By Amy Gaeta
One of the most tragic developments in policing in the last forty years has been the massive expansion of their role in managing people with mental illness and other psychiatric disabilities….The police are particularly ill-suited for this role, given their other functions; relying on police, jails, and emergency rooms to “manage” people suffering from mental health problems is expensive and inefficient, and does little to improve their quality of life.
—Alex Vitale (2017, p. 76)
The nature of the modern-day university—to secure itself at the expense of student, staff, and faculty safety—grew apparent to me when the weight of expectations and the limits of the normative time of graduate school left me mentally bitter and physically numb. Too stressed and poor to navigate the private healthcare system, I turned to my university’s mental health services where I was matched with a therapist. Due to university policy, students were allotted just 10 sessions with a therapist, typically all used within one semester. My assigned therapist was goal-oriented to the point of micromanagement as if in just 10 sessions I’d be a new, happier person with a clear outlook on life. Upholding a pillar of conventional cognitive behavioral therapy, she kept telling me that things would be better if I could just identify what had happened and find some way to make peace with it, let the hate within me wither away. Funny enough, she was always frustrated with me because I was indecisive and argumentative. She would leave me with worksheets each week to chart my moods and thought processes, giving me homework even after telling her how the workload of graduate school was burning me down to ashes.
I felt an eerie connection with this therapist; I could always predict what she would say next or how she would reply. It took me many years to realize why this therapist was so familiar to me, why she did not understand that I wasn’t interested in placing blame or shaking off particular labels attached to me. In this context, she was my father, and in a twist that could even make Freud laugh, my actual father was a cop. I was raised by and among cops and military service members, and this lens of experience proved itself most helpful when trying to parse my experience with therapy through a university mental health services program. This is not to equate therapists and cops as equal in social role and influence, nor am I rehearsing an old axiom of psychoanalysis (i.e., the client-to-analyst transference); rather, it is to probe the parallels and connections between university-organized mental health services and the police, and, by doing so, show how universities enable the same trauma and exploitation that they claim they seek to prevent and heal.
University mental health services are some of the most intimate yet public places on campuses for disabled students. Intimate in how students put their trust in mental health professionals to work through sensitive and difficult issues, and public in that the actions of university mental health services show their true, overarching attitude toward disability and disabled people. Universities reinforce the links between clinical psychology and policing, for instance, by holding partnerships between university housing, dean’s offices, and the local and/or campus police. After the George Floyd Uprisings of 2020 brought police brutality to the forefront of national conversations about systemic racism, some universities mental health services attempted to loosen or cut their relationship with the local or campus police. Stanford, for one, built a partnership with the local fire department, which will transport students experiencing a mental health crisis, in “most cases,” thereby implying that the police will still have a role (Weissman, 2020). Other schools, like the University of Wisconsin-Madison, strengthened the role of campus police in managing student mental health crises (UWPD, 2021). Disabled people, especially queer, trans, and/or Black disabled people are some of the most common victims of police violence (Gray & Gibson, 2016). It is widely reported that 33–50% of people killed by the police have a disability (Perry & Carter-Long, 2016). Given this, it is doubtful how well university mental health services can serve students if they conspire with institutions that treat disabled people as needing to be contained and controlled with violence. Even if the police played no role in supporting student mental health, we would still need to ask who or what is the university serving?
