The Road to Responsiveness


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The Road to Responsiveness

  1. 1. The Road to Responsiveness: The path to creating a collaborative and comprehensive program to address the drug problem among students<br />A presentation by<br />Carolyn Pile Natividad, M.A. Ed<br />23 November 2010<br />8th AFTC Conference<br />
  2. 2. Outline<br />Introduction<br />Necessity<br />Responsibility<br />Responsiveness<br />Post-partum update<br />Assertions<br />
  3. 3. Introduction: Starting at the end<br /><ul><li>SY 2010-2011: 3rd year of official implementation of our Collaborative Anti-Drug Abuse Program (CADAP)
  4. 4. School Council approval: 2007
  5. 5. Randomly test 25% of our college population every year</li></li></ul><li>Introduction: Starting at the end<br />Process:<br />Computer program generates names<br />Students are summoned one by one, primarily through their registered cellphone numbers<br />Student Affairs Office = drug testing order slip<br />Infirmary = actual testing<br />
  6. 6. Necessity: The Law and the School<br /><ul><li>Mandate from RA 9165 (The Comprehensive Dangerous Drugs Act of 2002)</li></ul>“It is the policy of the State to safeguard the integrity of its territory and the well-being of its citizenry, particularly the youth, from the harmful effects of dangerous drugs on their physical and mental well-being….” <br />“Towards this end, the government shall pursue an intensive and unrelenting campaign against the trafficking and use of dangerous drugs and other similar substances through an integrated system of planning and implementation and enforcement of anti-drug abuse policies, programs and projects”<br />The Philippine government has authorized drug testing - students of secondary and tertiary schools are among those specified<br />
  7. 7. Necessity: The School & the Problem<br /><ul><li>Made the school’s participation explicit, demanding some systematic response to the drug problem.
  8. 8. Arguing necessity:</li></ul>Statistics from surveys (YAFS), data provided by Dr. Benjamin Reyes of the DOH, data from a reputable testing agency<br />Situated the problem within our own context<br /><ul><li>Comprehensive survey
  9. 9. Anecdotal reports
  10. 10. Discipline data
  11. 11. Studies done by our own faculty and students</li></li></ul><li>Responsibility: The Questions<br /> In what ways we take responsibility<br /> How do we respond as we are called to respond, as limited by our ability and prescribed by our relationships?<br /> Covers: what we are asked to do, what we can do, and what we ought to do<br />
  12. 12. Responsibility: Birthing Pains<br /><ul><li>V.1: Concentrated on the Random Drug Testing (RDT)  presented in 2003</li></ul>High school context vs College<br />College: <br /><ul><li>Different schedules per day
  13. 13. Even if they have class, it may not be in the assigned room
  14. 14. No make-up work
  15. 15. Professors tend to be very possessive about the limited time with the students</li></ul>V.1 = FAIL<br /><ul><li>Community wasn’t ready for it
  16. 16. Implementing Rules and Regulations had not yet been released</li></li></ul><li>Responsibility: Birthing Pains<br />What we learned:<br />The fulfillment of your objective cannot occur in a vacuum  consider context, culture<br />A drug testing program alone is insufficient (What do we do after we catch them? How do we prevent students from getting into drugs in the first place?)<br />Structural changes were necessary.<br />Get the program under the appropriate office<br />Make adjustments to the Code of Discipline to address those who will not be compliant with the new process<br />
  17. 17. Responsibility: Birthing Pains<br />Formed a Council composed of representatives from various sectors/stakeholders who would collaborate jointly to address the problem from multiple perspectives:<br />Student Affairs Ofc (non-academic; may involve discipline)<br />LS Guidance & Counseling Ofc (source of info; helping professionals)<br />Ateneo Wellness Center (psychologists)<br />LS Health Services Ofc (Health issue)<br />Health Sciences Program<br />
  18. 18. Responsibility: Birthing Pains<br />Residence Halls (cases with absent parents)<br />Communication Department (get the message across)<br />InTACT Program (Freshman homeroom as a venue for info dissemination and source of positive influence)<br />Sanggunian/School Council (voice of the students)<br />ASPAC/Parents Council (voice of the parents)<br />
  19. 19. Responsibility: Birthing Pains<br />CHED “General Guidelines for the Conduct of Random Drug Testing for Tertiary Students” Sept. 15, 2003<br /><ul><li>Guiding Principles
  20. 20. School is obliged to employ every reasonable means to provide a healthy and drug-free environment to its populace.
  21. 21. Cognizant of the right of students to continue and complete their studies, the government and the schools shall give emphasis to the implementation of measures aimed at guidance and counseling together with the treatment and rehabilitation of any student found to have used or to be dependent on dangerous drugs</li></li></ul><li>Responsiveness: The CADAP Program<br /><ul><li>Responsiveness is responsibility in real terms</li></ul>Real needs, real restrictions, real time, real costs<br /><ul><li>The CADAP is aschool-initiateddrug program that satisfies but goes beyond the requirements of R.A. 9165</li></ul>Guiding Principles:<br /><ul><li>Opting for choices that contribute to one’soverall well-being and positive development
  22. 22. Personal responsibility for choices made
  23. 23. Communal responsibility for student welfare
  24. 24. A caring (rather than punitive) community</li></li></ul><li>Responsiveness: The CADAP Program<br /><ul><li>Three-pronged approach to creating a healthy, drug-free campus:</li></ul>PREVENTION,<br />TESTING and <br />INTERVENTION<br />Note: Still a work-in-progress<br />
  25. 25. Responsiveness: The CADAP Program<br />Prevention Program and Campaigns<br />Anti-Drug Media Campaign (the negative campaign)<br /><ul><li>Primers on dangerous drugs
  26. 26. Venues for dialogue
  27. 27. Eliciting the help of students and orgs in creating documentaries and multi-media campaigns</li></li></ul><li>Responsiveness: The CADAP Program<br />Healthy Lifestyles Choices Program (the positive campaign)<br />Promote resilience<br />Promote alternative coping strategies and the development of life skills<br />Develop and sustain support communities (orgs, barkadas, homeroom classes, home departments)<br />
  28. 28. Responsiveness: The CADAP Program<br />GAPS (Guidelines for Adolescent Preventive Services) by the American Medical Association is used to identify students who are at risk prior to drug testing<br /><ul><li>Referred to guidance and counseling</li></ul>Actual questions (Drugs):<br />35. Do you ever use marijuana or other drugs, or sniff inhalants?<br />36. Do any of your close friends ever use marijuana or other drugs, or sniff inhalants?<br />37. Do you ever use non-prescription drugs to get to sleep, stay away, calm down, or get high? (These drugs can be bought at a store without a doctor’s prescription)<br />38. Have you ever sued steroid pills or shots without a doctor telling you to?<br />.................................YES NO NOT SURE<br />
  29. 29.
