It is challenging to navigate Harvard’s email lists, bulletin boards — even bathroom stalls — without encountering flyers for mental health support resources.
But that doesn’t mean all students feel supported or trust the infrastructure that is meant to act as a safety net for students going through mental health hardships.
Rae P. Trainer ’26 said she doesn’t remember the incident that got her placed on involuntary leave. Following a night of drinking, Trainer, who had struggled with disordered eating, was told that she made a concerning statement to her proctor while intoxicated. She woke up hospitalized.
Because she was placed on an involuntary medical leave, Trainer said she was prohibited from returning to campus to retrieve basic necessities.
“I was not allowed on campus to get things like clothes, or my laptop,” Trainer said. “I actually had to spend almost a week in a psych ward without any clothes of my own. Another patient gave me the shirt off of her back because I wasn’t allowed on campus to get any of my stuff.”
Trainer successfully petitioned the College to allow her to resume her studies, but she said the series of events negatively affected her trust of institutional resources.
“I think that today I would be afraid to seek crisis care because I know what might happen. I know that my enrollment in school might be jeopardized,” she said.
College spokesperson Jonathan Palumbo declined to comment on Trainer’s experience, citing a policy against commenting on individual student matters.
Interviews with six students familiar with Harvard’s mental health ecosystem suggested that even as Harvard’s mental health offerings have become increasingly robust, barriers to student trust and understanding of these resources persist.
In 2004, The Crimson reported that Harvard College was facing a “mental health crisis,” portraying a campus environment where more students than not had experienced anxiety and depression in the last year. Many were unable to receive timely and comprehensive mental health care.
In the two decades following this report, surveys on student mental health at Harvard conducted by Harvard University Health Services have shown increasing incidence of mental health conditions on campus. Between 2014 and 2018, the percentage of Harvard undergraduates who reported that they have or think they may have depression jumped from 22 percent to 31 percent. For anxiety disorders, the proportion increased from 19 percent to 30 percent.
Though startling, Harvard’s statistics are consistent with, and at times in fact better than, national trends, which show college students have become increasingly likely to report poor mental health.
According to the annual Healthy Minds survey of more than 350,000 college students across 373 campuses, the percentage of students who reported “flourishing” mental health has steadily declined year over year for nearly a decade, from roughly 56 percent in 2013 to just 38 percent in 2021. Over the same period, the proportion of students who reported seeking mental health support rose nearly 10 percentage points.
Despite these measurable nationwide trends, the underlying cause of student mental health challenges at Harvard has been difficult to identify, with speculation ranging from bouts of imposter syndrome to a uniquely self-assessing student body.
Kaitlyn Tsai ’25, who has sought mental health care through Harvard’s Counseling and Mental Health Service — Harvard’s flagship mental health resource — said she did so after academics and extracurriculars crowded her mental space after a difficult summer.
“I traditionally responded to stress or negative events or emotions by just diving into work and numbing everything out and trying to ignore it all,” said Tsai, a Crimson Magazine editor. “Last year, I think I just reached my breaking point.”
A 2020 report by the Harvard University Task Force on Managing Student Mental Health identified several common stressors through focus group interviews, including competitive extracurriculars, loneliness, imposter syndrome, and overwork.
But according to Harvard Stem Cell and Regenerative Biology professor Steven E. Hyman, a former director of the National Institute of Mental Health who served as University provost from 2001 to 2011, “nobody really knows the truth.”
“They’ll say, ‘Well, it’s social media and people having their self-concept attacked by what they see on TikTok and Instagram’ and what have you. And others talk about the insane competitiveness of the college years,” Hyman said. “I don’t think we really understand this.”
At first glance, students seeking help on Harvard’s campus are presented with a wide range of options. And while the past decade has seen a steady decline in mental health on college campuses around the country, it has also seen an explosion of resources within Harvard’s gates.
Numerous initiatives, centers, and groups, ranging in the scope and focus of their services, beckon students to leverage their hotlines or drop-in hours. A significant number of these resources share a common theme: They are operated by students.
