perfect blonde wavy hair and kind blue eyes. He greeted me warmly and we proceeded into his office to chat, me on the couch and he in the facing chair with a yellow legal pad. I felt like I was in for a therapy session, until I pulled out my ARC-borrowed tape recorder and questions and he immediately reiterated that our conversation would be totally confidential. He joked about seeing a spread in the Miami Hurricane and I reassured him it would only turn up on wordpress. I began by asking him about his job at the Counseling Center. Having briefly spoken about my project on the phone, he launched right in, speaking quickly and efficiently.

Mr. McClellan is currently filling in for the director, as she retired last year, by managing university crisis situations and primary duties. He is on call 24/7, most of his time is spent doing clinical work, as they are significantly understaffed. They have seven full time licensed clinicians and three pre-doctoral interns.
Their mission is to “get them through their academic career, in a productive and enjoyable way. And in that spirit we do anything that’s crisis in nature… related to the university environment, but we do brief solution-focused therapy.”  A lot of times students have a lot more significant issues that require ongoing treatment, so they do a lot of referrals. The Counseling Center face very big budget constraints, he says but they are a big priority for the University in light of recent mass shootings.” They are working to improve and expand their services in physical space, staff and services. He comments that they are converting the utility closet to accommodate the newest psychologist on staff. They need to double the staff to meet national accreditation of counseling centers, who require one counselor per 1500 students. The Counseling Center is housed under the Department of Student Affairs, although he stressed that they are neutral party between the student body and the University’s administration. They use a short term model, where they will meet with a student in crisis, do a psych evaluation and hold therapy sessions once every two weeks (due to time and money limitations), and “hook people up with services to get through their academic career.” He tells me they do a lot of referrals, as more and more students are coming to the university counseling centers with a long history of counseling. They are used to the “more intensive model” (i.e. in depth therapy sessions) so “a big service is referrals” to mental health professionals in the community. “The stigma is lessening,” he tells me.

All therapy services are free, except for seeing the psychiatrist, but that is also free with student health insurance. Students can only be prescribed medication by the Counseling Center’s psychiatrist if they have had therapy sessions with them for one month. Students seeking help meet with a counselor in a “Walk-in,” an immediate therapy session for a “crisis that can’t wait,” where they do a brief evaluation so as to determine they are not a danger to themselves or others. An “intake” is a previously scheduled appointment, very high in demand, where they meet with a therapist, discuss their background and personal history and develop a treatment plan. “We decide if its appropriate to treat here at the Counseling  Center or we refer them off. It’s very easy process, the initial intake process is a pretty big barrier then from there it’s pretty smooth process.” He tells me that the Counseling Center “has to appear neutral, unbiased and not advocating for the university…We’re here for students, students have to come to us, we can’t go out and get them.” The Dean of Students is in charge of campus security, with the expectation that students are emotionally prepared to be at school.

Mr. McClellan is the first to bring up “Baker Acting” someone when I ask about third parties contacting them to intervene with someone suffering from mental pain. He cites an example of a student will be Baker Acted by the Police Department, and the Counseling Center is not involved at all. The University will involve the Counseling Center to determine if a student is “stable enough to come back to campus.” Then the Director will administer a mandated psychiatric examination, but he stresses their assessment is “only one of the larger determining party.” He says typically the way it happens is someone comes to the counseling center and makes it known that they are in imminent danger of hurting themselves or others. If they are suicidal, they must verbally communicate a plan of action to carry out their intention. Expressing suicidal thoughts would be a case of an immediate intake, where the therapist cancels all other engagements and attends to their crisis. He told me that about three to six University of Miami students is Baker Acted a year.

Obviously this would be the worst-case scenario for a student in mental distress. The qualifier is “danger to self or others,” The law is also used as a verb: to Baker Act someone, means to legally and involuntarily send them to the hospital.

A bit of background: The Florida Mental Health Act, or Baker Act was enacted in 1971, and is a statute allowing for involuntary commitment for up to 72 hours in a secure psychiatric facility. Licensed mental health professional or a member of the Police Department have the right to “Baker Act” someone. They must have evidence that the person: 1) has a mental illness (as defined by the Baker Act) and 2) is a harm to self, is a harm to others, or self neglect. In 2009, 136,120 people were Baker Acted in the state of Florida (most recent available statistics from the Baker Act Reporting Center). The breakdown reveals that an equal proportion of licensed mental health professionals and police officers initiated the Baker Act (about 48%). Miami-Dade County had the largest percentage of Baker Act cases at 12% (16,672 people).

