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Confidentiality Preserved at GW

June 22, 2006

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Officials at George Washington University confirmed Wednesday that the institution has abandoned a controversial plan that would have required students seeking help at the University Counseling Center to sign a waiver in order to receive treatment. The waiver, which had been mulled for months by administrators, lawyers and counseling center officials, would have allowed information discussed during sessions with students to be shared with administrators.

“At the moment we have no plans to make changes to the waiver system currently in use,” said Tracy Schario, a spokeswoman for the university. “Pros and cons were weighed, and officials ultimately determined that the process isn’t broken.”

Currently, when students seek treatment, they are asked to fill out paperwork that conforms to widely accepted ethical and legal standards, including a consent for treatment form. As is customary at college counseling centers nationwide, students are assured of confidentiality unless they reveal information that suggests that they may harm themselves or others.

Since the plan first came to light in December, mountains of criticism have been heaped on the institution. Many mental health professionals and legal experts said that the waiver would stigmatize students who seek care, discouraging many of them from seeking help, and might conflict with confidentiality guidelines traditionally associated with psychological and psychiatric treatment.  

“It was a wise move to dump it,” Richard Kadison, the chief of mental health services at Harvard University, said upon learning about the tabled plan. “It’s not really informed consent to have a generic form.” If Harvard administrators were to ask him to help adopt such a policy, he said he wouldn’t agree to it and does not believe it would be legal or ethical.

Kadison said that many administrators have felt “pressured” to enact policies that would protect their liability in the event that a student with a mental disorder were to harm himself or others.

Schario acknowledged that the ongoing Jordan Nott case against the university did play a role in the consideration of the proposal. The former GW student claims he was forced to leave the institution and threatened with criminal prosecution after he sought help for depression at the university’s counseling center. The university's lawyers have defended the removal and suggested that Nott’s conduct could have barred his recovery if he remained at GW. 

“It would be disingenuous to say that it was not part of the conversation,” said Schario. “But we have been looking into our policies since before the lawsuit. Once the lawsuit hit, it certainly made us take a look at our procedures.”

Karen Bower, a lawyer for the Bazelon Center for Mental Health, who represents Nott, was perplexed at why his case would have had the institution thinking about making its rules stricter. The point that the lawsuit is making, she said, is that there should be a greater measure of protection between counseling services and administrators.

“I think they overreacted,” said Bower. “Policies should help all students succeed, not punish them for seeking treatment.” Court documents filed in the Nott case indicate that the university responded with disciplinary action by barring the student from the institution after he sought treatment for depression.

“If schools don’t trust the evaluations of the mental health system,” added Bower, “then they should help focus on fixing the system." She said that more community-based services and mental health awareness programs would be helpful for many students.

Jaquie Resnick, director of the Counseling Center at the University of Florida, said that she, too, was pleased to hear that GW had scrapped the waiver idea. “I think it’s important to protect a student’s confidentiality to the degree that’s allowed under the law,” she said. “I think it was presented maybe with the best interests of the students in mind, but ended up being way too blanket, trying to do too much.

“I’m not aware of anyone who has spoken out in favor of it,” added Resnick. “The pendulum tends to swing on these issues, and it was an extreme reaction.”

Kadison believes that many institutions are focusing too heavily on liability issues, which may be leading students to feel stigmatized if they seek treatment. “Each situation has to be looked at separately,” he said. “You cannot break privacy except in very dire circumstances.”

Kadison believes that in “99.9 percent of situations” a student who poses potential harm to himself or others can be spoken to and convinced to leave the institution for a period of time in the course of treatment. “You cannot create monolithic policies,” he added. “It just won’t work.”

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Comments on Confidentiality Preserved at GW

  • When Students Go "Postal"
  • Posted by Craig C , political pundit at http://blogresponder.blogspot.com on June 22, 2006 at 9:50am EDT
  • So when the kid seeking counseling goes berserk and kills several people on campus, then the school gets sued. Wow, everybody wins, or at least the lawyers do.

  • Protections are in place
  • Posted by Rachel on June 22, 2006 at 10:45am EDT
  • Craig, the ethical and professional guidelines of the counseling profession have taken into account the student at risk for "going postal". If a student is a threat to himself or others, counselors are required by law and by our code of ethics to intervene. This is in the standard waiver mentioned in the article.

    Walking into the counseling center is scary enough without adding the undue burden of worrying about where personal information will be shared. The vast majority of students are seeking counseling for situations that are personal & confidential but not dangerous. Let's keep counseling centers a welcoming place for these students so they may succeed personally and academically.

  • You're Absolutely Right, Craig
  • Posted by AC on June 22, 2006 at 12:05pm EDT
  • Hey, someone has to win in a capitalist society. That's why we should all just quit our jobs as educators and become lawyers.

  • Dangerous Stuff
  • Posted by Ira Socol at Michigan State University on June 22, 2006 at 2:55pm EDT
  • University counseling centers that violate confidentiality are dangerous places. The students most in need of help will not go to them, and may thus not seek treatment at all.

    A few basic rules for Campus Counseling Centers:
    (a) Keep professional confidences.
    (b) Avoid very public waiting rooms (I've seen - and worked on - campuses with huge windows looking from public corridors onto students waiting to see mental health professionals).
    (c) Never use student staff for your waiting area or records handling. This alone is a huge violation of privacy. Students need to be certain that coming for help is not a public event on campus.

  • No Choice
  • Posted by mike , Unfortunately on June 22, 2006 at 5:15pm EDT
  • Universities have no choice in this matter - especially in the case of the small, private college! One whopping lawsuit can hurt the institution for decades. Students should be required to waive their right to sue before stepping into a counselors office.
    As it stands now, institutions may be held liable for the conduct of a student. If a student committs suicide, the parents can sue the school (and possibly win). Those who provide treatment have little protection on a college campus.

  • If that is true
  • Posted by Ira Socol at Michigan State University on June 22, 2006 at 9:00pm EDT
  • Mike,

    If that is true, then please, the college should not operate a counseling center. If it cannot abide by professional rules or function in a professional manner it should not pretend to be a mental health facility of any kind. Perhaps a college that feels as you suggest can contract with outside agencies to provide these types of services, or simply admit, up-front, that these services are not available to students.

    Getting someone competent to do the job, or not doing it at all, is preferable to doing it badly.