DeRomana_OSAC - Miami University
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Transcript DeRomana_OSAC - Miami University
Areas of Responsibility
Risk Assessment
Physical/Mental Health
Emergency Management
Health Clearance
Safety and Security
Emergency 24/7 First
Responder
Management and
Reporting of Individual
Student Incidents
Compliance
Process
Student Health
Insurance
Students with
Disabilities
Student Conduct
Title IX/SHO Officer
Take a Moment
What are your views about depression, counseling,
mental health, suicide?
Recognize your own reactions
Where did you first learn about mental health,
counseling, mental illness?
How does your family feel about counseling?
How does your culture view mental health?
Who is Protected by Section 504 and the ADA?
Persons that
• have a physical or mental impairment that substantially
limits one or more major life activities; or
o Learning is considered a major life activity
• have a record of such an impairment; or
• are regarded as having such an impairment
National Trends
Depression
•
Rates among college students have doubled since
1998
Anxiety
Sexual Assault
Suicidality
(Benton, 2003)
200%
400%
300%
2010 Counseling Center Directors’ Survey
91% report trend continues: greater number with
severe psychological problems
70.6% report crisis required immediate response
60.0% report learning disabilities
45.7% report alcohol abuse
45.1% report illicit drug use (Other than alcohol)
http://www.iacsinc.org/NSCCD%202010.pdf
Prevalent diagnoses on college campuses. . .
Anxiety/panic disorders
Depression
Eating disorders (highest mortality rate)
Suicidal tendencies
Self injurious behavior
Bipolar disorder
College Age (18-25) …
Emergence of significant mental illness typically
occurs during college years
• Bipolar disorder – increasingly recognized that often the
onset is in adolescence
• Schizophrenia – ¾ develop it between 16 &25; onset
uncommon after 30
• Major Depression
• Personality Disorders
Adding Complexity
Non-disclosure due to stigma and fear
• fear of being labeled, judged, and perceived differently
Sleep deprivation (high cost)
• irritability, moodiness, psychopathologies (depression,
ADHD, etc.), decreased concentration and memory
Stress
Developmental stages (counseling concerns)
• On campus psychological emergencies overtax delivery of
services to general wellbeing and developmental needs of
the student population
Adding complexity
High risk behaviors: Substance abuse
• Co-occurring mental disorders are common where
substance abuse is present
Buying/selling medication; abuse of non-prescribed
medication; abuse of OTC medication (cough and cold
medicines, etc.)
• Adderall
Self-medicating - non-prescribed
Non-compliance with medication; significant issue
• Side effects
• Interferes with alcohol consumption
Adding complexity
Student’s failure to obtain needed help
• Resistance
• Lack of awareness
• Stigma; discrimination
Therapy reluctance
• Waiting until problems are severe
• Reluctance to continue treatment (time commitment)
• Family cultural values; parental denial
Alcohol Abuse
Binge drinking: five consecutive alcoholic drinks for
a man, four for a woman
• 2 of every 5 students—more than 40 percent—
About 1,825 college students die each year in
alcohol-related accidents – unintentional injuries,
including automobile accidents
About 97,000 students are raped or sexually
assaulted each year
http://www.niaaa.nih.gov/Pages/default.aspx
Alcohol Abuse
About 696,000 a year are assaulted by another
student who has been drinking
About 25% say alcohol has hurt their academic
performance
8% – 400,000 students – report having unprotected
sex when drinking (increased risk for pregnancy,
AIDS, STDs)
100,000 too intoxicated to know if they consented
to having sex
Are Current Users of Alcohol Excluded from
Protection under Section 504?
No. Section 504's definition of a student with a
disability does not exclude users of alcohol
However, Section 504 allows disciplinary action
against students with disabilities using drugs or
alcohol to the same extent as students without
disabilities
Next Exit? Study Abroad
Supporting
students
Consultation
Consultation is key
Do not try to handle things on your own
Know your institutional counseling staff
■ Culture Shock
A normal developmental phase of adjustment
Mimics more severe psychological problems such as
clinical depression and anxiety …
o feeling helpless, out of control, vulnerable, fearful, anxious,
confused, crying or sleeplessness
■ Usually Time Limited – (e.g. 2-weeks)
Contributing elements
Separation
Travel stress
Culture shock; different
expectations
Adjusting to local conditions;
social pressures – new friends
Learning or using a learned
foreign language to
communicate
Managing condition in
unfamiliar setting; foreign
language skill
Preexisting or dormant
conditions
Change in medication
Stopping medication
Lack of continuity of care─no
plan
Self medication (drugs,
alcohol, etc.)
Unforeseen events
New relationships gone wrong
Financial hardship
•
Financial hardship of family in
the U.S. due to job loss
Impact on Education Abroad
Upward trend in the number of students with mental
disorders (mild – severe)
Local laws are different
Culture is different
Local language may be different
Common Issues Abroad
Substance Abuse
Anger Management
Disregard of others within
student community
Abruptly stopping
medication, or medication
not legal/locally available
• “magic cure”
History of eating disorder
Unable to manage health
condition
History of severe
depression, anxiety,
bipolar disorder
History of suicide
attempt/ideation
• Suicide is the second
leading cause of death in
college students; the
third leading cause of
death in adolescents.
