Brett Sokolow gave the following interview to Chris Hill from MAGNA Publications about an upcoming webinar addressing student suicide.
Q: Most reputable schools don’t want to let fear of legal liability outweigh concern for the student. But it’s a blurry line to keep in focus. How can administrators tell if they’ve crossed it?
A: While the answer requires a lot more complexity than I'll offer here, one good way to keep on the legal side of the line is to utilize interim suspension or voluntary withdrawal when a student needs to get help externally, and try to avoid involuntary separation longer-term unless absolutely necessary. When you have to go that route, only separate the student based on suicidal threats or attempts, rather than on lesser ideation or gestures.
Q: Shin vs. MIT is generally thought to have changed the landscape in the area of student suicidality. Is it possible that, with time, that case will come to seem one exceptional incident, instead of grounds for changing our whole approach?
A: Actually, just the opposite. We've become all things to our students -- we feed them, house them, entertain them, clothe them, provide for their fitness, health, and mental health. The law is actually just catching up with the FACT that we have changed our legal relationship to our students. In ten years, the majority of courts will operate from the principle that colleges are in a special relationship to students, and that we owe them a commensurate duty of reasonable care. Having said that, I don't think Shin or any other case requires us to change our whole approach. We have to ensure that we bring reasonable care to our interactions with suicidal students. I'd like to think that we do that regardless of a legal mandate. In fact, I think one of the lessons of the Shin case may be that MIT tried too hard, rather than that they did not do enough. We need to have some tough conversations on all of our campuses about how and why we are coming to resemble mental health facilities rather than colleges, and whether that is a direction we really want to be taking.
Q: Because colleges and universities are so exposed in student suicide cases, does that justify us in intruding on student privacy, i.e., requesting mental health records from incoming students?
A: Just as we must challenge how far we want to go in providing mental health services, I think there must be a healthy debate on every campus about how to more successfully balance individual rights with the welfare/safety of the community. Prior to Virginia Tech, I think the balance skewed too heavily toward privacy on many campuses, and now we are charged with finding a more successful happy medium. If that means better data mining, I think that option should be on the table for discussion not as a mandate, but as a voluntary sharing option.
Q: How can we establish such a behavioral baseline for each student that we are able to detect significant variation from it? How can we possibly find the time and person-power for such a project?
A: I don't think we can or that we should. I think establishing a baseline for those who are at-risk (e.g., those whose conduct brings them to the attention of a behavioral intervention team) is the best we should be doing now, and then we need to keep tabs at intervals to see if there is a substantial departure from that baseline that causes us concern. A baseline for everyone is neither desirable nor possible. In fact, I think just accomplishing the task of establishing a baseline for only the known at-risk individuals may be overwhelming. As currently practiced, behavioral intervention will overwhelm many campuses. More are hiring full time team chairs and case managers. More are looking to options to mandate assessment externally, and even then are finding that local mental health providers are as overwhelmed as campus resources. We are, unfortunately, well behind the 8 Ball in addressing campus mental health issues. We're scrambling to catch up. Yet, we're still addicted to spending money and time on cameras, text warnings, and door locks, rather than allocating what we really need to the NECESSITY of a comprehensive behavioral intervention capacity. That will change by choice or by tragedy, but it will change.
More on this June 9th webinar can be found at: http://www.magnapubs.com/calendar/319.html
Wednesday, May 27, 2009
Friday, May 22, 2009
Various BITs
This week’s blog is going to address a few recurring questions that we are getting about behavioral intervention teams.
1. What do you see as the ideal/appropriate functions of a BIT?
• Centralize reporting
• Triage reports
• Assess threat/risk
• Assess available resources
• Perform or empower interventions
• Coordinate follow-up
• Assess long-term success/outcomes
• Educate the community
2. What are some affirmative steps we can take to implement our BIT once we have formed it?
• Fully implement all twelve 2nd gen BIT best practices as identified by NCHERM in the Whitepaper posted at http://www.ncherm.org/pdfs/2009NCHERMwhitepaper.pdf
• Develop and implement strategies to empower a culture of reporting within your campus and community
• Conduct bystander intervention training for your students and staff
• Ensure access to adequate mental health services
• Train faculty & staff on what to report, how, when and to whom – supplement training efforts by your team members with the new online course Campus Safety 101 from MAGNA Publications (http://www.magnapubs.com/courses/cs101.html)
• Offer suicide gatekeeper training to your community (QPR, Campus Connect, etc.)
