distressed & distressingstudents creating a safety net for high risk students elizabeth downing,...

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

distressedistressedd

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


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


Student Health – Student Health – Next Exit?Next Exit?

students

Increasing number of

UC students are taking

psychotropic medication

(UC student Mental Health Committee, 2006)


National Trends ofNational Trends ofDistressed Distressed StudentsStudents

students



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”.



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



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



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”.


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


The MillennialsThe Millennials

students

• Increasing competition

• High admissions standards

• Limited coping resources

• Difficulty being average

• Helicopter parents


Hovering Parents/Hovering Parents/Needy Students?Needy Students?

students


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


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


Social Work Social Work StudentStudent

Referral IssuesReferral Issues

students

• Parental Concerns• Mental Health

Concerns• Triage• Financial Issues• Crisis Intervention


Social Work Social Work StudentStudent

Referral IssuesReferral Issues

students

• Academic Concerns• Health Insurance• ER & Psychiatric

Hospitals• Withdrawal & Re-entry


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


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


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


Campus OutreachCampus Outreach

students

• Student brochure

• Web listings

• Parent newsletters

• Media coverage


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


ChallengesChallenges

students

• Parental Notification• Outreach to Students• Treatment Compliance• Eviction from Housing• Health Insurance/Pharmacy Coverage/

Medi-Cal


ChallengesChallenges

students

• Intensive Treatment Options

• Impact on campus community

• After-hours issues• Data collection


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


More InformationMore Information

students

Elizabeth Downing, [email protected]

805-893-2251

Burt Romotsky, [email protected]

805-893-3380


mailto:[email protected]

mailto:[email protected]

distressed & distressingstudents creating a safety net for high risk students elizabeth downing,...

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