Kristen Marquez, an ASU freshman studying digital culture with a focus in music, scheduled her first appointment with ASU Counseling Services in September. Marquez said stress from the semester and the year's events put her already existing mental health struggles in an odd place.
"(Telehealth) was weird," Marquez said. She said her five appointments went fast and lacked any discussion with context for what she was feeling in the moment. She said it was "helpful" to have most of it online but "the actual counseling felt kind of weird and rushed."
The counselor she spoke with did their job by asking questions, taking notes and working to create a plan for more outside help, but "there was no really addressing any bigger problems," Marquez said.
"It was just kind of like 'Okay so you feel this way, maybe you shouldn't,'" Marquez said.
ASU Counseling Services helped a number of students this semester cope with extended mental health issues as a pandemic raged on during their shortened semester, but several said it wasn't quite enough.
While students were logging in to classes over Zoom, ASU Counseling Services began using telemedicine — virtual patient-provider interactions for advice, intervention and monitoring — to continue delivery of mental health help.
Erin Trujillo, director of ASU Counseling Services, said its focus is on immediate action after the first appointment, which sometimes means referring students to see a different therapist full-time.
"Our capacity supports a brief model of services for as many students as we can serve," Trujillo said. "This fall, we have focused on immediate access to care. We are always thinking about how to build a model that meets as many needs as we can within the student population."
Barriers to overcome even before providing counseling
Counseling was made available 24/7 this semester for every campus, and some out-of-state students for the fall semester. Jay Thorne, a University spokesperson, said there are about 40 professional counselors, psychologists and social workers employed. In general, calls and service remained comparable to previous years.
Trujillo said "telehealth was always in the plan, it just got moved up faster with the pandemic." She said it was an "accessible way to see students" and it was "more natural than sitting across from one another with masks on."
With an almost entirely remote semester, student internet access, finding a quiet, private place to talk and overcoming Zoom fatigue to get real help was a struggle for both patient and provider.
"We've found that we are more concerned about privacy than students at times," Trujillo said. "For us, it is unethical to continue if someone else is in the room. And I think everyone has Zoom fatigue — students, staff, clinicians, everyone."
Lilly Golich, an ASU sophomore studying English, said there were a few Zoom appointments she did not go to because "it felt easier not to, I didn't want to talk about things at that moment."
It would have been harder to avoid if counseling were in-person, she said, which was a flaw of the system implemented due to COVID-19, not her counselor or those directing the service, she said.
"It was a little bit exhausting to go to then another Zoom meeting," Golich said. "It was especially hard for me because when you have so much schoolwork, it's hard to schedule something for yourself, and especially when it's already going to be content that is difficult to talk about."
Trujillo said ASU Counseling Services worked across legal, ethical and technological facets to develop thorough training for counselors. New informed consent forms were drafted, ways to fill out paperwork online were developed, a new patient portal was created and general adaptation to Zoom was all part of an inevitable transition.
READ MORE: 'Voices of ASU' zine chronicles students' stories of ASU Counseling Services
"Telehealth allows us to see facial expressions, to hear tone of voice and to express ourselves," Trujillo said. "It can be hard if someone is having a significant health crisis, but it is better than not having anything."
Surface-level, impersonal experience on a screen
Counseling through ASU, Marquez said, felt like a surface-level discussion with quick advice at the end of the session. She said if she's going to put herself through any kind of therapy, she doesn't like the idea of "going in and (a counselor) saying, 'If I do these things over time, it will get better.'"
"For me to go through therapy, it would feel better if we accept how I feel," Marquez said. "I'm going to feel this way so let's work on how I'm going to cope with that."
Athena Ankrah, an ASU sophomore studying transborder studies and journalism, said her first and last appointment with ASU Counseling Services was in February right before lockdowns and the University's shift to remote learning, realizing the form of counseling implemented did not make the most sense for her.
"I needed someone to meet me half-way," Ankrah said. "And when I went into the session, I kind of got the impression that even though ASU Counseling was trying to be helpful, they didn't really have the tools to help me in the way that I needed."
Golich had never done any kind of counseling before reaching out to ASU Counseling Services this semester. Immediately after her first appointment, the office was working to find her a non-ASU-affiliated counselor.
"Basically, they didn't want me to have to start over," Golich said. "(ASU Counseling Services) was sort of like a temporary placeholder but it was so helpful while I was doing it."
Marian Ruvalcaba, a junior studying secondary education with a focus in mathematics, used counseling services last fall and has since found a therapist not affiliated with the University. She said she stuck with ASU Counseling Services for a number of semesters because "it was really helpful, I saw results and realized it's nice to get help."
Outside of COVID-19, Golich said she still sees flaws in the system. She said ASU Counseling Services presents itself as a place to get help when students might be stressed about a test but "the system isn't really set up in a way that's prepared to handle people who need more help," she said, adding that the counselors seem to know students might only visit once.
Ruvalcaba said she would recommend ASU Counseling Services to other students in desperate need for help. She said the focus in her appointments was on fast results and that wasn't what she needed for permanence or to maintain better mental health, but it might help others.
"Due to the fact that they have a lot of students, it did feel like a 'tell me' and then 'here's the results,'" Ruvalcaba said. "Even though it was really nice when (a counselor) would hear you out, it felt like a conveyor belt."
Reach the reporter at pjhanse1@asu.edu and follow @piperjhansen on Twitter.
Like The State Press on Facebook and follow @statepress on Twitter.
Piper Hansen is the digital editor-in-chief at The State Press, overseeing all digital content. Joining SP in Spring 2020, she has covered student government, housing and COVID-19. She has previously written about state politics for The Arizona Republic and the Arizona Capitol Times and covers social justice for Cronkite News.
