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Counselors As Mental Health Consultants. Sharon Mitchell, Jessalyn Klein, & Brad Linn University at Buffalo Counseling Services. Introductions. Introduce presenters & context. Learning Objectives. Understand types of mental health consultation taking place on a college campus
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Counselors As Mental Health Consultants Sharon Mitchell, Jessalyn Klein, & Brad Linn University at Buffalo Counseling Services
Introductions • Introduce presenters & context
Learning Objectives • Understand types of mental health consultation taking place on a college campus • Name most common concerns consultees bring to counseling centers • Obtain recommendations for more effective consultations
Roles and Function of College Counseling Centers • Counseling (individual, group, couples, family) • Prevention & education • Training • Mental Health Consultation (growing role)
Mental Health Consultation Assumptions Consultation is: • a problem solving & educational process • dyadic or triadic • voluntary • collaborative • temporary • focused on mental health problems Adapted from Michael Dougherty (2009)
Assumptions cont’d. Consultation: • helps both Consultee & Person of Concern (POC) • is a relationship in which Consultant has no control over Consultee’sactions • is a situation where Consultant may/may not have direct contact with POC • entails working with Consulteeto enhance Consultee’s effectiveness in assisting POC
Venues for Consultation on a College Campus • After hours On-Call Crisis Intervention • Students of Concern (SOC)/Behavioral Intervention/Threat Assessment Team • External Consultations: Phone, e-mail, or face-to-face contact with concerned others (family, friends, faculty, staff)
How Was On-Call Service Used? • Total number of calls: 58 • Total number of consultees: 41 people* • Average call length: 28 minutes, range 8-125 minutes • Most consultees were students seeking assistance for him/herself (76%) • 24% were others consulting about a student
Typical On-Call Consultee Typical POC was a Caucasian, heterosexual, undergraduate (male or female) who reported high level of general distress and was already a client at the counseling center
On-Call: Interventions • Coaching (95%) • Contracting for safety • Short-term coping skills or problem-solving • How to talk to someone you are concerned about • Referred to Counseling Services (93%) • Sent for hospital evaluation (7%) • Referred to community services (2%) • Other points of contact • 27% Students of Concern • 44% External Consultations
On-Call: Case Examples • “My father is annoying me by calling all the time” • “Holding on to distress all weekend”
Students of Concern Committee • Representatives: University Police, Judicial Affairs, Residence Life, Health Services, Counseling Services, others as needed • Meets weekly • Hospital transports for alcohol or mental health • Role of Counseling Services Rep
Typical Student of Concern The typical SOC is a Caucasian, undergraduate, male who is not a client at the counseling center. He was referred to the committee by campus police or faculty/staff because of concern about his suicidal thoughts or behavior.
Students of Concern: Interventions* • Student support coordinator 66% • Counselor notified 38% • Referred to counseling 17% • Judicial hearing 14% • Police follow-up 13% • Counseling Services outreach 8% • Mandated evaluation 6% • Referred off-campus 3% • Referred to Health Services 2%
Students of Concern: Case Example “Victim of Home Invasion“ “Significant Disruption in the Apartments”
External Consultations: Overview • Emails, calls, or in-person consultations with counseling staff during business hours • 283 unique cases; 553 total consultations • 36% had multiple consultations • Only 1 student consulted about him/herself • 24% were discussed at SOC meeting • 5% had at least one On-Call Contact
External Consultations: Interventions • Referred to Counseling Services 70% • Coaching 24% • Related to hospital evaluation 10% • Referred off campus 9% • Police assistance requested 4%
External Consultations: Case Examples • “She was behaving very erratically” • “My son has a history of anxiety and depression”
A Special Case: No-Name Consultations • Note used when POC was not a student OR when student name was not shared • 59 No-Name notes for 55 people
No-Name Consultations: Interventions • 62% of consultees referred to off-campus providers • 18% of SOCs referred to Counseling Services • Only 9% of consultees were coached
Summary Thoughts on Data • The following varied based on type of consultation: • POC status • Consultee status • Problem type • Intervention implemented • Consultation is: • time-consuming • Total of 916 consultation contacts • Requires case management tasks • Requires thorough documentation • Augments AND takes time from direct clinical services • A pathway to counseling • An Environmental Management Approach
Recommendations for Effective Consultations: Consultees • Provide a student name & ID# or D.O.B • Be willing to be a part of the solution & the plan • Seek to understand limitations of the consultation
Recommendations for Effective Consultations: Consultants • Benefits/necessity of having student names • Ask for a call-back number or e-mail • Follow up with an e-mail • Be firm, direct, & honest. • Discuss why confidentiality is not always possible • Do risk assessment • Validate consultee’s feelings & fears
Recommendations for Consultants Cont’d • Assume the role of coach • Be “the Calm in the Storm” – debrief later • Provide developmental context • Discuss limit setting & self care • Have policies that support consultation • Have strong partnerships • Provide education to stakeholders PRIOR to a mental health emergency
Recommendations for Consultants Cont’d • Staff training in consultation & crisis intervention • TRUST that counselors want to minimize risk to individuals AND the campus community
