Diagnosing the counseling center

Anorexia. Depression. Thoughts of suicide. Coping with rape, confusion and stress.

Students visit the counseling center for many reasons, each looking to talk to someone.

The University of Miami’s counseling center, which opened in 1946, has developed programs, such as Sexual Assault Response Team and Body Acceptance Resources & Education, to assist and monitor students.

Although the center has opened its doors to 449 students this semester, not all have received the help they were expecting.


After it became public that Virginia Tech student Seung-Hui Cho had been diagnosed with severe anxiety disorder before going on a shooting rampage, several universities looked into training faculty and administrators to monitor student behavior.

Although UM faculty members do not go through any formal training, Counseling Center Director Pamela Deroian, a licensed psychologist with a doctorate, said she encourages faculty members to notify her of “irregular student behavior.”

“Faculty have a different vantage point of what goes on with students,” said Deroian, who has been with the counseling center for 17 years and became director in June. “We’ve focused a lot on the English Department, specifically creative writing, and I’ve gotten calls from professors about several things to look into.”

Deroian noted that the counseling center has focused on other areas as well, including the law school.

While Deroian plans these programs and activities for groups of students through the counseling center, five other administrators on campus are involved with weekly assessments of individual students who may be at risk to themselves or others.

The Student Assessment Committee comprises Deroian, Dean of Students Ricardo Hall, Health Center Director Dr. Howard Anapol, University Ombudsperson Mariana Valdes-Fauli, Case Manager Nicole Abramson and Assistant General Counsel Judd Goldberg. Goldberg does not sit in on the meetings, Hall said, but he is aware of what is discussed because his role is to ensure that the committee is following the Health Insurance Portability and Accountability Act.

Although students are guaranteed privacy when they go to the counseling center, Hall noted there are exceptions to the Family Educational Rights and Privacy Act, a federal law that protects the privacy of students’ education records.

“The only way [the case manager and I] see files is if something has happened that places the student at risk,” Hall said, which refers to a section of FERPA about inspection of education records. “There are specific exceptions to FERPA that provide means for communication to allow other people to know if a student may be at harm.”

Students who visit the counseling center are required to consent in writing. Deroian said this is similar to any consent form signed at a regular practitioner’s office. Deroian said The Miami Hurricane was not allowed to see a copy, citing privacy issues.

Hall said most students know they are being discussed by the committee unless a case is called under review immediately such as within 24 hours of an incident.

Deroian said that the committee met for years prior to the Virginia Tech massacre, and the center has made no significant changes since then because the university “determined we were already doing a good job,” Deroian said.

Still, Deroian is in the process of writing policy guidelines for the Counseling Center because there currently are none. Some other universities, such as Tulane and Emory, use the Diagnostic and Statistical Manual of Mental Disorders as guidelines.

The good, bad and ugly

The university’s counseling center will be reviewed in February by an external group comprising counseling center directors from different parts of the country.

“I want to know the good, the bad and the ugly,” Deroian said.

Some students say there is some of all three, but Deroian cannot comment on any specific student cases because of the Health Insurance Portability and Accountability Act. Also, The Hurricane cannot gauge whether the following are isolated cases because these are only instances from four students out of hundreds who attend the counseling center yearly.

“I went to the counseling center last fall because I had some legal trouble, and some girlfriend trouble, and I was overwhelmed,” said a junior in the School of Communication, who asked not to be named because of the personal nature of his situation. “I was considering suicide, I was depressed and I was in tears when I went to the counseling center. They helped me immensely, and I can’t even describe where I would be right now if I hadn’t gone in there.”

Other students, 25 last year, have been committed to a hospital as a result of their situations. Such removals are done in accordance with the Baker Act, a Florida statute that allows for involuntary examination, and can be initiated by a mental health professional.

Although the Baker Act is unique to Florida, each state has its own mental health laws that call for involuntary commitment under specific circumstances.

One student, a junior who lives off-campus, said he was committed to Mercy Hospital for one night his freshman year in spring 2006. The student said he was no risk to himself and recalls saying he loved life while at the counseling center, but he thinks his disheveled appearance was the reason he was sent to the hospital.

The student, who asked that his name be withheld because he fears disciplinary recourse by the university, said he went to the Counseling Center because he was feeling “depersonalized” and was having conflicts with his religion and spirituality. After a couple hours at the counseling center, he said he was escorted to an ambulance by police officers and taken to the hospital. There he received multiple examinations, including a blood test and a CAT scan, which had to be paid for by his parents.

