Bridging behavioral health and education: assessing the role of counselors in addressing high acute behavioral health symptoms in higher education

Higher education institution counselors are experiencing a significant transition. Their students are showing evidence of a higher service-need, both in terms of frequency and severity. Students are exhibiting more physical violence/aggression, sexual violence and coercion, and self-harm, including suicide. At the same time, these counseling centers are experiencing an increase in legal responsibility for their students’ behavioral health along with policy that limits coordination of care and the gathering of essential collateral information. Despite this increase in service-need, higher education institution counseling centers are providing less and less service, using budget-friendly models of therapy that provide less one-on-one psychotherapy. Collectively, this downsizing limits the ability for students with high acute behavioral health symptoms to manage their symptoms and impacts their relationships and their ability to function, including academically. Through the lens of systems theory, this qualitative study examines the narratives of six behavioral health clinicians practicing at higher education institutions, using a phenomenological approach. The participants’ stories can support findings that assist in developing ideas related to counseling practices and the relationships between counselor and student, counselor and leadership, and counseling department and the larger campus. Insights from the findings include a current view of the services provided to higher education institution students with high acute behavioral health symptoms and the potential gap in service to students experiencing a crisis or behavioral health episode. These insights led to the development of a model that may offer a fuller, more comprehensive view of higher education institution counseling practices.