Career overview of Jerry Phelps, Ph.D.

1. Clinical Services
Manager Presentation
Jerry Phelps, Ph.D.

2. Clinical Experience
Licensed Psychologist for 19 years
Experience in a variety of clinical settings:
Crisis line
Inpatient Mental Health
Outpatient County Mental Health
Veterans
Primary Care Mental Health
Adolescent Treatment Center
Rehabilitation Psychology
Counseling Center

3. Management Experience
Successfully led and managed multiple teams
Delivered high quality outcomes
Solved problems and worked creatively
Hiring, Supervising, Training, Mentoring
Collaborative implementation of initiatives,
Policies and procedures
CAPS, SHWB, UCSD and UCOP administration
Prepared reports, staff and customer surveys
Strong relationships with UCSD Departments

4. Mental Health Technology
Integration into CAPS and UCSD
Interactive Screening Program
Screened more students all
other UC’s combined
Mobile Help Center App
Integrated Self Management Skills
Red Folder Mobile App
Promoted and tracked using
Google Analytics
Assisted Dr. Remoter in creation
of CAPS
mobile technology on
UCSD App
SAFE Survey – Online Personalized
Feedback

5. Supervision
Licensed Psychologists
Post-Doctoral Fellows
Pre-Doctoral Interns
Paraprofessional Trainees
Non-mental health staff
Student workers

6. Orientation
Supervision and Management
Strengths
Growth
Self Determination Theory – The importance
of intrinsic motivation
Autonomy
Competence
Relatedness
Clinical
Positive Psychology, Student Development,
Motivational Interviewing, Social Justice,
Strengths, Growth, Resilience, Mindfulness,
Lifestyle Mental Health and Health Technology.

7. Relationships with San Diego
Mental Health Community
• Veterans Administration Healthcare System
• UCSD Department of Psychiatry
• UCSD Family Medicine
• Scripps Behavioral Health
• Aurora Behavioral Health Care
• San Diego College Recovery
• Practical Recovery
• Others

8. • Motivational Interviewing Trainer for 15 years
• Alcohol Issues and Policy Committee Member
• Lead CAPS Clinician for Alcohol and Substance Abuse issues
• Initiated the CAPS/SHS SUDS Clinical Committee
Alcohol and Substance Abuse Expertise

9. Personal Attributes
• Calm Under Pressure
• Strengths Focused
• Service Oriented
• Student Facing
• Collaborative and Consensus Building
• Work Life Balance a Priority
• Problem Solving
• Fun and Positive Style

10. Problem:
Example: SAFE (2001-2008)
• Mandatory Substance Abuse Referrals clogging CAPS intake system (2000)
Solution:
• Train specialty providers in Brief MI
• Integrate behavioral health technology
• Utilize trained peer educators
• Develop a stepped care approach
Outcome:
• Developed Peer and Pro SAFE program
• Created a web-based, personalized feedback application
• The SAFE Survey
• Developed, tested and implemented policy for mandatory alcohol
referrals in collaboration with student affairs, student conduct
and CAPs

11. A 2001-2002 study tested the effectiveness of Peer SAFE (SAFE),
the alcohol class (AC), and Computerized Motivational Interviewing (CMI)
for mandated students.
Peer SAFE: Effective

12. 6 week follow-up: Total number of drinks (36)
SAFE = decrease of 23.6 drinks (SD = 24.5)
CMI = decrease of 1.8 drinks (ns)
AC = increase of 5.25 drinks (ns)
Binge drinking episodes (4)
SAFE = decrease of 2.5 binges (p <.01)
CMI = no change
AC = increase of 1.7 (ns)

