Do Folks Have People They Can Talk to in College?

In 1972, Dr. John Fryer, going by the name of Dr. Henry Anonymous, confronted the American Psychiatric Association with a wig, mask, and a box to distort his voice. He spoke, "I am homosexual, and I am a psychiatrist." He spearheaded a revolution.

I learned about Dr. Anonymous today in a conversation with Dr. Jim Probert, a psychologist who has advocated for the human rights and engagement of students faced with difficult experiences. He is himself a person who has courageously shared his own lived experience of psychological distress, the mental health system, and reclaiming his life (Probert, 2021). I met with him to better understand his approach, which includes leading efforts to integrate peer support within a college campus.

Peer Support

Within the traditional relationship between service users and mental health professionals, there has been a hierarchy, power dynamic, and common reality of fear.

In peer support, individuals meet with someone who has walked through a journey like their own and, unlike the traditional doctor-patient dynamic, meets them with equality. Peer support is offered in a range of settings, ranging from grief support and addiction intervention to mental health.

Dr. Probert is, in many ways, an ambassador. He presents as both a psychologist and a former service user himself. He is an associate clinical professor and peer services coordinator at the University of Florida Counseling and Wellness Center (UFCWC).

In his approach, Dr. Probert emphasizes "informed consent." During times of crisis, individuals’ self-determination has sometimes been compromised by the mental health system (for example, with consultations not involving the individual, paternalistic practices, and a lack of provision of information concerning one’s treatment and rights). Peer support creates a bridge where individuals are ideally included in all decision-making that concerns them, and someone’s right to self-determination is upheld.

He marks the importance of a willingness to listen deeply to and partner with those in need in the ways they recognize as most helpful. He emphasizes the process of dialog as opposed to recommendations. Dr. Probert shares that people must be able to make an informed choice on the services they wish to receive. A part of this could be what Dr. Probert calls " conventional support," things like psychotherapy or psychiatric services in addition to peer support.

The Value of Peer Support

Before the change process, which Dr. John Fryer began publicly, presenting as anything other than heterosexual and cis-gendered was conventionally diagnosed as an invariable indication of impairment in the mental health fields. As Probert suggests, peer support offers a parallel transformation process to the one jump-started by Dr. Anonymous. The lived experience of conventionally diagnosable human experience is separated from any invariable or irrevocable assumptions regarding competence and capability.

With experiences that could be diagnosed as mental health conditions, this is especially meaningful as the peer support specialist may have particular insight into aspects that cannot be taught in books, such as what it feels like to hear voices or be told that one is having delusions. In addition, peer supporters demonstrate that life can go on after a crisis.

Regarding peer support, Dr. Probert makes clear that it is essential that "people are in charge of how they make sense of their own experiences." He describes peer support as a way of listening deeply and learning together, referencing Intentional Peer Support (Mead et al., 2013), a method frequently utilized within peer-run crisis respites.

Within the UFCWC, students have access to a variety of peer supports, including the evidence-based program of Wellness and Recovery Action Planning (WRAP) (Cannacot et al., 2019). This program was created by Dr. Mary Ellen Copeland, a researcher who has openly shared about her mental health recovery (Mead and Copeland, 2000). Within its sessions, WRAP allows participants to create a plan for wellness, including activities to maintain one's well-being and planning for if things go off track.

We Are All Peers

As we speak, I notice myself reflecting on the construct of "peer." What does peer mean? Who defines who is a peer to whom?

A typical psychiatrist-and-client relationship certainly doesn't feel like one among peers. Is there a peer relationship between a primary care physician and their patient? What about the nurse? If the nurse is your cousin, does that make a difference?

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Dr. Probert discusses the importance of having "people we can talk to" for all of us. Yes, doctors and other mental health professionals included. He discusses experiences that might qualify one for a diagnosis in the Diagnostic and Statistical Manual of Mental Disorders.

He quotes a statement from the British Psychological Society acknowledging overwhelming evidence that mental distress diagnosed as mental illness is on a single spectrum with "normal" experience and not categorically different. I envision such a spectrum also encompassing experiences such as grief, burnout, physical illness, and relationship difficulties. It is very normalizing.

Other Supports

Dr. Probert references other supports available to students on college campuses, like those provided through a college's disability support office. Accommodations like extended time on tests and flexible deadlines for assignments can make higher education accessible to students with a mental health diagnosis.

Dr. Probert also discusses how colleges can work with students who may be in distress by offering medical leave if applicable or the ability to take a reduced course load to decrease stress. A student might be struggling academically and be given the option of dropping one particularly stressful class as opposed to withdrawing from school entirely.

Closing

I appreciate my conversation with Dr. Probert. I look forward to the day when peer support might be available to anyone in distress. I am impressed by how such practices are utilized in a college setting and hope these continue to grow.