Your Campus Counseling Center Referred You Out. Now What?

By Amanda Blassl, MSN, APRN, FNP-C, PMHNP-C

You finally worked up the courage to go to your campus counseling center. You filled out the forms, sat through an intake, and talked about what has been going on. Then, instead of scheduling your next session, they handed you a list of outside providers and said you would be better served elsewhere.

If you felt confused, disappointed, or even rejected, that is completely understandable. But a referral is not a judgment about you or a sign that your problems are "too much." It is usually about what the counseling center is set up to provide. Here is what it means and how to take the next step.

Why counseling centers refer students out

College counseling centers do valuable work, but most are designed for short-term support. Common reasons for a referral include:

•        Session limits: many centers offer a set number of sessions per semester or year

•        Long-term care needs: ongoing conditions, such as ADHD, bipolar disorder, OCD, eating concerns, or long-standing trauma, may need more continuous care than the center can provide

•        Medication management: many counseling centers do not have a psychiatric prescriber, or have very limited availability

•        Specialized treatment: some concerns benefit from a specialist or a specific type of therapy

•        High demand: centers may simply not have enough staff to see everyone as often as they need

Being referred out often means they want you to get more than they can offer.

Step 1: Figure out what kind of care you need

It helps to know the difference between providers:

•        Therapists and counselors (such as licensed professional counselors, social workers, and psychologists) provide talk therapy

•        Psychiatric prescribers (such as psychiatric nurse practitioners and psychiatrists) evaluate, diagnose, and manage medication, and many also provide brief therapy

•        Primary care providers can sometimes manage common conditions and help with referrals

Many students do best with both a therapist and a prescriber. Ask the counseling center which they think you need. Our post, Understanding the Key Differences Between PMHNPs and Psychiatrists, explains those roles.

Step 2: Check your insurance

Before you start calling, gather:

•        Your insurance card, which may be a parent's plan or a student health plan

•        The member services phone number on the back of the card

Ask your insurer for in-network mental health providers in the state where your school is located. If you are on a parent's plan from another state, ask whether out-of-state providers are covered.

If you are on a parent's insurance and privacy is a concern, ask the insurer how explanation of benefits statements are sent.

Step 3: Remember the location rule

Mental health providers must be licensed in the state where you are physically located during your appointment. That matters if your home and school are in different states. A provider in your home state may not be able to see you by telehealth while you are on campus. Look for providers licensed where you will be for most of the year.

Step 4: Use telehealth to widen your options

Telehealth can open up providers across your state, not just in your college town. That can mean shorter waits, more appointment times, and more privacy, since you are not seen in a waiting room your classmates might use. You will need a private space, such as a reserved study room, a parked car, or your room when roommates are out.

Step 5: Make the calls (or the emails)

Calling providers can feel overwhelming, especially with anxiety. Try:

•        Making a short list of three to five providers and contacting them on the same day

•        Using a simple script: "Hi, I'm a college student looking for a new patient appointment for [anxiety, depression, ADHD, etc.]. I have [insurance]. Are you accepting new patients?"

•        Booking online when available

•        Asking a friend or family member to sit with you while you call

If someone has a waitlist, ask to be added and keep looking.

Step 6: Bridge the gap

While you wait for your first appointment:

•        Ask the counseling center whether they offer drop-in hours, groups, or crisis support in the meantime

•        Keep up with basics: sleep, meals, movement, and staying connected with people

•        Reach out to disability services if your symptoms affect your coursework

•        Know your crisis options: call or text 988, contact campus police, or go to an emergency room

Step 7: Sign a release of information

Once you have a new provider, signing releases lets the counseling center, your new provider, and any other clinicians share information. That keeps your care connected and prevents you from retelling your story from scratch.

You did the right thing by asking for help

A referral can feel like a closed door, but it is really a hallway to the next one. At Windrise Psychiatry and Wellness, I see college students ages 16 and up who are located in Arizona or Montana, by telehealth, with evaluation and medication management for anxiety, depression, ADHD, mood disorders, and more. You may also find our post, Understanding College Stress, helpful.

If anxiety is a problem and calling is too much, you can text me or email about making an appointment.

Windrise Psychiatry and Wellness

Telehealth psychiatric care for ages 16 and older in Arizona and Montana. Most major insurance plans accepted.

Book an appointment or call/text (406) 298-4981.

This post is for educational purposes only and is not a substitute for individualized medical advice. Please do not start, stop, or change any medication without talking with your prescriber. If you are in crisis, call or text 988 or go to your nearest emergency room.