Dear Alice!

I have a close friend who has a number of rather difficult issues. One of the most important is a long history of abuse (largely psychological) from her mother during her childhood. (She is now 19.) It is incredibly difficult to talk to her about any of these things. I would like her to see Psych Services, but I am worried about the fact that there are only a limited number of sessions available — that is actually one of the reasons she has offered to me as to why it would be a waste of time to go.

Unfortunately, the only medical coverage she has is through her mother's medical insurance, she has no real money outside of her parent's control — it would be extremely difficult for her to pay for counseling, in other words, without alerting her parents.

What the hell can she do? What can I do?

Dear Reader,

Although you see obstacles in the way of getting your friend help, you (and your friend) do have options. If your friend is a full-time student at Columbia, here's how it works.

Counseling and Psychological Services (CPS) is committed to meeting students' mental health needs by listening; helping them identify their issues and manage their stress, anxieties, and/or depression; providing information, perspective, and coping strategies; prescribing medication where needed; and, demonstrating support in a crisis situation. CPS's diverse staff of trained professionals also serves as a resource to students who have friends, roommates, partners, or family members in need of help. If you're a Columbia student, then you can make an appointment for yourself to explore ways to approach and support your friend.

CPS providers also assess approximately the amount of time that may be needed for a student and therapist to work together. While CPS is available for a certain number of visits, some students can be helped in a few sessions, while others benefit from a longer-term relationship with a therapist where trust can build over time. In this case, the CPS provider facilitates a transition to an off-campus therapist, who can see him or her over a longer period. If cost is a concern, you and/or your friend can talk with the CPS provider about low-cost counseling options.

Since all full-time students pay the University's Health Service Fee, they can see someone at CPS at no additional cost. The Health Service Fee also covers a certain number of off-campus mental health services for students. In order for this benefit to kick in, students need to be seen in CPS at least once to have an assessment and to receive a referral. An appointment or two with an on-campus provider can provide the necessary referral for your friend to see someone for a longer term, as well as ensure a smooth transition to an appropriate off-campus mental health care provider.

Columbia students can schedule an appointment to see a CPS provider by calling x4-2878 for a brief consultation. To offer your support, you could even go with your friend to CPS, to the waiting room, or even to the appointment.

Understandably, your friend wants her counseling records to be kept confidential. At Columbia, every health-related appointment a student has is kept confidential. A student's medical file is never shared with anyone, not even his/her parents, without explicit permission from that student. So whether your friend chooses on- or off-campus help, her mother need not know or find out about it, unless she chooses to tell her.

You also mentioned that your friend is covered by her mother's health insurance. Students are often already covered by a parent's health insurance plan. Your friend, then, has the option to pursue coverage under her mother's health insurance. In that case, however, her mother could, as the primary policyholder, be provided with information about the services being delivered to her daughter.

While this may seem frustrating, maybe if this insurance option ever becomes necessary, your friend would have worked with her therapist to prepare her for this discussion with her mother.

If you and/or your friend are students at another school, together you can find out about your college's or university's mental health services. This information can empower your friend to get the help she needs and deserves.


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