When starting an antidepressant, there are several things to remember:
In general it takes at least 2 weeks (sometimes as long as 6 wks) to start feeling the benefit of these medications.  Take them consistently as prescribed and keep follow-up appointments. 
Common side effects when starting these medications can be a little nausea or diarrhea, headache, slight increased agitation or anxiety, decreased interest in sex or ability to orgasm, or increased difficulty sleeping.  If these occur and are tolerable, continue taking the medication.  Most side effects will stop within 2 weeks of regular dosing. 
If side effects occur that are intolerable, stop the medication and return to the clinic.  Please report immediately if you have increasing thoughts of suicide, sudden or dramatic changes in mood or increased panic, acting on dangerous impulses, acting aggressively or being violent, worsening depression or anxiety, or extreme increase in mood (called mania).
Remember that the more you do to help yourself, the more effective treatment will be.  Attend counseling, eat healthy small meals, get adequate sleep, exercise regularly, avoid intoxicants, and practice relaxation or meditation.

If you feel you are in crisis after business hours, call the Mental Health Crisis number at:  888-849-5728.

Humboldt Student Health Center:  707-826-3146

Humboldt Counseling and Psychological Services:  707-826-3236

Experiencing problems with your sleep?  Here are several guidelines for getting back on track:
1. Get up and go to bed at the same time every day, even on weekends.  You are training your body to get into a sleep schedule.  Even if you had a tough time falling asleep the night before, it is important to get up when the alarm rings.  You may be a bit tired during the day, but you will be more likely to fall asleep on schedule that night. 

2. Develop sleep rituals.  Give your body cues that it is time to slow down and sleep.  For example, listen to relaxing music, read something soothing, have a cup of chamomile tea, meditate, or do relaxation exercises.

3. Don’t try to “make” yourself sleep.  If it has been over 20 minutes since you went to bed and you are still lying there awake, get up and do something boring for a short stretch of time.  For example, move to a couch or chair in a dimly lit place and read something that is fairly dull.  This is not the time for a new Stephen King novel.  Let yourself get drowsy and then get back into bed. 

4. Exercise, but do it early in the day (at least 3 hours before bedtime).  Exercise that gets your heart pumping (cardiovascular exercise) is most helpful.   Morning/early afternoon exercise is best: 20+ minutes of cardio or 45-60 minutes of brisk walking.

5. Only use your bed for sleeping and sex.  Don’t use it to watch TV, do homework, read, etc.  You are training your body to associate bed with sleep. 

6. Avoid caffeine, nicotine, alcohol and other drugs at least 4-6 hours before bed.  Caffeine and nicotine are stimulants that interfere with your ability to fall asleep.  Alcohol, while it may feel like it helps you get to sleep, will actually interfere with your ability to have a deep restful sleep (that is, you will actually wake sporadically throughout the night).  If you are a caffeine drinker, try limiting it to 1-2 cups in the morning; if you are still having trouble with sleep, try cutting caffeine altogether.

7. Don’t go to bed hungry or overly full.  It may be helpful to have a light snack before bed.  Having a glass of warm milk is actually quite helpful as this contains a natural sleep inducer (tryptophan).

8. Make sure your bed and bedroom are quiet and comfortable.  If there are external noises that are bothersome, wear earplugs or use a “white noise” machine.  Consider a “blackout shade” for your windows if the light bothers you in the mornings.  Make sure you are comfortable in terms of temperature (that the room is neither too hot nor too cold).  Typically, most people do best with the room a little on the cooler side (60s).  Make sure to have adequate blankets.

9. Take a hot bath or shower 90 minutes before bedtime.  There is research that shows that a drop in body temperature following a bath may leave you feeling sleepy.

10. Use sunlight to set your biological clock.  As soon as you get up in the morning, go outside and turn your face to the sun for 15 minutes.

