After four weeks at MIT Medical, Alan Siegel, chief of the Mental Health Service, talked with Michael Glover, MIT Medical's communications manager, about his first impressions of MIT, the challenges he faces and his vision of what a healthy MIT community might look like.
Siegel comes to MIT from the Cambridge Health Alliance, where he was director of the Division of Psychology. He received the A.B., Ed.M. and Ed.D. from Boston University and trained as a psychoanalyst at the Boston Psychoanalytic Society and Institute. He is an assistant professor of psychology at Harvard Medical School and a lecturer in psychiatry at the B.U. School of Medicine. His doctoral dissertation investigated depression and alienation among college freshmen and the effect of these emotional states on suicidal tendencies, academic achievement, drug use, patterns of friendship, sexual behaviors and family relationships.
Glover: You're a psychologist, and you're the new chief of MIT Medical's Mental Health Service. Is that a first?
Siegel: It is a first here at MIT. However, many universities have a psychologist directing mental health services. Over the years, I've had many psychiatrists working with me and for me, so I've come to understand the different strengths various disciplines bring to a service.
I'm not sure that the search committee was looking to hire a chief from a particular discipline. I was hired, perhaps, because of other things: my humanistic approach, strong foundation in clinical work, ability to develop mental health systems, and a real and profound commitment to working with people who suffer, and to make a difference for people who feel lost.
How do MIT Medical's mental health services look to someone who's been in the outside world?
A couple of things are very clear. The commitment of MIT Medical and the Mental Health Service staff to the health of the MIT community is incomparable. There is a profound dedication to provide accessible, responsive care. The staff are invested in people's ability to grow and be healthy, and are committed to providing excellent care.
But perhaps even more important is that many of the services and programs that support personal and community life here at MIT, including the Mental Health Service, have been listening to, and are making changes that students, faculty and staff have asked for.
What got you to MIT?
Before I decided to take this job, I tried to contact any student who had publicly written something about the MIT Mental Health Service, especially critical commentaries, using just the MIT online directory to find people. In their articles, many students were quite upset and critical. But those I talked to were so ready to work on making things better, so eager to help make things change, that I said to myself, "If these are the people I'm going to be working with, I'm ready - I want to be part of this."
What about the recommendations of the Mental Health Task Force?
I think the questions that were taken up by the task force are very important - they were right on many issues.
But in any system where you have a lot of very smart people, one usual problem is that everyone likes to study things, so often there are a lot of studies, reviews and analyses of problems, and then nothing happens. So I'm amazed to see how many of the Mental Health Task Force recommendations, made less than a year ago, have already been implemented.
I see that my initial work is to work with the Mental Health Task Force implementation group appointed by Chancellor Clay to continue implementing key task force recommendations. And in the process of that work, we'll start to see and begin to answer some important questions: How are we addressing this community's needs? Are we responsive? Are we reaching out to people, and are we reaching people? Are we accessible? Are we understanding the MIT community in a way that allows us to tailor our services? Are we being flexible?
The real challenge of this job is to develop a seamless support system that responds to students, faculty and staff, while respecting privacy and boundaries.
The Task Force recommended lower barriers to seeking mental health help, based on an assumption that MIT is a culture where people don't easily ask for help. How do you begin to work on that?
There may be a culture at MIT of solving one's own problems, whether they be technical, intellectual, interpersonal or intrapsychic. But if you look at the broader world, I don't really think that anyone likes to ask for help. Most people feel terrible about it - or humiliated, or weak - so it's not unique to MIT.
What we need to do is reframe what we can do in a modern, diverse Mental Health Service like this one. It's moving beyond the idea that it's always about "I have an illness" or "I have a weakness." It's not always about asking for help. It's really about recognizing that being a person - that growing and facing life - can sometimes be very, very hard. Most everybody gets stuck at one point or another. That's where talking with a counselor, psychologist, nurse, social worker or psychiatrist can be useful in thinking about options, looking at possibilities, and working through hardship and disappointment. That's really how mental health services can be useful: to help look at choices.
How much of the resources of the Mental Health Service should focus on students and how much on faculty and staff in the Traditional or Flexible MIT Health Plan?
There's no question that we're paying extra close attention to the needs of students and are working to become even more involved with students outside the MIT Medical building - in their residences, living groups and other community groupings.
But our mandate really is to provide responsive mental health services for both groups. I'm not sure that the question "How much?" will help me figure out how to do that. Because it's too easy to translate that into "Who's more important?" or "Who deserves more?" I'm not sure that's the best way to look at this.
What we hope to do, for any person who comes to the Mental Health Service, is to tailor a response that is going to be most useful for that person. That starts with a comprehensive assessment and evaluation, to figure out what the concerns are.
Next is to develop the best possible approaches and to see, given our resources and the resources within the community, what the best match is. Not everyone has the same needs, so we try to make each response fit each person. We'll see some people a few times, others more frequently, and refer others to outside therapists or programs.
Having said all that, we also need to look at who is the most vulnerable in the community, and to use that information to help plan what we do.
What's your vision for a healthier MIT community?
I haven't been here long enough to have a comprehensive vision for the MIT community. But I have an idea about people in a community that might help start a discussion. What a healthy community (and maybe a healthy family) does is to allow and encourage people to develop what's most unique about them. A healthy community supports that process with whatever resources possible, to help each person realize his or her personal vision.
That person's personal vision may not be what I would want for me, and it may not be what the next person would want. I hope for a community that can support differences, uniqueness, individuality and creativity - understanding that not everyone who comes here lives, works or studies in the same way.
We need to have a humane, respectful environment where the individuality and uniqueness of people is both celebrated and encouraged. That's a very big vision, I suppose, but it really suggests that it's important to have differences, it's important to have disagreements, it's important to have folks pursuing their own dreams.
A successful mental health organization can help nurture that community - a community that prizes each member's uniqueness, a place where people respect and care for each other.
A version of this article appeared in MIT Tech Talk on October 2, 2002.
