In March of 2014, the University tragically lost a member of its community to a drug overdose. Juliette Richard was a bright and well-liked 19-year old freshman from eastern Massachusetts with a strong aptitude for biology. Her death is still deeply felt at the University and was a loss that shined a light on the need to enhance resources and support for students who have a drug or alcohol addiction.
The University undertook a thorough, two-year review of its policies and procedures in the areas of counseling and mental health, drug and alcohol abuse prevention, and addiction treatment. Based on these results, as well as on student ideas for improvement heard this past year at Town Hall meetings, the University has implemented several changes and enhancements to its services to help ensure that University students needing clinical support can get it easily, effectively and promptly.
“A high priority as a University is keeping our students healthy and safe,” said University President Joel Seligman. “There are a lot of treatable conditions and illnesses, including anxiety, depression and substance addiction that when left untreated can become debilitating. We want to make sure that struggling students have appropriate care readily available to them so that they may cope and recover.
“The Richard family has been enormously valuable in helping the University work through these important changes, which are being made to help prevent another heartbreaking loss of a student and in remembrance of Juliette,” said Seligman.
Jim and Kathy Richard, Juliette’s parents, in response to the University’s efforts stated:
“Juliette’s death is a tragedy that our family and her friends live with every day. Juliette was engaging, compassionate and quick to make friends. We have heard many stories from students at the University of Rochester and at home about her kindness and willingness to help others. We were so proud of her many accomplishments and hopeful for her future. We appreciate the efforts the University has made in response to Juliette’s experience to improve their counseling center and policies regarding drug and alcohol abuse. We urge anyone who is abusing drugs or alcohol to seek help from their families, friends and medical/mental health professionals.”
Among the changes that have been implemented are:
EXPANDED CASE MANAGEMENT FUNCTION AT UNIVERSITY COUNSELING CENTER
An additional University Counseling Center (UCC) case manager was hired in October 2015 to dedicate more time to follow-ups on appointment referrals for students needing outside treatment services. All UCC case managers have important discussions with students on insurance coverage for referrals, as well as assist them with issues of transportation to and from appointments, but this position focuses on ensuring that successful connections at off-campus specialists are being made and continue.
For student transportation to referral offices that are difficult to access via public transportation, financial assistance and other resources from the University are now possible.
In addition to the case manager staffing increase, UCC has instituted new guidelines for phone call follow-up to students once referrals are given. If a student states at the outset that he or she does not wish to pursue the referral, case managers consult with the appropriate UCC staff to decide the appropriate course of action.
An additional full-time psychologist is also expected to be added this fall to meet the increasing demand for counseling services.
EXPANDED COVERAGE AND STAFFING FOR ALCOHOL AND DRUG TREATMENT
A second counselor with drug and alcohol addiction training (AOD) has joined UCC; a third counselor is in the process of additional AOD training. These counselors with specialty AOD training are available for consultation, supervision and referral assistance as needed.
UCC’s policy will remain that students presenting with severe drug or alcohol addiction will be referred to outside specialists. Even if referral is the appropriate action, consideration will be given to linking a student with an addiction to a drug and alcohol specialist within UCC who can facilitate the student’s transition for more intensive treatment.
For students with an emergent problem of drug or alcohol abuse, additional specialists in this area will help ensure that early counseling intervention occurs to reduce the likelihood of the escalation of the abuse problem. In addition, UCC now gives an Alcohol Use Disorders Identification Test (AUDIT) to every student who comes in. The AUDIT is a 10-item screening tool developed by the World Health Organization to assess alcohol consumption, drinking behaviors, and alcohol-related problems.
SUPERVISOR REVIEW POLICY
It is standard practice for the professionals who supervise post-doctoral counselors to provide weekly oversight and sign off on at least the initial visit notes and the terminal visit notes. Starting August 1, 2015, the UCC supervisors have continued to provide weekly oversight, but also sign off on all visit notes of all trainees and post-doctoral counselors.
UCC’s requirements for trainee clinical supervision exceed those of New York State, but this will be “belt and suspenders” assurance that the supervisor is well informed about the content of the sessions by the supervisee.
EXPANSION OF UCC COVERAGE BEYOND WORKDAY HOURS
Additional UCC staff time has been made available during the evening hours so that more students can see a counselor on River Campus. UCC hours have been expanded at Eastman School of Music and the Medical Center due to increased student demand for mental health services. Emergency health services continue to be available 24/7.
UCC is piloting an online counseling program called TAO—Therapy Assisted Online. It was developed at the University of Florida and is a seven- to 14-week therapist-assisted online program that helps students with anxiety or depression and who wish to use a computer-based training module with therapist assistance. This provides students 24/7 access to tools and allows students to schedule secure video-conference sessions with a therapist to monitor progress and facilitate change.
Group therapy sessions have been expanded to give students access to more counseling options. UCC worked with Strong Recovery to start a recovery group called “Choices” that utilizes a harm-reduction model.
CARE NETWORK RESOURCES
Administered through the Dean’s Office, the CARE Network enables members of the University community to express their concern about a person, incident, or issue by submitting an online CARE report.
Traditionally the CARE Network has focused on undergraduate students, but another staff member has recently been added to build a stronger program for outreach to graduate students.
Student CARE Ambassadors were introduced in the fall to help peer-to-peer education on the value of the CARE network and its related amnesty policy.
MORE EDUCATIONAL RESOURCES TOWARD PREVENTION
Alcohol and drug education training for University students, administrators and resident advisers (RAs) is expanding. Members of the Student Support Network and student groups will be given additional resources on drug use and its warning signs. The Student Support Network is made up of professionals from several campus offices and departments who meet regularly to identify students and issues that may need attention, support, or other intervention.
RA training will be updated and enhanced with greater information on drug use prevention, and health education communications will be disseminated to students.
The Dean of Students Office has also added a new position for a person to work with students who have exhibited high-risk drug and/or alcohol use behaviors. The position will conduct the BASICS (Brief Alcohol Screening and Intervention for College Students) program and connect students with resources that may assist them in reducing the risk of harm from substance abuse.
PARENTAL NOTIFICATION
In addition to the implemented changes in policy and services, the University is also evaluating the policy on parental contact and when it should be made when it comes to actions or incidents that are potentially detrimental to a student’s well-being.
The biggest issue with parent notification continues to be the deterring impact it has on students willing to report substance or mental health issues to administrative or health care personnel. The overall objective is to come up with a list of factors that should be considered in each case to help make a determination as to whether to contact parents. In the end, notifying parents continues to be a judgment call that balances the status of the student as an adult, the seriousness of the issue, the purported relationship of the student with his or her parents and the impact of any parental disclosure on student willingness to report to Dean’s Office personnel.