11. If you can’t sleep, try to avoid getting too upset about it.  Pay attention to your thoughts and whether they are likely hindering or helping.  Tell yourself that, if you don’t get much sleep that night, you will likely be tired the next day, but you will be able to function adequately and your sleep is likely to be better the next night.

12. Avoid prolonged use of sleep medications.  Short-term sleep aids can be helpful in getting a couple of nights of good rest during a difficult period, but long-term use of medications should be avoided.  Certain medications, once stopped, can cause rebound insomnia, and medications can be habit-forming.  See your health care professional about the appropriate use of such medications.  Overall, lifestyle changes are safer and more effective in producing quality sleep over time.
Resources: Some of the above tips are adapted from The Anxiety & Phobia Workbook by Edmund Bourne, Ph.D.

Signs and Symptoms of Substance Abuse and/or Dependence

• Recurrent substance use resulting in failure to fulfill role obligations at work, school, or home (e.g.: repeated absences at school or work, not completing homework or job duties, suspensions, expulsions, neglect of children or household work).
• Using substances in physically hazardous situations (e.g.: while operating a machine or driving an automobile or motorcycle).
• Legal problems related to substance use (e.g.: DUI/DWI, disorderly conduct).
• Using substances despite having persistent or recurrent social or interpersonal problems caused or increased by the effects of substances (e.g.: arguments with friends/family, physical fights).
• Needing increased amounts of the substance to achieve intoxication or a desired affect
• Using more of the substance than intended or using the substance more often
• Unsuccessful attempts to cut down or control substance use
• Experiencing withdrawal effects or utilizing the substance to relieve or avoid withdrawal effects (e.g.: headaches, vomiting, anxiety, depression, sleeping a lot or too little, transient visual, tactile, or auditory hallucinations or illusions, psychomotor agitation, seizures, increased sweating or pulse greater than 100, dry mouth, increased or decreased appetite).

We are unable to provide diagnostic assessment of ADD or ADHD.  While we do provide counseling based services through our CAPS providers, we are unable to provide the more common ADHD/ADD medications through our center.  Click here to learn more and find providers in the area who may provide these services.

The Student Disability Resource Center has a tram service to help transport students with mobility issues around campus. If you need tram services, you will need to be seen at the Student Health Center to complete a Medical Documentation Verification Form.

Yes, the person picking up must have their own photo identification card and the patient’s Humboldt student identification card or driver's license (a TEXTED photo is also acceptable).

Yes, our Student Health Center Pharmacy accepts all valid prescriptions from outside providers; however, we do have a LIMITED formulary and do not bill any third party insurance other than the California Family Planning, Access, Care, and Treatment (Family PACT) program. The charge is typically less than an off-campus retail pharmacy since we only charge our acquisition cost in addition to a $4 dispensing fee. Feel free to call the pharmacy at (707) 826-5043 to inquire if your prescribed medication is on our formulary. 

Our pharmacy DOES NOT STOCK ANY SCHEDULE II CONTROLLED SUBSTANCES - such as hydrocodone (Vicodin, Norco), oxycodone (Oxycontin), methylphenidate (Ritalin, Concerta, Metadate CD, Jornay PM), lisdexamfetamine (Vyvanse), mixed amphetamine salts (Adderall), etc.

New prescriptions may sent electronically through SureScripts to "Humboldt SU Hlth Ctr Pharmacy" or faxed to (707) 826-5012 directly from the provider’s office.

All charges will be billed to your Humboldt Student Center that can be accessed through the campus portal myHumboldt. We do not accept any form of payment at the Student Health Center. You will usually see the charge within a few weeks of service date, and payment will be due within one month of posting date. The item description of the charge will be listed as “Health Center – Pharmacy” in the Account Activity tab. Please be aware that medications administered during your medical visit to the clinic are also charged under the same item description. You can pay in person at the Cashiers office on the second floor of the Student & Business Services (SBS) building or online via myHumboldt (online credit card payments are subject to a 2.75% service fee). A detailed receipt of the charges may be obtained in person at the Student Health Center Reception window - please present your Humboldt student identification card.