I found the Baker Act Quality Improvement Committee’s minutes online from January 2011. The Committee is comprised of twenty-one members of equal numbers of men and women. In the hour and twenty minute meeting, there was no use of the word “people,” patients was used twice in reference to the meaning of the term “adults screened,” which they agreed should be everyone that comes through the door of a psychiatric facility. New business to be discussed by future new subcommittees (yet to be formed) were the set of Stabilization Guidelines, the Discharge Process and “Lessons Learned” (no specification of what this meant). The three-page report mostly referred to future organization and issues to be discussed at the next meeting in March (of which there was no record).

So these are the people in power, they’re paid to think about the Baker Act, but it is disturbingly clear the empathetic, human side is missing.

I spoke to two interns on campus and a member of UM Police Department, asking them their thoughts on the Baker Act. They all told me that the Baker Act was a necessity. The police officer understandably had his safety blinders on, and told me many times people can be psychotic that they don’t realize what harm they pose to themselves. He said many people actually appreciate the intervention, and willingly go with the police to the hospital to see a doctor.

I can understand why society has created and supported this collective intervention to act on behalf of the individual. But there is a severe disconnect between thought and action. Public perception does not have a grasp on what it means to be in mental pain. Stripping someone of their autonomy and involuntarily committing them to a psychiatric facility is not the answer for a troubled UM student. Although the University makes concessions for people who need to take “medical leave,” which is absolutely confidential and includes all mental illnesses as well as physical illnesses, there are few supportive steps for students prior to this. The Baker Act is an incredible violation of basic civil rights. It is a political extension of our cultural amnesia, the legal remedy to banish the ugly and unpleasant from our lives: “Out of sight our of mind.” This brings to mind something Professor Pompele said in the beginning of the semester, society tends to oscillate between listening to and silencing the mentally ill. The Baker Act, and its threatening presence, is a silencer. Its existence is supposed to contribute to campus safety, but is it really protecting students?

Knowing that we are all capable of madness, that we all have a critical psychological threshold, we are all equally viable candidates to be Baker Acted – contained, silenced, transported away – is the knowledge of this possibility safe?

My impression of the Counseling Center was drastically improved, thanks to Kirk McClellan. Our conversation continued for an hour and a half, ranging from theory of psychotherapy, to the mental health repercussions of Facebook, to gender differences in mental stress and coping to the hypothetical CVS-style access to psychotropic medication. Mr. McClellan was adamantly against such an easy access model, citing brain damage as the main reason it would be dangerous.Not a surprisingly he saw it as a safety risk, people are not competent enough to have that responsibility. It is a direct violation of the authority of his education and expertise, but he took it pretty well.

Walking away, it is clear that the “licensed health professional” does the job because they want to help people, they want to make a difference in peoples lives by communicating an outside perspective in the cognitive-behavioral, psychoanalytical, therapy model. And that’s precisely it. They are trained in a specific framework of how to define and approach someone with mental pain – with a goal-oriented, rational schema of what a “normal” student is and what should be done to regain that “normalcy.”

The idea of seeking help in the University setting is riddled with standards of conduct, although openly discussing personal psychology is more acceptable now than in the past. But students face the stigma of socially acceptable struggles to have in college. It is challenging to internally define what is going on in one’s emotional life, let alone accurately communicate that to a complete stranger sitting in the Counseling Center. In this interaction there are a million assumptions made by both parties, expectations from the struggling student and from the clinical professional based on their own experience and cultural background.

The Counseling Center is caught in the middle of meeting students’ needs and meeting the institutional, administrative needs of the University. The bureaucracy asks for definitive cause-effect programs that show results, budget efficiently and continue the American expectation of “constantly improving” the mental health of the student body. With time and budget constraints, their model puts efficiency before sensitivity to student’s vulnerability. It is unfortunate but disturbingly common in our culture.

When thinking about this disconnect between “normal” and “abnormal,” “sick” and “well,” and the individual against larger society, one short, famous feminist idea is evident: the personal is political. The basis of all social ideas, issues, progress and challenges at large is the individual. People come to the University of Miami to pursue their education, expand their mind and future opportunities. These years are the most memorable because of the intense social connection, both positive and negative. It is important to remember that everyone faces unique challenges, there is no way to compare or equate the sources or results of personal trials. In times of great mental pain and profound need of love and support, it is always good to remember that people are out there that wholeheartedly want to give it. They may have alternate unconscious motives, but the overlying intent is true: no one wants others to suffer and there are people ready to help.

In my opinion, the very best mental health resource is picking up the phone and calling your mother. Sure, it may not be the perfect soothing remedy, but a mother is the one person in the entire world that whole-heartedly cares about one’s health and wellbeing. Having conceived you in love, having born, bathed and nurtured your physical, emotional and intellectual wellness everyday until adulthood, your mom is in the best position to understand your emotional pain. And if nothing is urgently wrong at the moment, call your family anyway.