Don’t treat students as customers when it comes to mental health

“Who are your customers, and how well have you served them?” The question, newly introduced into our annual performance review, knotted my stomach. 

As a psychiatrist in an American university counselling centre, I provide clinical care to college, graduate and professional school students who come to me for difficulties such as mood swings, anxiety, and relationship problem. I consider them patients, people, students.

My non-MD colleagues (those who don’t hold the doctor of medicine degree) refer to them as clients – a term I avoid – but which I understand was introduced specifically to free those we help from the potentially pejorative perspective that they are sick or broken.  But “customer”, with its attendant focus on “service”, feels not only antithetical to what we do, but also potentially dangerous, especially in the setting of higher education. We shouldn’t treat students as customers when it comes to mental health care because, though all health care ultimately seeks to bring satisfaction in the form of alleviated suffering, good mental health care sometimes takes a circuitous route. Treatments take time and may even cause side-effects before they deliver benefits. 

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