PAWcast: Student Mental Health With Calvin Chin and Jess Deutsch ’91

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From left, Jess Deutsch ’91 and Calvin Chin

Sameer A. Khan h’21

After speaking on the PAWcast with three students about mental health at Princeton, PAW invited columnist Jess Deutsch ’91 and director of Counseling and Psychological Services Calvin Chin to add their perspective on the issue. Addressing points the students raised, they discussed the pressure Princeton students feel to achieve, what services the University offers and what messages it tries to project, and what alumni can do to help.

TRANSCRIPTION:

Liz Daugherty: I’m Liz Daugherty, digital editor of the Princeton Alumni Weekly, and this is our second podcast about student mental health here at Princeton. Last time we heard from three students who are active in mental health initiatives on campus, and today I’m pleased to be speaking with Jess Deutsch, an alum in the Class of 1991, and Calvin Chin, director of Counseling and Psychological Services at Princeton University’s Health Services Department. 

Could I ask you both to briefly explain your work and what you’ve been doing for student mental health here at Princeton? 

Listen to PAW’s first mental health podcast, featuring three Princeton students

Calvin Chin: So I am the director of Counseling and Psychological Services here at Princeton. I’ve been in this role since 2013, and so my job is all about just mental health, both the direct services that we provide to students through the counseling service, but also consulting with faculty and staff around mental health, talking and thinking through best practices around supporting mental health more broadly on the campus, and really just trying to figure out the best ways to support students holistically. I think that that’s a lot of what I do.

Jess Deutsch: And I’m Jess Deutsch. I’m an adviser working privately with college and grad school applicants across the country and encouraging them to go through the process of next steps in their educational lives with a sense of purpose and well-being. I’m a member of the Class of ’91, as you mentioned, and I have a master’s in education and in social work and in recent past was working on campus in health professions advising and athletics. And breaking news, I’ll be writing a column coming soon for the PAW on student well-being.

LD: And we’re really excited about that. And Jess also works and lives locally, which is cool because you’re here and you know some of the students that we’ve spoken to. 

OK. So let’s start with what resources does the University have to help students who are struggling with mental health and are they enough? This was something that the students had talked to us about last time. And are there plans to add to or change anything that’s offered? Calvin, it sounds like it might be a little bit in your wheelhouse. Do you want to start with that?

CC: Sure. Yeah. I’m really proud of the resources that the University provides to support mental health. It starts with the counseling service. The counseling service has over 30 mental health practitioners that work there. Our staff include psychologists, social workers, psychiatrists, psychiatric nurse practitioners, and we provide free short-term counseling, crisis intervention, medication evaluations, medication management, couples therapy, group therapy, as well as workshops. 

One of the things that I’m particularly proud about is the ways in which we try to create as many different access points as possible for students to access mental health services. So a good example of that are the TigerWell Outreach counselors that we’ve been able to hire and put in place across the University. These are counselors who have offices outside of the McCosh Health Center so that they can see students at Jadwin Gym or in a residence hall or in another space on campus that might feel more accessible or easier to find or more comfortable for a particular student.

The other thing that these outreach counselors do is that they really work on developing relationships with the different communities that they serve so that it further reduces barrier to entry, so that a student might feel even more comfortable accessing services if they need it. 

The other thing that we have in place is something called the CPS Cares line. This was launched a year ago and this provides students with 24/7 access to a mental health counselor by phone, 365 days of the year. So a student, regardless of where they are, they could be halfway across the world, if they need to speak with a counselor in the moment, at any time they can call the CPS Cares line and get connected to a counselor. 

The final thing that we launched this past year, and this is through the support of a grant through the state of New Jersey, is Uwill, which is a telehealth company that provides to Princeton students free ongoing counseling through telehealth, they are 30-minute appointments. Students just need to create an account on their platform and then they can choose from any number of counselors who are available and schedule right there on the platform. And unlike the CPS Cares line, this is really intended to be ongoing counseling. And so this is completely free. Students don’t need to use any of their insurance benefits to access a counselor through Uwill. They can see counselors after hours, on the weekends. They can even have text conversations with their counselors through Uwill. And so that’s another just effort to just try to make sure that there are a lot of different opportunities for students to get the support that they need. 

