Questions and Answers with Dr. Paul Summergrad

Marjorie Malpiede / December 16, 2016

The president of Tufts University, Anthony Monaco, recently announced the creation of a university-wide task force dedicated to mental health. He named Dr. Paul Summergrad his co-chair for reasons that seem obvious: he is currently Chair of Psychiatry at the Tufts School of Medicine, Psychiatrist-in-chief at the Tufts Medical Center, and is a past president of the American Psychiatric Association.

In talking with Dr. Summergrad in his office in Boston, it is clear he brings more to the task than an unparalleled CV. He is passionate about supporting the mental health of young people at a point in their lives when it is most vulnerable. His extensive knowledge of the young adult brain brings a critical perspective for practitioners and policymakers struggling to support individuals on campus.

In the early 2000s, Summergrad led a study of mental health patterns and services at Harvard, which gives him a unique view on how student mental health as a field has changed – and how it has stayed the same. These are important dynamics for administrators and students as they think through capacity and policy regarding mental health on campus, as well as the role of universities in a student’s overall wellbeing.

The task force will start with a comprehensive review and assessments of the state of students’ mental health and will then assess the services, resources, and practices related to mental health at Tufts across all departments and schools. The task force will conclude with the release of a report in the fall of 2017. At the time of this interview, the effort was just underway. Here’s what the co-chair had to say:

MCQ: What is the scope of the new task force you are leading?
PS: Number one is, we want to find out about student, faculty, and staff experiences. Secondly, we want to make sure that students can talk to us directly about their own experiences, whether good or bad.
The project involves survey work and expert analysis, and will reach all aspects of the university – students, staff, and faculty at undergraduate and graduate levels on all our schools and campuses. We hope to come up with an understanding of what we’re doing well, what’s not working, and what the gaps are. Additionally, we want to know what students, faculty, and others need in this area. We will then come up with some concrete recommendations about meeting those needs.

MCQ: What is the motivation behind such a comprehensive effort?
First of all, this comes directly from the president. As his co-chair, I think that sends an incredibly important message about how central this is. I think every college and university president is concerned about the mental health of their students, but for different reasons. You look at some of the suicide contagion issues that some institutions have faced and you wonder: What more can we do? To my knowledge, we haven’t had that situation specifically at Tufts. We do have a large, diverse university community and a lot of strategic questions around how best to support students with illnesses, those that are at-risk and others who are at vulnerable stages in their development.

The reality is mental illnesses – and the broad range of illnesses and substance abuse that goes with them – are the preeminent disorders of young people. In the aggregate, the biggest risk for people getting sick and being disabled at this age is mental illness and substance abuse, so it’s a logical time to look at it. It’s also a time when other people are going through normal developmental challenges. Sorting out the difference is a big part of this work.

Not every developmental challenge is a psychiatric illness, but there’s also illness and substance abuse that come on during this time in young peoples’ development and we need to be aware of that. How do we make sure that when that bleeds over or becomes something that needs addressing that we’re supporting them with robust services? How can students who are ill leave and come back in a way that is not stigmatizing or marginalizing?

MCQ: This begs a lot of philosophical questions. What are some of the big ones?
It seems one of the most important questions is: What role do universities have in fostering the best, most optimal development of young people, especially as we have a major commitment to be a diverse community?
There was a point where universities seemed to have an obligation toward the development of young people and young peoples’ character and wellbeing. Was that proscriptive? Was that constraining? But in addition to this there are other types of roles, like providing services for people who are ill and preventing harm, whether it’s keg parties or having appropriate policies and actions around sexual assault.

Clearly, we have a role toward education and educational development. Is there some other additional role universities should have? Used to have? Need to stay out of? And what are the boundaries between them all?
One of the things that interests me is something I read in a book by J.D. Vance about his upbringing, which included service in the Marines. What he said was the Marines provided a kind of oversight of his development, a parental role that helped him become who he was.
Is there a similar role for universities dealing with this similar age group?

MCQ: Can you give an example?
PS: We have good evidence that kids who grow up, even in the most challenging circumstances, who have a mentor from outside their family who takes an interest in them have more secure paths. They do much better. What does that mean for colleges and universities? Most schools are secular and have very diverse cultures, but one of the common things we can offer students is mentorship.

Not everyone wants to go back to his or her family and talk to them. Their families or others may be at odds with their sexuality or some other element in their lives. We know that young people are still developing when they come to college; they’re still not developed at 19, 20, 21, and 22. That’s an important consideration. They need to rely on as many people on campus as they can. Should we help our faculty see that as part of their role? If it isn’t faculty, is it someone else at the university?

MCQ: You did a similar mental health survey at Harvard that was published in 2000. How have these issues changed since then?
PS: We've become more public about talking about mental health and mental health concerns than we used to be. This has had a positive effect. I think this fits with wanting to create a university environment that supports diversity, supports a different perspective, including the ways in which young people develop. We also want to create an environment that provides the needed health services when issues become clinically significant.
Some of it is better treatment and better systems.

When I was first training in psychiatry, people thought that Obsessive Compulsive Disorder was almost non-existent. And then people did epidemiology studies and found that 1 to 3 percent of the population had OCD, but they weren't coming forward because there was no effective care. Once you have effective care, medications, and treatments, people begin to come forward and use those treatments. The treatments we have now for OCD are not perfect, but they're pretty good, and they're much better than what we had 40 or 50 or 60 years ago.

Similarly, for health on campus, I think more people are coming forward because we have better treatments. People are seeking help because they believe it will be effective.

Are the students any different? I can’t say. One thing that hasn’t changed is university presidents’ interest in wellness, health, and whole-student development. When university presidents come together, this is something they consistently talk about. I am honored to serve with President Monaco and applaud him for his leadership.