Delivering Effective College Mental Health Services This page intentionally left blank Delivering Effective College Mental Health Services L E E K E Y E S © 2019 Johns Hopkins University Press All rights reserved. Published 2019 Printed in the United States of America on acid-free paper 2 4 6 8 9 7 5 3 1 Johns Hopkins University Press 2715 North Charles Street Baltimore, Maryland 21218-4363 www.press.jhu.edu Library of Congress Cataloging-in-Publication Data Names: Keyes, Lee, author. Title: Delivering effective college mental health services / Lee Keyes. Description: Baltimore : Johns Hopkins University Press, 2019. | Includes bibliographical references and index. Identifiers: LCCN 2018036805 | ISBN 9781421428857 (hardcover : acid-free paper) | ISBN 9781421428864 (electronic) | ISBN 1421428857 (hardcover : acid-free paper) | ISBN 1421428865 (electronic) Subjects: LCSH: College students—Mental health services. Classification: LCC RC451.4.S7 K49 2019 | DDC 616.8900835—dc23 LC record available at https://lccn.loc.gov/2018036805 A catalog record for this book is available from the British Library. Special discounts are available for bulk purchases of this book. For more informa‑ tion, please contact Special Sales at 410‑516‑6936 or [email protected]. Johns Hopkins University Press uses environmentally friendly book materi- als, including recycled text paper that is composed of at least 30 percent post- consumer waste, whenever possible. With gratitude to Lisa, Halley, and Harrison, for their love and support, and to all my family, who taught me to question the prevailing narrative This page intentionally left blank Contents Acknowledgments ix Introduction 1 Chapter 1 5 Mental Health Paradigms and Service Models at Colleges Chapter 2 34 Developing an Accurate Picture of College Students Chapter 3 51 Developmental and Societal Factors Fueling the Clinical Picture Chapter 4 90 Orientation Mismatch and Young Adults’ Needs Chapter 5 133 Outreach and Consultative Work at College Counseling Centers Chapter 6 157 Paradigm Conflict in Delivering College Mental Health Conclusion 169 A Road Map for Success References 179 Index 187 This page intentionally left blank Acknowledgments Heartfelt and special thanks go to Paul Polychronis, David Wal- lace, and Jon Brunner, for their stimulating conversation and encouragement, and to the many courageous counseling center directors who supported and taught me through the years, often without knowing they were doing so. I also thank my colleagues and friends at the University of Alabama’s Counseling Center and Division of Student Life, who, as partners, worked alongside me as we strove to help students become who they are. Most important, I am grateful to the students who allowed me into their lives and in so doing taught me how to be a helper. Without them, everything I have ever done professionally would have been impossible. ix