To address students’ mental health needs, school counselors and other school-based student support staff can connect youth and their families to resources in the community. You can also take steps to help increase the likelihood referrals will be successful.
Developing Referral Lists
In developing a referral list of community-based mental health professionals, include a provider’s capacity to treat clients with particular presenting problems, ability to work with multicultural populations and comfort with languages other than English. Note logistical factors, such as a provider’s hours, location and accessibility by public transportation, affordability and accepted insurance plans.
Ideally, such lists are updated fairly often. You may want to visit agencies or speak with providers by phone to gain a sense of their approaches or take a field trip during a professional development day.
Serving as a Bridge
Even with a referral list of qualified and well-matched community practitioners, making a successful referral can still be challenging. To increase ties among students, families and community-based providers, invite local mental health providers to parent workshops, school-based family events and select classroom lessons focusing on mental-health-related topics.
For example, as part of a school’s focus on wellness, community-based professionals could offer strategies to de-stress and discuss warning signs of when students may need more support. These more informal introductions help the school-based staff become a bridge connecting families and students to outside agencies. Community providers are often invested in such activities if it can increase their referrals and decrease their no-show rates.
School counselors can also help to connect students and families to services by addressing common barriers and concerns. Try to create an open dialogue that allows families to feel heard and engages them in a process of mutual problem solving, recognizing their strengths. Authors McKay and Gopalan and colleagues have written about many of the barriers and strategies highlighted here.
Provide students a developmentally appropriate explanation of the reasons a student might be referred to outside mental health services. Understanding the student’s and family’s feelings and concerns about accessing mental health services is important, as is assessing whether outside mental health services (as opposed to other supports) are the best match for the family.
Address common concerns and questions: Does the student have fears about being labeled “crazy” or being singled out? Does the family feel blamed by the school or a previous provider? What are the family’s opinions about medication? What are the family and student hoping for in an outside practitioner? How does the parent or guardian view the child’s functioning? Are there concerns about privacy? By listening to and addressing the family’s unique needs, concerns and questions, you’ll be more likely to provide a successful referral.
If parents want help addressing practical barriers, include the family and student, when appropriate, as much as possible in the process so they can more independently access resources in the future. For example, with the parents’ permission, you might make the initial phone contact to an outside provider while the parents are in the room.
Following Up
Once you’ve made a referral, particularly with more severe cases, be sure to follow up. To share information with an outside provider, you’ll need consent to exchange information. You can also connect directly with families or students to check on progress of referrals. If you have significant concerns about a student even after an outside referral, consider the nature of the outside services and whether other supports might be warranted. When students are transitioning back from an out-of-school mental health setting, it is particularly important that school counselors and/or related school staff connect with the student, family and outside providers to make a transition plan for the student’s return to school. When students are receiving regular counseling both inside and outside of school, it is important that school staff and the provider connect.
Systems such as checklists and standardized approaches can assist the referral and follow-up processes. A school checklist of steps for referral processes, required documents (such as releases of information), strategies for record-keeping of contacts and most frequently asked questions can make the process more efficient for all involved. Checklists can also help teachers and school counselors efficiently share information about student progress with outside providers. Schools can invite outside mental health practitioners to key meetings (when permissions are in place) to maintain meaningful connections between providers. Other school staff may be able to help in the referral process: perhaps a student support team member can take the role of managing outside partnerships and connecting with providers about students’ progress.
Connecting with the School-Based Team
When assisting families and students who have greater mental health needs, remember to work as a team with other school staff in connecting students and families to resources. School psychologists, school social workers, other school counselors and student support team members can help identify potential referral sources, connect students and families to resources, support follow-up and support one another’s work with students. Nurturing your school-based connections with school-based colleagues is important for supporting both students and staff.
Jacqueline Zeller, Ph.D., is with the Harvard Graduate School of Education’s Prevention Science and Practice/CAS in Counseling Program. She can be reached at zellerja@gse.harvard.edu. Contact the author for references for this article.