The University of Toronto’s Counselling & Psychological Services (CAPS) has been incorporated into the university’s Health & Wellness services, ending the service as it now stands. After undergoing a series of infrastructural and systematic renovations, mental health care previously provided through CAPS can now only be accessed through a single point of entry at Health & Wellness.
The amalgamation involves changes to the referral process: at their first appointment, students will meet with a nurse or a family physician, and after assessment will be referred to a care plan that best suits their individual needs.
System changes
According to Janine Robb, executive director of Health & Wellness, it was feedback from students that prompted the changes. CAPS has been a significant source of frustration for many students seeking treatment for mental illnesses, primarily due to long wait times to access services. With almost 56,000 appointments at Health & Wellness annually, approximately 3,100 of which are in the realm of mental health care, Robb emphasized that this change was extremely necessary.
“There’s no one-size-fits-all approach to wellness planning. We were seeing mental health on our mental health side and we were also seeing mental health in our physical health side. So the idea of amalgamating everything, and having students register in one area would allow for continuous, comprehensive care,” said Robb.
The Health & Wellness Centre administration and staff hope that this new integration will provide a clear and cohesive pathway for patient-centred care; where the patient is actively involved in personalizing a treatment route that works best for them.
“The episodes of care in this holistic approach, where students are able to come in at one access point, determine their needs moving forward. Those needs may change according to their journey over time at U of T… they could vary across a trajectory of a number of years for a student. Students can move in and out of the system in a very flexible manner,” explained Dr. Andrea Levinson, Psychiatrist-in-Chief at Health & Wellness.
Dr. David Lowe, a long-standing family physician and doctor at Health & Wellness, provided insight into the need for these changes. “There were three doors; there was a solely counselling unit, a psychiatric unit and there was a health service. The doors didn’t communicate very well. A person could be going to all three different places, but there was no communication,” Lowe explained.
“This merging allows, a dynamic team that maybe comprised of a family doctor, nurse and a counsellor working together and communicating in a way to best serve the needs of the student at the time,” he said.
THE STUDENT EXPERIENCE
Paloma*, a second-year ethics, society, and law student, visited CAPS during the amalgamation and encountered issues with CAPS’ bureaucratic structure. “Overall, it just seemed like nobody in the office knew what was going on or who they were supposed to talk to in order to get things done,” she said.
Paloma said that she had trouble obtaining the request documents she needed for a petition. These documents would prove that she had attended sessions with CAPS. In the end, Paloma claimed that it took over a month and a half for her to get them.
“I can understand the director of CAPS being busy, what with the amalgamation, but a month and a half for a signature on a form is unacceptable,” she said, “Every time I went in, it seemed like the staff had no idea how to communicate with one another, and the entire office was a chaotic, bureaucratic nightmare.”
Once Paloma finally got her form, the final exam period had ended and her petition request was late. According to Paloma, CAPS backdated the letter. “CAPS actually backdated my letter to within the exam period to make it look like I had been a lazy student who hadn’t picked up the letter, and as a result, I have no idea what’s going to happen to my petition.”
“Honestly, I’m not sure that students will benefit from these changes,” Paloma said, adding “it seemed like a giant rebranding, rather than actually tackling substantive issues. I wish I could be optimistic about the changes that are happening — but honestly, I have little faith in the administration at this point.”
Leo*, a second-year East Asian studies student, had also visited CAPS in the later phases of the amalgamation and had had prior experience with mental health services provided by Health & Wellness. “I have not noticed a significantly negative change throughout the amalgamation,” he said of his experience. “[The] changes seem to facilitate my treatment by freely offering me the services required from both organizations. As a result, I have noticed that I am having a more positive experience with both Health & Wellness and CAPS,” he added.
Although Leo believes that students will benefit from the changes in the long-term, he expressed concern with chronic issues of overcapacity. “I do hope that the ability of Health & Wellness and CAPS to handle many students at once is continually improved on. That is, I hope the university will monitor the students’ need for help at both services and allocate personnel and resources in an appropriate manner.”
Leo expressed surprise that Accessibility Services was not included in the amalgamation, as he has been urged by his psychiatrist at the university to register with them. “If registering with Accessibility Services is something that will help students to such a large degree, then I do believe that it would be helpful to offer it as a part of the aid and treatment the university offers. This way, it would be easier for students to actually get the help they need, rather than continually answering the same questions over and over and being stuck in waitlists.”
According to Robb, the most important part of the amalgamation was “creating this team approach so no one falls through the cracks.”
*Name changed at student’s request