No, the Student Health Center In-House Pharmacy does not accept any health insurance plans, other than Family PACT.  The student account will be charged out-of-pocket our acquisition cost in addition to a $4 dispensing fee.

Please inform your provider that you need your prescription sent to an off-campus pharmacy of your choice during your appointment. If a prescription is warranted upon evaluation, your provider can electronically send your prescription to the off-campus pharmacy of your choice.

No, the Student Health Center Pharmacy generally does NOT transfer to or from other pharmacies. Special circumstances may warrant a transfer, but this will be at the sole discretion of the pharmacist. New prescriptions may sent electronically through SureScripts to "Humboldt SU Hlth Ctr Pharmacy" or faxed (707) 826-5012 directly from the provider’s office.

No, we have a variety of over-the-counter products to cover your basic healthcare needs available to all currently enrolled students; we cannot sell to staff, faculty, or the general public. We have products to relieve cold symptoms, seasonal allergies, constipation, heartburn, diarrhea, headache, etc., as well as basic first aid, pregnancy tests, and feminine products. The pharmacist will gladly help you select the proper over-the-counter product to relieve your symptoms. Please present your Humboldt student identification card. We do not accept any form of payment at the Student Health Center. All items will be charged to your Humboldt Student Center.  Also of note, SHWS has several over-the-counter health vending machines located on campus where students can purchase health supplies by cash or credit card.

Yes, emergency contraception is available over-the-counter to currently registered students aged 17 and older. Currently, one dose is $10 plus tax charged to your Humboldt Student Center - please present your Humboldt student identification card. If you would like your Family PACT to cover your emergency contraception, please call the Humboldt Health Center Clinic line at (707) 826-3146 for a prescription. Emergency contraception is also available at one of the three over-the-counter vending machines on campus for a small fee (cash or credit card) - located 1) in Nelson Hall East across from the Goodwin Forum, 2) next to the Housing Cashier on the third floor of the Jolly Giant Commons, or 3) in the College Creek Mail Room lobby.

If you do not provide your immunization records in the 2 step process described here, you will be allowed to register and attend your first semester; however, a registration HOLD will be placed on your account if these records are not received before it is time for you to register for your second semester. The registration HOLD will be removed only after the records are received at the Student Health Center. If you have questions, please contact us at (707) 826-3146.

If you can’t find your immunization records, you can do any of the following:

• Obtain a blood test (titer) to show that you are immune to Measles, Rubella, and Hep B. You can get a titer at the Student Health Center for a small fee.
   
• Complete an immunization waiver. 
  IMPORTANT NOTICE! If a measles or mumps outbreak should occur on campus, students who lack verification of MMR immunity (including those who have waived vaccination) may be asked to remain off campus until the outbreak is declared over by campus health officials. This could take up to several weeks.

The Student Health Center offers a variety of vaccinations for a fee.

Local pharmacies also provide various vaccinations: Pharmacies that Provide Immunizations/Vaccinations

Public Health Clinics

Price list of vaccinations at Public Health Clinics

The x-ray process itself is free. $25 is billed to your student account to cover the reading by a radiologist. Each x-ray exam costs $25 and will be billed to your student account. No payment is necessary at the time of service.

Your provider will take an initial look at the x-rays for a preliminary reading the same day. The x-rays will be sent to a radiologist for the “official” reading which is generally back the following day.

Yes, the image can be burned to a disc for you upon request.

No. First, the light rays are “collimated” which means they run parallel and therefore the spread of light is minimal. Secondly, you will be wearing protective shielding. For these reasons, x-ray exposure is limited. The radiation exposure from one chest x-ray is roughly equivalent to the amount one experiences from natural surroundings in 10 days.

Most results return within a week.

The lab does not give out results.  You can only get your results from a provider.  In most cases, “no news is good news,” however, you and your provider can discuss this at the time the lab was ordered.