And then the last thing that I’ll say is that sometimes students really want to be seen in person, so Uwill is just telehealth. We have developed something called the Exclusive Provider Network, which includes over 200 mental health professionals in the Princeton area. And these are psychologists and social workers who have agreed to see Princeton students who have the student health plan for just a $20 copay. And these are therapists who ordinarily may not accept insurance but are willing to see Princeton students because we are able to adjust the reimbursement rates on our student health plan so that they’re competitive, and also because a lot of these mental health practitioners in the community really enjoy seeing Princeton students. And so it’s yet another option for students who would like to see a counselor maybe weekly, and there are no session limits with this and there’s no deductible that they have to pay. And so it’s another access point for therapy.

LD: That really sounds like a lot. Do you find that students are taking advantage of all these things?

CC: They are, yeah. I mean, one of the things that we’ve noticed is that we’ve increased the staff at the counseling service by over 40% over the 10 years that I’ve been working at Princeton. And what happens is that as we hire new counselors, we just see an increased number of students. It’s almost like a vacuum. And so students definitely are making use of the mental health resources available on campus. We’re seeing students take advantage of Uwill. Certainly the CPS Cares line is something that we see a lot of utilization around. And then for the exclusive provider network, we can see that directly just even in the costs that the student health plan is paying to cover the mental health care. And so the good news is that students are taking advantage of all of the different range of resources that are available.

LD: The vacuum. That’s an interesting thought there, that the more you add, the more all the appointments go. Do you feel like you have enough? Do you feel like it’s enough? It sounds like a lot. Does it feel like it’s enough, what’s being offered?

CC: I think that we always are looking to expand when we can. And so I mentioned that it’s like a vacuum. The more counselors we hire, that just results in more students utilizing our services. And so one of the things that it can be challenging I think for students is that, because of the number of students who seek out our services within the counseling service, we can only do short-term work. So we can’t see students in an ongoing way. 

The other thing that can happen is that it limits the frequency with which we can see students. And so in most cases we’ll see students every other week. And so I think that that can be frustrating for students is I think that they on the whole have a really positive experience with the counselors who they see at CPS and I think that they may wish to be able to see their counselors more frequently. But because of, again, the demand, we see almost 3,000 students a year, we have to figure out ways of distributing our services so that the students who are most in need get the care that they need. And if we can connect a student to one of these off-campus resources, we do, so that if a student wants or needs weekly treatment, they’re able to get it.

JD: I think it’s interesting — and kudos to Calvin and to CPS and TigerWell for all the extensions and expansions and meeting students where they are. I think that work’s been really apparent. And it’s interesting to try to reconcile that with the student perceptions from the previous podcast about students not having time to use the services. 

I think the issue of how much students are using service and how little they’re talking about it creates some discrepancies in student understanding of what’s possible. And so I think that it’s interesting to think about what’s happening in that gap.

CC: Yeah, no, I agree. I mean I think that what’s challenging is that even though there are so many resources, I think that, and we try to, at every opportunity that we can, let students know about them. Mental health resources, like other kinds of medical care, you only really look for it or pay attention to what is available when you need it, in the moment. And so in the middle of a mental health crisis, sometimes it can feel confusing to sort of know, all right, look, well where of the many different resources available should I start? And then there are also all the other barriers that exist around accessing care, having to do with maybe what it would mean to you to reach out for mental health support, what it means to acknowledge that you have a struggle that could benefit from a therapist. Stigma still exists and I think that that’s something that absolutely can impact someone’s readiness to reach out for help when they need it.

LD: When we were talking to the students, we definitely got on the subject of the campus culture, and these are students who all of them do things on campus involving mental health and so they’re aware of how much was offered. One of them in particular gave us a list and I had the same reaction. I was like, “Wow, that really sounds like a lot.” But they said students don’t always, just like Jess said, don’t always feel like they have the time to take care of it.

