Paul Joffe, Counseling Center

1. The “Illinois Approach” to Responding to Troubled and At-Risk Students and EmployeesA Panel Presentation and DiscussionAugust 18, 2008 Paul Joffe, Counseling Center Jeff Christensen, Division of Public SafetyKatherine Galvin, Office of Legal Counsel

3. Definition: Public Mental Health Crisis A public mental health crisis is defined as any incident that occurs in a public setting and results in another member of the community being alarmed, distressed and/or disturbed and which involves a known or perceived mental health issue.

4. Examples of Mental Health Crises • A suicide attempt that occurs in the residence halls • Non-suicidal cutting that draws the attention of other students • Public intoxication • The expression of persistent and unwelcome romantic interest • The expression of a paranoid delusion

7. In responding to troubled and at-risk students, the single most important step a campus can take is to take charge of the campus community and any crisis that might occur in the campus community.

8. Case Example: Taking Charge in Romantic Context • Matt is a 24 year-old Ph.D. candidate in humanities • E-mails the professor of a class he is taking a series of provocative messages indicating romantic interest. • She ignores the romantic content and focuses on academic issues. • Mid-semester, he shows up after class to go to a “planned dinner.” • She asks him to leave and he refuses. • She phones the police who over the phone ask him to leave. He refuses. • Police arrive and ask him to leave. He does.

9. Note: • Matt’s conduct did not cross a criminal threshold that might lead to his arrest. • Because the professor declined to file a report, Matt’s conduct was not in violation of the Student Code. • While Matt did not make an actual threat, his conduct was alarming and threatening.

10. Principles of In-Chargeness • Those who become violent usually have deep-seated issues around control and being in-charge. • Those who become violent, usually have a history of small-scale incidents in which they engage in conflicts of control or in-chargeness. • Many people have issues of control/being in charge. • Only a small handful of people with issues of control/being in charge will eventually become violent. • It’s important to respond to all students who display issues of control/being in charge via small scale precursor incidents. These would include small ruptures in the fabric of civility.

11. The University’s Practice ofProgressive Engagement Matt is called to a meeting with Director of Graduate Studies, who expresses his concern/alarm and future expectations. Matt is instructed not to attend class the following Monday and not to contact the professor by any means. Matt is called into a meeting the department head (also his advisor) who expresses concern/alarm and future expectations. Matt is called to a meeting with the Director of the Office of Conflict Resolution. Provisions are made for Matt to complete the course as an independent study with another member of the faculty. Matt abides by all limits and expectations.

12. Taking Charge in Context of Suicidal Intent • In 1984 the University of Illinois established a standard of self-welfare. • Self-inflicted injury for the purpose of ending one’s life was considered a violation of this standard. • Students who threatened or attempted suicide were required to attend four sessions of mandated assessment. • The university took suicide off the table as an option for students.

13. Results • Since 1984 approximately 3000 students have gone through the program. • The rate of suicide has been reduced by 46 percent. • Only one student has been withdrawn. She was subsequently readmitted after three months.

14. Virginia Tech Report:Recommendation IV-4 “Incidents of aberrant, dangerous, or threatening behavior must be documented and reported immediately to a college’s threat assessment group, and must be acted upon in a prompt and effective manner to protect the safety of the campus community.”

15. Illinois Approach: Key Elements • Key thresholds • Call to engagement • Wrap around community • Micro-culture of limits and expectations • Alternate being in charge and not being in charge • Stepwise process • Student self-demonstrates his/her fitness to be in school

16. Six Behavioral Thresholds • Suicide attempt/threat • Homicidal threat • Significant homicidal ideation • Substantially and inappropriately “in-charge” • Persistent pursuit of options that don’t reasonably exist • Presence of a delusion

17. The Call to Engagement • The crossing of a behavioral threshold becomes a call to the community to engage with the student (e.g., a suicide attempt or persisting unwanted romantic attention). • The engagement is diverse and spans both the personal and the administrative, the formal and the informal, the encouraging and the expectant. • The engagement is coordinated and consistent across several members of the community.

