Multicultural, feminist, and social justice counseling theories are often viewed as disparate helping models. This article examines the complementary nature of these models and discusses the need to promote a clearer understanding of the ways in which these common threads can be used in counseling practice.

Objective COVID-19 is an international public health crisis, putting substantial burden on medical centers and increasing the psychological toll on health care workers (HCW). Methods This paper describes CopeColumbia, a peer support program developed by faculty in a large Urban Medical Center's Department of Psychiatry to support emotional well-being and enhance the professional resilience of HCW. Results Grounded in evidence-based clinical practice and research, peer support was offered in three formats: groups, individual sessions, and town halls. Also, psychoeducational resources were centralized on a website. A Facilitator's Guide informed group and individual work by including: (1) emotional themes likely to arise (e.g., stress, anxiety, trauma, grief, and anger) and (2) suggested facilitator responses and interventions, drawing upon evidence-based principles from peer support, stress and coping models, and problem-solving, cognitive behavioral, and acceptance and commitment therapies. Feedback from group sessions was overwhelmingly positive. Approximately 1/3 of individual sessions led to treatment referrals. Conclusions Lessons learned include: (1) there is likely an ongoing need for both well-being programs and linkages to mental health services for HCW, (2) the workforce with proper support, will emerge emotionally resilient, and (3) organizational support for programs like CopeColumbia is critical for sustainability.

Objective The epidemiology of psychiatric symptoms among COVID-19 patients is poorly characterized. This paper seeks to identify the prevalence of anxiety, depression, and acute stress disorder among hospitalized patients with COVID-19. Methods Adult patients recently admitted to non-ICU medical ward settings with COVID-19 were eligible for enrollment. Enrolled patients were screened for depression, anxiety, and delirium. Subsequently, patients were followed by phone after two weeks and re-screened for depression, anxiety, and acute stress disorder symptoms. Subjects’ medical records were abstracted for clinical data. Results 58 subjects were enrolled of whom 44 completed the study. Initially, 36% of subjects had elevated anxiety symptoms and 29% elevated depression symptoms. At two-week follow-up, 9% had elevated anxiety symptoms, 20% elevated depression symptoms, and 25% mild-to-moderate acute stress disorder symptoms. Discharge to home was not associated with improvement in psychiatric symptoms. Conclusion A significant number of patients hospitalized with COVID-19 experience symptoms of depression and anxiety. While anxiety improves following index admission, depression remains fairly stable. Furthermore, a significant minority of patients experience acute stress disorder symptoms, though these are largely mild-to-moderate.

The treatment of severe mental illness has undergone a paradigm shift over the last 50 years, away from a primary emphasis on hospital-based care and toward community-based care. Some of the forces driving this deinstitutionalization have been scientific and patient-centered, such as better differentiation between acute and subacute risk, innovations in outpatient and crisis care (assertive community treatment programs, dialectical behavioral therapy, treatment-oriented psychiatric emergency services), gradually improving psychopharmacology, and an increased appreciation of the negative effect of coercive hospitalization, except when risk is very high. On the other hand, some of the forces have been less focused on patient needs: budget-driven cuts in public hospital beds divorced from population-based need; managed care’s profit-driven impact on private psychiatric hospitals and outpatient services; and purported patient-centered approaches promoting non-hospital care that may under-recognize that some extremely ill patients need years of painstaking effort to make a community transition.The result has been a reconfiguration of the country’s mental health system that, at times, leaves large numbers of people without adequate mental health and substance abuse services. Often their only option is to seek care in medical emergency departments (ED) that have not been designed for the needs of mentally ill patients. Increasingly, many of those individuals end up waiting in EDs for appropriate care and disposition for hours or days. This overflow phenomenon has become so prevalent that it has been given a name: “boarding.” This practice is almost certainly detrimental to patients and staff, and it has spawned efforts on multiple fronts to understand and resolve it. When considering solutions, both ED-focused and systemwide considerations must be explored. This resource document provides an overview and recommendations regarding this complex topic.

This study analyzed data from the 2012 Student Experience in the Research University (SERU) survey, collected from undergraduate students at 9 universities. Researchers explored how demographic and behavioral variables related to avoidance of psychological help when needed. A total of 7,992 SERU participants responded to target items included in the present study. We examined whether student characteristics and behaviors differed between 3 self-report groups: (1) students who indicated they did not need counseling services; (2) students who reported needing counseling services, but not using them; and (3) students who reported using counseling services at least once during the 2012 academic year. Students who reported needing, but not using, counseling services were significantly different from the other 2 groups in that they were more likely to be female, Hispanic, endorse financial difficulties, and work longer hours while attending school. The 3 groups did not differ in understanding others with observable disabilities. Implications for college counselors and student affairs personnel are discussed. (PsycINFO Database Record