Help with client flow at a campus crisis clinic?

[Glees]

Hey you all! I'm looking for ideas to help with client flow at my workplace. I work at a campus clinic that provides both scheduled and walk-in brief counseling and advocacy (like emailing professors, attending Title IX meetings, and going to court) for survivors of sexual assault, relationship violence, and discrimination. We also have a 24/7 hotline and conduct multiple outreach events and trainings.

As a senior student I help manage all of the interns, who are my junior students in the clinical psych program. This semester we've seen quite the uptick in clients, and we've been pretty swamped. Paperwork isn't getting completed promptly and we can't finish one thing without having to attend to a new walk-in client or phone call on the support line.

The way our clinic is set up is this: We have an admin, a boss who's always out of the office (because she's super busy, not because she's irresponsible), myself as a full-time employee, 4 part-time interns who are there between 10-20 hours each week, some undergrads who help with the support line for a total of about 15 hours, and a part-time employee who is in charge of about half of our outreach and trainings. We try to have a "point person" to take walk-ins, but we may get multiple walk-ins in the same hour, and because most of our staff is part-time with caseloads of 6-10 clients, many of them end up having to schedule their ongoing clients during their walk in shifts. This leads to general chaos, with no protected time to get anything done.

Any ideas about how to continue offering walk-in services while also protecting clinicians' paperwork time? We're looking into hiring a few more interns per diem, but our funds are limited. Thank you!!

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[PsychPhDone]

Hey you all! I'm looking for ideas to help with client flow at my workplace. I work at a campus clinic that provides both scheduled and walk-in brief counseling and advocacy (like emailing professors, attending Title IX meetings, and going to court) for survivors of sexual assault, relationship violence, and discrimination. We also have a 24/7 hotline and conduct multiple outreach events and trainings.

As a senior student I help manage all of the interns, who are my junior students in the clinical psych program. This semester we've seen quite the uptick in clients, and we've been pretty swamped. Paperwork isn't getting completed promptly and we can't finish one thing without having to attend to a new walk-in client or phone call on the support line.

The way our clinic is set up is this: We have an admin, a boss who's always out of the office (because she's super busy, not because she's irresponsible), myself as a full-time employee, 4 part-time interns who are there between 10-20 hours each week, some undergrads who help with the support line for a total of about 15 hours, and a part-time employee who is in charge of about half of our outreach and trainings. We try to have a "point person" to take walk-ins, but we may get multiple walk-ins in the same hour, and because most of our staff is part-time with caseloads of 6-10 clients, many of them end up having to schedule their ongoing clients during their walk in shifts. This leads to general chaos, with no protected time to get anything done.

Any ideas about how to continue offering walk-in services while also protecting clinicians' paperwork time? We're looking into hiring a few more interns per diem, but our funds are limited. Thank you!!

Is this a legit college counseling center or some other kind of clinic? If not, is there a college counseling center on campus? And how many students are enrolled in your school?

 

[Justanothergrad]

What do you mean 'provide counseling' since it seems run by undergraduates?
What are the referral guidelines to other providers?
What resources are available for outside referral? What does current paperwork look like?
Why does it look the way it looks (e.g., clinic director preference, university mandate, habit, etc).
Critically, why doesn't your boss ask this question rather than you?



As a complete aside, and as a proud southerner, it confuses me when I read "You all" and not "Y'all". Why all the extra letters?!

 

[foreverbull]

I would agree that this issue is a question that should be asked by and resolved by the clinic director, not staff.

If you're getting more than one crisis/walk-in per day, your clinic is doing way too much crisis/walk-in work in relation to the staff you have.

Per diem staff may be the only recourse unless your clinic can hire clinicians permanently. Or do very brief assessment for walkins...we did mini-intakes at my internship site that took about 20-30 minutes, which is basically safety assessment, current problems & goals, then send you on your way with an appointment date unless you were in imminent danger of harming self or others.

Ultimately, this just sounds like way too much crisis/walk-in volume for your clinic, and your director needs to take charge with this one. I would say if you have no additional resources, stop doing walkins altogether. I worked in a community clinic (individual therapy for community clients) at a university and we didn't do walk-ins at all because that is a really high level of acuity/crisis for trainees to manage and because our clinic director/supervisors were not onsite a fair amount of the time.

 

[PsyDr]

1) why would anyone do Outreach when they can’t handle what they have? That sounds spending time you don’t have to get in more patients that you can’t see.

2) nonclknical staff can do paperwork for a week or two until things are shored up.

3) that volume of walk-ins sounds like you are reinforcing poor coping skills. In the ER, we had that problem. Person with zero resources and coping skills gets emergency care. Then uses that as their only method of coping. One walk in. Then scheduled appointments.

 

[WisNeuro]

Triage staff. Concerning the walk-ins, who needs to be seen vs. who can wait until follow-up appt.

 

[singasongofjoy]

I second the pausing of outreach, unless your outreach starts including a significant focus of other places people can call/go if htey need emergent services. We've paused outreach at my clinic (different population) because we can't handle current volume and when people call/come to the clinic without appointment we salso send them with info on a vareity of other local resources they can contact. Walkins should have a very clear protocol. Risk assessment, with different flow depending on level of risk, help setting up a scheduled follow-up appointment. Should not turn into a full-on therapy session. Maybe clinicians are having a hard time sticking with that?