Rebecca Alifimoff | For me, the CAPS referral process was barely better than Google

Our efforts as a Penn community to destigmatize mental health have been working. Like every Penn student, I often feel the overwhelming pressure that inevitably comes from being an overachiever on a campus full of overachievers, but I’ve never felt truly alone when dealing with waves of anxiety or depression. At every turn I’ve been met with friends and acquaintances who were willing to speak up about their own struggles with mental health. They’ve been open about their need to seek help and their decisions to take time off from Penn in order to deal with their mental health. I’ve benefited immeasurably from this honesty and transparency.

Invariably, conversations about mental health at Penn center on Counseling and Psychological Services, and my experience with CAPS centers on their referral services.

According to estimates by CAPS Director Bill Alexander, 15 percent of students who go to CAPS are referred to an outside provider. Some students receive referrals on their very first visit to CAPS, while others receive referrals after working with a CAPS clinician for some time. Despite the existence of a referral coordinator on staff, there is no set procedure for the referral process. Alexander has said that reforming the referral process is a goal for the semester. 

When I first reached out to CAPS for a referral in the spring of my freshman year, I was experiencing the sort of stress that is fairly common at Penn. Academics and extracurriculars seemed overwhelming. It seemed I was the only person I knew without some kind of amazing summer internship. In addition, my parents had been in the middle of a messy divorce for months. I felt stressed and overwhelmed, so I decided to do what felt like the emotionally responsible decision: what the Thrive At Penn modules I’d completed before I arrived on campus told me I should do — go to CAPS.

I went to CAPS explicitly for a referral. The semester was ending and it seemed best to be immediately set up with a long term provider. My referral experience consisted of a game of phone tag, a series of emails, and ultimately, a 20-minute conversation with CAPS Referral Coordinator Nicole Nardone. After our conversation, during which we discussed my insurance, current mindset, and mental health history, I was emailed two links: one to the Aetna Health Insurance's Student Health webpage and one to Aetna’s general “find a doctor" tool. Both are easily Googleable. Neither was particularly helpful.

I thought that CAPS would put me directly in touch with a provider who could meet my needs. Instead, I went through an administrative process only to end with links to readily available databases. My CAPS experience wasn’t a referral as much as it was a brush-off.  

For College sophomore Kelly Huang, the referral process was also underwhelming. At CAPS, a counselor searched a database and gave her a list of names. 

“I think it was something I could have done by myself,” Huang said. “But I have experience looking for counseling/therapy and my parents helped as well. I could foresee it being a much more difficult process if I didn’t have experience or familial support.”

I am not under any illusions about the type of services that CAPS offers. Its 45 clinicians cannot offer long-term treatment to every student that comes through their doors. Referrals are a necessary part of what CAPS does, and an important way to connect Penn students with resources that can best meet their mental health needs. But the problem with the CAPS referral process is that it is barely a process. It’s an administrative barrier that sucks time from both students and clinicians and ultimately achieves what could be accomplished with a quick Google search. 

The underwhelming realities of the referral process frequently clash with student expectations of what CAPS treatment is going to be like. Often, CAPS is treated as the ultimate mental health resource on campus; the best or only place to go during a mental health crisis. A reformation of the referral process will be as much about open communication between students and CAPS as about expectation management surrounding the kind of care that CAPS can offer. 

With the launch of the University's new wellness portal and renewed focus on consolidating resources and holding campus-wide conversations about Penn’s mental health culture, now is the time to rethink how we talk about CAPS as a tool and an institution at Penn, realizing where it needs to improve and recognizing its limitations.

REBECCA ALIFIMOFF is a College sophomore from Fort Wayne, Ind. studying history. Her email address is ralif@sas.upenn.edu. "Alifimoff's Alley" usually appears every other Wednesday.