• Provide team training on aggression management (www.aggressionmanagement.com)
3. What are the responsibilities of a BIT post-intervention?
• Case management, such as:
-- Coordinate care, pharmacology and insurance issues that may inhibit long-term therapeutic goals
-- Prophylactically inhibit triggers that may impede an individual’s current level of coping (e.g., helping someone avoid over-involvement in activities that overwhelm; blocking opportunities such as study abroad, if access to needed supports will be an issue when abroad; coaching the individual on techniques to maintain a regimen of needed medications, etc.).
• Mind the gaps by occasionally checking in on the at-risk individual or those who can update on that individual’s status
• Coordinate compliance with team mandates
• Coordinate communication with parents, spouses, faculty, and other relevant stakeholders
• Ease voluntary withdrawal options (if necessary) by addressing financial and academic disincentives to withdrawing
• Assess areas where a referral or mandate for skills training is an ongoing need
That’s all for now. Have a great weekend and holiday.
Brett Sokolow
1. What do you see as the ideal/appropriate functions of a BIT?
• Centralize reporting
• Triage reports
• Assess threat/risk
• Assess available resources
• Perform or empower interventions
• Coordinate follow-up
• Assess long-term success/outcomes
• Educate the community
2. What are some affirmative steps we can take to implement our BIT once we have formed it?
• Fully implement all twelve 2nd gen BIT best practices as identified by NCHERM in the Whitepaper posted at http://www.ncherm.org/pdfs/2009NCHERMwhitepaper.pdf
• Develop and implement strategies to empower a culture of reporting within your campus and community
• Conduct bystander intervention training for your students and staff
• Ensure access to adequate mental health services
• Train faculty & staff on what to report, how, when and to whom – supplement training efforts by your team members with the new online course Campus Safety 101 from MAGNA Publications (http://www.magnapubs.com/courses/cs101.html)
• Offer suicide gatekeeper training to your community (QPR, Campus Connect, etc.)
• Provide team training on aggression management (www.aggressionmanagement.com)
3. What are the responsibilities of a BIT post-intervention?
• Case management, such as:
-- Coordinate care, pharmacology and insurance issues that may inhibit long-term therapeutic goals
-- Prophylactically inhibit triggers that may impede an individual’s current level of coping (e.g., helping someone avoid over-involvement in activities that overwhelm; blocking opportunities such as study abroad, if access to needed supports will be an issue when abroad; coaching the individual on techniques to maintain a regimen of needed medications, etc.).
• Mind the gaps by occasionally checking in on the at-risk individual or those who can update on that individual’s status
• Coordinate compliance with team mandates
• Coordinate communication with parents, spouses, faculty, and other relevant stakeholders
• Ease voluntary withdrawal options (if necessary) by addressing financial and academic disincentives to withdrawing
• Assess areas where a referral or mandate for skills training is an ongoing need
That’s all for now. Have a great weekend and holiday.
Brett Sokolow
Saturday, May 16, 2009
Discrimination by Student Organizations
Yesterday I participated in a day-long seminar on the topic of religious student organizations and denial of recognition and/or funding by the college or university for refusal to agree to institutional non-discrimination policies. I have been involved with many controversial legal issues over the years, but none that seem to have held the deep personal impact that this issue holds on individuals. The lines of this controversy are unpredictably drawn and not predictable based on religious beliefs, race, sexual identity or gender.
I provided the introductory presentation that set forth the legal issues and the court decisions handed down over the past few years. The panel discussions that followed my presentation provided an eye opening experience of passion, anger and perspective that was like peeling back the layers of an onion. From a legal perspective the issue revolves around First Amendment rights. Those rights encompass freedom of expression, freedom of religion and freedom of association. Generally a Constitutional issue requires a “compelling governmental interest” to limit or regulate. However, the courts have carved out circumstances, based on a forum analysis, that allows a lower standard for regulation of expression in certain circumstances. The higher requirement of strict scrutiny applies in all circumstances regulating religion or association, however. Thus, across the country courts, from district courts to courts of appeals, are rendering opposing opinions on identical sets of circumstances using standards based on expression versus religion or association. The coming years will provide an interesting opportunity to watch judicial bodies address this issue and the legal arguments put forth.