And also they felt like the messaging was not strong enough on “make this a priority,” that here at Princeton the emphasis is on your academics, you need to be achieving — that is priority one. Taking time for yourself — we were talking about taking care of yourself, not self-care, not mud masks and facials, but taking care of yourself, eating right, exercising, sleep, exactly, these things that just make you a healthy person mentally, physically — that the messaging was not strong enough that that should be a priority for them. And I wonder what you guys think of that, whether you’re seeing the same thing, where does it come from?

JD: I think that this is an issue that is clearly having an impact at Princeton and also a much broader issue in the culture at large. And so we haven’t normalized the idea of self-care in those basic needs as a part of high performance. And so I think that’s the narrative that really needs to change, and that is a work in progress. And so as many times as a University office may say it or a faculty member may say it, whether or not it’s heard or felt by a student who has in their head this other narrative that what matters most is how I perform academically — it’s just an ongoing process. And so I think we’ll never be done with it.

I think about my own time on campus as compared to now. We didn’t have a language for any of this or one that we were utilizing in any meaningful way. And so it was much more hidden, it was much more stigmatized. But still there’s work to be done so that it feels like taking care of yourself before there’s a big problem or when there’s a struggle is the right thing to do and you’re in a community that supports that. I think that’s still very much a work in progress here.

CC: I agree with you completely. I think that’s spot on. I think that it’s a larger issue in our culture even around what is valued and what is perceived as OK to do. And I think that part of it is even just the fact that Princeton students are so high achieving, they have to do so much and be so excellent to even get accepted at Princeton, that performing and performing well becomes such a part of their identity just because that’s something that they’re so used to doing, which makes complete sense. 

And so it can be really challenging to think about putting their health before an assignment that’s due or making a decision about you know what, I want to do a couple of less extracurricular activities so that I can have more time just to hang out. I think that the Princeton culture and our culture at large is so heavily focused on just achieving and doing more and that it can be difficult to make that proactive decision to do less even and to really think about other things.

And then there are also real pressures, that it’s not just internalized pressure. I mean when you think about Princeton students who are interested in becoming doctors or becoming lawyers, going into consulting, becoming investment bankers, getting jobs at Google — GPA is a real thing. The achievements that you accomplish during your college career do make a difference in terms of whether or not you get the most coveted positions and you get accepted into the highest rated graduate programs. So that’s all true too, and that’s all something that they’re having to balance as well. It just ends up being, I think, really challenging.

LD: Are you, your office or anyone else on campus trying to get that word out, trying to get the messaging to change a little bit that you should take care of yourself, this is important. Getting into Yale Law School is important, but so is taking care of yourself. You know what I mean? Is anyone doing that or trying to do that?

CC: I think there’s so many offices that do it, and as Jess mentioned, it almost doesn’t matter how many people you have saying it, although that’s really important if you’re pushing against all of these other cultural norms that say, well no, that’s not important. But I do think that at the University, the fact that the president of the University even has put health and well-being as part of the informal mission of the University, I think, speaks volumes about centering health and well-being and understanding the importance of health and well-being to thriving, to student success. And I think that that also is a message that’s reiterated from staff of the residential colleges. You think about all of the different live-well, be-well programming that is done in the residential colleges that really tries to create and foster opportunities for community and self care. I think that there absolutely are faculty that try to reinforce that message, that talk to their students directly about health and well-being, and the Center for Career Development I think also does that.

So speaking directly to your point about the question about the job at Google versus taking care of yourself. I think that the career advisers are having conversations about, you’re not going to be successful if you’re not taking care of yourself. And so I think there are a lot of folks that are trying to have that conversation. And I think as Jess said, I think that we have to continue to have it and it’s a really challenging thing to think about how we can change a culture. But part of it happens through conversations and part of it happens through really just trying to think more broadly about how we can define success.

