Managing
Mental Health Emergencies
By Jan Schumacher,
Director of Residential Services, Muhlenberg College
Introduction
This past
October I had the privilege of being part of a panel discussion on Effective
Management of Mental Health Emergencies on Campus: A Student Development
Perspective at the annual Pennsylvania Associate of College Personnel
Administrators (PCPA) held at Carlisle, PA. The other members of the panel
were Joseph Merkle, Dean of Students at York College, Joseph Puzycki,
Director of Judicial Affairs at Penn State University and Dennis Wilson,
Director of Counseling and Health Services at Saint Francis University.
The idea for the session came from an informal discussion at dinner during
the executive boards summer retreat. As our conversation progressed
we realized that mental health issues were consuming a great deal of time
and effort for a multitude of staff members on each of our campuses.
The goal
of the session, and what made it a successful discussion, was the ability
to look at crisis from the viewpoint of each office involved. While the
overall mission of an institution regarding crisis is often the same,
the manner in which each office must respond can be different. The Counseling
Center has an obligation to maintain the confidentiality of the student
while getting assistance for the student. The Dean of Students office
has to keep the overall picture in mind and ensure each member of the
staff is doing his or her job in relationship to the emergency. The Judicial
Affairs office must ensure that the code of conduct is being upheld, that
the response is focused on the students behavior; not the student
his/herself, and that all students involved receive due process. The Residential
Services office must keep in mind any member of the residential community
that has been impacted, especially if the student crisis occurs in the
halls. The Campus Safety department must ensure the safety of all members
of the community and is usually the communication center for the other
offices and staff members involved.
As we prepared
for the session we had an opportunity to share and discuss situations
involving students from our campuses. We collaborated on situations that
each of us had experienced and then prepared case studies to begin the
flow of discussion with conference participants. During this process,
we challenged each other on how we would handle these situations given
the responsibilities and constraints of our offices.
Who
Does What: Understanding departmental roles
Whether
the emergency occurs in the residence halls or elsewhere on campus, the
potential for impact includes: the student, his/her roommates, the floor
mates, the friends, the RAs and perhaps the greater campus community,
depending on the nature and severity of the incident. There are many offices
that pull together in responding to each incident such as the Dean of
Students, Counseling Center, Health Center, Judicial Office, Residential
Services and Campus Safety. The immediate response is to assist the student
as well as any other member of the campus community affected. Then in
the hours, days and weeks that follow, each office deals with the documentation
of the situation and provides follow up meetings and services with the
residence hall community and friends of the person(s) involved.
Residential
Services
Residential
Services is in many instances the front line staff responding to the situation.
Staff intervene, confront, document, support, and communicate regarding
the incident.
One difficulty
the Residential Services office has had to deal with is the confusion
and frustration of the resident(s). This is protracted if the students
crisis involved another student. An example is a student who is physically
assaulted by another student. The victim may blame the administration
for not stopping the behavior before it happens. The student who acts
out, as well as the students who witness this behavior or are victims
of the behavior, may experience a sense of fear due to a of loss of control
during the event. The victim often wants to know why the person acted
out and what is wrong with the person and he/she wants assurances
that this will never happen again. Usually, the victim feels that the
perpetrator should not be allowed to re-enter their community. Problems
arise because many of the questions and concerns cannot be answered due
to the confidential nature of the situation. Sometimes just having a forum
to share their feelings is enough for some victims, but often there is
a need to take action to do something to make it better. Oftentimes students
are not clear on what that action should be, except perhaps not allowing
the perpetrator to come back to the building or to the campus. When this
does not happen, it can cause some students to become angry with the members
of the administration because they feel the perpetrator will eventually
move on with the normal rhythm of his/her life.
Dean
of Student Office
Often the
Dean of Students office begins the process of working with any issues
involved with a student experiencing a mental health emergency. This office
may have the first contact with the students family and ensures
that each office involved is communicating appropriately with each other.
At Muhlenberg College, the Dean provides any formal letters to the student
regarding his/her status during the emergency. The student may be placed
on a temporary or semester long leave either voluntarily or involuntarily.
Depending on the nature of the emergency, there may be a component of
a continued counseling relationship. This is done in conjunction with
the Counseling Center.
Counseling
Center
The Counseling
Center has the dual role of working with the student with the mental health
crisis as well as the other members of the campus community. Depending
on the nature of the students mental health emergency, the Counseling
Center may need to assist the student in getting help with outside practitioners
or treatment facilities and maintain a working relationship with these
groups. The staff from the Counseling Center will be faced with trying
to assist other offices on campus while maintaining the students
confidentiality, especially if he/she hasnt signed a waiver giving
them the authority to discuss the students mental health needs.
Campus
Safety
The Campus
Safety Department may be the first response depending on when and where
the event occurs. If they are the first respondent then they are often
in charge of relaying information and contacting of other offices to come
and assist. They maintain the safety of the individual in crisis as well
as any other members of the community in the area. In addition, they may
assist with monitoring the student until he/she is evaluated or taken
home by the family. Because they are often involved from the beginning,
they will also produce a detailed report of the incident for the other
offices including the Judicial Affairs office.
Judicial
Affairs
Judicial
Affairs is normally involved after a situation has occurred on campus.
Regardless of the nature of what happened, the Judicial Officer must review
the documentation focusing on the behavior of the student. If this behavior
is found to violate College policy, the matter must be dealt with in the
same fashion as any other violations. It is important to remember this
student will need the same consistent compassion and due process that
any student receives on campus.
The
Importance of Being Prepared:
Are you ready to handle a mental health emergency on your campus?
While we
may say a silent prayer each year that we dont have to deal with
a serious mental health crisis, it is important to be prepared. One of
the benefits I received from planning and participating on this panel
was the opportunity to dialogue the what ifs and how
tos with colleagues. Often during increasingly hectic semesters,
the ability to take the time to discuss and review how to handle crisis
of any nature can become challenging. I encourage you to make that time.
I suggest
some of the following questions to consider for your own campus:
- Do you
have policies regarding students who experience a mental health emergency?
- Do they
cover the possibility for voluntary or involuntary leave?
- Does
your campus have an overall plan for dealing with emergencies?
- Does
it cover what offices need to be involved?
- Are
you clear as a staff team on how each office must deal with the emergency
and its impact on your operations?
- Have
you worked with the institutions lawyers on any potential legal
issues?
The complexity
of mental health emergencies provides us with the chance to review how
we balance the needs of the student with the needs of the campus community.
It can test how well the campus can work together. Participating in this
panel has also reminded me of the need to collaborate with members of
our profession at other campuses. The sharing of experiences and techniques
that have worked are a valuable method of professional development.
About the Author
Jan Schumacher
is the Director of Residential Services at Muhlenberg College in Allentown,
PA. She has worked at Muhlenberg for 5 years and is in her third year
as director. She received her undergraduate degree in psychology and masters
degree in Student Affairs in Higher Education from Kutztown University.
She was a member of the host committee for MACUHO 2002 and currently serves
as the recorder for PCPA.