Mental Health Issues in DISability Services

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Mental Health Issues in DISability Services

• Beth Lesen, Ph.D. and Sarah Hahn, Ph.D.

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Students with Mental Health Issues in
Disabilities Work

• What are some of your challenges with working
  with this population?
• What issues plague you?
• What keeps you up at night?
• How and why do you feel you are succeeding with
  this population?

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What are the Issues of Mental Health in Higher
Ed?

• Suicide
• Homicide
• Crisis
• Classes missed due to emergency hospitalization
  (and resulting academic fall out)
• Retention
• Academic performance below potential

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What are the needs of Students with Mental Health
Disabilities (SMHD)

• Education/awareness/registration with SDS
  (outreach)
• Assistance with Treatment (finding, consistently
  utilizing, and communicating with outside
  treaters)
• Assistance with building networks of support
  (social , educational, professional, and links
  within).
• Counseling

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Outreach

• Education/awareness/registration with SDS
  (outreach)
• Tabling
• These students tend to think of themselves as non
  disabled (even if clearly diagnosed and
  medicated), have confidentiality concerns, and
  are skeptical of SDSs ability to assist.

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Assistance with Treatment

• Assistance with finding a therapist
• Encouragement in consistently utilizing treater.
• Assistance in communicating with outside
  treaters.
• If comfortable, with release, have SDS counselor
  in contact with outside treater.
• Assistance supplementing treater (psychiatrist
  AND psychologist, as necess)

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Assistance with building networks of support

• Social
• Educational
• Professional
• Links between!

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SDS Counseling of SMHD

• Includes but not limited to
• counseling, education, academic advising,
  information gathering, skills teaching, reality
  testing, time management assistance, and teaching
  appropriate help seeking behaviors, and wellness
  coaching (diet, exercise)

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Individualized level of Intrusive Advising

• Many students need personal connection to stay
  involved
• Others have disorders that verge on paranoia and
  need a light touch with intrusive advising.
• Balance is often decided based on diagnosis, GPA,
  quality of counselor/student relationship, risk
  assessment, and other supports.

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Accomodations

• For most of our other students, the accomodations
  are central to their success, and the support
  services are helpful to many
• For SMHD, we find that the accomodations are less
  central and the other ancillary support services
  become the most central to their success.
• Accomodations become sticky wicket and are often
  used as enticement.

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Many MH students require guidance in SDS
utilization frequency

• Underutilizers
• Overutilizers
• Erratic Utilizers

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Our Approach

• Contracting with an MHP
• We feel our approach successfully addresses the
  specific needs of students with mental health
  issues without being overly intrusive or turning
  the DS office into an outpatient mental health
  facility.
• This population is growing.

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What it is

• MHP provider in your office, working with your
  team
• Part time or full time
• Payroll or contrac
• Masters level, ABD, or Ph.D., School psych or
  LCSW , LMC
• License is ideal.

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Affordability

• Psychology casualty of managed care
• Part time
• Early career, restarting career
• Or try to work with mental health agency or
  school based support and they do their own
  billing. This is more challenging but it is
  possible.
• One licensed person can triple the hours via
  graduate students.
• Grant funding available for mental health issues

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Why the need

• There are secondary mental health issues which
  are undiagnosed, under diagnosed, or
  underreported in our disabled students population
• Clinical presence in outreach can help coax
  students with mental health disorders who are not
  presenting themselves at all.
• CYA

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Fit of MHP is Essential
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Old School Clinical Model limitations in Higher
Ed

• Lack of communication within school
• Fill up time with existing students
• Inspire dependency rather than teaching
  independence and appropriate help seeking
  behavior.
• Tend to dig deeper than is needed.
• Not trying to run an outpatient clinic.

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MHP

• Carry caseload
• Help build networks of support and link them
• Counsel
• Academically advise with respect to disability
• Outreach
• Workshop
• Teach appropriate help seeking behaviors.
• Intrusive advising, keep them connected
• Between semesters contact, advanced planning

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Bifurcated Goals

• General well being, keeping mental health and
  general functioning stable or improving.
• Academic success
• Sometimes these goals work in harmony and
  sometimes there is dissonance.

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Results

• This is first year that there has not been a
  crisis, hospitalization, decompensation.
• Mental health students have remained the same or
  improved.
• Two students took a semester off and came back
  instead of dropping out.
• Several students went from full courseload to
  part time.

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Questions

• Beth Lesen, Ph.D.
• blesen_at_ccny.cuny.edu
• Sarah Hahn
• shahn_at_ccny.cuny.edu