(h/t
Metafilter)
I just heard
about Senior House. Goddamn.
Also. I hadn't realized that dealing with the administration in his capacity as Senior House's housemaster is what drove Henry Jenkins from MIT. God
damn.
I am surprisingly angry and sad about this, given that I'm not a SH affiliate.
The shutdown of Senior House would be bad news, by itself. This is appalling:
The questionnaire, the Healthy Minds Survey, was administered by the University of Michigan. Many schools around the country give it to students as a way to pinpoint problems on campus and decide how best to allocate resources. When MIT administered it in 2015, they told students that it was a confidential survey intended to help them. One of the chancellor’s assistants who had lived in Senior House when she was an undergraduate went to Senior House and specifically requested that the residents take it. They did, in large numbers.
What they didn’t know—and what they couldn’t have known from reading the consent form that accompanied it—was that MIT had embedded metadata that allowed the administration to pinpoint the location of those filling out the questionnaire, enabling them to segment the results by dorm. The only question about dorm type in the survey was vague—“What kind of dorm do you live in? Small, large, off campus?”—but by tracking the metadata, Barnhart and the administration were able to see exactly where respondents lived.
It was this data that enabled Barnhart to see what she called a troubling hot spot of drug use. “If it wasn’t a direct violation, it was at least a violation of the spirit of informed consent,” Johnson says.
In light of that...
As Senior House students spread out across campus this year, former advisers worry that they’ll be at even greater risk. They can reach out to MIT’s mental health services if they need it, the chancellor says.
Is there some reason that MIT students should trust MIT Med to keep their information confidential? When MIT just used the confidential results of a "Healthy Minds Survey", which was advertised as a way of seeing where resources were needed, to eliminate resources from vulnerable populations? And the relevant IRB gave it a pass?
(Dear MIT students, and alums concerned about them: it is
apparently hypothetically possible for students on the default MIT student health insurance ("extended" plan) to see therapists unaffiliated with MIT, but it has a pretty punative copay:
If you are covered by the MIT Student Extended Plan, and you see a mental health clinician who participates in the Blue Cross Blue Shield (BCBS) PPO, your first 12 visits in a calendar year are covered in full (100%). After that, you will have a $25 copay for each visit.
If you are covered by the MIT Student Extended Plan, and you see a mental health clinician who does NOT participate in the Blue Cross Blue Shield (BCBS) PPO, your first 12 visits in a calendar year are covered at 100 percent of the BCBS allowed amount. After that, your insurance will cover 80 percent of the allowed amount, and you will pay the other 20 percent. For all of your visits, your clinician may bill you for the difference between the BCBS allowed amount and his or her charges. This is something you should discuss with your clinician ahead of time.
I don't know for certain what BCBS's "allowed amount" is, but I know they're paying master's level therapists about $85 per therapy session, so I'm guessing that's it. So if a therapist's regular fee is $100, you'd be paying ($85*0.2)+($100-$85)=$32 per session. A lot of therapists are charging rather more that $100/session these days. At $120/session that's $52/session.
That copay/cost-sharing is
absurd. Obviously, many students couldn't possibly afford $25/week copay – specially the most vulnerable ones. So that's a hell of an incentive to seek care from MIT Mental Health and Counseling Service directly: as they proudly state, no copay or other fees to see the therapists that work for MIT.
Less obviously, it's not even vaguely in line with the market right now. I see people who
have jobs and pay $10 and $15 copays on other insurances. That students would be charged a $25 copay to see a therapist –
in-network! – is incredible. Honestly, students being charged
any copay is pretty out of line.
Seriously: MIT students, the people who stock the shelves in the Star Market behind Random have better access to mental health care than you do. That grocery store shelf stocker qualifies for a subsidized Medicaid Expansion plan, which covers at least a therapy session per week, with no copay. Also, their plan has hundreds, if not thousands, of therapists to choose from, none of whom report to your landlord cum diploma-granter-maybe cum civil authority cum boss of your local police.
Also, availing yourself of the option of seeing a non-MIT therapist on your MIT student insurance, even though it's through BCBS, requires a "referral" from MIT Med:
If you are already seeing an outside clinician or have a specific outside clinician in mind, you don’t have to make an appointment at MIT Medical to get a referral. Just call the Mental Health and Counseling Service at 617-253-2916, and ask to speak with someone about getting a referral for your outside treatment.
This may be completely pro forma, but the upshot is that MIT is making it a requirement on you that you notify MIT if you're getting psychotherapy, and that you divulge to them from from whom you are getting it.
That someone is in therapy and from whom they get that therapy is highly confidential information, that frankly MIT has no business knowing. You should be able to see a therapist on your student insurance without MIT even knowing about it.
So if you wanted to work for the benefit of students' mental health, there's a great target: demand that MIT's insurance for students provides off-campus, unaffiliated psychotherapy with no copay, cost sharing, or balance billing – or radically less than at present, so MIT students can freely avail themselves of treaters not on MIT payroll; and abolish the need for a referral, because info about your utilization of mental health care is prejudicial, privileged information that can be used against you. But be careful to keep a third-party insurance co in the loop, instead of MIT directly paying therapists; whomever pays the therapist is allowed to snoop in your psychotherapy records.
Or, honestly, given some of the crappy-ass general health care friends of mine have gotten through the Med Center, maybe just agitate for all students to just get a regular BCBS PPO membership instead of having to go to the Med Center, at all. Or given how much BCBS sucks, try to get students into the Medicaid Expansion, so students get a choice of providers. That would be harder.
P.S. Disclosure of conflicts of interest: none – I don't take BCBS, so even if the copay/cost-share/balance-billing were eliminated, and students started flocking to off-campus therapists, I still wouldn't benefit by any of that business, unless somehow you managed to get students into Medicaid Expansion, and then only if students were willing to travel all the way to Medford to see me – I just have it in for MIT Med, and MIT MHCS especially.)
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martianmooncrab
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