Introduction to the Special Section-Severe and Persistent Mental Illness on College Campuses: Considerations for Service Provision

Abstract

This collection of articles represents the second time that the Journal of College Counseling (JCC) has published a special section of articles based on a topical theme. The first collection, appearing in the spring 2004 issue of JCC, focused on nontraditional students. The topic of severe and persistent mental illness on college campuses was selected for our second special section theme because recent research has indicated that the severity and prevalence of mental illness on college campuses have increased over the past several decades. Furthermore, students with severe and persistent mental illness present unique needs and therapeutic issues to the college counseling setting. In recent years, there has been a reported increase in the number of students presenting with chronic mental illness, suicidal and other self-injurious behaviors, personality disorders, and sexual assault and early traumatic experiences. Not only are these stressful for the individual student, they also cause disruption to the living and learning environments to which that student belongs. Faculty, staff, and other students often are unprepared to interact with these students. Nonetheless, counseling center staffs have been challenged to adapt traditional ways of working with students to meet the needs and address the therapeutic issues of these students. In the past, counseling center staff described much of their clinical work as developmental in nature. Many counselors saw their role as facilitating students through the developmental tasks encountered in late adolescence and early adulthood. Increased psychopathology of their clients challenges counselors to rethink their developmental models and their methods of service delivery. In addition, as counseling center staffs are confronted with increased severity of problems in the students, budgetary supports remain at the same or lower levels, and staff sizes are held stable or have decreased. It is clear that creative approaches are needed to address these concerns. In the 1990s, counseling centers responded in a variety of ways. Many moved to time-limited sessions, referring to off-campus agencies and practitioners when the session limits were reached. Others moved to a fee-for-service model or the implementation of student insurance. Special offices or staffs were created to deal with issues such as substance abuse, learning disabilities, and sexual assault. More recently, disability services have been created for students with psychiatric disabilities. In some institutions, student judiciaries have become involved with students with mental illness who become disruptive. …