University mental health services operate in a network of forces, like the one described by Leah Lakshmi Piepzna-Samarasinha (2018) as the survivor industrial complex (SIC), which she defines as “the web of institutions, practices, and beliefs that works to manage, contain, and/or offer resolution to survivors of sexual violence” (p. 229). Piepzna-Samarasinha (2018) identifies the police and mainstream psychology, including clinical practice, as primary strongholds of the SIC. Together, they spread notions of who counts as a victim deserving of access to resources, how to manage trauma, and what it means to be a “good survivor.” The SIC is held together by the “good survivor,” a hypothetical ideal. The good survivor helps me to imagine what the “good” student would be in the eyes of the university. The good student is uncomplicated. They are not mentally ill, but they sometimes have “mental health issues.” These issues fade away and heal permanently with no scars. And they certainly do not affect the good student’s ability to complete academic work to standards and on time. They follow all their therapists’ advice. They do not need long-term help, intensive care, and especially not accommodations. Their trauma is inspirational. They do not disobey, disrupt, or dissent from the university. The university would never send the police to the good student’s house for a wellness check, nor would a professor ever suggest the good student drop out if the program were too stressful. With the good student, the status quo of the university and its community partners remains intact and pristine.
The good student could never exist. From inflicting emotional neglect to acting as a financial predator, the university regularly enacts and overlooks a wide range of forms of violence against students. Students of color, poor students, disabled students, and queer and trans students—millions of students across the U.S.—are subject to even grosser forms of abuse and more likely to suffer the consequences simply for existing as themselves. When looking at the university, we can easily see how Foucault’s famous comparison of schools and prisons has warped into something more vampiric and savvier, cloaking itself in the language of diversity and equity while routinely subjecting staff and students to predatory labor and tuition policies.
Disability studies scholars have addressed the ways in which universities exclude and silence disabled students and staff from within the university walls by upholding and weaponizing some of the pillars of academia itself, such as reason and linearity (Price, 2011; Rice-Evans & Stella, 2021; Dolmage, 2017). Margaret Price (2011) observes that universities use the rhetoric of normalcy to police who should and should not be included in the school, such as how a student should respond to a given situation, how emotional is rational, and what types of behaviors are disruptive to learning. By setting these norms, power is withheld and taken from disabled people in higher education in ways that appear normal, harmless, or even good. University mental health services compound these parameters of normalcy, and therefore inflict exclusion, by the design of their services. This returns to the “good student.” The good student needs no more than 10 individual therapy sessions to be magically healed, and they certainly are not inhibited or made uncomfortable by being recorded during therapy, seeking help from a program that collaborates with the police, or having their therapy sessions on campus. Affirming this claim is a study on the rhetoric deployed by university mental health services, conducted by Ada Hubrig & Leslie Anglesey (2022). The authors found these centers foregrounded academic productivity and success over student well-being, and tend to treat disabilities as a deviation from a fanciful norm of a healthy student, what we might see as “the good student”’ Upholding notions of the “right” kind of student with mental health issues makes room for the “bad” student with mental health issues to face exclusion and abuse.
Rewarding and marginalizing certain behaviors of people seeking therapy reinforces the linkages and similarities between the criminal justice system, policing, and mental health care in the U.S. A plethora of scholarship on this topic has noted that psychiatric institutions are prisons in themselves, and that psychology and its clinical practice have a long, problematic relationship with policing, especially as each is rooted in white supremacy (Newnes, 2021; Metzl, 2010). Clinical therapists themselves have even compared their work to that of the police, noting that they each manage crises at an intrapersonal level and must confront the suffering of others on a daily basis (Green, 2018). Due to these parallels and crossovers, it is little surprise that calls for abolitionist and anti-racist practices in psychology have been raised (Grzanka, Gonzalez & Spanierman, 2019). And, accordingly, greater scrutiny has been placed upon the role of the police in responding to mental health crises and calls related to neurodivergent people expressing signs of distress.
Lending to this discourse, I examine my own experience as a patient at a university mental health clinic in order to tease out the micro-level ways in which university mental health services may reproduce and reinforce punitive logics and sketch preliminary ideas for a disability justice-informed university mental health service. I draw from the personal to leverage my unique position as someone with both scholarly and embodied knowledges of the operating logics of universities, ableism, and policing. My aim is not to suggest that my experience encapsulates the entirety of university mental health service experiences. Rather, I proceed with the conviction that my experience is a partial reflection of the psychic environments enabled by mental health services operated by the university—referring to the university as a type of institution rather than a specific university. My hope is that by writing this, we can expand our scope of understanding of how universities perceive the mental health of their students, and what psychic environments are created by universities.
