You Don’t Have to Carry These Cases Alone

Most school counselors, pediatricians, and solo-practice therapists I know can tell you about the night they sat with a high-risk case alone.

It’s almost always at night.

You finished a session that took a turn you didn’t expect. A 14-year-old said something that’s sitting heavier than it should. A parent left a voicemail you haven’t returned yet. You wrote the safety plan. You did the screen. You followed the protocols. And still, when you close your laptop at 9pm, the case is sitting on your chest, and there’s no one to think it through with.

In hospital-based behavioral health, that case gets staffed the next morning. A whole team of people walks in with their coffee and helps you carry it. You leave the meeting with a plan, a second set of eyes, and the relief of knowing you’re not the only person tracking this kid.

Community providers — the ones doing some of the most important work in our state, often with the families who slip through the cracks at hospital systems — usually don’t have that. School counselors. Pediatricians in solo practice. Therapists in two-person offices. Mediators and custody evaluators who suddenly find themselves the most-clued-in adult in a child’s life.

That’s a gap, and it’s the gap I want to help fill.

What I’m offering

Pro bono pediatric and adolescent suicide prevention consultation, available to any Texas-based provider working with a young patient at elevated risk.

No fee. No paperwork. No commitment. No expectation that the patient becomes a referral to my practice. Just a confidential, collegial conversation between two clinicians thinking through a hard case together.

You can use it for:

• A second opinion on risk level and safety planning
• A patient whose access to higher levels of care is blocked, delayed, or refused
• A transition out of inpatient or PHP back to your care
• A high-risk student you’re staffing before a family meeting
• A pediatric patient whose family is in your office and you’re the only behavioral health voice involved

We meet on Zoom or by phone. Whichever fits. One conversation, or an ongoing thinking partnership — whatever the case needs.

Why this work matters to me

For most of my career, suicide prevention has been the work I keep coming back to.

I consult with the Mental and Behavioral Health Department at Children’s Wisconsin, where I work with Zero Suicide implementation — the framework that has substantially reduced suicide deaths in healthcare systems that have adopted it. I provide weekly consultation on high-acuity cases as a consulting supervisor and serve on the system’s Suicide Prevention Committee workgroup.

Nationally, through my partnership with Children’s Wisconsin, I serve as a workgroup member with the Children’s Hospital Association Behavioral Health Learning Collaborative, where pediatric institutions across the country share what’s actually working to keep kids alive.

That’s the lens I bring to these consultations. It’s not credentialing for its own sake — it’s the years of thinking about risk, safety planning, family involvement, and care transitions that I want to put to work for the providers in Texas who don’t have a hospital-sized team at their back.

What this is — and what it isn’t

To be clear: this is not crisis intervention. If a child is in immediate danger, please call or text 988, your local mobile crisis team, or get them to the nearest emergency department.

It’s also not a transfer of clinical responsibility. The patient stays under your care. It’s not a substitute for required supervision or your institution’s own risk protocols.

It’s a phone call with a colleague who has thought about a lot of these cases and wants to help you think through yours.

How to reach me

If you’re a Texas-based provider — therapist, school counselor, pediatrician, behavioral health staff, mediator, custody evaluator, anyone whose work brings them face-to-face with a young person at risk — you can reach out at:

When you reach out, include a brief de-identified note about what kind of consultation would be most helpful and your preferred way to connect. I’ll respond within two business days.

Pro bono availability is limited and prioritized by acuity. If I can’t take a request directly, I’ll do my best to point you to another qualified consultant.

One ask

Forwarding this to one person who needs it might matter more than you know.

Dr. Kristin Kroll, PhD, is a licensed psychologist and founder of Little Dove Psychology in Austin, Texas. Outside of private practice, she consults on pediatric suicide prevention with Children’s Wisconsin and the Children’s Hospital Association Behavioral Health Learning Collaborative. Learn more about her practice.