Nearly everybody at the University encounters difficulties in trying to acquire a liberal education, but some students find that elements in their personal lives make the learning process either secondary or unaccountably difficult. To help meet these vexing personal obstacles, the University maintains a variety of services. Among them is the Psychiatric Service of the Hygiene Department.

The fact that nearly 800 people consulted University psychiatrists last year, and that at least as many are expected to do so this year, gives the psychiatric service, only 20 years old, an important place in University life. And, since the material with which many psychiatric interviews are concerned comes from what Sigmund Freud has called the unconscious, the Service's growing importance is likely to be the subject of debate, and often of unfavorable comment from those who feel psychiatry has no place in education.

Recent Growth

The sharpest growth in the Service's history has taken place during the past two years, since Dana L. Farnsworth succeeded Arlie V. Bock as head of the University Health Services. During 1953-1954, Gaylord P. Coon, Chief of Psychiatry since 1946 and the only full-time psychiatrist, and other, part-time, psychiatrists saw a little over 500 patients, a decrease from the previous year. In 1954-55, Farnsworth's first year, Coon was still the only full-time man, and the Service saw nearly 600 people. Last year, the staff had been expanded to include four full-time psychiatrists, three part-time men, and a half-dozen trainees. Plans for six full-time psychiatrists went awry when one psychiatrist was drafted and another caught polio. This year's staff includes six full-time psychiatrists, two on part-time, and no trainees, although Farnsworth hopes for some later this year.

Great Demand

The increase in staff has brought no relief from the crowding of which Coon annually complained in his reports. Coon's 1955-56 report describes the problem this way:

"Although our psychiatric staff is somewhat larger than that of many comparable universities, the clinical demands which are made upon it grow ever more taxing. Almost always every available space in the psychiatrists' appointment books is filled for weeks in advance. In this already overburdened setting new patients keep streaming in, often with urgent problems requiring immediate attention. Appointment schedules must be repeatedly altered to meet the new demands and new patients in acute difficulty must be sandwiched into the already crammed daily program of work. Some of the students with less pressing trouble must have their appointments set aside to make room for the accumulating emergencies."

The crowding of the psychiatric facilities places a sharp limit on the intensity of therapy which University psychiatrists undertake. Coon's report said, "Students with deep-seated, persistent neuroses can expect to receive from us with our present facilities little more than a holding action, or, at best, to be tided over crises." He hastened to add, however, "Such chronically disabled students are encouraged to obtain treatment from private psychiatrists or other outside sources such as out-patient psychiatric clinics attached to certain hospitals in the Metropolitan area." Some of these clinics offer care for low fees or, in some cases, free. For those who cannot get help outside, the Service tries to see them as often as possible.

The limit upon the length of therapy is also a matter of policy. It is felt that "the college is not a Sanatorium" and that a college psychiatric program should emphasize the removal of blocks to learning. Also, Dr. Farnsworth and others feel that a college psychiatric service, if it is to serve the student properly in the future, must keep some time in reserve for research, for talks with members of the community interested in psychological and mental health problems, and the relation of psychiatric insights to education.

A paradox arises here, to which the Hygiene Department's 1953-54 annual report called attention: "Unfortunately those students who require lengthy treatment are the ones most apt to provide the psychiatrist with a more thorough understanding of the psychological difficulties which beset students' lives."

Major Illness

The kinds of difficulty which arise in University students' lives are indicated somewhat by the list of diagnoses published each year by the Hygiene Department in its report to the President of the University. During the past year, 13 students became ill with "major psychoses" such as schizophrenia and manic-depressive reactions, and were committed to mental hospitals. Three students, none of whom were under psychiatric care here, committed suicide. Anxiety neuroses occur the most frequently, and what are known as "affective disorders" next most frequently. Alcoholism involved five people, and drug addiction none. Interpersonal problems were frequent.

Both Coon and Farnsworth have written about the kinds of student problems they have encountered in their psychiatric work. Coon has noted that Freud felt the neuroses to be "serious, constitutionally determined affections, which are seldom restricted to a few out-bursts, but make themselves felt as a rule over long periods of life, or even throughout its entire extent."

"The emotional disturbances," Coon continues, "which we meet so frequently in college students appear 'prima facie' to have the same more or less serious, intractable character commonly ascribed to the classical neuroses, but I think there is evidence to indicate that they are in many instances really troubles of a less stubborn and persistent nature.

"It is my impression that they are disorders which are more situational than constitutional; more the result of stresses pertaining to the especial time of life and way of life of the college student than an expression of the prolonged operation of deeply ingrained psychopathology."