All charges will be billed to your Humboldt Student Center that can be accessed through the campus portal myHumboldt. We do not accept any form of payment at the Student Health Center. You will usually see the charge within a few weeks of service date, and payment will be due within one month of posting. You can pay in person at the Cashier’s office on the second floor of the Student & Business Services (SBS) building or online via myHumboldt (credit card payments are subject to a 2.75% service fee).

Answer: No. For more information please see Financial Services.

The health center does not bill insurance. Please check with your insurance company to identify providers in Humboldt County who accept your insurance.

Those who don't have insurance now and those who currently purchase their own insurance (meaning they don't get it through an employer).

You do it all online. Each state has its own website (California = Covered California). You go to the website (www.coveredca.com), provide some basic information (like where you live and how old you are) and you'll get a list of plans available in your area.

Call the Covered CA line (800-300-1506). There are trained people there called assisters and navigators who can walk you through the process.

• outpatient care
• emergency services
• hospital care
• mental health and substance abuse care
• rehabilitation
• lab work
• prescription medicines
• wellness services
• pediatric care
• maternity and newborn care

Plans will also give you some services that PREVENT illness for free. You will not be charged a co-pay or deductible for these. Birth control that requires a prescription will also be available for free. Here are some of the free services:

• blood pressure screening
• cholesterol screening
• colo-rectal cancer screening
• depression screening
• diabetes screening
• diet counseling
• HIV screening
• vaccines for adults
• tobacco use screening
• mammograms for women
• cervical cancer screening for women
• osteoporosis screening for women

If you already have health insurance, such as through your job, you may not need to sign up. But you must have a certain amount of health insurance - otherwise you risk being fined. This fine will get bigger over the next few years.

You will be able to pick from plans that have different premiums, co-pays, deductibles, and coverage. Different plans will work with different providers. Make sure your provider is "in network" if you want to keep seeing him/her. Also, check the plan to make sure your medicines will be covered.

www.coveredca.com

You may also go to www.healthcare.gov to learn about plans in your area - you may also call 800-318-2596. These resources can also help you find out if you can get financial help with your plan or perhaps a tax credit.

You may get lower costs if you don't smoke and if you try to keep a healthy weight.

You can't be turned away or charged more because of a condition you already have. You can't be charged more for a plan if you're a woman. There are no lifetime or yearly spending limits on your care.

You may not need to sign up. Talk with your parents about health insurance options.

Be ready with your social security number, income information and policy numbers of health insurance plans currently covering your family members. The sooner you sign up, the sooner your coverage will begin.

The Affordable Care Act, also known as the health care law, was created to expand access to affordable health care coverage to all Americans, lower costs, and improve quality and care coordination.

The Marketplace is a new way to shop for and purchase private health insurance (for example, health coverage other than VA health care programs) that fits your budget and meets your needs. People who purchase insurance through the Marketplace may be able to lower the costs of health insurance coverage by paying lower monthly premiums. (www.healthcare.gov)

You do not have to make a payment if you have coverage that meets a minimum standard (called "minimum essential coverage"). If you have access to affordable coverage but remain uninsured starting in 2014, you may have to make payment when filing your taxes. This payment will either be a flat fee or a percentage of your taxable household income, depending on which amount is higher. This payment will be phased-in according to the schedule below:

• $95 or 1% of your taxable income in 2014
• $325 or 2% of your taxable income in 2015
• $695 or 2.5% of your taxable income in 2016

Exemptions from the payment will be granted under certain circumstances. For more information on these exemptions, visit www.healthcare.gov.

Yes. If you are enrolled in any of VA's programs below, you have coverage under the standards of the health care law:

• Veteran's health care program
• Civilian Health and Medical program (CHAMPVA)
• Spina bifida health care program
  
  

Visit the VA's website at www.va.gov/aca or call 1-877-222-VETS (8387) M-F 8:30am to 10pm, or Sat 11am-3pm EST. For information on the Marketplace, visit www.healthcare.gov.