BUT...what I observed throughout the rest of the day was not just a scholarly legal debate of the issue, but was even more interesting, and perhaps more significant from a social justice perspective—and that was the passion and anger and outrage expressed by individuals involved with the actual controversy. Throughout the day participants challenged one another about equality and belief systems and recognition and affirmation. The discussions were loud, emotional and personal.
Clearly this issue cuts far deeper than just a scholarly legal analysis.
Have a great weekend,
Saunie Schuster
I provided the introductory presentation that set forth the legal issues and the court decisions handed down over the past few years. The panel discussions that followed my presentation provided an eye opening experience of passion, anger and perspective that was like peeling back the layers of an onion. From a legal perspective the issue revolves around First Amendment rights. Those rights encompass freedom of expression, freedom of religion and freedom of association. Generally a Constitutional issue requires a “compelling governmental interest” to limit or regulate. However, the courts have carved out circumstances, based on a forum analysis, that allows a lower standard for regulation of expression in certain circumstances. The higher requirement of strict scrutiny applies in all circumstances regulating religion or association, however. Thus, across the country courts, from district courts to courts of appeals, are rendering opposing opinions on identical sets of circumstances using standards based on expression versus religion or association. The coming years will provide an interesting opportunity to watch judicial bodies address this issue and the legal arguments put forth.
BUT...what I observed throughout the rest of the day was not just a scholarly legal debate of the issue, but was even more interesting, and perhaps more significant from a social justice perspective—and that was the passion and anger and outrage expressed by individuals involved with the actual controversy. Throughout the day participants challenged one another about equality and belief systems and recognition and affirmation. The discussions were loud, emotional and personal.
Clearly this issue cuts far deeper than just a scholarly legal analysis.
Have a great weekend,
Saunie Schuster
Thursday, May 7, 2009
What a Disaster!
Preparing for the next disaster
With all of the school closings, a group of recent students being “quarantined” from graduation, and Vice President Biden telling everyone not to travel on public transit (later recast as “if you are SICK, don’t use mass transit”), the H1-N1 virus(we have now been told not to call it the “swine flu” so as not to negatively impact pork sales in the US, where no swine have been infected – true story) has dominated headlines. But, as we at NCHERM are in the business of PREVENTIVE law and risk management, we hope that our clients (and readers) will pay attention to other potential threats and prepare accordingly, so as to avoid being stuck in reactionary modes.
So, in that vein, here are some other things to consider over the next year:
A recent forecast for the 2009 Hurricane Season predicted 12 named storms with 2-3 being “intense.” While the Gulf Coast states are painfully aware and prepare every year, the East Coast schools tend to sporadically prepare – as other things (e.g., H1-N1, school deaths, etc.) tend to get in the way. But I would offer yet another cautionary suggestion to our inland colleagues. While I am confident that the Federal response to another Katrina-esque storm will be better, (could it possibly be worse?!?), our inland colleagues should dust off the post-Katrina reports (if you have them) and make sure you are ready to house, enroll, treat, and/or shelter a group if need be. Not only is it the right thing to do, but the positive PR cannot be ignored (kudos to Mayor White and the city of Houston and Stephen F Austin State University among many others). From a risk management perspective, this is a “Natural Disaster;” an inevitability, not a possibility, so get ready – you will be measured not on prevention, but response.
Another news story has been tracking the wildfires over the last year in California, Florida, New Mexico, Arizona, Texas, and South Carolina and predicts that, as global warming continues to increase drought days in these areas, the wildfire phenomenon will continue. While these events feel like “Natural Disasters,” I classify them in my Risk Management Arena as “Man-Made Disasters.” Not because of the arson possibility or to make some global warming political statement, but because, especially for those schools in high-risk states and areas, you will be measured – in the risk management world – on your risk reduction activities as well as your response.
