NBC News: Battling Low Enrollment Through Retention

[marshwiggle]

I'm quite skeptical of universities trying to be social welfare conglomerates with adjunct departments of health and human services rather than focusing on their core mission.

In theory I agree, but again, when you, as the responsible adult in the room, run into a serious problem it is awfully good to have resources.  Having social welfare at your disposal is a better option than calling the police.

The point is not whether those services should be available to those that need them, but whether the institution should devote resources to duplicate services which are offered by other organizations who can do it better because they do it at a greater scale. Should campuses have their own fire departments? Should they have medical services including outpatient surgery? Should they have seniors residences for retired faculty?

The smaller the campus, the more ridiculous it becomes to set aside resources to provide a mediocre version of a service to a tiny number of students which could be better provided by an external agency which has the resources and infrastructure and mandate already.

I understand the point.

My point was that I actually had resources on campus during an emergency.  Literally.  It has happened twice in my time with two different students.  I am surprised there are not more stories like mine.  And I don't think it is a "tiny number of students" that need serious help.

Is it worth the expense when the core mission of so many schools are contracting, including my own?  I dunno.  But don't minimize the importance of campus mental health either.  These are serious matters dealing with students' lives, after all.

Most (at least larger) campuses have a health services (including EMT services in some cases), and their own police force, among many other services, because these are essential services to provide on campus for fast response times and accessibility to students. Mental health services are no different than other health services in this respect-- there should be parity between them.

If the goal is to have faster response than off-campus services, then this would pretty much require 24/7 staffing of campus mental health services, since hospitals and things like crisis lines in the community would typically provide those.

And the fast response times only matter to a subset of student mental health problems; issues like depression and anxiety which are chronic probably only occasionally reach crisis pitch requiring intervention within minutes. If the response doesn't have to be within minutes, unless a campus is in a small town or rural area there are probably community resources available 24/7 that can be accessed within the same day, and typically much sooner than that.

Given that the resources on campus will likely be much more limited than those in the community, the potential advantage of faster response has to be weighed against more complete service available elsewhere.

[Puget]

I'm quite skeptical of universities trying to be social welfare conglomerates with adjunct departments of health and human services rather than focusing on their core mission.

In theory I agree, but again, when you, as the responsible adult in the room, run into a serious problem it is awfully good to have resources.  Having social welfare at your disposal is a better option than calling the police.

The point is not whether those services should be available to those that need them, but whether the institution should devote resources to duplicate services which are offered by other organizations who can do it better because they do it at a greater scale. Should campuses have their own fire departments? Should they have medical services including outpatient surgery? Should they have seniors residences for retired faculty?

The smaller the campus, the more ridiculous it becomes to set aside resources to provide a mediocre version of a service to a tiny number of students which could be better provided by an external agency which has the resources and infrastructure and mandate already.

I understand the point.

My point was that I actually had resources on campus during an emergency.  Literally.  It has happened twice in my time with two different students.  I am surprised there are not more stories like mine.  And I don't think it is a "tiny number of students" that need serious help.

Is it worth the expense when the core mission of so many schools are contracting, including my own?  I dunno.  But don't minimize the importance of campus mental health either.  These are serious matters dealing with students' lives, after all.

Most (at least larger) campuses have a health services (including EMT services in some cases), and their own police force, among many other services, because these are essential services to provide on campus for fast response times and accessibility to students. Mental health services are no different than other health services in this respect-- there should be parity between them.

If the goal is to have faster response than off-campus services, then this would pretty much require 24/7 staffing of campus mental health services, since hospitals and things like crisis lines in the community would typically provide those.

And the fast response times only matter to a subset of student mental health problems; issues like depression and anxiety which are chronic probably only occasionally reach crisis pitch requiring intervention within minutes. If the response doesn't have to be within minutes, unless a campus is in a small town or rural area there are probably community resources available 24/7 that can be accessed within the same day, and typically much sooner than that.

Given that the resources on campus will likely be much more limited than those in the community, the potential advantage of faster response has to be weighed against more complete service available elsewhere.