[from "Questions and Answers About the Affordable Care Act" (Prescriber's Letter, September 2013; and from "VA Health Care and the Affordable Care Act: Frequently Asked Questions" (June 2013)]

To prevent delays in receiving medical care and to avoid a hold on your registration, please complete the following forms:

1. Complete the immunization form through the Secure Message Portal AND fax or mail a copy of your immunization record to the Student Health Center.
2. Complete the Medical Record Release Form if you have medical records to transfer from another healthcare facility to the Student Health Center.

See the Forms/Medical Records page.

See the Forms/Medical Records page.

Yes, there are a few permitted or required by law. Our medical staff are “mandated reporters” and are required by law to report injuries caused by weapons, possible sexual assault, domestic or child abuse, or if you are in danger of injuring yourself or others. If you wish to discuss your situation with someone who is not a “mandated reporter”, we can connect you with certain staff members who have no mandated reporting requirement. Also, if a clinician feels that your health or safety, or those of others, are immediately at risk, they may consult anyone who may be of help, including police, with or without your permission.

Emergency Contacts will be called when Student Health Center staff become aware that the student is experiencing a major medical or psychiatric emergency; one in which their life, safety or long term health appear to be at risk. They may also be contacted as explained above, even without the student’s permission, if the student’s situation puts themselves or others in dire risk. However, they will be contacted for less dangerous or severe medical or psychiatric problems only at the student’s request.

Since the vast majority of students are 18 or older, they have legal status as adults, and therefore under Federal law have control over what medical information about them can be released to whom. Thus, documented consent from the student is necessary for any information to be released to anyone, including parents and guardians, with a few exceptions as discussed above. We will certainly be willing to listen to parents’ concerns, but what we can tell you is quite limited without a student’s permission. For students under the age of 18, parents or guardians may request and receive information, though information about birth control, pregnancy, treatment of sexually transmitted diseases cannot be discussed even with parents under California state laws, without the student’s documented permission. Such permission can be given in writing or verbally to Health Center staff. In instances of sexual assault or psychiatric problems, parents will not be contacted if the treating clinician determines that it would harm the student to do so.

The Secure Message Portal is a feature of our computerized Medical Record System, which allows us to communicate with patients in a medically confidential fashion, as required by Federal law. It is password-protected to maintain this confidentiality. Not only can messages be sent, but copies of lab reports and important forms reside in the Secure Message Portal. Don’t share your password with anybody, unless you’re OK about them seeing your confidential info!

If you do not provide your immunization records in the 2 step process described here, you will be allowed to register and attend your first semester; however, a registration HOLD will be placed on your account if these records are not received before it is time for you to register for your second semester. The registration HOLD will be removed only after the records are received at the Student Health Center. If you have questions, please contact us at (707) 826-5036.

If you can’t find your immunization records, you can do any of the following:

• Obtain a blood test (titer) to show that you are immune to Measles, Rubella, and Hep B. You can get a titer at the Student Health Center for a small fee.
   
• Complete an immunization waiver. 
  IMPORTANT NOTICE! If a measles or mumps outbreak should occur on campus, students who lack verification of MMR immunity (including those who have waived vaccination) may be asked to remain off campus until the outbreak is declared over by campus health officials. This could take up to several weeks.

The Student Health Center offers a variety of vaccinations for a fee.

Local pharmacies also provide various vaccinations: Pharmacies that Provide Immunizations/Vaccinations

Public Health Clinics

Price list of vaccinations at Public Health Clinics

Our accredited health center provides basic services at no cost to the student. These services include doctor/nurse visits and referrals. Additional charges may apply for augmented services, such as x-rays, lab work and pharmaceuticals. These charges are applied to the student’s account as we do not accept cash or credit cards. See “Charges/Fees”

Yes. The Health Services fee is a mandatory fee, paid as part of tuition, which provides services to all enrolled students.

The health center does not bill insurance. Please check with your insurance company to identify providers in Humboldt County who accept your insurance.

