Penn students and faculty share the process, challenges and costs of taking psychiatric medication

When Wharton and Nursing junior Sydney Liu first started seeing a therapist at Counseling and Psychological Services, she was pushed not to take medication for what she felt was a worsening condition of anxiety.

Her therapist was not authorized to prescribe medication, but Liu pushed for a referral to a psychiatrist within CAPS and was prescribed Zoloft, an anti-depressant and anti-anxiety medication, about a year ago.

Liu is among the approximately 20 percent of students at Penn who are prescribed medication from CAPS to manage their mental health. While these students say that their prescriptions are essential to managing their health at Penn, they recognize that there are often financial or logistical barriers that prevent others from gaining access to this resource. 

“[Medication] really help[ed] me untangle a lot of the internal issues I was having,” Liu said. “The way that it really worked for me was that it raised the threshold for which I would start panicking. I would have less panic attacks day-to-day or when things got stressful.”

College freshman Jamie Albrecht has been taking Lexapro for depression daily for the past two months after receiving a prescription from a local psychiatrist outside of CAPS. Albrecht said he was not on medication before he entered Penn as a freshman, but has struggled with depression for a long time. 

“Penn is just really demanding,” Albrecht said. “Being un-medicated when you have [a mental health issue] here is just really difficult.”

Bill Alexander, the director of CAPS, said the department tends to use behavioral interventions such as psychotherapy more often than it uses medication. He estimated that approximately 20 percent or less of students treated by CAPS are prescribed medication.

“What we have learned here at the Counseling Center is that for very mild mood instability and mild depressions, psychotherapy is just as effective, if not more effective, than medications,” Alexander said.

Forbes reported last year that, while research supporting the benefits of behavioral therapy has grown, the helpfulness of antidepressants has been placed under increasing doubt. 

Alexander said CAPS determines every student’s need for medication on a case-by-case basis and prescribes medication through its own psychiatrists. He added that students with depression or anxiety disorders can benefit from medication.

“Most students can take them without any serious side effects,” Alexander said. “Certainly they are much more able to participate successfully in their academics on the medicine than off the medicine.”

Students who are prescribed medication from CAPS often have different experiences with them, Alexander said. 

“Each medicine is slightly different and people respond to them differently,” he said. “It’s tailor-made, you could say.”

Albrecht agreed, adding that medication is not a “cure-all.” During the first few weeks after starting Lexapro, Albrecht said he actually felt more tired and more depressed, which is one of the side effects of the drug. 

He also said that it can be hard as a student to make time for regular therapy sessions. Albrecht said that one time, he forgot to pick up his prescription for three days because he was overwhelmed with school. 

"You’re allowed to have emotions [at Penn], but there is a caveat — you’re still expected to do everything and be fully functional," he said. 

“That’s just not realistic when you have mental health issues,” Albrecht said. “You just can’t do certain things sometimes. You can try to fight against it and not let it affect you, but sometimes you can’t. At Penn, that’s not necessarily an option.”

Liu, who is on the Penn Student Insurance Plan, said one of her concerns was the cost of prescriptions and co-payments for therapy sessions. She said that, although it is “thankfully not an issue” for her, it could definitely be a financial burden for some.

According to the outline of PSIP coverage, Penn students using a preferred provider must pay a $10 co-pay per visit for outpatient mental health services, such as therapy sessions, and a $100 co-pay for admission to inpatient services, such as psychiatric hospitals. 

While a preferred health care provider has a contract with health insurance companies, a non-preferred provider does not. If students go to a non-preferred provider, students must pay 30 percent of the full bill, or the co-insurance, which can be substantially more than a co-pay. Prescription co-pays can vary from $20 to $40 per month depending on the brand and type of drug.

“It kind of bugs me that it does cost some money. Some people may not feel like spending $10 a month on this kind of stuff is the best way of spending $10,” Liu said. “I’m just very fortunate this isn’t an issue for me, but I definitely know people and have friends who would feel like that is an extra financial burden.”

Students may also see differences in their prescriptions based on the psychiatrist to whom they are assigned. The class of medications that treat anxiety and depression are called selective serotonin reuptake inhibitors, or SSRIs.

“There’s a number of different specific medications that fall into that group,” said Karin Borgmann-Winter, a psychiatrist in the Department of Child and Adolescent Psychiatry and Behavioral Sciences at the Children's Hospital of Philadelphia. “A different psychiatrist might use different versions of those for the treatment of anxiety and depression.”

 CAMPUS RESOURCES

The HELP Line: 215-898-HELP

Counseling and Psychological Services: 215-898-7021 (active 24/7)

Student Health Service: 215-746-3535

Office of the Vice Provost for University Life: 215-898-6081

University Chaplain’s Office: 215-898-8456

Reach-A-Peer Helpline

• 215-573-2727 (every day from 9 p.m. to 1 a.m.)
• 215-515-7332 (texting service available 24/7)

Penn Benjamins (in-person peer counseling)

• Su, M, T 8-11 p.m. Harnwell Library First Floor
• W, Tr 8-11 p.m. Houston Hall Chaplains Office