Low-Income African-American Caregivers' Experiences of Being Referred to Mental Health Services by the School Counselor: Implications for Best Practices
Tucker, Catherine PhD, Professional School Counseling
Referring students for mental health care is a core job function for school counselors, and one that is often stressful for all parties involved. In this phenomenological study, six low-income African-American caregivers were interviewed about their experiences of having a son or grandson referred for mental health care by the school counselor. Issues of how the participants viewed the school, mental health care, and the process of being referred were explored. Key findings include the caregivers' experiences of alienation in the face of a rigid system for parent involvement in educational decision making, caregivers' perceived lack of power, and caregivers' lack of understanding of school administrative processes. Recommendations for school counseling practice are given, along with suggestions for school counselor education.
Referring children who are experiencing behavioral problems at school to mental health care providers is a key aspect of the professional school counselor's job (Baker, 1996; Erford, 2003; Ritchie & Partin, 1994). The referral process is often highly charged emotionally for all stakeholders (Arcia, Fernandez, Marisela, Castillo, & Ruiz, 2004; French, Reardon, & Smith, 2003). These referrals can be the turning point for a student accessing needed resources (Bussing, Zima, Gary, & Garvan, 2003). Students who are in need of mental health care and are not receiving it are not likely to perform well academically, and they may be disruptive to the learning environment for others (Arcia et al.; Bussing et al.; Chow, Jaffee, & Snowden, 2003). The research on the process that low-income families experience between initial referral for and entry into mental health services suggests that there is often a long delay between the two (Arcia et al.; Bussing et al.; Chow et al.; French et al.; Huang et al., 2005; McKay, Lynn, & Bannon, 2005). During this delay, children's problems often worsen, and parents feel overwhelmed and frustrated by the time they reach a clinic (Arcia et al.).
In the diverse landscape of American public schools, counselors interact with students and families from many races, cultures, and classes. Counseling programs accredited by the Council for the Accreditation of Counseling and Related Educational Programs (CACREP) provide training regarding issues of multiculturalism, which is defined as the "diversity of racial, ethnic, and cultural heritage, including issues of socioeconomic status, family structure, age, gender, sexual orientation, religious and spiritual beliefs, profession or career, and physical and mental abilities present in a nation's population" (CACREP, 2001). Referral practices are covered in most school counseling texts, but not with specific information regarding all of the layers of multicultural issues outlined by CACREP. Priester et al. (2008) recently surveyed 64 syllabi from master's level multicultural counseling courses and discovered wide disparities between courses in terms of both content and skill development. Additionally, Priester et al. found that "for many European-American counseling trainees, multicultural training seems to be about 'those people over there' and does not necessitate any new skill development" (p. 35). These findings clearly point to the need for an examination of content and methods employed by counselor educators in teaching about multicultural issues. In the current article, the intersecting issues of race, class, and referral making are examined, with recommendations for school counselor practice and education.
SCHOOL COUNSELORS' REFERRAL PRACTICES
School counselors' job descriptions have long included referral of students to outside service providers for a large array of health and social service needs (Baker, 1996; Brown & Trusty, 2005; Erford, 2003). School counselors are key figures in the referral of children to mental health care facilities (Baker; Ritchie & Partin, 1994). …