In the same arena as Hurricanes, an interesting, yet not well publicized report was made analyzing fault lines around the world. Of particular note was the Heyward fault, which runs through Northern California, and directly through SF and Oakland. For over 700 years, there has been a major earthquake roughly every 104-140 years(defining “major” is apparently a sticking point, but doesn’t matter here). If you count the “Big One” of 1906 (no one seemed to count the World Series interrupting 1989 quake as “major” – except for the victims, I am guessing), we are coming up on time for the next one. If you don’t, we are long overdue (by about 25 years). Either way, imagine a minimum 3500 dead, 50,000+ injured, 75,000-100,000 homeless, and the 30+ schools in the area devastated. These are Katrina-esque numbers, but in larger metropolitan areas.
I certainly don’t want to ruin your summer, but I do want us all to be prepared. In an odd way, this makes even more critical the need to have practiced, established preventive protocols and solid risk management practices in place for the (by comparison) “mundane” issues like student self-injury – intentional or otherwise – and other mental health issues.
Have a great weekend.
Scott Lewis
With all of the school closings, a group of recent students being “quarantined” from graduation, and Vice President Biden telling everyone not to travel on public transit (later recast as “if you are SICK, don’t use mass transit”), the H1-N1 virus(we have now been told not to call it the “swine flu” so as not to negatively impact pork sales in the US, where no swine have been infected – true story) has dominated headlines. But, as we at NCHERM are in the business of PREVENTIVE law and risk management, we hope that our clients (and readers) will pay attention to other potential threats and prepare accordingly, so as to avoid being stuck in reactionary modes.
So, in that vein, here are some other things to consider over the next year:
A recent forecast for the 2009 Hurricane Season predicted 12 named storms with 2-3 being “intense.” While the Gulf Coast states are painfully aware and prepare every year, the East Coast schools tend to sporadically prepare – as other things (e.g., H1-N1, school deaths, etc.) tend to get in the way. But I would offer yet another cautionary suggestion to our inland colleagues. While I am confident that the Federal response to another Katrina-esque storm will be better, (could it possibly be worse?!?), our inland colleagues should dust off the post-Katrina reports (if you have them) and make sure you are ready to house, enroll, treat, and/or shelter a group if need be. Not only is it the right thing to do, but the positive PR cannot be ignored (kudos to Mayor White and the city of Houston and Stephen F Austin State University among many others). From a risk management perspective, this is a “Natural Disaster;” an inevitability, not a possibility, so get ready – you will be measured not on prevention, but response.
Another news story has been tracking the wildfires over the last year in California, Florida, New Mexico, Arizona, Texas, and South Carolina and predicts that, as global warming continues to increase drought days in these areas, the wildfire phenomenon will continue. While these events feel like “Natural Disasters,” I classify them in my Risk Management Arena as “Man-Made Disasters.” Not because of the arson possibility or to make some global warming political statement, but because, especially for those schools in high-risk states and areas, you will be measured – in the risk management world – on your risk reduction activities as well as your response.
In the same arena as Hurricanes, an interesting, yet not well publicized report was made analyzing fault lines around the world. Of particular note was the Heyward fault, which runs through Northern California, and directly through SF and Oakland. For over 700 years, there has been a major earthquake roughly every 104-140 years(defining “major” is apparently a sticking point, but doesn’t matter here). If you count the “Big One” of 1906 (no one seemed to count the World Series interrupting 1989 quake as “major” – except for the victims, I am guessing), we are coming up on time for the next one. If you don’t, we are long overdue (by about 25 years). Either way, imagine a minimum 3500 dead, 50,000+ injured, 75,000-100,000 homeless, and the 30+ schools in the area devastated. These are Katrina-esque numbers, but in larger metropolitan areas.
I certainly don’t want to ruin your summer, but I do want us all to be prepared. In an odd way, this makes even more critical the need to have practiced, established preventive protocols and solid risk management practices in place for the (by comparison) “mundane” issues like student self-injury – intentional or otherwise – and other mental health issues.
Have a great weekend.
Scott Lewis
Friday, May 1, 2009
A Month of Violence
On the Predictability of Virginia Tech
I am struck by the awesome change in the landscape of higher education since the shootings at Virginia Tech. Not because of the fact that so many were killed in such a horrific manner – that number of people dying at any one time always warrants significant analysis, like in a plane crash, hurricane (i.e., Katrina), etc., and it should. What struck me then, and continues to strike me, is how it was (and continues to be) treated like such an anomaly.