You clearly missed the part of my response about easy access for students-- it isn't just about response times. But yes, we do have 24/7 response for mental health emergencies -- someone from the counseling center is on call, and there are of course also student life staff in residence. The bolded part of your response is simply false most places-- maybe you live someplace where there are an abundance of mental health services available in the community, but in most of the US, most therapists and psychiatrists (a) aren't taking new patients at all or have long wait times for an appointment, and (b) don't take most, or any, insurance. It also isn't always easy for students to get to, or fit in, off campus appointments.

College counseling centers aren't some new thing. And they are generally more, not less, complete than elsewhere, because it is integrated care in one place--e.g., we have staff psychiatrists who do the proscribing and actually meet and share charts with the therapists, unlike if they were seeing a psychiatrist (or GP) for medications and a therapist in private practice for therapy, which is the norm in the community. They will still be referred out if they need more intensive treatment than can be provided on campus, but that's the same as would happen if they were getting treatment off-campus. Really, mental health services in general would benefit from being run more like those on well-run campuses.

[Anon1787]

Universities with hospitals and medical schools make providing health services part of their core mission, but most colleges and universities don't. It is mission creep to say that universities should assume the responsibility of trying to fill the gap because community health services are overburdened. At the very least, health services offered by the university should be self-supporting (as my university requires for summer courses).

[Wahoo Redux]

I think this deserves a survey...

[jimbogumbo]

In theory I agree, but again, when you, as the responsible adult in the room, run into a serious problem it is awfully good to have resources.  Having social welfare at your disposal is a better option than calling the police.

The point is not whether those services should be available to those that need them, but whether the institution should devote resources to duplicate services which are offered by other organizations who can do it better because they do it at a greater scale. Should campuses have their own fire departments? Should they have medical services including outpatient surgery? Should they have seniors residences for retired faculty?

The smaller the campus, the more ridiculous it becomes to set aside resources to provide a mediocre version of a service to a tiny number of students which could be better provided by an external agency which has the resources and infrastructure and mandate already.
[/quote]

I understand the point.

My point was that I actually had resources on campus during an emergency.  Literally.  It has happened twice in my time with two different students.  I am surprised there are not more stories like mine.  And I don't think it is a "tiny number of students" that need serious help.

Is it worth the expense when the core mission of so many schools are contracting, including my own?  I dunno.  But don't minimize the importance of campus mental health either.  These are serious matters dealing with students' lives, after all.
[/quote]

Most (at least larger) campuses have a health services (including EMT services in some cases), and their own police force, among many other services, because these are essential services to provide on campus for fast response times and accessibility to students. Mental health services are no different than other health services in this respect-- there should be parity between them.
[/quote]

If the goal is to have faster response than off-campus services, then this would pretty much require 24/7 staffing of campus mental health services, since hospitals and things like crisis lines in the community would typically provide those.

And the fast response times only matter to a subset of student mental health problems; issues like depression and anxiety which are chronic probably only occasionally reach crisis pitch requiring intervention within minutes. If the response doesn't have to be within minutes, unless a campus is in a small town or rural area there are probably community resources available 24/7 that can be accessed within the same day, and typically much sooner than that.

Given that the resources on campus will likely be much more limited than those in the community, the potential advantage of faster response has to be weighed against more complete service available elsewhere.
[/quote]

You clearly missed the part of my response about easy access for students-- it isn't just about response times. But yes, we do have 24/7 response for mental health emergencies -- someone from the counseling center is on call, and there are of course also student life staff in residence. The bolded part of your response is simply false most places-- maybe you live someplace where there are an abundance of mental health services available in the community, but in most of the US, most therapists and psychiatrists (a) aren't taking new patients at all or have long wait times for an appointment, and (b) don't take most, or any, insurance. It also isn't always easy for students to get to, or fit in, off campus appointments.

College counseling centers aren't some new thing. And they are generally more, not less, complete than elsewhere, because it is integrated care in one place--e.g., we have staff psychiatrists who do the proscribing and actually meet and share charts with the therapists, unlike if they were seeing a psychiatrist (or GP) for medications and a therapist in private practice for therapy, which is the norm in the community. They will still be referred out if they need more intensive treatment than can be provided on campus, but that's the same as would happen if they were getting treatment off-campus. Really, mental health services in general would benefit from being run more like those on well-run campuses.
[/quote]

And this from the other thread. And , speaking as someone who's child would be dead if the 24/7 on call CRISIS counselor had not been available, this entire conversation makes me sick.

