Calm in a Crisis

By Rose Cahalan in Features, May|June 2012, Special on April 26, 2012 at 9:48 am | 1 Comment

Across the country, college students are needing more and more mental help. In 2010, the Forty Acres witnessed a horrifying breakdown. How UT’s Counseling and Mental Health Center is using unconventional tactics, from theater to triage, to keep students stable and safe.

On the morning of Sept. 28, 2010, Chris Brownson was pouring a cup of coffee when his campus nightmare sprang to life.

A coworker blurted: “There’s been a shooting on campus. We are on lockdown.”

Brownson, BA ’92, MA ’97, PhD ’01, Life Member, director of the UT Counseling and Mental Health Center, has a calm voice and steady hands. Before grad school, he taught fifth grade in LA’s gritty Compton neighborhood. Not much fazes him—but that day was different.

Brownson’s cell phone buzzed with a text message from University police: “Armed subject reported last seen at Perry-Castañeda Library on 9/28/2010. Details to follow.” A masked shooter with a machine gun had run along 21st and Speedway, looking people in the eye and shooting in the air, websites and tweets were reporting. Within minutes, sirens began blaring outside.

Coffee in hand, Brownson rushed through the office. He and a coworker hit every room in the 17,000-square-foot center, ordering counselors to lock their doors. They ushered students from the waiting room into interior offices.

Across campus, students huddled under desks and SWAT teams knocked down doors. Nightmarish visions of deaths at Virginia Tech, Columbine High School, and UT’s own 1966 Tower shooting leapt to mind. That sunny September morning, the entire UT community shared a palpable fear that a massacre could be unfolding.

Jane Bost, a longtime associate director at the counseling center, remembers gathering in Brownson’s office with other leaders. “It was terrifying,” she says. “At first, we didn’t know what had happened. We immediately began planning.”

Police combed the campus looking for a possible second gunman. After waving an AK-47 in the air and firing it on the street, sophomore Colton Tooley had run into the library and up to the sixth floor. In the end, it turned out Tooley had acted alone, and he took only his own life. But as strong as the campus’ crisis response was, the tragedy’s isolated nature was pure luck for UT; the 19-year-old had ample opportunity to kill UT students.

The quiet was eerie all afternoon. Yet counselors knew they would soon see a flood of students dealing with the trauma. As it turned out, the Tooley incident would be a watershed moment for the Counseling and Mental Health Center, multiplying exponentially the UT community’s awareness of its services.

But could they have reached Tooley himself? Though they will never know, the center has worked frantically to ensure no such tragedy unfolds on campus ever again.

Trauma Triage

In just 30 minutes, four staffers hatched a plan for helping the anticipated flood of students. The counseling center implemented an ER-like triage system—one in which every student’s first point of contact was with a trained clinician, not a receptionist. Questions like “Do you need help right away?” helped the counselor prioritize each student’s needs.

Their planning paid off. Soon the center was deluged with students who needed immediate help. Some had witnessed Tooley’s suicide; for others, the event triggered memories of past traumas.

In the next three days, counselors held 62 urgent walk-in appointments—a six-fold increase over the previous week. The 24-hour telephone hotline buzzed with 80 calls. Staffers worked grueling days, staying until 8 p.m. to treat more students. They hired three temporary counselors and handled dozens of media interviews. The triage system worked so well that the staff later decided to implement it permanently.

In the midst of a crisis, UT’s counseling center ran like a machine. “When people in college mental health talk about a national model, a pinnacle, they always say UT-Austin first,” says Aaron Kras now, dean of students at Arizona State University’s Polytechnic campus. “That’s because no one does it better. Texas is always one step ahead.”

Today, the counseling center is far more than a place where students can talk about their problems. It’s grown into a dynamic hub for all things mental health-related, from psychiatry to meditation and even theater. As host of a national research consortium on mental health, the center is a living lab for top-notch psychological research. And never before has that research been needed so desperately.

Campuses in Crisis

In the last two years, the number of students arriving at the UT Counseling and Mental Health Center with urgent mental health needs has ballooned by more than 80 percent.

That’s an alarming statistic, but it’s in line with national trends: a 2010 American College Counseling Association survey found that 44 percent of college students who seek counseling have severe psychological disorders—up from 16 percent in 2000.

Mental health practitioners nationwide are puzzling over these dire numbers. No one can fully explain what’s behind the rise in severe cases. Researchers point to a range of factors, from improved care—meaning that teens with disorders like schizophrenia are more likely to make it to college in the first place—to the recession.

“Nationally, there’s the sense that we are approaching a real crisis,” Brownson says. “Counseling centers are stretched to the limit.”