JD: And I would add to that, I think that there’s a really exciting opportunity for alumni to be part of this conversation if we can be creative about facilitating those conversations so that alumni can tell the stories of their own struggles and their successes and the ways in which their attendance to their own well-being has been a factor in the achievements that they’re able to accomplish and the contributions that they’re able to make. This is a long haul and I think there are a lot of alumni who have stories of struggle and success and telling all of that, I think will continue to have students think in new ways about what it means if they’re struggling and what it will look like to have successful lives.

LD: Oh, that’s a really good point. A lot of times when you read that great PAW story about the person who had this amazing career, you don’t necessarily see all of the background that went into this or what’s happening in their personal life or in their wellness life. So that’s a really good point. A lot of that’s invisible to students who are looking at it from the outside. 

We started hearing a lot about student mental health, not only at Princeton but all across the country just a couple of years ago and how the need and the problem of it was getting so great. And I wonder if you guys have a perspective on what changed? Did something change? Are students fundamentally different today? Has the world changed? Are we just paying closer attention? Was it the pandemic? Do you have a sense of this?

CC: I mean, I think there are generational differences. There’s a sociologist named Jean Twenge who wrote a book called iGen that speaks to differences between what’s typically called Gen Z and other big groups of people. When you compare Gen Z to Gen X and to millennials, you see actual differences in rates of things like anxiety and depression. You also see very positive things like increased tolerance, increased commitment to diversity, lower rates of substance abuse, lower rates of unplanned pregnancy. So I do think generationally there is a difference and there have been a lot of researchers that have tried to understand why we are seeing higher rates of depression and anxiety among young people of this generation.

And people have thought about the impact of social media on mental health. They talk about the level of isolation that a lot of young people experience. And I think related to that, the pandemic absolutely has had a big impact on everyone’s mental health, but especially on young people, when during the height of the pandemic, when they would do these surveys of mental health concerns, they saw increased rates of mental health concerns across all populations, but the highest increases were for young people. And I think it’s easy to understand why, because COVID hit young people. Our Princeton students, a lot of them were in high school. And so you think about the lost opportunities for connection with each other, the lost learning opportunities, all of the ways that the normal tasks of growing up can help prepare you for interacting with new people that you meet, for being able to manage really challenging situations.

A lot of it was forestalled by the pandemic and being isolated and learning from home. And so that absolutely, I think, has had an impact. I mean, when we look at rates of mental health concerns for Princeton students in particular, the good news is that the rates of anxiety and depression seem to have been going back down following big increases during the pandemic years, but it’s also within a context of steadily increasing rates of depression and anxiety, I would say over the past 10 years, even pre-pandemic.

JD: And I think I would also pair with what Calvin just described the epidemic of loneliness that is so much affecting the world right now. And so there’s a sense of constant connection and constant information and a million screens open and so much to be taking in and processing and also a sense of being alone in doing so. And I think, again, we’re not immune on that campus at Princeton. And there’s an alum, Jeremy Nobel (’77) in Boston who’s doing some really interesting work on, it’s called Project UnLonely, looking at the ways that disconnection and connection are functioning and the role that art and expression can play in bringing people together. And I think that working on building community is probably Princeton’s best chance and the world’s best chance at countering what feels like, and what is, an epidemic right now.

CC: I mean, the other thing that comes to mind too is just, I remember this was so powerful, but I was talking to a group of mostly first year college students and I asked them to raise their hand if they had ever been part of an active shooter drill. And almost everyone had raised their hand. And so that’s chilling because that’s certainly foreign to me. I’ve never been part of an active shooter drill in high school. 

But I think it just speaks to also just the reality of what a lot of young people currently have lived through and are living through. You think about the impacts of climate change and climate anxiety I think is a real thing, the sense of worry about the future because all of the forecasts about the most terrible things that will happen as a result of climate change are when our students at Princeton are going to be in the prime of their lives. You even think about just the political climate and how polarized things are and how truth becomes this fungible thing. And I think that there can be a lot in the world that filters down and that can just exist as something else, an additional burden to have to shoulder in addition to everything else you might have going on in your life.

