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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


  • 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.


  • 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 consultees description
On-Call Consultees: Description

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

Soc referral source contact transports n 136
SOC Referral Source, Contact& Transports (n = 136)

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 consultees description
External Consultees: Description

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