UT has kept pace by hiring more psychologists (the center has 50 full-time staff members), building stronger partnerships with mental health providers in the Austin community, and switching to the triage system to cut wait times. Another huge focus is prevention, with counselors training more than 1,500 people on suicide prevention annually. Still, about three or four UT students commit suicide every year—a number that has stayed close to the national average for decades.

“Twenty years ago, college mental health was a one-on-one interaction between a student and a therapist,” Bost says. “Today it is no longer an individual issue. It’s a community issue and a public safety issue, especially since the Virginia Tech shooting. It’s even a political issue, as the conversation around graduation rates grows.”

As director of the National Research Consortium of Counseling Centers in Higher Education, Brownson, with his UT team, is at the forefront of the crisis. He runs studies that involve as many as 26,000 students from 70 colleges. And the results are already changing practice—not just at UT, but nationally.

Krasnow, at ASU, says a 2006 consortium study on suicide helped counselors on his campus know which questions to ask students when they first visit the counseling center.

“The data showed us which intake questions are better predictors of the risk of suicide,” Krasnow explains. “Just asking ‘Are you suicidal?’ is not enough. You have to ask many other targeted questions, and those decisions are data-driven. UT has been a big part of that.”

How UT Blazes the Way

Eight student actors are standing around an invisible beer pong table, discussing the intricacies of the game before they get in character. Not everyone knows how to play. “When do you wash off the ball?” one young woman asks.

Their director, Lynn Hoare, MFA ’98, asks the students to show how tall they think the table is. Turns out everyone’s been imagining different heights—which makes for an odd-looking drinking game. They settle on one height, then restart the scene.

It could be a rehearsal for an avant-garde play, but this is a different kind of theater. These students are trained peer educators preparing a performance for the counseling center’s Theatre for Dialogue program. The program uses interactive performances to teach students to recognize and prevent sexual assault, dating violence, and stalking. UT’s Counseling and Mental Health Center is the only counseling center in the nation known to employ someone with an MFA in theater.

It’s crucial that the beer pong scenario they’re rehearsing feels real, because otherwise audiences won’t relate. In this scene, two students want to hook up, but one goes too far, goaded on by a friend: “Come on, dude, she’s been knocking ’em back all night; she’s good to go. You have to get some.”

The dialogue is improvised and a little awkward, but that’s what makes the scene come alive—since real college parties are awkward, too. In the final performance, the audience will shout “pause!” whenever they see a behavior that doesn’t seem right—training them to recognize the difference between harmless flirting and harassment.

“Just talking about sexual assault can be really difficult,” says Bost, who founded Voices Against Violence, the theater group’s parent program, in 2001. “So we use the tools of theater to encourage students to think about their own relationships, their communication. It’s unconventional, and it works.”

Theater isn’t the counseling center’s only unconventional tool. There’s a MindBody Lab, which looks like something out of Star Trek, with computers and lounge chairs in a dimly lit room. Students can drop in anytime to try relaxation or meditation DVDs and tapes, or just to rest in a quiet place.

The Voices Against Violence program also includes an emergency fund that helps students who are survivors of dating violence. The counseling center paid to have one student’s locks changed; another student was living in a tent after fleeing a dangerous relationship, and the center helped her move into an apartment.

Last year, Bost testified before the Texas Senate on a bill that makes it easier for survivors of sexual assault to get protective orders against their attackers. “I’m so proud of that,” she says. “The bill passed, and we just helped one of the first students to benefit from it.”

Then there’s the Integrated Health Program, which collaborates with UT’s University Health Services to blend physical and mental healthcare. If a student goes to a UT doctor for help with chronic pain, for example, counseling center staff are ready with alternatives like a stress-relief group or a meditation session.

All these elements of the counseling center—theater, holistic and alternative services, and the emphasis on research—are working to dispel the stigma attached to mental health care. The center’s goal is not only to show all students that help is available, but also to nourish a sense of community in which everyone looks out for one another.

On a campus of 50,000, reaching every student is a colossal undertaking. After Colton Tooley committed suicide, police found that he had visited websites about depression. But he is not known to have sought counseling. That knowledge is a burden that weighs heavily on the minds of UT counselors. “The outcomes of situations like this can depend so much on whether a student gets help,” Brownson says. “We have more work to do.”

Top photo by Larry Kolvoord/Austin American-Statesman. Middle and bottom photos by Tamir Kalifa/Daily Texan.

Tags: Aaron Krasnow, Chris Brownson, Colton Tooley, Integrated Health Program, Jane Bost, MindBody Lab, Theatre for Dialogue, UT Counseling and Mental Health Center, Voices Against Violence