Regina Ray’s commute to work as a mental health counselor at Virginia Tech is a three-minute walk.
Ray isn’t your typical campus therapist: she’s an embedded counselor in the university’s dorms. “Living around your customers” is a unique experience, she said. “Having to give that disclaimer has been really interesting, especially when I’m like, ‘Hey, by the way, we live on campus, so you can see us.'”
Hiring embedded advisors like Ray served a dual purpose for Virginia Tech. Administrators wanted to make it easier for students to access mental health services. They also wanted to ease the pressure on resident assistants, or RAs, to respond to the mental health crises of their peers. In recent years, RAs have increasingly dealt with the complex psychological issues of students late at night when other resources are not available, even if they lack professional training.
At Virginia Tech, the majority of the 10,000 students who live on campus are freshmen transitioning into college — a stressful time when mental health issues often surface.
In fall 2021, Virginia Tech revamped its residential life program to focus more closely on student welfare and to integrate other departments with student affairs, including the counseling center and learning programs alive. The revamp included reimagining the role of RAs as “student residential wellness leaders”. Instead of being assigned rooms in a dormitory, student leaders were organized into trios serving between 110 and 150 students.
The university also created the Integrated Counseling Program. Ray and three other professional mental health counselors started in the fall of 2022.
This is a huge support for RAs because they have a lot more easy resources to refer a resident to.
THE advisers live in one of their assigned dormitories and work in a central office in the residential part of campus. They offer walk-in counselling, crisis intervention, and short-term individual and group therapy after hours. And they serve as connective tissue at the Cook Counseling Center, where students can receive more services.
Embedded advisors have become more common over the past five years. A handful of institutions have created such positions in particular athletic departments and academic units, hoping to target support toward specific populations.
Using therapists to work in dormitories, as Virginia Tech has done, is a newer approach.
With onboard counselors, the university is expanding its “tool belt” of mental health services available to students, said Rebecca Caldwell, director of residential wellness.
“It’s a huge boost for RAs because they have so many more easy resources to refer a resident to,” Caldwell said. “If a student shows up at an RA, it’s 7:45 p.m. on a Tuesday night, and the student says, ‘I’m really struggling,’ the RA might say, ‘Hey, we have counselors here, just two buildings, which are here just to work with students in the halls of residence.
The “second shift”
As the integrated counseling office operates from 2pm to 11pm Monday to Thursday and 8am to 5pm Friday, many students show up after they have finished their course. Some come in pajamas, says Ray.
One of the goals of integrating therapists, Caldwell said, is to add a “second team” to the counseling center, which closes at 5 p.m.
“People hang on during the day and start shaking at the end of the day,” she said. “And all of a sudden they show up at the door of your counseling center at 4:55 p.m. residential custody and AR.
Late spring is a particularly stressful time for students, as they prepare for final exams and prepare to say goodbye to their friends for the summer. Bad grades, burnout and breakups dominate the workload.
At the end of an appointment, the counselor will ask the student what they are looking for in the future. Students can pursue one-on-one therapy through the Counseling Center or TimelyCare, a telehealth platform with which Virginia Tech has a contract, or they can seek off-campus care. There’s also the ability to stay on the built-in advisor workload, Ray said.
If the goal is to reduce the barrier to care, you want to make sure people are as accessible as possible.
On average, students are seen one to three times, said Ellie Sturgis, director of the Cook Counseling Center. Most appointments take place between 5 p.m. and 10 p.m.
The program has been well received so far: according to Sturgis, embedded counselors have seen 1,183 students this academic year. She said she was unable to determine from the center’s metrics how many were referrals and how many students were seeking services on their own.
Ray estimated that about 60% of students make appointments, while 40% show up. as possible to treatment.
Often students just want someone to talk to at all times, to listen to them and help them solve problems.
Kevin Shollenberger, vice provost for student health and welfare at Johns Hopkins University, said colleges that want to integrate counselors into dorms should first think about the role of the counselor and then communicate it clearly. to students.
In 2021, Hopkins embedded a counselor into its athletics center to support athletes and coaches. The university is also looking to place a counselor in its graduate school for hospitality hours.
“Personally, I’m more in favor of drop-in than providing the continuous therapy model, because otherwise…people will have a hard time getting appointments at some point,” Shollenberger said. “If the goal is to lower the barrier to care, you want to make sure people are as accessible as possible.”
RA and pandemic stress
In addition to essentially extending counseling center hours, embedded counselors play another key role: easing pressure on student RAs.
Historically, an RA’s primary role has been to create community in the dorm and connect students to campus resources, Shollenberger said.
“But with mental health issues on the rise nationally and on college campuses,” Shollenberger said, RAs “are finding themselves more on the frontlines and dealing with difficult mental health issues.”
During the pandemic, RAs also found themselves with an unexpected set of responsibilities: controlling how and where students congregated and the kinds of precautions they had to take. “We talk about community development as being central to their role and about them as a resource,” said Steve Herndon, assistant vice president for student life at Syracuse University. “That changed drastically,” he said, because RAs were supposed to enforce public health policies.
In this fiscal environment, at least one institution has recently decided to phase out ARs altogether. In 2021, george washington university replaced RAs with live-in staff to deal with crises in the dorms. The more mundane parts of the job – reception, move-in day, etc. – have been reassigned to students as part-time work.
Similarly, Virginia Tech does not want RAs to directly handle student mental health issues.
With counselors available in the residential area, it is quite easy for an RA to simply accompany a student instead of relying on them to call the counseling center the next day. “This student may not follow,” Shollenberger said. “Whereas here, the RAs have a better idea of the support and can make a more transparent transfer.”
Alex Sing, a residential wellness student leader at Virginia Tech, took advantage of the new integrated counseling program when one of his residents expressed mental health issues related to a poor grade. Sing filed an incident report and then scheduled an appointment to accompany the resident to the counselors office.
“We’re not certified therapists,” said Sing, a sophomore. “We are here to listen to the inhabitants… But in the end, it is not up to us to give them advice. This is where embedded advisors come in.
On-board counselors can also be a resource for RAs themselves, who may want to talk about roommate disputes or other issues down their halls. At Virginia Tech, there is a designated support group for student leaders, and counselors sometimes make rounds with student leaders.
“I see a lot of exhaustion in them because they’re so compassionate, they have so much to give everyone,” Ray said of ARs. “And then it’s like, ‘Hey, you gotta take care of yourself too.’ So it feels good to be able to pour into their cups as well.