Reaching The Ones That Won’t Walk-in: A Community Based Service Approach to Students in Need...
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Transcript of Reaching The Ones That Won’t Walk-in: A Community Based Service Approach to Students in Need...
Reaching The Ones That Reaching The Ones That Won’t Walk-in: A Community Won’t Walk-in: A Community Based Service Approach to Based Service Approach to
Students in NeedStudents in Need
Gregory T. Eells, Ph.D. Cornell University
Mahnaz Mousavi, Ph.D.Georgetown University School of
Foreign ServiceDoha, Qatar
OutlineI. IntroductionII. Relevant DataII. Philosophical FrameworkIII. Description of Community Based Services at Cornell
IV. Application in QatarV. CasesVI. Conclusion
IntroductionThe Virginia Tech tragedy has brought considerable attention to college counseling services.Questions have been raised about mental health care and college students who might “fall through the cracks.”Raising questions of how we continue to extend The Colorado Cube of Morrill, Hurst, and Oetting into today’s counseling center
IntroductionWe are all more challenged by the need for consultation and support among the network of faculty and staff on our campuses.There are a significant proportion of students in distress who are not receiving services.The majority of students who kill themselves never receive counseling services Gallagher (2005)
Relevant Data In past year:
“so depressed it was difficult to function”
Cornell: 44% seriously contemplated suicide
Cornell: 11%attempted suicide
Cornell: 1.3% (~175 undergraduates)
2006 National College Health Assessment (NCHA) 1902 Cornell undergraduates responding
In last 12 months, was unable to function academically for at least a week due to depression, stress, or anxiety:
White: 37%Asian-American: 50%URM*: 54%International: 51%
*URM = underrepresented minority2005 Enrolled Students Survey
4790 undergraduates; 37% response rate
In last 12 months, seriously considered attempting suicide:
White: 6%URM*: 8%Asian-American: 10%International: 10%
In last 12 months, attempted suicide:White: .04%URM*: 1.9%Asian-American: 2.5%International: 2.9%
*URM= underrepresented minority2005 Enrolled Students Survey
4790 undergraduates; 37% response rate
CAPS Utilization Rates
0
5
10
15
20
25
30
2000 2001 2002 2003 2004 2005 2006
% u
tili
zin
g C
AP
S
African-American Hispanic
American Indian Student Body
CAPS Utilization Rates
0
2
4
6
8
10
12
14
2000 2001 2002 2003 2004 2005 2006
% u
tiliz
ing
CA
PS
Asian-American International Student Body
Asian and Asian-American students: >50% of completed suicides
Philosophical Framework engagementbuild relationships before counselingreach students in alternative waysnot bound by the traditional counselor role and setting don't wait for students to come to us
Philosophical FrameworkAddress problems where they occurMental health concerns do not just originate “in the students’ heads,” but also in the systems and communities in which they live.Therefore, environmental interventions are essential
Philosophical FrameworkOperate from a social justice multicultural frameworkThe narrative around mental health is increasingly told by the pharmaceutical industry that says all mental illness is brain disease-defective.In reality this narrative is a small part of the story
Philosophical FrameworkThese organic explanations of every form of
mental problem-including crime and delinquency, alcohol and drug addiction, and all forms of child and adult distress-make social change unnecessary. If underpaid workers, exploited and undervalued women, uneducated minorities, the unemployed, the aged, all have high rates of mental disorders, alcoholism, drug addiction, and crime these pathologies are due to defective biology/chemistry. They are not the fault of the system say the ruling elite.
George W. AlbeePast President, APA
Philosophical FrameworkRealize that traditional mental health services are outside of the “Meaning making sentence” of many groups.Culture involves both an internal and external experience and is the space that cross cuts all of our work. Our goal is to open up these spaces:Through asking difficult questionsThrough assessing the impact of crossing bordersThrough approaching justice by understanding that human life is more malleable than we understand
Community-Based Services
Clinic-Based Services
Counseling and Psychological Services (CAPS)
What is Community-Based Services (CBS)?
The outreach arm of Counseling and Psychological Services (CAPS) at GannettAn effort to support students who don't usually come to counselingAn attempt to overcome stigma, cultural barriers & institutional barriers
THE CBS Program at Cornell
Presentations, trainings & orientations"Let's Talk" offsite walk-in hoursInformal discussion groupsCommunity Consultation and Intervention (CCI)
Presentations, Trainings and Orientations
Presentations, Trainings and Orientations
opportunity to meet students outside of counseling contextreduce barriers to seeking helpinform students about mental health issues and resources
Pre-Freshman Summer Program
all seven colleges90 minute interactive presentation on survival skills for Cornellintroduction to CAPS and related resources
Let’s Talk
Let's Talk daily walk-in availability nine sitesfreedirect referrals from trusted members of the student's communitymeeting outside of the health center, often within the student's community
Let’s Talk
“consultation and support”informal, friendly formatfocus on immediate problem solving, resources, and advocacyoption for anonymous visitreferral to CAPS if necessary
Let’s Talk Utilization55% are students of color or international students Vs. 32% of CAPS clients
Informal Discussion Groups
Community Consultation and Intervention
(CCI)
CCI Components• Student-centered consultation• Direct intervention• Program-centered consultation
Student-Centered Consultation
Consultation with faculty and staff regarding students in distress
Student has already been unsuccessfully referred to counseling, or the issue is predominantly environmental (e.g., financial problems), not intrapsychic
Advise staff on providing informal counseling when necessary
Behind the scenes case management and advocacy
Periodic follow-up to monitor student’s situation
Direct Intervention Relationship with staff member
sometimes helps facilitate referral Service defined as “student support” Focus is on immediate problem-solving,
support, advocacy, and case management First contact often outside of counselor’s
office Sometimes evolves into counseling
relationship, sometimes not
Program-Centered Consultation
Specific cases highlight systemic problems creating student distress
Program centered consultation evolves from cases
Consultations often lead to training Issues surfaced by multiple cases lead
to policy changes Program-centered consultation and
training leads to more student-centered consultation and direct intervention
Application in Qatar
Cases
DirectionsCollecting data and quantifying the rich qualitative data that already existsChallenges of systematizing and institutionalizing the workMore general clinicians doing CBS workTelling the story about the work
Conclusion