Estevan Garcia joined Dartmouth one year ago as the institution’s inaugural chief health and wellness officer, overseeing the Student Health Service, the Student Wellness Center, and Employee Wellness. A member of President Sian Leah Beilock’s senior leadership team, Garcia is playing a key role in delivering on Dartmouth’s Commitment to Care—a strategic plan to support student mental health and well-being.

Garcia came to Dartmouth with experience as a physician and a public health official. A specialist in pediatric emergency medicine, he served as the chief medical officer for the Massachusetts Department of Public Health prior to joining Dartmouth in March 2024. In addition to his on-campus responsibilities, he is on staff at Dartmouth Health and a member of the departments of emergency medicine and pediatrics. 

In this Q&A, Garcia discusses his priorities for the community’s wellness and safety and his personal commitment to creating a healthier campus.

Q: As the first person to hold this role at Dartmouth, how has your first year been, and what are your thoughts on mental health on campus?

As I reflect on my first year, I’m proud of the way we’re approaching mental health on campus. When I accepted this role, I came in thinking we needed to expand clinical services, which we’ve done. Now, we’re focusing on prevention, overall well-being, and what that looks like for our community. 

Over the past 20 years or so, we’ve begun to think about wellness more as an optimized kind of life, rather than a healthy-versus-sick dichotomy. This wasn’t something we talked about when I was in training in the late ’90s, and certainly not when I was a medical student. What we’re seeing today is an understanding that wellness is about optimizing belonging and well-being in a way that allows students to excel.

President Beilock has spoken about the importance of centering well-being and linking health and well-being to a successful academic career. Events such as the historic panel at Dartmouth that involved eight surgeons general discussing mental health and the upcoming United Nations Development Programme symposium on the world mental health crisis show that Dartmouth is a leader in this space. 

It’s rewarding to be part of the effort to make wellness central to our community, both inside and outside the classroom. We’re making progress thanks to our committed team of professionals in the division of Health and Wellness and a strong network of supportive campus partnerships.

My role at Dartmouth is to explore additional wellness resources and programs for our entire community, with an immediate focus on our students. What we saw in the past five years—what I certainly saw in my clinical work—was the general fraying of the social fabric and community that are essential for many students to learn and thrive. When COVID came, we isolated ourselves to keep each other safe, but that social isolation negatively impacted so many children and young adults. As a public health practitioner, I see that we didn’t fully appreciate the impact of the pandemic on the socialization and social support structures while trying to protect our physical health. Now, our role is to remove barriers for students to find and create community. 

We know students need to feel that somebody cares about them. Every one of our staff members is dedicated to helping support our students’ journey. We are constantly evaluating how we are connecting with students and asking, how are we reaching out if there’s a situation on campus? How are we engaging them so that they can tell us what is working and what’s not working for them? They rightfully expect that.

We—Dartmouth and higher education as a whole—are assessing the types of engagement that are most beneficial and the ways that students communicate their needs. To lead in this area, we’re continuing our ongoing activities and engagement with students, while making sure we leverage our research expertise to influence some of the behavioral health engagement and opportunities across campus.

Q: You’ve been meeting with students extensively. Were you surprised by anything you learned?

A key component of this direct engagement is the proposition that students must have a voice at the table. One of the reasons my position was developed was to make sure Dartmouth has someone on the front lines who is working with students and focused on their wellness and their behavioral health. It’s important to listen and take time to understand where students are in their life journey and bring resources to help them meet their goals. 

To build communication and accountability between my office and the student body, I meet regularly with leaders of student organizations that have a focus on health and wellness. These include the Mental Health Union, Dartmouth Student Government, Access Dartmouth, which is a student group dedicated to disability advocacy, and the Nathan Smith Society, a student group that serves students interested in all health professions. These meetings have been insightful and have led to program changes, such as adding a 50-minute Uwill teletherapy option in addition to the 30-minute option. 

I’m also connecting with our graduate and professional students to learn more about their needs. When I met with the student leaders of Tuck’s Mental Health and Wellness Initiative during the fall term, they shared that first-year Tuck students needed access to services during winter break and other times when undergraduate students are not typically on campus. Now, we have taken steps to prepare the campus for first-year graduate students and offer counseling services closer to where graduate students attend classes. 

Our students are incredibly successful and have academic goals. This is where Dartmouth excels. At the same time, we also need to focus on other aspects of well-being and work to integrate healthy habits and supports into our culture. It will take time, but it can happen. 

Q: How does this relate to your past experience as a physician and public health official?

I’ve seen that kind of change in the medical profession. When hospitals started to place limits on the amount of time someone could spend on-call, some people said, “You’re going to miss a lot of learning opportunities,” as opposed to considering the quality of care we could deliver when we were better able to take care of ourselves. It took a while for that attitude to evolve, but we came to agree that just because we managed something one way in the past doesn’t mean it was the right way. 

My career and experience have prepared me for this moment. When I began treating patients in the emergency department, I found it very satisfying to see a patient, identify the issue, and treat the problem.

As I continued my practice, I found it frustrating to work within or work around a system that was not designed to support health and well-being. I could write a prescription, but my patient and their family may not have the resources to fill it. That is why I decided to also devote myself to the public health space. We need to address immediate needs while also looking ahead and building a system that supports and promotes healthy communities. 

Q: How does Commitment to Care figure into all of this?

Commitment to Care, our strategic plan for supporting student mental health and well-being, outlines many of the initiatives I’m putting into action. Part of this plan focuses on strengthening resources such as the Student Health Service, which provides counseling for nearly a quarter of our students.

In addition to in-person appointments at the Counseling Center, we have also offered teletherapy options since late 2022 through Uwill, a free and confidential teletherapy service. Uwill is available to all students, including students who are taking an off-term or are on leave. We’ve seen approximately 1,700 unique registrations for Uwill and over 7,000 completed counseling appointments.

The next part of the plan that I’m focusing on is the evaluation component. Our clinical care is solid, and in the coming years I will be focusing on prevention and how to evaluate what we’re doing. Along with talking to students, we’re also looking closely at data and surveys to help guide our decision-making.

Q: How can Dartmouth center well-being?

Commitment to Care addresses all eight dimensions of wellness: intellectual/academic, emotional, social, physical, occupational, financial, environmental, and spiritual. Each dimension impacts members of the Dartmouth community, and if one dimension is neglected, overall well-being will suffer. 

Traditionally, we excel in intellectual wellness and environmental wellness. We are a community of academic excellence and have robust programs such as the Outdoor Programs Office. There’s room to grow in other areas. I’m looking forward to building our spiritual wellness by amplifying the great work that is happening through the Tucker Center, for example. I’m also looking forward to partnering with Joe Catrino, our new executive director of the Center for Career Design, to build programs that support occupational wellness.

We’re also excited about the plans for the Kirsten and Eugene F. “Buddy” Teevens ’79 Center for Peak Performance, which will offer programs to maximize mental and physical performance for all students.

And it’s worth noting that while our $500 million investment in building new housing and revitalizing residence halls is reshaping parts of campus, it’s also an investment in the well-being of our students, faculty, and staff. 

Dartmouth has been fortunate to have the Student Health Service at Dick’s House and the Student Wellness Center in the heart of campus, and down the road I’m sure we’ll be looking at ways to enable those facilities to continue to provide the best possible care and services for students.

Whatever we can do to help prepare students for the rest of their lives in all dimensions of wellness is important and speaks to their overall well-being. That is what we owe ourselves and our community.