The Urgent Care Model is a mental health treatment delivery system that primarily focuses on college campuses. There is a broad trend internationally for college students seeking help for mental health concerns in record numbers. This has taxed nearly all university counseling centers, and has created the need for a re-imagining of mental health care on campus.
Generally, the Urgent Care Model suggests that the previous versions of university counseling center systems, most of which are based on primary care clinics (advanced scheduling, thorough assessment, assumption of continuous care, etc) are no longer meeting student needs. These models are also based on Eurocentric (and often male) assumptions of what mental health care should look like, and that they do not match the current level of diversity at universities.
Given that, the Urgent Care Model proposes that university counseling centers should focus on providing same-day access to care for as many students as possible, utilizing concise counseling sessions (25-30 minutes) as the default “dose” (sessions length), taking an immediate treatment orientation (offering clinically meaningful help from the first session), and a range of flexible follow up options that involves the entire campus community. This should be provided in a culturally-informed clinical context.
Same Day Access
One of the most common complaints about university counseling centers is that the wait is too long to get help. Same day access is a method of providing faster care where the wait is hours rather than weeks. Some ways this has been implemented are providing entire weeks where all clinical staff are only providing same day scheduled sessions, and building in same day access for all levels of needs each day (not just for urgent situations).
Concise Counseling Sessions
When considering psychotherapy as a dose, most university counseling centers have every student receive the maximum dose of care (a 20 minute “triage”, followed by a 50-minute intake, and then weekly or biweekly 50-minute psychotherapy sessions). The Urgent Care Model assumes that a majority of students can be served just as well with an immediate (next section) smaller dose of treatment. When the concise session dose is shown to be ineffective at meeting the client’s clinical goals after a few meetings, clinicians can titrate amount of care to more traditional 45-50 minute sessions. We are also actively involved in outcome research on these types of sessions.
Immediate Treatment / Goal-Focused Counseling
The first meeting (or 2) at most university counseling centers is primarily focused on assessment. A triage session is a shorter interview designed to get students to the right type of next step. Often that is a longer intake interview that focuses on history and the broader context of the client’s presenting concern. The next session is usually where more of the focus is on the client’s clinical goals. In the Urgent Care Model, the first session is focused on providing something “clinically meaningful” to the client, and only assesses enough to help with the immediate concerns and any safety issues. Intake interviews are generally not conducted, and clinicians gather relevant information as they go.
Flexible Follow Up Options
The Urgent Care Model looks to create as many unique pathways through the counseling center as possible. Some centers many only be able to offer a smaller range (concise or traditional follow ups, urgent sessions, same day scheduled, or group), whereas others may have a wider range of options. The main philosophy is to allow students to create a unique path (choose your own adventure) through the clinic in a way that meets their individual needs for care.
I have a larger slide deck that is regularly updated that I am happy to share that includes outcomes at our university, more context for each element, and a large implementation FAQ. Contact me here if you are interested and I will happily send you the latest version ([email protected]).