“He sought help by professionals, but they didn’t help,” said his mother, who went to the hospital that night to see her son. “Instead it cost us thousands of dollars, aggravation and maybe even humiliation for [student’s name]. I wish I hadn’t been reminded of this horrible incident. There was a huge lack of human warmth.”

Patricia A. Whitely, vice president for Student Affairs, said the university errs on the side of caution when using the Baker Act, especially after Virginia Tech.

“If my staff determines a student needs to be Baker Acted then that’s the decision they will make,” Whitely said, referring to using the Baker Act in general, not the student mentioned above.

Hall said fewer than five students have been withdrawn from the university by the committee this year.

“We’ve had severe depression, psychotic episodes in classrooms and other potential crises, but it’s not a great number,” he said.

Hall noted that students are often referred to a counseling center off-campus if their treatment requires long-term care.

“The counseling center, like most university counseling centers, isn’t set up for long-term care, but rather short-term crisis,” he said. “It’s not staffed or equipped to do [long-term]. The university recognizes the services it can provide, as well as our limitations.”

Senior Ben Brislawn, who was referred for off-campus counseling this year, said he was pleased with the counseling center, but thinks he shouldn’t have to pay for alternate therapy.

“I was a little surprised because I think that it should be a place that people can go to talk to somebody whether they have depression, anxiety or any mental issues,” Brislawn said. “I think you should be given access to services on campus if you seek them.”

Still, Deroian said students are never forced or penalized if they do not adhere to the counseling center’s recommendation to continue therapy off campus. She also noted that students are never turned away from the counseling center.

In contrast, one student, a rape victim, said that she was told to seek guidance off-campus during her second visit to the counseling center, or else her admission would be revoked.

“I felt like I was being victimized a second time,” said the student, a junior who had to pay about $2,000 for off-campus counseling. “Because our insurance would have to pay for treatment, I had to tell my parents, which I never would have done otherwise.”

As a matter of policy, The Miami Hurricane does not name rape victims.

Although university officials cannot comment on any specific student cases because of the Health Insurance Portability and Accountability Act, Hall said he is aware that some students will walk away from the counseling center unhappy.

“I know that sometimes we look like the bad guys,” Hall said. “But everything we do is in the best interest of the student.”

Karyn Meshbane may be contacted at k.meshbane@umiami.edu.

Counseling Center facts

Founded in 1946

Office Hours: 8:30 a.m. to 5:30 p.m.

Located in building 21-R in the apartment area

Pamela Derorian, the center’s director since June although she had been with the counseling center for 17 years, is the fourth director since the center’s creation. The previous director was Malcolm Kahn, who led the center for 16 years

The center has four licensed psychologists, one counselor who has a doctorate and is getting her license next year, one social worker, one post-doctorate counselor, three interns who are in their last year of a doctoral program in psychology and three practicum students

Counseling Center Facts

Though the counseling center has been on campus since 1946, it has not been accredited since the 1980s. Currently, the counseling center’s training program is certified by the American Psychological Association, and the university is seeking accreditation by the International Association of Counseling Services.

According to the Journal of Counseling and Development, six of UM’s nine sister schools were accredited in 2003. Also, the University of Florida, the University of North Florida, Florida International University, Florida A&M, Florida State University and the University of South Florida are all accredited.

“I’m surprised UM is not accredited,” said Chun-Chung Choi, the Outreach Coordinator for UF’s counseling center. “I thought they were very well established.”

According to the IACS 2006 National Survey of Counseling Center Directors:

41.7 percent of centers are supported by mandatory fees. 22.6 percent comes from student health fees, 16.6 percent from a student life fee, and only 2.5 percent of these fees are specifically identified as a counseling center fee.

On average, counseling centers saw 9 percent of enrolled students last year.

58 percent of schools offer psychiatric services on campus, and provide 22 psychiatric consultation hours per week on average.

Directors report that 40 percent of their clients have severe psychological problems, 8 percent have impairment so serious that they cannot remain in school, or can only do so with extensive psychological/psychiatric help, while 32 percent experience severe problems but can be treated successfully with available treatment modalities.

2,368 students were hospitalized for psychological reasons.

51 percent of centers participated in depression screening days. 10,430 students were screened and 2,735 were referred for counseling.

16.6 percent of centers participated in Anxiety Screening Days. 3,280 students were screened and 617 were referred for treatment.

6.8 percent of directors report that their administrative responsibilities often interfere with their counseling effectiveness

28 states share mental health records with the FBI: Alabama, Arkansas, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Iowa, Kansas, Kentucky, Maryland, Michigan, Missouri, North Carolina, New Hampshire, New York, Ohio, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Wisconsin, Wyoming

– FBI data compiled from from stateline.org, citing FBI