Pause for a moment to consider your allostatic load. That’s the scientific term for “the sum total of all the stressors you might have on your body, within your body and your heart, mind and spirit at any one time,” says Wendy Adam, Williams College’s director of Integrative Wellbeing Services (IWS). Your allostatic load can make you feel anxious or depressed. It can physiologically change your access to memory and concentration. It can affect your entire body, including your blood pressure, metabolism and immune system. Chances are, says Adam, your allostatic load right now is “probably through the roof.”
That’s not surprising, given that we’re dealing with the ramifications of a global pandemic, war, political turbulence and social injustice. These stressors and many others add a layer of complexity to an already challenging mental health landscape at Williams and on college campuses everywhere that are working to meet the rising demand for counseling, education and support.
There are no quick fixes or easy solutions. But changes Williams has made in its approach to mental health over the last decade are helping the college to meet the moment. And while counseling remains a central aspect of IWS’s work, the office’s focus has expanded to include preventive care and a holistic approach to wellness, with the goal of helping students cultivate skills and practices that will last a lifetime.
Earlier this year, Adam joined outgoing Dean of the College Marlene Sandstrom and Athletic Director Lisa Melendy in a conversation with alumni about the state of mental health and well-being on campus. Excerpts of that conversation and subsequent interviews with them follow and have been edited for clarity and space.
What is the goal of integrative well-being, generally?
Wendy Adam: What we are trying to create on campus is the capacity for students to pursue well-being, even amidst an intensive, high-performance educational experience. This means paying attention to students psychologically, emotionally, physically, spiritually, socially and environmentally. What Williams can do, through a variety of things, including traditional mental health services, is help students to integrate the full range of human experiences.
The strength of integrative well-being is that it prepares students to live in the world as it is right now, with all of the hardships. When things are hard, students might feel frustrated, sad or stressed out. We want them to understand that they shouldn’t shut out or ignore those emotions but instead expect them as a part of life. Students can learn how to recognize and acknowledge their emotions, integrate them, and use resilience-based strategies to manage them.
Lisa Melendy: Our athletic teams sometimes function as a microcosm of this healthy life we’re talking about. Team members have deep relationships. They have a caring adult in their life on campus. Students tend to focus on the outcome of athletics, but our coaches are trying to break that cycle and shift the focus to process—that is, focusing on shared work and relationships while doing something you’re passionate about and that makes you feel good. Athletics should bring you joy through physical movement and through setting appropriate goals and meeting them.
What are some of the resilience-based coping strategies that students learn?
Adam: We teach students, literally, how to breathe through mindfulness and meditation practice in a program called Mindful Mondays. This helps with concentration, sleep, one’s relationship to stress and just overall well-being. Many groups focus on creating meaningful connection with peers and integrating our myriad identities. We help students explore their relationships to food and their bodies. We partner with many offices across campus to offer workshops on journaling, doodling and other creative outlets, self-care and healing after trauma. We recently co-hosted with the chaplains’ office and health education office a full-day rest, resilience and restoration retreat via Zoom videoconference. These are all skills that can be learned and reinforced.
Marlene Sandstrom: Another skill that everybody can practice and strengthen is the ability to recognize that you can feel lots of things at once. And that’s OK. You can know that you have a lot of work to do, which makes you feel a little anxious, but you can also be in the moment and be grateful for the 10 minutes you have to touch base with a friend. Sometimes it feels to us like we have to be overcome by the worst feeling we have. But lots of things can be true at once, and that’s a skill that you practice.
Melendy: All of our offerings in athletics—varsity teams, recreation, intramural sports and physical education classes— are about physical well-being and connection. Self-regulation helps people be physically healthy. You can’t exercise in a mindless way; you really need to be paying attention to what you’re doing. You’re thinking about your teammates. You put your phone down for that amount of time. You are out connecting with people.
Our coaches now have students fill out daily or weekly assessments about how they’re feeling. Are you sleeping? Do you have a lot of work this week? Are you stressed? So coaches know where students are and can adjust their training. The students at Williams who are athletes want to really achieve athletically, yet we’re finding that pulling back on some of the training is actually helpful both in keeping them whole and in their performance. They’re not as tired; they’re not as burnt out.