Indigo Peer Counseling, for example, aims to support undergraduates from intersectional backgrounds. Harvard ECHO specializes in issues of body image, exercise, and eating disorders, and Contact Peer Counseling focuses on experiences around LGBTQ+ identities.
Harvard Undergraduate Group Peer Therapy and Room 13 also offer spaces for students to receive non-directive therapy, even through the early hours of the morning.
Though an important part of Harvard’s mental health support network, some peer therapy groups exist, in part, to address needs unmet by institutional resources.
Suhaas M. Bhat ’24, who co-founded HUGPT, said much of his motivation to form the group was born out of the lack of available professional counseling during the Covid-19 pandemic.
“It was very clear that there was just not enough resources to go around,” Bhat said.
“Some people definitely were there because they had to wait too long to get CAMHS,” Bhat said. “But a lot of people, I think, just preferred having a peer to talk to.”
Hyman said peer counseling is “more than a stopgap” for the dearth of professional help at Harvard, describing it as a viable option for struggling students in its own right. “It really helps,” he said.
Still, if a student is in search of accessible, professional therapy through the school, there is just one option on campus: CAMHS.
Ideally, students in need of professional therapy can consult CAMHS for an initial consultation — appointments where clinicians help students figure out a best course of action — before being matched with an available therapist for multiple sessions, funded by the annual student health fee, mandatory for most students.
In 2018, in response to a dramatic uptick in the number of students being admitted to psychiatric units, CAMHS debuted a new system that prioritized reducing wait times. The system aimed to schedule students for an initial 30-minute consultation within 48 hours of their booking.
But the initiative proved insufficient to address the underlying disparity between availability and student need, especially as Covid-19 wracked campus and raised staff turnover rates. In spring 2022, therapy appointment wait times stretched as long as six weeks. CAMHS did provide care for students in need of urgent help, and the 24/7 CAMHS Cares hotline, rolled out in summer 2021, was also available as a resource.
One student, whom The Crimson provided anonymity to discuss private health matters, said they were hospitalized for a self-harm injury in fall 2021 after they were unable to secure a CAMHS appointment.
“It was gonna be a three-week wait, and that was not doable for me,” the student said. “It’s just this really big, bad thing that I feel like could have been avoided if I was able to get care earlier.”
In October 2022, CAMHS announced the launch of a partnership with TimelyCare, a Texas-based telehealth provider, to help connect students with therapy more immediately. Around this time, CAMHS also announced it would hire additional staff to conduct initial consultations.
Tsai said she was able to secure her first appointment with TimelyCare “within a week or so” and met with three different providers before settling on her current therapist.
“My experience with her has been pretty great,” Tsai said of her provider.
According to Barbara Lewis, senior director of student mental health at CAMHS, the move was made in part to free up capacity for Harvard clinicians to conduct more therapy and see patients in need of in-person care.
To date, 2,785 students — about 12.7 percent of the student body — have registered with TimelyCare and logged a total of 6,418 visits, according to HUHS spokesperson Tiffanie A. Green.
Selorna A. Ackuayi ’25, co-president of CAMHS’ student-led Active Minds program, said many students are unfamiliar with their mental health options at Harvard, despite an increase in resources and shrinking wait times. Active Minds aims to promote the use of these resources.
“By the time you get to your junior year, you don’t remember all the details of the stuff you were told during one weekend of orientation your freshman year.” said Ackuayi, a Crimson Arts editor. “As the years go on, as students become more busy, they’re not as aware of resources as maybe they were at the very beginning.”
Ackuayi said she believes many students do not seek out Harvard’s mental health resources because they anticipate long wait times.
“The first thing they’re saying is, ‘Oh, I heard that there’s long wait times’ or ‘I heard that it takes forever,’” Ackuayi said. “There’s a lot of this word-of-mouth talk about some negative experiences that people have had with CAMHS as far as having to wait for an appointment.”
“I would say that’s probably one of the largest barriers other than maybe a fear of not being able to find a clinician that works for them,” she added.