Since students 18 years or older are adults under the law, they have control over what and with whom their health care can be discussed. In all but the most dire situations (such as those in which the student's life or well being are under serious threat), we will need to have verbal or written permission from the student before providers can discuss their health care with anyone who is not another health professional involved in their care.

No. We recommend that students maintain health insurance coverage for emergency or specialty care services.

Humboldt does not require nor sell insurance. However, it is important for students to have insurance coverage for emergency and specialty care services. Many CSU students and their families may be eligible for financial assistance in purchasing health insurance. In California, the exchange for health insurance is called Covered California, an online marketplace for affordable health insurance. Individuals and families may qualify for financial assistance in paying the costs of health insurance coverage. More information can be found at www.coveredca.com or www.calstate.edu/coveredca/about.

No, only enrolled students may use the health center.

The CSU system requires new and readmitted students born on or after January 1, 1957 to present proof of immunity to measles and rubella, or be immunized. Students under the age of 19 also need to show proof of immunity to the Hepatitis B virus prior to their second semester at Humboldt. Submissions are done by fax (707-826-5042), mailed or dropped off (not emailed). Please note that, even if immunization records were provided to Admissions as part of the transcripts, the immunizations records need to be filed separately with the health center. A hold will be placed on your student’s ability to register for classes unless the health center receives copies of their immunization records.

Student Health and Counseling Services are available during business hours on weekdays during the academic year. We offer expanded telehealth services through TimelyCare.  TimelyCare services are available in the evenings, weekends, and holiday breaks.

For any serious medical emergencies the student should call 911. If a student is seen at the Student Health Center and it is determined that they have a condition that requires emergency care, we will help coordinate their transfer to a local hospital Emergency Department. Students can also visit Redwood Urgent Care in Eureka, or one of the local Emergency Departments.

At this time, Student Health and Counseling Services are open for services at our physical locations on campus during the academic school year (click here for hours).  We provide medical and mental health telehealth services during the summer months through our partners at TimelyCare at no extra charge to our students.

Yes, students who are eligible for medical services at Humboldt are also eligible for basic medical services at all other CSU campuses at no additional cost.

The closest Kaiser facility is four hours (225 miles) south of Arcata in the city of Santa Rosa. Kaiser will cover only emergency department visits in Humboldt County. You may call Kaiser for authorization to be seen at Redwood Urgent Care in Eureka instead of going to the ER for a non-life threatening and non-emergent medical condition.

We have an In-House pharmacy at the Student Health Center with a limited formulary, however they do not bill any third party insurance other than FPACT.  

Barnes Arcata Family Drug is 8 blocks away located at 1080 G Street in Arcata - closed on weekends.

CVS Arcata is 14 blocks away located at 600 F Street in Arcata (in the Safeway shopping center).  

Ongoing care is beyond our scope of practice so students with these types of needs will be referred to local primary care providers or specialists. Please discuss long-term care with your Primary Care Provider, and research providers in the Humboldt County area who handle your student’s special needs.

The Student Health Center provides Family PACT reproductive health services. This state program provides confidential services for contraception, sexually transmitted infections, well health exams, urinary tract infections, some labs and immunizations. All Family PACT services are available at no cost to you while you are enrolled. Eligible students may sign up at the Student Health Center. Annual re-enrollment is required to keep your program benefits.  You can do this with our receptionists.  

Please review the eligibility screening. If you feel you qualify, please fill out the client eligibility certificate and bring it with you to the Health Center. The receptionist will validate if you're eligible and enroll you in the program, at which time we will issue you the Family Pact Health Identification Card.

• Elgibility Screening
• Client Eligibility Certification Form

To find out if your FPACT card needs to be renewed, call 800-541-5555 (press 1 then 2)

The health center will continue to offer its basic and augmented services to students. However, some augmented services that will be billed by the health center, such as immunizations, physical therapy, lab work and x-rays, may be provided at no cost by your Primary Care Provider. Whenever possible, the health center recommends the student see their Primary Care Provider to utilize their ACA benefits.