How has the demand for counseling services changed, and what has Williams done to meet it?
Sandstrom: Like most colleges and universities across the country, we’ve seen an increase in the number of students seeking mental health services, particularly individual therapy. In the fall of 2018, 475 students were seeking individual psychotherapy through IWS. By the fall of 2019, that number grew to 525. This past fall of 2021, it was 610. This growth is actually a good thing. We want students who need help to feel that they’re in a culture and a climate where they can say so and where they can get the help that they need.
One thing we did in response to this growth was hire more contract therapists to assist our staff therapists so that we could manage the wait list we were beginning to see and make sure we had the bandwidth to support students in need. Our student-to-therapist ratio dropped from 140 students per therapist to 117 with the recent hiring of a few contract therapists. International Accreditation of Counseling Services, an organization that sets standards for higher education, sets an “aspirational” minimum staffing ratio at one professional staff member for every 1,000 or 1,500 students. That includes both very large state universities as well as smaller colleges. Our ratio is among the best in the country.
Still, it’s very concerning to us—and this is not unique to Williams—that this group of emerging adults is struggling with a lot of challenges at a time in life where we’re hoping that they have the energy and competence to participate in all the incredible opportunities that we have here. We take very seriously our responsibility to help make this place accessible so that every student can take full advantage.
Adam: Every single student who’s enrolled at Williams has access to live psychotherapy and psychiatry, either in person or via video, 12 months per year, at no additional cost to them. IWS offers on-campus therapists and psychiatrists, psychotherapy, psychiatry services, crisis intervention and grief support sessions. Students also can access Talkspace, a video-based teletherapy business. We contracted with Talkspace a couple of years ago, before the Covid-19 pandemic. It was fortuitous—it positioned us very well to offer a remote option for students who studied off campus when the college closed in spring 2020 due to the Covid-19 pandemic. Students can also make use of ProtoCall Services, which provides on-call, 24-hour crisis assessments and support when the office is closed.
What are students seeking support for?
Adam: Issues like loneliness and grief and anxiety and depression, difficulty with concentration and attention—these are things that students are talking about openly in ways that may have been reserved historically for a few who were actively engaged in treatment. Now it’s very much in the global dialogue on campus, in large part because of these traumas we’re all living through. Students are experiencing what are typically seen as symptoms of mental illness and seeking to be evaluated and treated for things like attention deficit disorder. In supporting these students, we need to determine: Are they grappling with mental illness or are they grappling with the realities of “now” in the context of an allostatic load that is just extraordinary? Is it possible that almost an entire generation is mentally ill in terms of increasing rates of depression, anxiety, suicidality and other markers? A student I met with recently perhaps said it best: “Maybe we can all be broken now, since the world is.”
What do students need right now?
Adam: Students are showing us a need for an emphasis on meaning and connection, on a sense of purpose and presence and rest, and on how these things work together to support a healthy student, not only while they’re in college but beyond. They might be walking outside and there’s a beautiful view of the mountains everywhere you look on campus, and the sun is out. It’s gorgeous. But in their mind, they’re writing their economics paper. And so they have a moment where they could experience wonder, but they’re not connected to that present moment. I think that our students have capacity to feel joy, to experience those moments. But that’s part of what we want to teach them—that part of being a healthy human being is to be fully engaged in what you’re in. That moment when you’re writing your economics paper, be all in on that. When you’re practicing field hockey, be all in on that. But when you’re walking across campus, take the moment to allow your mind to be present to walking across the sidewalk, noticing what’s there.
I think that that’s where some of the skills training that we’re trying to do comes in. It’s not about teaching joy. It’s about teaching presence. And I think that’s where the opportunity lies for us to make changes, both in the classroom and outside of the classroom. If we can give them the capacity, through this integrated well-being construct of skills and knowledge to cope with the world as it is, and continue to take care of themselves—heart, mind, body and spirit—then we will have done our job as a liberal arts institution in preparing them to be citizens of the world.