Counseling contracts Counseling Services of Addison County (CSAC), our local community mental health agency, to provide psychiatric evaluations, medication management, and emergency services to Middlebury College students.

Counseling therefore plays the role of a conduit between students and their desired psychiatric services.

Generally speaking, Counseling refers students to CSAC, works collaboratively with the psychiatrist and/or advanced practice registered nurse (APRN), and maintains counseling throughout the student’s relationship with a CSAC clinician. If the student is seeing a private practice counselor in-town, they continue to meet with their private practice clinician.

If another health care provider is already prescribing psychiatric medication to a student, we recommend that the student continue to see that health care provider to ensure continuity of care.

Getting Started

Students must see a counselor before receiving a psychiatric referral to CSAC. The counselor will discuss options, answer questions, and help to clarify what the student hopes to gain from a psychiatric evaluation. If the student decides to proceed with a referral, our office will schedule the initial consultation appointment.

Often, a psychiatric evaluation leads to lifestyle recommendations; medication may also be an option. People who are prescribed medication by CSAC are highly encouraged to participate in counseling, whether on campus or with a therapist in the community. In the treatment of depression, anxiety, and a number of other psychiatric conditions, medications are most successful when used in combination with counseling.

In order to provide continuity of care, students will be required to send pertinent medical records to CSAC before their initial consultation.

Initial Evaluation

The first appointment with CSAC lasts 45-90 minutes and focuses on concerns that are interfering with the students functioning and wellbeing. The psychiatric practitioner will perform a mental status evaluation, and ask questions about:

  • Current mental health problems and symptoms
  • Previous psychiatric treatments, hospitalizations or medications
  • Current medical problems and recent surgeries
  • Family history of psychiatric illness
  • Substance use history
  • Work, school and relationship issues

Continuity of Care

The psychiatrist or APRN may arrive at a diagnosis after the first appointment. Sometimes, medical evaluation by a primary care provider, as well as psychological, laboratory or other tests, may be recommended to clarify the diagnosis or rule out medical causes. Next, the student and the psychiatrist or APRN will set up a treatment plan that may include psychiatric medications. Thirty-minute follow-up appointments will be scheduled throughout treatment to monitor symptoms and response to medication. In the beginning, these visits will be more frequent; as treatment progresses, appointments may be one to three months apart.

Insurance and Billing

Psychiatric evaluations and medication visits are billed to the student’s primary health insurance plan. If this is a concern, please contact us at (802) 443-5141. We do not want finances to be a barrier from proper mental health care.