Mental health on the campus revisited.

The author briefly reviews Mental Health on the Campus: A Field Study, published in 1973, noting areas of consensus and points of tension or disagreement that were reported in that study. He then assesses the extent to which the current state of mental health on the campus is an echo of that report. These comparisons form the basis for anticipating the probable direction of future developments in campus mental health. The areas and issues considered include the increased diversity of the student body, the stable incidence of psychotic disorders, the increased prevalence of gender-related diagnoses such as sexual abuse and eating disorders, the continuing financial pressures bearing on campus mental health programs, and the forms of care and treatment that fiscal and other circumstances are imposing. The author concludes that although the resources available and the particular challenges that are faced may have changed, the traditional goals of a campus mental health program, as articulated 75 years ago when the American College Health Association was founded, remain valid, even if they are difficult to attain.

Divided loyalties in adolescent psychiatry: late adolescence.

The paper discusses problems that arise in psychotherapy with late adolescent patients when other individuals somehow become indirectly involved in ways that require or suggest some exchange of information. These individuals may be parents or administrative and teaching personnel within an institution. The differences between confidentiality, privileged communication, and privacy are discussed, and specific difficulties discussed in the therapy of late adolescents who are in the process of psychologically (as well as legally) attempting to achieve the independent status of a young adult.

KIE: Arnstein, a member of the staff of the Yale University Health Services, discusses problems that arise in psychotherapy with college students relating to the exchange of information with third parties. He is concerned with maintaining a physician patient relationship of trust and cooperation while fulfilling obligations to parents and the institution. After providing brief information on the legal aspects of confidentiality, privileged communication, and privacy in Connecticut, Arnstein describes Yale's policy on disclosing student psychiatric information to parents, university personnel, other universities, and potential employers, and on resolving problems created by psychologically disturbed students.