18. Elements of Engagement • Members of the community express concern over the recent incident. • Members of the community convey the seriousness of the situation. • Members of the community clarify the boundaries of the domains in which the student and others are legitimately in charge. • Members of the community clarify what reasonable options exist. • Members of the community establish explicit limits for future conduct. • Members of the community notify the student of the consequences for failing to adhere to limits.

19. Ten Core Practices • Team approach (7 specialized teams) • Trained reporting network • No contract • No trespass • Point of contact • Exhausted all route of appeal • Systematic disengagement • Virtual teams/executive coaching • Letter of expectation • A shift to formal process only

20. The U of Illinois’ Seven Teams • Suicide Prevention Team • Eating Disturbances Intervention Team • Alcohol/Substance Abuse Intervention Team • Trauma Response Team • Interpersonal Violence Working Group • Workplace Violence Working Group • Special Situations Working Group

21. Special Situations Team • Legal Counsel • Counseling Center • McKinley Health Center • Office of the Dean of Students • Campus Police • Housing Division • Graduate College • Office of the Provost • Office of the Chancellor • Office of Student Conflict Resolution • Office of Equal Opportunity and Access • Office of International Student and Scholar Services

22. Colleagues:Occasionally it is helpful to limit a student’s contact to a single University entity when the student has contacted several units attempting to address problems and concerns. Identifying a single person with whom the student can work helps the student focus her or his energies on problem-solving and assists our various units by keeping them from working at cross or overlapping purposes.I ask that you direct current student “student’s name” to Dean “deans name:” as her contact point for the University to discuss her student and employment status.Please let me know if you have questions or concerns.

23. Police Response and Resources • Importance of (pre-incident) intervention • Case Review • July 2007, 4th and Green St., Champaign • 1996 – 1998, Benjamin Smith • 2008, Steven Kazmierczak • Prevention is KEY; Response is CRITICAL • Preparation over panic • Police response to active threats • http://www.dps.uiuc.edu/activethreat.htm

24. Safety Issues as Presented in the Employment Context

25. Same Intervention Model for Students and Employees Overarching Principles: Be Pro-active Focus on Conduct & Impact on Environment Communicate & Enforce Expectations Engage the Community & Access Resources

26. Inclination & Desire to be Compassionate How do we best accomplish that goal to help an employee who may be in crisis?

27. Early, Clear, Consistent and Firm Supervision is Compassionate Confronting problems early is the most compassionate thing to do for the person in crisis. Helps them get to the resources they may need. Preserves working environment & relationships Avoids more serious and possibly irredeemable consequences

28. It is in the best interests of co-workers, colleagues & staff Safety First: ensures that this highest principle is honored & pursued. Protects employees from adverse work and educational environments.

29. It is in the Institution’s Best Interest Protects against litigation and liability. Allows proper & undistracted focus on higher education mission.

30. Focus on conduct and not the person. Don’t diagnose. Don’t speculate. Don’t discuss (with caveats). Do be aware and document how conduct is impacting the employee’s work and the work environment of others.

31. Document, Document, Document Keep good records of the problems and your responses to them. Every verbal counseling should be followed up with a written summary to the employee. Provide clear guidance regarding expectations and consequences.

32. Confidentiality Preserve Confidentiality to the fullest extent possible and reasonable. SAFETY FIRST: make appropriate disclosures to attempt to keep the employee, the campus and the public safe. If in doubt, ask for guidance.

33. You don’t have to do it alone - You have excellent resources available. It may be new to you, but it isn’t to others. Don’t delay asking for help. New administrators may want to identify some situation early on in their new role and seek out one of the resource contacts to work through the situation. Trust us: we also want what is best for the employee, your unit and the institution.

34. Your Resources Academic Human Resources, 3.6747 Staff Human Resources, 3.3101 UA, Employee Relations & Human Resources, 4.1397 Counseling Center, 3.3704 Office of the Dean of Students, 3.0050 Division of Public Safety Non-emergency, 3.1216 Emergency from campus phone 9.911 Office of Legal Counsel, 3.0560

35. Relevant Policies Policy on Workplace Violence, http://www.fs.uiuc.edu/cam/CAM/ix/ix-a/ix-a-19.html Environmental, Health and Safety Responsibilities of Deans, Directors and Heads of Academic and Administrative Units, http://www.fs.uiuc.edu/cam/CAM/v/v-b-1.2.html