risk student has been identified? Who takes the lead role? What
action do you take if you determine that a student represents a
danger to the campus community? What are the procedures for
involuntary hospitalizations? Under what circumstances will
you contact or notify parents? When and how do you involve
campus police? How do you follow up with students after a
crisis? This list is not exhaustive, but it is a good start. A great
resource for both SSAOs and counseling center directors is the
Framework for Developing Institutional Protocols for the
Acutely Distressed or Suicidal College Student by The JED
Foundation ( http://www.jedfoundation.org/framework.php).
If your university has not already developed a comprehensive
set of protocols for assisting students in crisis, formalizing
those protocols must become a priority.
Get Comfortable with Confidentiality
Confidentiality can be a bitter pill to swallow for many
SSAOs who are used to being in the know on issues involving
students. Keep in mind that counseling center directors, at
times, find themselves in the awkward positions of being ethically and legally bound to withhold student information from
their vice presidents. Living with confidentiality can be frustrating and stressful for both parties.
An important first step for SSAOs is to recognize the
significance of confidentiality. A patient’s right to privacy and
a mental health provider’s responsibility to maintain confidentiality is firmly rooted in state and federal laws and
professional ethics for good reason. An assurance of confidentiality is understandably essential in a student’s decision
to seek help at a counseling center. One can imagine the
chilling effect that the weakening of privacy could have on
campuses. The ability of counseling center staff to enhance
student’s academic functioning, decrease potential disruptions, positively impact retention, and maintain a safe campus would be negatively impacted if personal information
was freely shared. A very powerful incentive for counseling
center directors to protect confidentiality is that they are the
individuals who are usually sued or who lose their licenses
when confidentiality is breached.
Confidentiality in not absolute, and this is often a source
of confusion. The numerous exceptions to privacy that are
found in FERPA (Family Educational Rights and Privacy Act),
HIPAA (Health Insurance Portability and Accountability Act),
and state laws can be contradictory. Just because FERPA or
HIPAA may allow an exception to confidentiality does not guarantee that state law will recognize that exception. Confidentiality
statutes differ greatly from state to state. An innovative approach
to addressing confidentiality as part of an at-risk student
protocol used at a university in one state may not be feasible
in another state depending on the language in state privacy
regulations. The inconsistencies across state regulations may
perplex the savviest SSAO. However, an SSAO must remember that there is an individual on staff with a strong working
knowledge of confidentiality—the counseling center director.
Wise SSAOs have learned to ask hypothetical questions that
don’t require a director to break confidentiality. “How do you
typically treat a student with a severe eating disorder?” is much
easier for a counseling center director to answer than “What is
the counseling center doing to help student X?” Again, written
protocols provide a roadmap for SSAOs to understand the
process for treating students in distress, and they can minimize
the temptation to ask questions that violate confidentiality.
Establish a Sense of Mutual Appreciation
A productive working relationship depends on how effectively
SSAOs and counseling center directors understand the unique
responsibilities and abilities of one another. Each individual
brings strengths and weaknesses into the working relationship.
Appreciation develops over time when each party comes to
value the contributions made by the other in reaching a shared
goal: providing the best services possible for students.
For SSAOs, start forging that relationship by communicating the responsibilities and challenges you face. Counseling
center directors, especially individuals new to the position,
may not fully understand the SSAO role. Help them understand the big picture on campus, including the political
realities that all SSAOs must manage. I still remember my
surprise years ago when I began to understand the magnitude
of demands that my vice president faced from the president,
university regents, parents, and staff. This understanding
helped me to better serve and support my SSAO on a professional and personal level.
It also is important for SSAOs to understand the unique
challenges faced by counseling center directors, including
greater numbers of students seeking counseling with more
severe problems than in the past; pressure for more information sharing from parents, SSAOs, and other campus officials;
balancing the needs and rights of the individual (treatment,
support, and confidentiality) with those of the campus
community (minimizing disruptions, risk management,
and safety); greater concerns about liability and litigation;
increasing requests for consultation from faculty members
who are increasingly sensitized to possible signs of mental
health problems; the difficulty of finding community referrals
for students requiring long-term treatment; and staff burnout.
This onslaught of demands comes at a time of zero growth or
shrinking budgets for many directors.
A Challenging Time
Clearly this is a challenging time to serve as a university
or college counseling center director. It is also true that the
work of counseling centers is more important than ever
to ensure success for new generations of college students.
Counseling center directors need advocacy from their SSAOs
at the highest level to make student mental health needs pri-
orities on today’s campuses.
Jamie Davidson is the assistant vice president for student wellness &
student affairs technology and a licensed psychologist at the University of
Nevada, Las Vegas.