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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

Counselors As Mental Health Consultants

Sharon Mitchell, Jessalyn Klein, & Brad Linn

University at Buffalo

Counseling Services

introductions
Introductions
  • Introduce presenters & context
learning objectives
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
Roles and Function of College Counseling Centers
  • Counseling (individual, group, couples, family)
  • Prevention & education
  • Training
  • Mental Health Consultation (growing role)
mental health consultation assumptions
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
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
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
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 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
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
On-Call: Case Examples
  • “My father is annoying me by calling all the time”
  • “Holding on to distress all weekend”
students of concern committee
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
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
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
Students of Concern: Case Example

“Victim of Home Invasion“

“Significant Disruption in the Apartments”

external consultations overview
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
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
External Consultations: Case Examples
  • “She was behaving very erratically”
  • “My son has a history of anxiety and depression”
a special case no name consultations
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
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
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
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
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
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 d1
Recommendations for Consultants Cont’d
  • Staff training in consultation & crisis intervention
  • TRUST that counselors want to minimize risk to individuals AND the campus community
ad