Precisely due to the type of violence and neglect inflicted by the university and the violence that regularly occurs on college campuses (e.g., sexual assault, hazing, etc.), the university is anything but a safe space for so many students, staff, and faculty. Acknowledging this, an overlooked pitfall of any student support services center is that it is located on a campus in which many students do not feel welcomed, valued, or even safe. Indeed, I was one of those students. Appointments were held in the same building in which numerous administrators have their offices, a building located less than half a mile from my office and home department. Each appointment, my discomfort was compounded by the excess surveillance procedures with which I was required to comply. I was required to input my student ID number and fill out and submit two electronic forms each visit, one measuring how much of a threat I was to myself and others and another measuring my anxiety level. The therapist would review these forms before I was allowed into her office.
Next, I would sit in a cold, crowded waiting room among fellow students waiting for my name to be called by a person with a badge. We were afforded no privacy in this waiting room. A small camera was installed in one upper corner and the room was wide open. Several times I saw former or current students of mine, and we would make eye contact and then turn away—both seemingly embarrassed that we were “here.”
The whiteness of the clinic was not lost on me. Almost all the students and staff I saw appeared to be white. Based on my knowledge of the ongoing racial prejudice and discrimination in psychology as a field and practice, I would guess that non-white students did not feel comfortable using the services. Compounding the very reality of racism in psychology was the very reality of racism in the university.
There was, indeed, good reason to be worried about using mental health services if you already feel unwelcomed and maybe even targeted by the said institution. I realized this more in the waiting room. Such an environment coupled with the check-in process established a clear power dynamic: You are being watched for our own good. This is our space. You are permitted only on our terms.
Since I was receiving therapy at a student training clinic, I had the choice to let the therapist decide to record every session. I consented to this, in the spirit of learning, and every session was taped and stored on a university file management system. After she started the recording, she rehearsed the same gambit, every time: Everything I say in this room is confidential unless I appear to pose a threat to myself, others, or national security. Yes, national security. She sounded automated, declaring in a tone that a veteran uses when saying the Pledge of Allegiance.
From my first step into the office to the therapist’s couch, I was marked as a potential threat, a liability, in the eyes of the university, and even the federal government. This speech did nothing but stir my preexisting paranoia and anxiety. Trump had just been elected at this time, and so images of fascism and anti-LGBT legislation clouded my mind. I would rather have felt like a pity case than a liability, which is truly saying something as a disabled woman.
The very context of the appointments transported me to images from my childhood, visiting dad at work or getting rides to school in a police car, cramped and crowded by an array of cameras, ID checks, and constraints, all to protect the cop and the institution of policing. The police motto “protect and serve” rang with pure irony then as it did now. The very mention of me being a potential national security threat gave off a similar message: you are the problem, and we are the ones in control.
As disability justice activist Stacey Milbern has challenged us to consider: “Is medicine about quality of life, or is it about social control? And perpetuating this idea that you have a good body?” (Spade, 2017). Or, in this case, perpetuating this idea, as well as the image, that university students have a “good” mind, and that university was a “good” one that “cared.” The question of who, or perhaps what, university mental health services serve is one we all must ask, especially in cases like mine, where my university workload is what drove my mental health into the dirt and triggered intense bouts of anxiety and depression.
Within a privatized healthcare system, and likewise, expensive university tuitions, disabled and nondisabled people alike are habituated to accept and even be grateful for any free or low-cost care. Lesser discussed is the quality and quantity of such care and the conditions by which it is free.
Institutional policies, in tandem with a surveillance-clad environment, are, by their design, sure to diminish the potential of any transformative change, which even affected me at the individual level in therapy. I was restricted to just ten 50-minute sessions with the therapist, which, in part, seemed to result in sessions structured like how cops examine any given case—with the intent to identify the “problem.” In policing this is often a person or group, never the complex social-cultural milieu that led a person to make certain choices or actions.