[mamselle]

We just crossed in the ether...I noted the convergence of discussions on the other thread, just now.

I'm very glad your child got the help they needed.

And that was the point of my post, for the two situations I dealt with.

It's like quibbling over how to get the jets across the Canadian border in WWII, so England could have them...

SAVING LIVES is the point, people.

M.

[mleok]

Given that the resources on campus will likely be much more limited than those in the community, the potential advantage of faster response has to be weighed against more complete service available elsewhere.

Let me try to make an analogy, imagine you're a small town, and there is a big city about 20 minutes away. Just because the big city has a hospital, does not mean that the small town shouldn't also have a GP.

[marshwiggle]

Given that the resources on campus will likely be much more limited than those in the community, the potential advantage of faster response has to be weighed against more complete service available elsewhere.

Let me try to make an analogy, imagine you're a small town, and there is a big city about 20 minutes away. Just because the big city has a hospital, does not mean that the small town shouldn't also have a GP.

Sure, that's reasonable. By that same analogy I'd say the rule of thumb would be that if you have a condition/injury that allows you  to  drive yourself (or be driven by someone else) for treatment, you'd be able to get it done in town. If you'd need an ambulance, you'd expect to go to the bigger town/city. So for mental health services, something for which a person couldn't be trusted to be safe going on their own  should probably be going to a bigger place with in-patient services. Campus mental health services should be aimed at situations where the person can come in on their own, and doesn't potentially need to stay for observation.

[jimbogumbo]

Given that the resources on campus will likely be much more limited than those in the community, the potential advantage of faster response has to be weighed against more complete service available elsewhere.

Let me try to make an analogy, imagine you're a small town, and there is a big city about 20 minutes away. Just because the big city has a hospital, does not mean that the small town shouldn't also have a GP.

Sure, that's reasonable. By that same analogy I'd say the rule of thumb would be that if you have a condition/injury that allows you  to  drive yourself (or be driven by someone else) for treatment, you'd be able to get it done in town. If you'd need an ambulance, you'd expect to go to the bigger town/city. So for mental health services, something for which a person couldn't be trusted to be safe going on their own  should probably be going to a bigger place with in-patient services. Campus mental health services should be aimed at situations where the person can come in on their own, and doesn't potentially need to stay for observation.

The bolded part is exactly what we provide with the 24-7 on call counselor. They do a quick assessment to see if (1)an emergency vehicle-campus police should be engaged or (2) they themselves need to escort the person to a facility we have contracted with to provide emergency services. I honestly thought that was understood.

[marshwiggle]

Given that the resources on campus will likely be much more limited than those in the community, the potential advantage of faster response has to be weighed against more complete service available elsewhere.

Let me try to make an analogy, imagine you're a small town, and there is a big city about 20 minutes away. Just because the big city has a hospital, does not mean that the small town shouldn't also have a GP.

Sure, that's reasonable. By that same analogy I'd say the rule of thumb would be that if you have a condition/injury that allows you  to  drive yourself (or be driven by someone else) for treatment, you'd be able to get it done in town. If you'd need an ambulance, you'd expect to go to the bigger town/city. So for mental health services, something for which a person couldn't be trusted to be safe going on their own  should probably be going to a bigger place with in-patient services. Campus mental health services should be aimed at situations where the person can come in on their own, and doesn't potentially need to stay for observation.

The bolded part is exactly what we provide with the 24-7 on call counselor. They do a quick assessment to see if (1)an emergency vehicle-campus police should be engaged or (2) they themselves need to escort the person to a facility we have contracted with to provide emergency services. I honestly thought that was understood.

Given that 6 people, (22% of respondents) on the poll in the other thread picked "Maybe...kind'a...but do we need a full-fledged facility?", I'm guessing I'm not the only one unsure of what advocates expect will be provided in-house.