University and college counseling services face growing demands for services and self-reported increases in the level of presenting psychopathology, including need for psychiatric hospitalization. However, challenges in communication often occur between the systems of an inpatient psychiatric unit and an outpatient college and/or university counseling service. Concerns include students being sent back to the college or university with no communication, premature discharge, and lack of understanding by hospital staff of the college environment. The present article discusses critical components of developing effective collaborative relationships, protocols for assessing and transporting students, and ways to facilitate good aftercare.