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Definition. Limited Engagement refers to situations where a young adult is only partly engaging, inconsistently engaging, or refusing to engage with parents, providers, school supports, or some combination of these.

Planning Before, During, and After a Crisis

Before

  • Have an honest conversation about how often you expect to communicate and how (calls, texts, etc.). Agreeing on what works can make it easier to notice when something changes.
  • Share phone numbers in case of emergencies. Parents/families may share some good alternatives for when they are unavailable, and the young adult may share phone numbers of roommates or friends to reach out to, if you cannot get in touch with them.
  • Discuss and consider HIPAA and FERPA release forms, care provider Release of Information (ROI) forms, emergency contacts, insurance cards, and identifying local providers, hospitals, and crisis resources near the college. Store important phone numbers so you can find them quickly. Emergency services, campus, and off-campus have more emergency resource numbers.
  • If the young adult takes medication and is moving to live at school or away from home, offer to pull together medication lists and help make plans for transferring prescriptions, finding the right clinicians in the new location, and choosing a local pharmacy.
  • If the young adult has had mental health hospitalizations in the past, offer to help them set up or update a safety plan. If they have psychiatric treatment preferences they are willing to outline, a psychiatric advance directive can document those, in case of emergency.
  • Line up your own support: someone you can call, family, friends, or a therapist. It is easier to lean on that support if it is already in place before a crisis. See caregiver well-being.
  • If you start to have concerns about your young adult, consider both safety and your relationship before contacting the school or treatment team. If your concerns are valid but not urgent, and if the young adult does not want you involved, it may pay to wait. But when safety is at stake, safety is the higher priority.

During a Crisis

  • Review safety planning as often as needed and consider whether the young adult's housing situation is safe. Prioritize safety and keep communication open.
  • The number of issues may feel overwhelming, so start with whatever is most urgent and revisit longer-term issues once you meet the immediate needs.
  • Write or update a summary of the young adult's health history, medications, observed behaviors, and safety concerns that you could share with a hospital or clinician. Keep it calm and concise. The hospitalization section of this site includes a one-pager template and questions for the treatment team.
  • Even when a school or hospital cannot share information with you, you can still call and provide background, observations, and safety concerns. You may need to say, “I understand you may not be able to respond, but I have information to provide.”
  • If more than one parent/caregiver is involved, try to agree on common messaging. The young adult may prefer talking with one person. Try to avoid situations where you contradict each other.
  • For young adults in college, the Dean of Students' office may be a good starting point for academic accommodations, reduced course loads, medical withdrawals, or leaves of absence. Disability Services may help students obtain academic accommodations.
  • If you are frightened or overwhelmed, call your own support person before you call your young adult. Staying grounded may help communication and safety. See caregiver strategies.

After a Crisis

  • Shift focus to stability. The young adult may need help to secure stable housing, slowly resume school or work, and other daily routines.
  • Support them as they follow through on continuing care, including their safety plan, appointments, and medications. Waitlists and insurance delays are common, and the young adult may need help navigating these roadblocks. See continuing care.
  • The weeks after an ER visit, hospitalization, or any step down in care can be a vulnerable time. If the existing providers are still a good fit, ask whether seeing them more often may help.
  • Be open to reassessing expectations. The young adult may consider switching to a different path, even temporarily, if it's better for their mental health. This phase is about building a sustainable path forward.
  • As stability returns, revisit issues you set aside during the crisis. Offer support while the young adult takes responsibility for parts, and gradually reduce that support as stability and skills increase.
  • Refocus on your own sleep, meals, medical care, and support, especially if they waned during the acute crisis. See caregiver well-being.