With this therapist, I wanted to learn how to come to peace with the past, particularly around people who had hurt and neglected me. Each session felt like a race for her to figure out who hurt me and how I can forgive them. I would tell her that I did not need to place blame to heal; there was no “one” to blame. My pain was the result of a complex constellation of people, factors, and institutions across which power and effects flow. Yet, she would often give me guided worksheets to track cause and effect across my relationships and moods.
Sometimes at the end of a session, she would bring up my check-in mood indicator questionnaire and analyze it in front of me, asking me to explain why I checked certain boxes and points on a Likert scale. How funny and how terrifying I thought; she thought there was some hidden meaning in these reductive standardized and quantifying tools after I had just spent 40 minutes bearing my soul.
This was not just poor therapy; this was academic ableism. The therapist lacked the proper time needed to do her job, care for students, and build trusting relations with them due to university policies and the understaffed therapy clinic that was helping more students than it could bear. While frustrated with the therapy quality at the time, looking back now I see it as a shocking display of how little universities thought about students. Our pain was knowable and solvable within less than ten hours to them. We did not need nor deserve privacy. We could be measured by scales and numbers. We were given the bare minimum of help so that the university could spout some hollow rhetoric: we support student mental health. “Mental health:” a cursed euphemism that many institutions hide behind as a way to discuss mental illness, madness, and other mental disabilities without ever actually discussing them.
Disability studies scholar Jay Dolmage (2017) has most famously detailed academic ableism and how ableism manifests in different forms at all levels of higher education institutions. Historically, argues Dolmage, these institutions were not designed for disabled people, but, in fact, were designed for the seeming opposite of disabled people: able-bodied people with the most potential to contribute to society; the hyper-abled, if you will. How, then, do we understand university services designed to support mad, mentally ill, and/or otherwise mentally distressed students? And for that matter, how do we reckon with the disabilities produced by university expectations, neglect, and conditions?
I began this essay with a quote from Alex Vitale’s The End of Policing to paint a picture of the need for quality and disability justice-informed mental health services in the university; services that do not fall back on the police because of their own limitations. To no fault of the individual counselors and staff working in these centers, university mental health services are likely to operate more as a mechanism of “managing” disabled students if the university is unwilling to make material changes to address the causes of student mental health issues. To make this type of claim necessarily entails confronting how the university is more focused on securing its own status as a business and institution of power than it is focused on the safety of its staff, faculty, and students (Doyle, 2015). It also means confronting how discourses of “well-being” and “mental health” are weaponized by universities to create a facade of “care.”
To truly support student mental health as well as disabled students, the university itself would need to fundamentally change by eliminating common causes of student mental distress: student debt, heavy academic workloads, poor working and learning conditions, sexual harassment and assault, discrimination at the system and intrapersonal level, and many more. It would, in short, mean destroying the university and the very systems it was built upon: capitalism, racism, colonialism, cisheteropatriachy, and ableism (Eve, 2021; Harney & Moten, 2013; Ahmed, 2016).
In a disability justice framework, the response to violence, illness, and distress is care, which often includes ensuring that people not only feel safe but feel that their sense of self and right to autonomy is intact. Deploying police-like tactics of heavy surveillance, labeling people as “threats,” and pre-determining and quantifying the amount of “care” needed to “fix” a given person are all bound to fail if the aim is to help one heal or better manage mental distress or illness. These tactics may be successful, however, in ensuring the university has control over its students, especially those whose mental state is “unstable” and thus a potential threat.
In the long-term—towards the long struggle to liberate us all—simply reforming mental health services on university campuses will never be sufficient if it is the university implementing these services. The abusers cannot heal the survivors. The good student will and can never exist. Right now, for the students who need support and cannot wait any longer, we must strive to improve existing systems while also cultivating networks of care both within and outside university limits.
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