distressed & distressingstudents creating a safety net for high risk students elizabeth downing,...
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Distressed Distressed & &
DistressingDistressingStudentsStudentsCreating a Safety Net For High Risk Students
Elizabeth Downing, M.D.UCSB Medical Director
Burt Romotsky, L.C.S.W.Student Health Social Worker
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students
UCSB UCSB && Community Community Mental Health ResourcesMental Health Resources
Health EdCounselors
Alcohol &Drug Program
Student HealthServices/
Clinicians
Student HealthPsychiatry
Student HealthSocial Worker
Eating DisordersNutrition
Sexual HealthStress Management
Alcohol &
DrugCounseling
SBIR*
CASE*SAM*
TobaccoMarijuana
REST*
Urgent CareGeneral Medicine
DoctorsNurse PractitionersMental Health NP
SocialWorkIntern
Triage & ReferADHD Triage
Crisis InterventionCase Management
Distressed Student Protocol*
CASE – College Alcohol & Substance EducationSAM – Skills, Awareness & MotivationREST – Recovery Enhancement Success TrainingSBIR – Screening, Brief Intervention & ReferralDistressed Student Protocol – SW point of contactCoaching Program – support for ADHD/LD studentsHosford Clinic – campus sliding scale counselingPAC – Psychological Assessment ClinicCLAS – Campus Learning Assistance Services
Campus/Community ReferralsCampus/Community Referrals
CampusAcademic/
Support Services
CampusMental Health
Assessment/Treatment/
Community Mental Health Assessment/ Treatment
DSPCoaching Program*
CLAS*EOP
Academic ServicesCareer Services
Counseling ServicesHosford Clinic*
PAC*Women’s Center
Therapy ReferralsPsychological AssessmentSliding Scale Counseling
Psychiatry ReferralsCrisis/Psychiatric Hospitals
Pilot ProjectPilot Project
students
• Social Worker hired 11/2002 with ADA Advisory group and Student Health funds
• Campus Social Work role developed
• Brochures developed
• Education/Outreach to campus community
• Distressed Student Protocol committee
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Why a Social Why a Social Worker?Worker?
students
• Complicated and time-consuming student situations
• Multiple department contacts
• Single point of contact
• High risk students
• Early intervention
• Crisis intervention
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Student Health – Student Health – Next Exit?Next Exit?
students
Increasing number of
UC students are taking
psychotropic medication
(UC student Mental Health Committee, 2006)
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National Trends ofNational Trends ofDistressed Distressed StudentsStudents
students
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National Trends ofNational Trends ofDistressed Distressed StudentsStudents
students
• 85% of college counseling centers reported an increase in the number of students they treat for psychological problems
UC Davis, Counseling & Psychological Services, “Responding to Distressed or Distressing Students”.
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National Trends ofNational Trends ofDistressed Distressed StudentsStudents
students
• 62% of college students reported feeling hopeless, 44% said they felt so depressed they could barely function, 79% were very sad and 9% felt suicidal
American College Health Association-National College Health Assessment (ACHA-NCHA) Web Summary. Available at http://www.acha-ncha.org/data_highlights.html
hopelessdepressedsuicidalvery sad
62
9
79
2005-2006
44
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National Trends ofNational Trends ofDistressed Distressed StudentsStudents
students
• Top 10 physical and mental problems
American College Health Association-National College Health Assessment (ACHA-NCHA) Web Summary. Available at http://www.acha-ncha.org/data_highlights.html.2006.
2005-2006
118 12
8
46
47
13
1829
9
Back PainAllergySinus InfectionDepressionStrep ThroatEar InfectionAsthmaBronchitisAnxietySAD
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National Trends ofNational Trends ofDistressed Distressed StudentsStudents
students
• Suicide is the 3rd leading cause of death among 15-24 year olds and the 2nd leading cause of death among college students
• 44% of college students describe themselves as binge drinkers
• 13.3% of college women say they have been forced to have sex in a dating situation
UC Davis, Counseling & Psychological Services, “Responding to Distressed or Distressing Students”.
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Why are CollegeWhy are CollegeStudents Students
Distressed?Distressed?
students
Kadison, R. & DiGeronimo, T. (2004) “College of the Overwhelmed”.distressedistressedd
• Normal developmental issues• Pressure and competition: academic,
extracurricular, parental, racial & cultural
• Financial worries• Social fears• Feeling hopeless and helpless: depression, sleep
disorders, substance abuse, anxiety disorders, eating disorders, self-harm
The MillennialsThe Millennials
students
• Highly structured academic life
• High parental involvement
• High levels of individual attention
• Emphasis on performance
• Little experience with failure
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The MillennialsThe Millennials
students
• Increasing competition
• High admissions standards
• Limited coping resources
• Difficulty being average
• Helicopter parents
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Hovering Parents/Hovering Parents/Needy Students?Needy Students?