14. 8 Professional Presentations
Phelps, J. & Jimenez, J. (2008). Brief Motivational Interviewing in College Counseling Centers. Presented at the Organization of Counseling Center Directors in
Higher Education.
Phelps, J. & Taylor, L. (2007). Motivational Interviewing and Brief Screening in a Single-day Campus Alcohol Outreach Program. Presented at the Department
of Education,
National Meeting on Alcohol and Other Drug Abuse and Violence Prevention in Higher Education.
Phelps, J. (2007). Peer-Facilitated Motivational Interviewing With Mandated High-Risk College Student Drinkers. Presented at the BACCHUS Peer Education
Regional Conference.
Phelps, J. & Bacio, G. (2005). Peer-Facilitated Motivational Interviewing With Mandated High-Risk College Student Drinkers. Poster presented at the
Department of Education,
National Meeting on Alcohol and Other Drug Abuse and Violence Prevention in Higher Education.
Phelps, J. (2005). Award-Winning, Effective Approaches to Preventing Drinking and Driving on Campus. Presented at the Department of Education, National
Meeting on
Alcohol and Other Drug Abuse and Violence Prevention in Higher Education.
Phelps, J., Whisenhunt, N., Sintov, N., Day, M. & Singley, D. (2005). Web Assessment and Peer Educator Motivational Interviewing with Mandated Students. CSU
Alcohol
Conference: Creative Leadership in Alcohol Prevention on College Campuses.
Hsin Hsu, S., Williams, C., Brown, S, Wall, T. & Phelps, J. (2004). Motivational Correlates with Alcohol Sanctioned College Students. Poster presented at the
American Association
of Behavioral and Social Sciences Eighth Annual Meeting.
Williams, C., Phelps, J., Wall, T. (2003). Motivational Interviewing with College Students: A web-based Peer Assisted Feedback Approach. Tenth International
Conference on
Treatment of Addictive Behaviors. Heidelberg, Germany.

15. Awards
Honorary Recognition (2007) Organization of Counseling Center Directors of Higher
Education (OCCDHE) The SAFE Program.
Regional Award Collegiate Drinking and Driving Prevention (2005) Automobile
Association of America,
Substance Alcohol Feedback and Education Program. A program using motivational
interviewing with
college peer educators to intervene with sanctioned students.
UNIVERSITY OF CALIFORNIA OFFICE OF TECHNOLOGY TRANSFER
Technology Transfer License
The Substance Alcohol/Feedback and Education (SAFE) Survey
http://caps.ucsd.edu/safe/

16. Student Mental Health Initiative
• Led the implementation of a 3 year grant
• Coordinated with UCOP
• Supervised one Psychologist, student interns and post-doctoral fellows
• To develop and enhance mental health and suicide prevention programs and services
• Marketing for stigma reduction and outreach
• Faculty/staff/student gatekeeper training
• Online mental health screening and intervention

17. Dissemination: One Publication
and Fifteen Presentations
Publications:
Phelps, J., Crandal. M. M., & Juarez, R. (2013). Effective suicide prevention in higher education. The California Psychologist, 46 (3).
Presentations:
Crandal, M. M., Phelps, J. & Mortali, M. (2014, September). Interactive Screening Program: Utilizing a Web-Based Mental Health Screening Program.
Presented at the Student Mental Health Best Practices Conference, Los Angles, CA.
Nishi, K., Crandal, M. & Phelps, J. (2014, September). Effective Campus Awareness Spotlight: May is Mental Health Month. Poster presented
at the Student Mental Health Best Practices Conference, Los Angles, CA.
Phelps, J. & Ramotar, K. . (2014, September). High Tech Mental Health: UC San Diego’s Strategies for Integrating Mobile Applications. Poster presented
at the Student Mental Health Best Practices Conference, Los Angles, CA.
Crandal, M. M., Phelps, J. Burgoyne, M. & Liu, L. (2014, March). Strategies for Stigma Reduction and Community Engagement and Collaboration. Poster
presented at the Tools for Change Conference, San Francisco, CA.
Phelps, J., Survanshi, N. & Crandal, M. M. (2014, March). Meeting Youth Where They Are: Online and Mobile Outreach Methods and Implementing Web-Based
Strategies to Reduce Barriers to Mental Health Services for College Students. Workshop Presented at the Tools for Change Conference, San Francisco, CA.
Phelps, J., Crandal, M. M. & Juarez, R. (2014, March). Implementing web-based strategies to reduce barriers to mental health services for college students.
Presented at the Tools for Change Conference, San Francisco, CA.
Crandal, M. M. & Phelps, J. (2014, January). High Tech College Mental Health: UC San Diego’s Strategy for Connecting with Students. Presented at the
National Association of Student Affairs Professionals in Higher Education Mental Health Conference, San Diego, CA.
Crandal, M. M., Phelps, J., Caldwell, T., Chan, D., & Cate, E. (2013, July). Suicide prevention and barrier reduction outreach:
Utilizing a web-based screening program.
Poster presented at the annual convention of the American Psychological Association, Honolulu, HI.
Caldwell, T., Crandal, M. M., Phelps, J., Lyda, J. (2013, June). Online depression and suicide screenings: Exploring risks and navigating challenges.
Symposium presented at the annual University of California Office of the President Risk Summit, Oakland, CA.
Phelps, J. & Crandal, M. M. (2013, March). Implementing a campus suicide prevention program. Presented at the 1st Higher Education Strategizing
Forum, San Diego City College, San Diego, CA.