Several interviewed students highlighted another reason why undergraduates might hesitate to consult resources on campus: a fear of being placed on mandatory leave. This factor was also noted in the 2020 task force report on student mental health.
“Leaves of absence seem to be a source of fear and anxiety for some students,” the report reads. “Students reported hesitation to disclose their mental health challenges to Harvard-employed counselors and others in the administration, fearing the possibility that they would be asked to leave if they were deemed ‘unsafe’ by CAMHS.”
According to the 2023-24 Harvard College handbook, students can be placed on a leave of absence following “circumstances that raise serious concerns about the student’s health or wellbeing and reasonably call into question their ability to function as a student in the Harvard College environment,” among other reasons.
Mandatory leave policies like Harvard’s have come under additional scrutiny in recent years. Critics have claimed these policies further deprive students of care and peer support when they need it most, including barring them from campus organizations and revoking their student health insurance — which is necessary for some students to afford therapy.
At Yale University, activism fueled by a string of student suicides resulted in the school changing its forced leave policies earlier this year. Now, Yale students on forced leave retain their insurance coverage and in most cases are allowed to visit campus, among other changes.
Harvard has yet to adopt similar policies, though it currently has no blanket policy on the extent to which students on leave are restricted from campus.
Trainer — the student who was placed on involuntary medical leave — said she learned her forced leave was triggered by statements she made to her proctor that were perceived as concerning.
“I’m told I said something like, ‘I want to die,’” Trainer said. “If I had been sober, probably what I would have said is ‘Oh my God, my proctor is here. I’m so embarrassed. I want to die.’”
Trainer said that she believes that “once you were labeled as a suicide risk, it is very, very difficult to get unlabeled as one.”
“It was like, because I fell under that category of psych patients, I could not be trusted either by Harvard or by my doctors,” she added.
Hyman said Harvard’s leave policies were not “created for the purpose of cruelty,” but he said the policies should “show a certain act of caring and empathy” in their implementation.
Tsai, despite her largely positive experience utilizing TimelyCare, said she did worry that the statements made to her therapist would make it back to the school.
“I basically went into every single link I could find on the website from the student or patient portal to see if there was something that would link it to the school,” Tsai said. “I also went into my HUHS patient portal to see if somehow TimelyCare records could show up there.”
“I couldn’t find them, so I felt okay enough with that,” she added.
Improving the reality and perception of mental health support on campus has few quick and easy answers.
CAMHS has run up against both funding and recruitment constraints to increasing its workforce. For one, hiring additional trained therapists reduces the number of specialists available for the surrounding area, which already sees strained resource networks.
Hyman said Harvard’s support network is likely already better equipped than Cambridge and the Greater Boston area.
“The University is working to buffer students from these really grim facts of an inadequate number of well-trained mental health professionals,” Hyman said.
Even necessary additional programs, like CAMHS’ 24/7 hotline, also run up against budget constraints. CAMHS Cares, born in part out of feedback from the task force report, is currently funded by a philanthropic donation from the parent of a Harvard undergraduate.
The 2020 task force report also suggests several preventative measures, including stronger mental health messaging in course syllabi and more frequent check-ins with students. In addition, the report pointed toward a renewed focus on creating a “roadmap” of where to find support on campus.
“It is still the case that many students, faculty, postdoctoral fellows, and staff do not know where to start when they or a student they know needs help,” the report reads.
Despite administrative initiatives to provide more accessible and higher quality mental health care to students, Tsai said she believes it is most important to create an environment in which students “feel safe to seek care.”
“No matter how many resources you provide, no matter how much you invest in this or that, if people don’t feel like they can trust those resources, they’re not going to use them or they will only use them out of desperation,” Tsai said.
Trainer said there is still work to be done on combating stigma and adopting improved policies and practices around placing students on forced leave.
“I think we need to continue to fight stigma on campus, but that goes beyond just putting up posters and saying, ‘If you’re struggling, we’re here for you,’” she said. “Words matter, but actions matter more.”