I know many of us on CC have kids who are dealing with a range of mental / emotional health issues. My D has dealt with anxiety issues, and we will be want her to have support available when she makes the transition to college; access to a psychiatrist and counselor to cover all the bases.
The large, state university that we think she will be headed to has these services right on campus, which makes it very convenient. To me, that means she is more likely to use the services.
But I was just given the advice (by a fellow CC parent) to avoid using the on-campus services (at any school, not specifically this one) and to use off-campus services instead.
This parent cites a few concerns:
-The student’s fear that the school will know too much about the issues discussed (whether true or not…the fear of it could be a deterrent for accessing the help).
-Although the health care providers have obligations to the student, they also have obligations to the school which may affect how broadly they define a student being a danger to themselves or to others. (Could be an issue that truly affects the providers reaction (over-reaction?) to the student’s issues, or again, could just affect how much the student feels willing to share).
-The limited types of therapy that may be available.
-Mental health care at schools is generally designed for short term help and not long term support.
Access and convenience are not small matters. Over time, the inconvenience of getting to the healthcare provider can really become its own stressor. Privacy and confidentiality are also, imho, false alarms. Our experience has been that a thorough knowledge of the student’s life, back story, and current situations are invaluable and nobody can know that like on-campus services. ymmv, of course, not all schools do an equally good job. But I would start there. If she needs long-term care or different services, campus people may have the best referral system.
One of the things students with mental/emotional health issues need is strong advocacy and public support. The antiquated notion of shameful lurking, warding off any disclosures for fear of judgement needs to evolve to a more honest inclusion of people who struggle. So by having these conversations with your daughter —and CC – about what will be best for her, and teaching her to speak up and reach out for appropriate care, you are doing a great thing for all our kids. Thanks!
You probably need a subscription for the chronical article. It is about the realities campus counseling centers face re demand for services vs, availability. Simply put, due to increasing demand, many places will have to limit services to short term and emergency only. Think about it. Until recently, your health care provider probably had limits on psych services due to cost. How can a school, whose primary function is not health care, provide unlimited care to an ever increasing number of students who need it?
Having had a student use both, I’d go private rather than univeristy, unless there was no way for my student to get off campus. Since Virginia Tech, schools have been under enormous pressure to avoid “incidents” of any kind on campus (look how recent suicides have made the news). They are going to interpret threat to self or others more narrowly. And while sometimes, yes, a student needs to go home, sometimes the best thing for a student is to stay put.
I think all of those things are true. My school had a history of putting the school ahead of the student, and forcing students to take a medical leave of absence as a way of reducing liability, regardless of whether or not it was actually in the best interest of the student.
Most on-campus care is limited to a certain number of visits (my school’s was 10), so if you anticipate her needing longer-term care and support, it would probably be better to establish that long-term relationship right off the bat than to run out of on-campus visits and then have to find someone new
Interesting article @ordinarylives. (I could only read the 2nd one). It’s just sad and frightening. In that article thought, one of the students had a hard time with the school counseling services, but then things were better with that same school’s on-campus psychiatrist. In another example, it was an off-campus psychiatrist who notified the school (wrongly).
Please make your decision on a case by case (school by school) basis. Ideally, you and your daughter would request a a meeting at the Counseling Center and/or the Health Center (perhaps at summer orientation) to ask specific questions about staffing, staff credentials, accessibility, therapy orientation, etc.For example, are the therapists licensed for independent practice in that state?
I feel confident that most mental health practitioners take student confidentiality quite seriously.
One benefit of services on campus is that the clinician knows the resources and policies of the school and can trouble shoot as necessary. Another benefit is that there is concentrated expertise in issues that present in young adulthood.
Whether these benefits would impact your daughter’s specific case is an unknown.
If she is currently in treatment, she could ask (and give permission) for her clinician to contact the campus mental health service directly to seek advice as to whether her specific needs could be better addressed on or off campus.
Good point. I think I would have just assumed they were. It seems that maybe the best scenario would be independent offices that simply lease space from the University, so there would be no conflict of interest (real or perceived). I don’t know if that exists anywhere, but it seems to me it would make sense.
I mention “licensed for independent practice” because it means that they have the same credentials (education and and supervised experience) as solo or group practitioners in private practice. They are also subject to the same laws and ethical standards of behavior. Whereas I can understand your concerns about (real or perceived) conflict of interest, ethics would dictate that the interests of the individual client are paramount. Psychologists (including those on-campus) tend to be fiercely protective of clients’ rights.