18. Trends in College Mental Health
Increased Utilization of CAPS Services
Increased Severity of Presenting Problems
Low number of high utilizers of services
Increase in use of Mental Health Technology

19. Mental Health Technology
800 + mental health apps
Elemental health rapidly increasing & effective
(VA is a leader in this area)
Technologies can augment in-person services (TAO)
Students are digital natives and comfortable with Telecommunication
technologies include telephone,
mobile devices, interactive videoconferencing, email, chat, text and Internet.

20. 2015 Annual Report
Penn State University

21. Chang Rates Between 2009-2010 And 2014-2015
For Counseling Centers And Institution (N=93)
Appointment
Attended
Students
Served
Institutional
Enrollment
5.6%
29.6%
38.4%

22. Institutional Enrollment
Descriptive statistics table (N=93)
students served
Appointments Attended
2014 Utilization
(% of student body served in the
counseling center)
change in intuitional Enrollment
Change in Students Served
Change in Appointments
Attended
Chang in Utilization
6,0821
4,525
30,656
26.3%
37.1%
210.1%
363.5%
212.2%
946
222
41
11.3%
-22.2%
-15.9%
-30.9%
-20.4%
19,506.4
1,529.9
7,716.5
9.5%
5.9%
31.8%
44.3%
24.9%
13,384.1
1,099.3
6,053.6
4.9%
103.4%
31.4%
46.3%
29.3%
Minimum maximum mean
Std.
deviation

23. 0
500
1,000
1,500
2,000
2,500
3,000
2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15
Clinical Statistics
Initial Evaluation
Psychiatry
Conjoint
Crisis, Urgent, Triage
Group
Forums & Workshops
Mentees
5,590
6,202
7,136 7,339
6,659
7,001
7,991
5,000
6,000
7,000
8,000
9,000
2008-092009-102010-112011-122012-132013-142014-15
Individual Counseling
CAPS Services Data
CLINICAL SERVICE STATISTICS
• 16,217 units of clinical service (+11% across 5 years)
• 1,571 crisis/urgent appointments (+44%)
• 2,454 initial appointments (+15%)
• 7,991 individual counseling appointments (+12%)
• 290 couples counseling appointments (+31%)
• 3,017 group visits (+20%)
• 733 psychiatric appointments (-46%)
• 3,237 students served (+16%)
• 3,687 initial appointment requests (+14%)
• AVG NUMBER OF SESSIONS: 4
• MODE: 1
• MEDIAN: 3

24. Utilization
• One is modal number of appts per client/per year.
• Clients averaged 5.86 appointments.
• 20% clients accounted for over 50% of all appts!
• 1% of clients accounted for 6.5% of all appointments,
averaging 38.13 appointments.
• 10 clients utilized a total of 878 appointments.

