Q&A: Dr. Paul Barreira The director of Harvard University Health Services on creating new models for students’ mental and emotional health Interviewed By Dr. Kaitlin Gallo
Paul J. Barreira, M.D., Henry K Oliver Professor of Hygiene, has been the director of Harvard University Health Services (HUHS) since 2012. For the previous eight years, he led Behavioral Health and Academic Counseling at HUHS and was an associate professor of psychiatry at Harvard Medical School. Despite his long tenure in the Ivy League, Barreira hardly fits the stereotype of the change-resistant academic. Barreira believes the traditional model for treating college students for a range of emotional and behavioral health issues is broken. His views on how to engage the academic community in partnering with health centers to address student mental health are anything but “old school.” Dr. Kaitlin Gallo, a clinical psychologist and former undergraduate mentee of Dr. Barreira’s, recently interviewed him on the subject. Their exchange follows. 04
Dr. Kaitlin Gallo: You have been on the front lines of student health, especially emotional and behavioral health, for many years. How do you see the field changing? Dr. Paul Barreira: I would say there are two areas where it is changing. One is the volume and frequency of students who want to come in and receive services. The other is the chronicity and severity of the problems that students are experiencing. We had 40 psychiatric admissions last semester. We used to have 20 in a year and the number has been increasing over the last five years. It’s not just a spike, it’s a trend. KG: How do you handle that as a university mental health service? PB: We have come to the realization that we can’t just hire more counselors. We need to change the model because the traditional model
for providing services simply doesn’t meet the needs of our students. I think of this as a bell-shaped curve. On one end, there are the students coming in for three or fewer visits – many of whom are having normal human reactions to stressful events. A number of these students could have a conversation with someone outside of the health service, within the academic community, that could satisfy their need to express their problem and think about ways to relieve their distress. On the other end of the bellshaped curve, there are students who need a higher level of care who should be helped by mental health professionals who can provide more intensive services in the community outside of Harvard. In the middle of the curve are the majority of students who can benefit from meeting with a mental health provider