LD: So let me touch on something: The students also brought up workload and not in a “my classes are too hard” kind of a way, but more in “maybe the system is not set up for wellness” kind of a way. And they talked in particular about the calendar, which I think that we have now gotten some more information on that. Jess, you looked it up. They were concerned that the semesters had been a little bit crunched back when exams were moved from January to December back in 2020, and it actually sounds like that’s not the case. The semester actually was not compressed, which I thought was interesting. But they all had come to the table with us with this perception that professors were trying to fit too much material into the semester. And I’m wondering if there’s some kind of a disconnect there. Have you heard that before, you two? And where do you think that’s coming from?

CC: I mean, I definitely have heard it, not necessarily about the change, but I think that it is a fact that the semesters are — they may not have changed, but they are pretty short when you compare it to some other colleges and universities. And so I think that that experience of feeling like there has to be so much shoved into an abbreviated period of time, I feel like that makes complete sense to me that that would be their experience. So I think that even though there may not have been a change, it is really just interesting for me to think about how the lengths of our semesters came to be. 

And to also, I would be really curious about how our Ivy peers, what are their semester lengths and how do they achieve that and yet still have their academic calendar structured in a way that works for everyone.

JD: And I think perception is reality. And so if it feels like there isn’t an acknowledgement of how fast this is moving and how much is being expected, then it can add to the overwhelm. And if you add to that also that what students talked about a lot was the emphasis in their own minds about GPA as opposed to love of learning, then why am I putting myself through the grind is maybe a question that they’re asking. And that also contributes to this sense of it’s just too much too fast and it puts them into this, what they described as survival mode as opposed to thriving. And that doesn’t feel good.

CC: I know, and I feel like that can sometimes be the biggest shame, because I’ve had so many conversations with students who are so passionate about learning and would love to be able to just take courses just because they’re interested in them, and how sometimes it can feel like you learn how to perform so you can get the grade versus learning for the sake of learning. And that I think is so tough because I think that everyone at the University wishes that, what the students want is, I think, exactly what the faculty want it is to really be able to dive into the material and to really engage with it in a meaningful way that feels really illuminating and exciting and inspiring.

And it’s not to say that there aren’t a lot of students that do engage with the material in this way, but I have heard from some students this sense that they have to put that as a secondary goal versus I need to do what I need to do to get the grade that I need to get. And at the furthest extreme is when I hear students talk about actually choosing not to take certain courses because they fear that it’s going to negatively impact their GPA. And that seems like the biggest shame to me. It’s like you’re not able to really explore as fully as you might want to because of fear that your GPA is going to be negatively impacted.

LD: What can students do, do you think, to make this a healthier campus? And you talked a little bit about what alumni can do, faculty, the University, what are some things that we can do to change that perception that you just spoke about?

CC: I mean, I think that one, students are already doing it, right? I mean, the students that you interviewed for the previous podcast I think are really beautiful examples of students who are really invested and committed to seeing about ways to change the culture. They’re all advocates around mental health and they’ve been doing a lot of really great work to get questions answered, to try to streamline processes that don’t make sense to give their impact and feedback on mental health resources and what are the best ways to put them out there and are there things that are needed on campus that we’re not doing, and how can we make those things happen? So I think part of it is already being done. There’s a lot of really beautiful advocacy and in my 10 years at Princeton, I have actually seen changes already in the culture and in the community in terms of the students being willing to open up about challenges in terms of their willingness to even talk openly about seeking out help from the counseling service.

And all of that makes a difference, how people talk about mental health concerns, how people can acknowledge vulnerability. Anytime someone opens up about their own vulnerability, it makes the person that they’re talking to feel a little bit more comfortable opening up about their vulnerability. And that’s how you can build real intimacy. And that’s also how you can chip away at a culture that really emphasizes perfectionism and it emphasizes just achievement at all costs, is people being willing to open up about their actual experience. I think that that’s part of it. 