Let me preface this by stating that I mean no disrespect to the victims, the families of the victims, the members of the community, or the staff and faculty at Virginia Tech. My shock is aimed at all of us in higher education, that we ignored the signs for as long as we did, and continued doing our work, “business as usual” in the face of such overwhelming data.
Allow me to explain. I was giving a presentation when a colleague referred to the murders (I also don’t like referring to it as a “tragedy,” I think that term misrepresents the horrific nature of the intent of the act) at Virginia Tech as “the 9/11 for Higher Education.” I have thought about that for a while, and I think he is almost right. It is the 9/11 for education, not just higher education.
(NOTE: I will acknowledge now the dissent that some may take with the political assertations and analogies I am going to make, but bear with me – we can argue about it later.)
Much like 9/11, there were multiple warning signs prior to Virginia Tech that – like 9/11 – were ignored in their increasing dynamic. The 1st bombing of the WTC, the bombing of the US Embassies and the USS Cole are analogous with the shootings at Paducah, Jonesboro, and Columbine.
The journal articles by K-12 teachers about increasing violence by and violent reaction of students, the crime statistics, and the anecdotal stories they were sharing – that higher education administrators and faculty ignored – are analogous to the memos (“Bin Laden determined to attack in US” and the memo outlining the threat of a repeat attack on the WTC come to mind) ignored by the Bush Administration in the year and a half prior to 9/11.
And now, sadly, the rush to implement response measures and the arguable overspending on them – text messaging systems, loudspeaker systems, security cameras to name a few – in lieu of equal spending on effective preventive measures – like well trained behavioral intervention teams at the college and K-12 level – are analogous to the monies spent on the initial response to 9/11 – the invasion of Iraq – which we now know had nothing to do with 9/11, and which has arguably not resolved the problems that led to 9/11.
Let’s hope that we are wiser in the future in both the observation of warning signs and the focus on actions that make us safer in the long run – preventive measures. Let’s hope our government does the same.
Have a great weekend,
Scott
I am struck by the awesome change in the landscape of higher education since the shootings at Virginia Tech. Not because of the fact that so many were killed in such a horrific manner – that number of people dying at any one time always warrants significant analysis, like in a plane crash, hurricane (i.e., Katrina), etc., and it should. What struck me then, and continues to strike me, is how it was (and continues to be) treated like such an anomaly.
Let me preface this by stating that I mean no disrespect to the victims, the families of the victims, the members of the community, or the staff and faculty at Virginia Tech. My shock is aimed at all of us in higher education, that we ignored the signs for as long as we did, and continued doing our work, “business as usual” in the face of such overwhelming data.
Allow me to explain. I was giving a presentation when a colleague referred to the murders (I also don’t like referring to it as a “tragedy,” I think that term misrepresents the horrific nature of the intent of the act) at Virginia Tech as “the 9/11 for Higher Education.” I have thought about that for a while, and I think he is almost right. It is the 9/11 for education, not just higher education.
(NOTE: I will acknowledge now the dissent that some may take with the political assertations and analogies I am going to make, but bear with me – we can argue about it later.)
Much like 9/11, there were multiple warning signs prior to Virginia Tech that – like 9/11 – were ignored in their increasing dynamic. The 1st bombing of the WTC, the bombing of the US Embassies and the USS Cole are analogous with the shootings at Paducah, Jonesboro, and Columbine.
The journal articles by K-12 teachers about increasing violence by and violent reaction of students, the crime statistics, and the anecdotal stories they were sharing – that higher education administrators and faculty ignored – are analogous to the memos (“Bin Laden determined to attack in US” and the memo outlining the threat of a repeat attack on the WTC come to mind) ignored by the Bush Administration in the year and a half prior to 9/11.
And now, sadly, the rush to implement response measures and the arguable overspending on them – text messaging systems, loudspeaker systems, security cameras to name a few – in lieu of equal spending on effective preventive measures – like well trained behavioral intervention teams at the college and K-12 level – are analogous to the monies spent on the initial response to 9/11 – the invasion of Iraq – which we now know had nothing to do with 9/11, and which has arguably not resolved the problems that led to 9/11.
Let’s hope that we are wiser in the future in both the observation of warning signs and the focus on actions that make us safer in the long run – preventive measures. Let’s hope our government does the same.
Have a great weekend,
Scott
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