Students without any
psychological illness
experiencing symptoms
for the first time abroad
Cutting
Best Practices
UCEAP Policy
Provide assistance with reasonable
accommodations to qualified students with
disabilities to help their successful participation in
the University's educational programs and activities
Encourage disclosure after acceptance to
assess accommodations in host country
Require pre-departure health clearance
UCEAP Team Approach Abroad
Disability Services Office
Partner Institution
Counseling Center
Local Resources
Student
UCEAP
Alcohol/Drug Program
Student Health Center
Mobility International
Medical Assistance Provider
Best Practices
Close work with University Counsel and Risk
Manager (protocols, forms/contracts)
Design policies to allow withdrawal for medical
reasons (involuntary withdrawal?)
• Consider: Work with travel assistance provider, can
student travel alone?
• Treatment resources for a safe transition back to the U.S.
campus
Design policies to allow return to program; know if
you can stipulate conditions
Best Practices
Clearly delineated protocols
• Before departure/during program
• Review and update protocols and policies
regularly
• Legal implications should never be the main
concern—student/faculty/staff safety
Best Practices
Require health insurance; med evac/repat
• Know your insurance/assistance providers
Require a pre-departure health clearance
•
•
•
•
After acceptance
Explain confidentiality
Encourage self-disclosure
Consider pre-departure safety health plans
Best Practices
Learn about health resources and have a list
ready before you need a referral
•
•
•
•
•
•
U.S. Embassy
Insurance carrier (travel assistance)
U.S. programs in area
U.S. university counseling center
Local health clinics and hospitals
Local health practitioners and specialists (English
speakers; culturally sensitive)
Best Practices
Be aware of the attitudes toward mental
disabilities in the local culture; explain to
students
Determine the role of culture in diagnosis,
treatment and outcome of mental illness
Training
Why is Training Important?
Some students in distress seek help
Others will not seek help, but will show warning
signs
Impact is on ALL students in program
Understand your Role: 5 Simple Steps
1. Learn to spot signs of distress early
(Assess student behavior: Is it normal? Atypical?
Any warning signs?)
2. Know how to offer support; work with student
3. Connect student to resources; know your limits
4. Know emergency procedures; insurance coverage;
assistance provider
5. Do not offer support beyond your expertise and
official duties
Why are Training and Collaboration Important?
Cross-train Counseling and Student Health staff
•
•
•
•
Consultants
Prevent stigma
Privacy vs safety
Guidance about local resources/legality of prescribed
medications from EAO
• Helps to remain focused and calm
• Helps with international students on your campus and
study abroad students (natural disaster, major unrest
affecting the host country)
Pre-departure:
• Discuss with student anticipated challenges, management
plan and risks
• Identify treatment provider in host country before leaving
home
• Consider agreeing to a Safety Health Plan (spelling out
expected behaviors and consequences of not following)
• Send message to all students about local resources,
medication
Do’s. . .
Be realistic about local
resources
Have contingency plans
in place
Provide pre-departure
information for
students and parents
Normalize process to
ask for help
Express your concern
directly
Have a plan, especially
if clinical support is
needed when abroad
Offer assistance with
appointment (use your
assistance provider)
Remove barriers (lack
of money
Use a team approach
Don’ts. . .
Diagnose or analyze
(not your job)
Minimize problems
Ignore comments about
suicide
Be sworn to secrecy
Try to manage situation
by yourself
Forget to self care (seek
support for yourself)
Be caught without a
plan
You can help…
The majority of students with disabilities can
participate successfully
• Proper planning
• Discuss potential study abroad stressors
• Provide resources
Resources
Active Minds (peer to peer resource)
• http://www.activemindsoncampus.org/
The American Association of Suicidology
• www.suicidology.org/
American College Health Association
• www.acha.org/
American Foundation for Suicide
Prevention
• www.afsp.org
Resources
Bazelon Center for Mental Health Law
• www.bazelon.org/
College Drinking – Changing the Culture
• http://www.collegedrinkingprevention.gov/
Jed Foundation
• www.jedfoundation.org
Resources
NAFSA Best Practices in Addressing Mental Health
Issues Affecting Education Abroad Participants
• www.nafsa.org/mentalhealth
My Student Body
• www.mystudentbody.com
National Institute on Drug Abuse
• www.nida.nih.gov/
Resources
Substance Abuse & Mental Health Services Administration
• www.samhsa.gov
• What a Difference a Friend Makes
o http://whatadifference.org/support.asp?nav=nav02_3&con
tent=2_3_3_peers
Helping your Student when Stress Turns into Distress (Guide for
Parents)
http://uhs.berkeley.edu/parents/stress.shtml
Resources
The Loneliest Disease
• http://www.wtop.com/?nid=226&sid=1357907
• WTOP's Darci Marchese and Kate Ryan look at the impact of mental
illness
Urban Dictionary
• www.urbandictionary.com
World Health Organization
• Mental Health Atlas
o http://www.who.int/globalatlas/default.asp
University of California, Berkeley Online Staff Training
http://uhs.berkeley.edu/facstaff/CPStraining/index.htm
http://uhs.berkeley.edu/training/violenceawareness/
Contact information:
Inés DeRomaña, Principal Analyst
Health, Security, and Emergency Response
University of California System
Education Abroad Program
6950 Hollister Ave. Suite 200
Goleta, California 93117-5823
U.S.A.
Ph: 1+805.893.7936|Cell: 1+805.451.1704 |Email: [email protected]
Permission to Use
Conditioned on acknowledgement of Ines DeRomana
as the author, with copyright belonging to The
Regents of the University of California.