I think that one of the things I’m really excited about is to see, I mentioned that now health and well-being is part of our informal mission of the entire University, to see the sequelae of that. I am really eager to see all of the different administrators and faculty at the University who I know are just as committed to health and well-being among our students as I am, to see how we can come together and really think about, are there different policies or ways that we’re doing things that could easily be changed that could just make it a little bit healthier or easier for a student that doesn’t compromise at all their educational experience, but instead enhances it and supports it? And I think that there are those opportunities. 

And the other thing that I noticed is that in my time here, I see so many people who are really committed to that cause and I think it’s just harnessing that energy to really see what can be done and what can be changed and what can be made better.

JD: I think that’s really hopeful, and I think that making the most of the moments when students do have the time to use their voices to be part of this conversation. And I’ll just do a little shout-out to Wintersession, which I think is this moment that exists now in between semesters where it’s possible to explore and try something new and explicitly for the love of learning it and then figure out how to create those smaller pauses throughout the year and infuse it into the whole experience of the time at Princeton. 

And I also think I’ll again raise the opportunity and the resource of alumni who, I think there’s a new poll about alumni engagement that’s just out that indicates alumni are really interested in engaging with current students and knowing what’s going on on campus in the present moment. And I think that that desire for engagement can also really help to move this conversation forward in a way that will be honest and vulnerable and real.

LD: So that actually gets through a lot of my questions. Is there anything that we haven’t touched on here that you’d like to talk about or anything you think people should know about the subject?

CC: I think my wish — and I think about the role of alumni and I really take to heart what you were saying, Jess, about how alumni can be helpful — my wish is for students to be able to have a broader perspective about life. And I think that it’s natural if you are 18 or 19, all you know is what it means to be 18 or 19. And failures and disappointments can loom so large because that’s your only context. And I think it’s hearing from alumni and hearing just from other adults about moments that feel monumental and moments that feel like they’re huge failures actually are survivable, that in the long range of a life you’ll look back at things that seemed so terrible at the time and you’ll be able to contextualize and see that actually I got through it. It felt terrible at the time, but I got through it and there was so much more to come that I could look forward to and that I could enjoy.

And that I think is the gift that alumni can provide because they’ve been through the Princeton experience, they came out from the other side. They’ve had their failures, they’ve had their disappointments, and yet they persisted and they are where they are. And so I think that oftentimes my wish when I’m in the office with a student who’s struggling with depression or who just failed a class or who is having to take a medical leave and they feel like their world is over, my wish is for them to just be able to have that insight into, you know what, this is survivable. There are always second chances. And even if Princeton and graduating Princeton isn’t even in the cards, that’s survivable too.

And so that’s my hope. And all of the different ways that you were talking, Jess, about ways that alumni could share their stories. I think that the more that those stories are shared, the more students can see examples of being able to survive adversity and come out from the other side. The more that they can be exposed to the fact that there isn’t just one path to a successful life, that I think can be incredibly powerful. A career trajectory is oftentimes very up and down, takes all of these different turns. And I think that that can be really hard to imagine, but to realize that that’s actually the typical story, I think, goes a long way towards making the challenges that they may experience now feel a little bit more tolerable.

JD: Very well said. I think that students have for a long time received a message that they are where they are because of what they’ve done. And I think we are in the best position to realize our full potential when we remind them, as many times as it takes, that you are loved for who you are. And I think that is a big part of the process.

You can do hard things when you feel supported and you feel loved.

LD: Oh, I love that. 

JD: Thanks for having this conversation.

CC: Yeah, thank you.

LD: Yeah, thank you so much for being here. This has been terrific. 

PAWcast is a monthly interview podcast produced by the Princeton Alumni Weekly. If you enjoyed this episode, please subscribe. You can find us on Apple Podcasts, Google Podcasts, Spotify, and SoundCloud. You can read transcripts of every episode on our website, paw.princeton.edu. Music for this podcast is licensed from Universal Production Music.