students
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Distressed StudentDistressed StudentTrends at UCSBTrends at UCSB
students
• Crisis cases have increased each year since 1991• Severity of cases have increased• Counseling Services provides assistance to
approximately 10% of the UCSB student population
• More students are referred to Student Health psychiatrists each year
• Concerns of distressed student affect academic performance to a significant degree
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Social Worker RoleSocial Worker Role
students
• Single point of contact• Psychosocial assessment• Case management of “at risk
students”• Crisis services• Safety net: collaboration with
clinicians, faculty, staff, hospitals
• ClosureSOCIAL WORK SERVICES ARE AVAILABLE SOCIAL WORK SERVICES ARE AVAILABLE
TO STUDENTS AT NO COSTTO STUDENTS AT NO COST
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Social Work Social Work StudentStudent
Referral IssuesReferral Issues
students
• Parental Concerns• Mental Health
Concerns• Triage• Financial Issues• Crisis Intervention
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Social Work Social Work StudentStudent
Referral IssuesReferral Issues
students
• Academic Concerns• Health Insurance• ER & Psychiatric
Hospitals• Withdrawal & Re-entry
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Coordinating Coordinating Resources & Resources & TreatmentTreatment
DistressedStudent
SocialWorker
CampusStudent HealthCounseling ServicesAlcohol & Drug ProgramOSLResource Center for Sexual & Gender DiversityEOPWomen’s CenterOffice of International Students & ScholarsDSPJudicial AffairsResidence HallsCampus Police & ParamedicsFinancial AssistanceAcademic AdvisorsFaculty & StaffCLAS
CommunityParentsPeers/roommatesTherapists – private insuranceHome community mental health treatmentMedical & psychiatric hospitalsCountry Mental Health TreatmentGovernment AssistanceChild CareRehabilitation ServicesHealth InsurancePharmacy Waiver ProgramsParamedicsPolice/SheriffEmergency Food & ShelterReligious Organizations
ADHD Treatment ADHD Treatment at Student at Student
HealthHealth
Established DiagnosisAnd no Suspected
Psychiatric Co-Morbid Conditions
SHS Primary Care MD
Established Diagnosisand Suspected Psychiatric
Co-Morbid Conditions
No Established Diagnosisand Suspected Psychiatric
Co-Morbid Conditions
SHS Psychiatry
CounselingServices
StudentSelf Referral
DisabledStudents Program
Hosford Clinic & Psychological Assessment
Center
Consult / Refer to SW Triages
Service Needs
Campus / Community Assessment & Treatment
Services
•Free ADHD / LD Screening•Psychological Assessments
•Hosford & PAC (see above)•Coaching Services•Counseling Services•Disabled Student Program•Campus Learning Assistance Services•Community Assessment /Treatment
Community Community CollaborationCollaboration
students
• Psychiatric Emergency/Hospital
• County Mental Health
• County Public Health
• County Social Services
• Social Security/State Disability
• State Department of Rehabilitation
• Therapists/Counseling Clinics
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Distressed Distressed Student Response Student Response
ProtocolProtocol
students
• Intervention guide• Referral identifiers: student behaviors
and/or reactions to these behaviors• Early intervention• Coordination of care• Campus resources• Referral procedures
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www.sa.ucsb.edu/distressedstudentsguide
Distressed Distressed Student Student
Response SystemResponse System Faculty/Staff Faculty/Staff
Roommates/Peers Roommates/Peers
Family Family
Judicial Affairs Judicial Affairs
Student Affairs Student Affairs
Housing Housing
Police Police
HospitalsHospitals
CounselingServices
SW Notified of Continued At
Risk Behaviors
Distressed StudentMeeting
Scheduled ASAP
Core Student Affairs Team Members and
impacted departments.
Student HealthUrgent CarePsychiatry
Social Worker
Intervention PlanParental Notification
Housing IssuesTreatment Issues
Campus OutreachCampus Outreach
students
• Provide “Referring Distressed Student” protocol training with representation from Student Affairs core team members
• Encourage early intervention
• Involve departmental representatives/liaisons regarding distressed student concerns
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Campus OutreachCampus Outreach
students
• Student brochure
• Web listings
• Parent newsletters
• Media coverage
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ConfidentialityConfidentiality
students
• HIPAA: Health Insurance Portability and Accountability Act
• FERPA: Family Educational Rights and Privacy Act
• Confidentiality exceptions: medical providers vs. staff/faculty
• Releases of information
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ChallengesChallenges
students
• Parental Notification• Outreach to Students• Treatment Compliance• Eviction from Housing• Health Insurance/Pharmacy Coverage/
Medi-Cal
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ChallengesChallenges
students
• Intensive Treatment Options
• Impact on campus community
• After-hours issues• Data collection
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ResourcesResources
students
• The Jed Foundation. (2006). Framework for developing institutional protocols for the acutely distressed or suicidal college student. New York, The Jed Foundation.
• The Jed Foundation. (2002) Safeguarding Your Students Against Suicide. New York, The Jed Foundation. www.jedfoundation.org
• Benton, S.A. and Benton S.L. (Eds.). (2006). College Student Mental Health: Effective Services and Strategies Across Campus. National Association of Student Personnel Administrators (NASPA), Inc.
• Kadison, R. and T. DiGeronomo (2004) College of the Overwhelmed, The Campus Mental Health Crisis and What to Do About It. San Francisco: Jossey-Bass.
• Martha Anne Kitzrow. (2003). The Mental Health Needs of Today’s College Students: Challenges and Recommendations, Vol. 41: No. 1, Article 9.
• Suicide Prevention Resource Center. (2004). Promoting Mental Health and Preventing Suicide in College and University Settings. Newton, MA: Education Development Center, Inc.
• University of California, Office of the President. (2006). Report of the University of California Student Mental Health Committee. University of California. www.ucop.edu/sas/studentaffairsandservices/SMHCommittee2006.pdf
•www.jedfoundation.org/framework.php
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More InformationMore Information
students
Elizabeth Downing, [email protected]
805-893-2251
Burt Romotsky, [email protected]
805-893-3380
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