Project LETS: A Strong, New Voice in Peer-to-Peer Support

Marjorie Malpiede and Blair Ballard / September 29, 2017

The organization trains students to provide mental health support for peers

Project LETS is a peer support and advocacy organization that launched its first campus chapter at Brown University. Founder and current Executive Director Stefanie Kaufman started the organization in 2009 and piloted its Peer Mental Health Advocate (PMHA) program at Brown in 2015. In October, Project LETS will hold a conference and training seminar on the Brown campus for student leaders from other schools seeking to open their own chapters. Among the participants are fellow Ivies: Princeton, Columbia, Yale, and Penn.

Project LETS’ transformation from one student group at one college to a national network of campus-based chapters is indicative of a growing movement in college behavioral health. Peer-to-peer programs are becoming the first resource of choice for many college students experiencing emotional and behavioral problems, and the object of both appreciation and skepticism among the established college mental health community.

Project LETS is short for Let’s Erase the Stigma, which speaks to its value in reaching students who might be reluctant to go to the college counseling center, due, in part, to the stigma that continues to exist around mental health. Project LETS, and numerous programs like it throughout the country, give students relatable, emotional support; direction in accessing resources; and advocacy, either in navigating or confronting school policies or in learning their rights under the Americans with Disabilities Act (ADA).

“We started Project LETS because there was a lot of confusion and fear on campus around mental health, whether it is getting help with an issue or getting accommodations if you have a diagnosis,” Kaufman said.

Kaufman is a recent Brown graduate with enormous energy and intelligence and a history of depression. Like everyone on her team, she has lived experience, which she believes is critical to helping others with mental illness on campus. She and her leadership team train students, who become Peer Mental Health Advocates to help other students with anything from navigating the health center to understanding what it’s like to live in a dorm with OCD.

There are many reasons students seek help from their peers. Many fear that revealing conditions could adversely impact their education either through discrimination by professors, hospitalization, or forced medical leave.

Mental health services on college campuses can be complicated. If students go to the counseling center and get referred to the community, many get stymied by the list of options; others won’t be able to afford it or, if they use family insurance, they may fear their parents will find out which can be a real issue for students in some cultures. Project LETS helps students with diagnosis as well as those Kaufman says, “need someone to talk to when they know something is wrong but they’re not ready to go to a counselor.”

Research affirms that there remains a disconnect between students in need and campus resources: 80 percent of students who die by suicide are unknown to campus counseling centers, and a majority of students who either report or screen for mental illness do not seek treatment.

Peers also tend to have a far more powerful influence over each other than professionals, and research has shown that distressed students turn to peers — a friend, roommate, or teammate — before anyone else.

It is not surprising that peer-to-peer networks are popping up on campuses across the country. Most of the programs are fairly similar, but there are some nuances. They can focus on relapse prevention, helping navigate relationships with healthcare providers, stress reduction, even emerging research. The efficacy of peer -to-peer support, when used in conjunction with professional treatment, is very strong.

One of the few national groups is Active Minds, which focuses on developing and supporting peer-driven mental health education, advocacy and awareness on college campuses. They help connect students with resources, create more productive and open conversations about mental illness, and serve as a liaison between students and mental health professionals.

While the majority of these programs are run in partnership with, or as an extension of the counseling center on campus, Project LETS is different: they operate as “charters,” independent from the counseling center and one of the only few led by students with lived experience.

The Project LETS website reflects its unique point of view. “We are trained students dedicated to supporting our peers outside of their therapy appointments, and in an alternative, friendly way. Each of us have valuable insight to pass along, and know who to point you towards if the situation requires more help than we can provide. We understand we’re not professionals. But we are the people this affects. The ones living with mental illness — every day of our lives.”

If there is a defensive tone in this narrative it may be that Project LETS, like many peer organizations, is used to refuting what many in traditional counseling see as risks associated with peers supporting peers in distress. Some fear that the paraprofessional nature of peer support is not adequate to deal with very serious situations. Others worry that those who share their own experiences with mental illness don’t have the neutrality that the counseling community considers an industry norm.

But regardless of the concern, most professionals believe peer programs have a role to play in student health and wellness – an area fraught with high demand, inadequate capacity and, in some cases, policies that are far from “student-centered.”

Molly Hawes, Director of Expansion for Project LETS, identifies a good reason for counseling centers to take peer programs seriously.

“These conversations are happening anyway, all the time,” she said. “Students are trying to provide help for their friends, but they don’t have the skills to do so, and they come to us looking for support.”

Will Meek is glad they do. Meek is the Counseling Director at Brown who, since starting his job in 2017, has embraced Project LETS as a partner in better supporting students with mental health issues on campus.

“There are lots of different ways to support people, and there are lots of different things that help people feel better,” he said.

In a lengthy interview at Brown this past summer, Meek, Kaufman, and Hawes presented a compelling case for how a well-coordinated relationship between CAPS (Counseling and Psychological Services) and groups like Project LETS can be the ultimate win-win for students. Meek says his interest in working with LETS was pretty simple. After meeting with their leadership and learning about their skills and training criteria, Meek found the LETS chapter at Brown to be a help-seeking channel that ultimately connects more struggling students with the services they need.

“It was clear that students loved them,” he said.

Meek described situations where a PMHA would email him with concerns about a student who may have had a negative experience with CAPS in the past, asking how to help. Sometimes, PMHAs walk students to CAPS for help.

“The idea that someone from Project LETS might be up with a person since 4:00 in the morning and when the CAPS office opens at 8:30 a.m., they say, ‘Let’s go over there together.’ From my perspective, that’s awesome.”

Meek sees Project LETS as an advocate in a number of changes he hopes to make at the university, including improving the intake process so that students can get the support they need, when they need it.

“Some students just want to have a touch point, to work through something that they are struggling with,” said Meek, who has hired an Urgent Care Clinician who sees students who have immediate needs for same-day appointments. They rarely do the lengthy intakes that many centers do.

“We need to be more creative with the ways we initially see students,” he continued. “Some people can be helped with one visit if we focus our efforts in the right places.”

Meek also supports Project LETS’ disability justice agenda and believes that educating the campus on students’ rights under the ADA is critically important.

“If someone has a physical disability, professors aren’t asking questions when they need accommodations, but with psychiatric stuff, a lot of folks don’t see it as legitimate. These guys (Project LETS) know the policies and the law very well, and that’s a big part of what they do.”

According to Kaufman, having the strong support of the counseling director has been a game changer for the Brown chapter.

“It has been one of the most affirming things for me to have this person in a position of power saying, ‘We’re fighting the same battle here. Let’s have a transparent discussion on how to make things better.’”