April 29, 2019

GUEST ROOM | Upstream Approaches for Improving Mental Health on Campus

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It goes without saying that mental health is a major conversation on campus. Currently, some of the mental health services offered at Cornell include Let’s Talk and CAPS, which are offered at Cornell Health, and EARS, a student-run organization. While all are extremely important services, all are arguably “downstream” mental health services. Since they are “downstream,” they can only be utilized by individuals who are currently having to address their mental health issues. There are very few specific services in place that attempt to dispel systems that can lead to mental health issues.

In moving forward, Cornell Health must improve its “downstream” services, but also start implementing programs that incorporate an “upstream” approach in mental health services. In healthcare, the “upstream” approach means considering the social, economic and environmental origins of mental health, not just the actual conditions. At Cornell, we must increase our upstream efforts, working to increase health and wellness programs. We should start with an informative program to properly equip everyone with the basic vocabulary and dialogue necessary to be proper mental health advocates for themselves. I suggest the implementation of a “Mental Health 101” program that will allow students to understand what mental health is, how can it be improved in stressful and unhealthy spaces, and how one could receive ample and necessary medical help. Mental Health 101 would be a pre-freshman summer online program, similar to AlcoholEdu. In addition, it could be modeled after a program found at one of our peer Ivy League schools. Harvard University recently implemented “Sleep 101,” an interactive module designed to increase student awareness of the health and performance implications of sleep and provide strategies on how to maintain a healthy sleep schedule.

Another semi-upstream approach would be increasing the accessibility of Cornell Health. As demonstrated, the recent renovation of Cornell Health increased the amount of health services provided.  The centralization of these different health services drove a significant increase in student usage of these services. Likewise, while it imposes a financial burden, the newly-implemented Student Health Fee reduces out-of-pocket charges to just a $10 copay for most health services. By increasing accessibility and reducing out-of-pocket charges, Cornell Health has started to knock down barriers for individuals on campus who otherwise wouldn’t be able to access or afford proper medical care.

Recently, the Student Health Benefits Advisory Committee has brought up two plans on how to increase accessibility of healthcare on campus. The first plan is to provide free transportation services to Cornell Health. With shuttle stops staggered around student-populated areas of Ithaca, the shuttle would provide a direct line to Cornell Health.

A second idea is to build a Cornell Health satellite on North Campus. This plan is ineffective for two reasons. First, creating a proper space that has all the necessary medical equipment would cost an exorbitant amount. Just the renovations recently done to Cornell Health cost more than $55 million. The cost of building and furnishing a new satellite campus would place an unnecessary financial burden on students. Staffing is another major concern.  Considering Cornell’s location, attracting top talent is a difficult task already for Cornell Health, and maintaining a full staff even more so. Properly staffing Cornell Health and a North Campus satellite makes the initiative unfeasible. It would only hurt the quality of care provided. The North Campus satellite would actually decentralize the medical system in place. Any additional resources should be allocated to a more upstream approach. This is why the shuttle system would work best. This would centralize and build on the existing structure in place. Increasing accessibility is vital, for with greater access comes greater utilization of health services. With greater utilization, individuals are  more proactive in getting to Cornell Health and getting the medical services that they need.

We need to work with the system we have in place. Major issues currently include long wait times, the lack of diversity in the medical staff, and ensuring that people are able to receive medical attention within a reasonable window of time. These are issues that are receiving top priority from student organizations, task forces and health committees across campus. It is increasingly more important that as we start to address the downstream issues of Cornell Health, we also start heading upstream when creating solutions. If we take a holistic approach and focus on the full spectrum from “upstream” to “downstream,” we can reach a wider audience and ensure that people are receiving the care that they need from the beginning.

Nick Matolka is a sophomore in the College of Agriculture and Life Sciences. Comments may be sent to [email protected]