25. CRITICAL INDICENTS AND RISK
(% difference across 5 years)
24
37
45
72
55 57 54
22
17
35
22
50
55
72
46
54
80
94
105
112
126
5
15
21 20
28 27 28
0
20
40
60
80
100
120
140
2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15
Hospitalizations and Psychosis
Hospitalizations- Admissions
Hospitalizations- Evaluations (less than
24hr stay)
Hospitalizations- Total
Psychosis (requiring emergency care)
• 126 total hospitalizations, including admissions and evaluations (+58%)
• 77 suicide attempts and hospitalizations (+60%)
• 2 completed suicides (+0%)
• 28 psychosis incidents requiring emergency care (+33%)
• 2014-15: 28% had suicidal thoughts in the past year, 9% had current thoughts of suicide,
• and 7% indicating at least one past attempt

26. CRITICAL INDICENTS AND RISK
(% difference across 5 years)
• 126 total hospitalizations, including admissions and evaluations (+58%)
• 77 suicide attempts and hospitalizations (+60%)
• 2 completed suicides (+0%)
• 28 psychosis incidents requiring emergency care (+33%)
• 2014-15: 28% had suicidal thoughts in the past year, 9% had current thoughts of suicide,
and 7% indicating at least one past attempt
15 15 16
25
14
21 1817
24
32
40
48 48
59
34
41
50
66 65
69
79
2 2 2 1 3 0 2
0
10
20
30
40
50
60
70
80
90
2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15
Suicide Incidents
Suicide- Attempts (serious, requiring
emergency care)
Suicide- Threats (serious, requiring
hospitalization)
Suicide- Total Incidents (registered
students)
Suicide-Completed

27. Problems
Increase volume of clients causes increase in wait times for Intakes
Intakes are so backlogged that Urgent Care is a de facto intake system.
Increased volume and severity of clients leads to urgent care staff to often
overutilized and feel overwhelmed.

28. Solutions
Add staff to Urgent Care
Integrate New Case Management Staff
Create an Urgent Care Committee
Phone Triage System
Use more same day groups and workshops
Possibly collaborating with Recreation for Yoga
Continue to improve management of high utilizing clients
Provide a customer service focus
Integrate Health Technology as needed

29. CAPS Changes
Services:
CAPS Case Managers
Added CP-II staff
Added CP-III staff
Approval to adopt changes recommended in the Urgent
Care brainstorming meeting

30. Pareto Principle 80/20 Rule
20% of the source causes 80% of the work.
Which 20% of client’s take 80% of effort? Focus efforts on how to most efficiently manage these
clients.
According to a 2015 Penn State Study of College mental Health,
20 percent of students seeking mental health treatment are taking up 50% of all campus
counseling center appointments.
Low frequency/High need students (identified in clinical oversight committee, nominated by
staff or via PnC data analysis)
New: Crisis, Suicidal Risk, Psychosis, Mania
Recurring: Recently hospitalized, low compliance, re-hospitalization, Students of Concern,
complicated clients

31. Low need clients
New: Direct off campus referrals, information about services, directly to group, documentation
Recurring: Renewals
Clinical: Use Case Mangers to create processes for and manage low need clinical issues.
Non-Clinical: Use Front Desk staff, website FAQ, telephone messaging, Proto Call training,
student
feedback, handouts, checklists, to assist students in being more informed consumers of CAPS
services.

32. Marketing CAPS Services
Improve expectations for urgent care and intakes
If clients have accurate expectations, they can ask for what they want and to self manage
needs, when appropriate
Also, marketing other options for mental health support such as Groups, TAO, Forums, Off
Campus
Referral, SARC/CAR and SHS., Marketing done trough website FAQ, Urgent Care
Description, Intake Description
Change the name of Urgent Care to ?

33. Vision
Continue Stephanie, Rob and others’ previous work.
Implement CAPS collective vision for Urgent Care.
Successfully integrate Case Managers (CM) into CAPS Clinical Services.
CM assists with hospitalization, UC and referral case management.
Focus on efficiency of services through phone triage and brief screening
Provide more upfront management of services to high risk/utilization issues and efficient service
delivery from low risk issues
With Judy, provide adequate training to all UC staff – telephone triage/crisis management.
Integrate with Sam and information technology such as Point and Click, laptop or mobile PC to UC office,
updating website and app, Telementalhealth, other technology for urgent care.
Continue to consult with outside colleagues, listservs and literature.
Provide excellent and responsive service to
Customers: Students
Partners: SHS, SA Case Managers, CARE/SARC, outside providers and referrals
Stakeholders: Staff, faculty, UCOP and the San Diego Community
Fellow CAPS Staff and CAPS Management.