Oxford mental health services fall short for WEPO students

In the first part of a Closer Look on mental health resources abroad, the Record explored the experiences and concerns associated with studying abroad at a program approved by but not associated with the College. This week, we turn our attention to experiences with mental health at one of the only study-abroad program operated by the College: the Williams-Exeter Programme at Oxford (WEPO).

Across all of the study away programs approved by the College, mental health resources vary by program in large part along the lines of divergent standards and expectations of the host country’s culture. This same trend plays out in student experiences with mental health services at WEPO; the ways in which its mental health resources differ from those found at the College are closely tied to England’s culture surrounding mental health and their socialized health care system, the National Health Service (NHS). As students at Oxford, WEPO participants have free access to two lines of formal treatment: the Oxford University Counseling Center (OUCC) and local hospitals through the NHS. However, both options tend to have long waiting lists and offer almost exclusively short-term counseling services.

Gretchen Long, professor of history and current director of WEPO, explained how the OUCC is structured around temporary counseling. “The mental health services do offer counseling, but it’s often on a short-term basis. They will often see a student for a few sessions that seem quite targeted at one specific problem,” she said. “They are primarily concerned with keeping students safe. They do not offer the kind of ‘on tap’ therapy that students might have been used to at Williams. This model is true at Oxford, and indeed, I think, over most of the U.K.” The OUCC’s services, in fact, terminate after six weeks for any student.

Wait times for the OUCC can also be much longer than students in need are comfortable with. Teague Morris ’17, who attended WEPO last year, recalled learning that he would have to wait six weeks to see a counselor. Dean of the College Marlene Sandstrom, who served as WEPO director during the 2014-2015 term, concurred that this long waiting list is a common occurrence at Oxford. “While the [OUCC] is well-equipped to provide good care, our students have sometimes reported facing waitlists or session caps at times, depending on the current demand on the system,” she said.

The other cost-free formal therapy options that WEPO students have access to are those provided by the NHS.

However, these services are similar to the University’s in being almost exclusively short-term and requiring extensive waits. “When you go to the NHS and request a therapy appointment, it’s very easy to get an initial consultation if you have some priority reason,” Morris said. “But then to get to an actual regular appointment, which would have been once a week for six weeks, was an eight week wait – so it was a longer wait than the sessions would have lasted.”

If students are in need of longer-term or immediate formal therapy not provided by the University or NHS, the next option is private counseling services, which can pose a significant financial burden.

“Local private practitioners also provide very good care. In this case, however, students need to pay the provider fee upfront and then work with their private insurance company for reimbursement,”  Sandstrom said. “This can add additional layer of stress at a time when students are already struggling.”

Because Morris’ mother works for the U.S. government, he said, his insurance covered private therapy, and he was therefore able to access this option; however, he emphasized that his situation is rather unique.

“That’s very much something that’s not available to most people,” he said. “[My appointments] $600-800 a week. And that’s because, in the U.K., if you’re going to a private practice for any medical procedure, it’s because you either have enough money to bypass the NHS or you have a really specific need.”

In his particular situation, Morris felt pressure from the College administration in Williamstown to leave WEPO rather than to seek these expensive and complex resources. “[The Dean’s Office was] apparently really of the opinion that I should be sent home,” he said. “Since the mental health access is limited and Williams has oversight, they sometimes just want to eliminate the problem.” The WEPO director, he said, as well as the rest of his WEPO class lobbied for him to stay, an effort that was successful and for which he expressed immense gratitude.

Long, Marlene Sandstrom and Noah Sandstrom, professor of psychology and director of WEPO in the 2015-2016 term, all highlighted the availability of alternative resources available at Exeter College for struggling students.

“Students often make use of the chaplain and the junior dean at Exeter College, both of whom provide valuable support for student welfare within the college,” Noah Sandstrom said.

Michelle Hufschmid, the current junior dean at Exeter College, also mentioned the resource of the student volunteer program, which resembles Peer Health at the College and is structured around diversity and inclusive representation. “There are the peer supporters, including peer supporters of color and LGBTQ+ peer supporters, who are well trained student volunteers,” she said. “There are as well a JCR [Junior Common Room] equalities rep, a male and a female JCR welfare rep, a male and female LGBTQ rep, a disabilities rep, a women’s rep and an international rep.”

Molly Bodurtha ’17, who participated in WEPO during the 2015-2016 term, found the junior dean at the time especially helpful. “[The program directors] directed me to the Exeter College Dean Emily Holman, who not only was herself helpful to speak to, but also helped me get an expedited appointment at the [OUCC], where I’ve had the best counseling I’ve ever had,” she said.

While she admitted that her experience may not prove representative of every participant’s experience at WEPO, Bodurtha found mental health resources quite accessible in large part due to the approachability of Holman. She also highlighted the kindness and accommodating nature of her professors at Oxford. “On the instances in which I chose to ask the program director to inform my Oxford tutors about personal hardship, the tutors were tremendously receptive and they went above and beyond in terms of providing accommodations,” she said.

Since WEPO is managed by the College, many involved with it believe that the College can work itself to improve the availability of resources. During his time as WEPO director, Noah Sandstrom worked with the Exeter College and Oxford University to amend mental health resources. “We found the administration at Exeter to share our concerns,” he said. “In addition, there is a university-wide committee of representatives involved in work specifically with visiting students, and this group has recently focused attention on mental health issues that are particularly relevant for visiting students. These conversations, for example, have led to renewed commitment from the [OUCC] that students will be seen in a timely fashion.”

Morris believes that another solution could lie in the College providing funding for private counseling in certain cases, especially because the College did subsidize his initial consultation.

“There are a lot of things about the cost of that program that are obscure and annoying,” Morris said. “One of them is that we pay [roughly] the same amount of money as to go to Williams but then don’t receive many of the same benefits as we would have if we went to Williams,” he said. “[The cost of therapy] is such a meaningless amount of money to the College – it doesn’t seem clear to me that they couldn’t [subsidize it]. If they can subsidize an initial consultation, it doesn’t seem absurd that they could at least partially subsidize some follow-up appointments if it’s been demonstrated that you need it.”

One point of restructuring agreed upon by all parties involved is the need for greater awareness about what services will and will not be provided to WEPO participants. “I think it also would have been better to have had more transparency about what was going to be available,” Morris said. “I found out how all the bureaucracy worked after I needed to, but not before I needed to.”

Long and the Sandstroms all emphasized a similar desire for greater awareness of resources for students deciding whether or not to enroll in WEPO. “It is important for all students who travel abroad to recognize that the accessibility and level of support for mental health in other countries is likely to differ from what they are used to at Williams. This is true for WEPO as well,” Marlene Sandstrom said.