  30. 30. 45%<br />Benzodiazepines<br />27.5%<br />THC/Cannabinoids<br />22.5%<br />Amphetamine/Methamphetamine (Shabu)‏<br />5%<br />MDMA-Ecstasy<br />Responsiveness: The CADAP Program<br />Random Drug Testing: Advocating Personal Accountability and Communal Responsibility<br />Identified a reliable drug testing agency<br />Chose the appropriate drug testing package<br /><ul><li>Based on statistical reports
  31. 31. Drugs used by students*:</li></ul>*School Drug Testing Program Statistical Report for 2004 of the Asia Pacific Medical and Diagnostics, Inc (APMD)‏<br />
  32. 32. Responsiveness: The CADAP Program<br />Determined the percentage of the population to be tested<br /><ul><li>Presented a whole range of options from 10% to 100%
  33. 33. Settled on 25% (once in your 4 years in college)</li></ul>Determined the source of funding<br /><ul><li>Everyone subsidizes those who are tested  less than P100/student/sem
  34. 34. Includes not just the test kit but overhead costs (e.g. Hiring)
  35. 35. Part of enrolment fees
  36. 36. It is cheaper than what other schools charge, given that we test for 4 substances</li></li></ul><li>Responsiveness: The CADAP Program<br />Determined the duration<br /><ul><li>Throughout the year, in all semesters</li></ul>Experimented with the most effective and appropriate procedures for randomization and summoning<br />Computer generates X number of names for a testing period  Held in confidence by the RDT head, verified by the Selection Board (as specified by law)<br />
  37. 37. Responsiveness: The CADAP Program<br />Officially summon the students to get their drug testing order slip (DTOS)<br /><ul><li>1st suggestion: Group sampling (entire classes)  simpler logistically. Not approved.
  38. 38. Individual summoning (go to class to hand them their DTOS)
  39. 39. More than 50% failure rate  only a 10min window at the start of class that you could disturb to summon a student from that class.
  40. 40. Students were frequently late or absent
  41. 41. Required a massive number of ushers
  42. 42. There are “peak periods” where classes tended to gravitate so sometimes 1 usher had to deliver 4 notices within the same 10 minutes, in different buildings (since the campus is quite large)
  43. 43. Settled on the use of cellphones since more than 95% had them</li></ul>Texted in the morning to get a letter from our office<br />They need to present themselves at the infirmary during their next free period (before 5:00pm)<br />
  44. 44. Responsiveness: The CADAP Program<br />Determined the consequences and intervention<br />(+)‏<br />(+)‏<br />RDT Results<br />Confirmatory Testing<br />Assessment of Level of Drug Dependency<br />Drug Dependency Exam<br /><ul><li> Preliminary case history
  45. 45. Review of past health history
  46. 46. Review of drug history
  47. 47. Vital signs monitoring
  48. 48. Physical Examination
  49. 49. Follow-up Drug testing
  50. 50. Clinical Correlation
  51. 51. Interventions & Recommendations</li></ul>WHO Definition of Drug Dependence:<br />Cluster of physiological, behavioral and cognitive phenomena of variable intensity, in which the use of a psychoactive drug takes on high priority, thereby involving, among others, a strong desire or a sense of compulsion to take the substance, and the difficulties in controlling substance-taking behavior in terms of its onset, termination, or levels of use<br />Medical: 3-Month Observation & Counseling (By law)‏<br />(Confined or treated on an out-patient basis, depending on the assessment and recommendation of attending physician)‏<br />(If assessed to be a drug dependent)‏<br />Administrataive: Refer to Student Handbook / Manual of Regulation for Private Schools<br />
  52. 52. Responsiveness: The CADAP Program<br />Levels of Intervention: Enabling Wellness<br />Basic components:<br /><ul><li>Training of drug counselors
  53. 53. Competent and accurate diagnosis
  54. 54. Counseling for non-dependents
  55. 55. Referral to a reputable rehabilitation center in cases of dependence
  56. 56. Conditions of re-integration</li></li></ul><li>Responsiveness: The CADAP Program<br />Guiding principles:<br /><ul><li>CHEDveers awayfrom a “strictly criminal” approach </li></ul>“test results shall not be used in any criminal proceedings” <br />Purpose of drug testing: “facilitate the rehabilitation of drug users and dependents” <br />“First time positive confirmatory drug test result shall not be a ground for expulsion or any disciplinary action against the student”<br /><ul><li>Punishment alone is an insufficient response from the perspective of a caring learning community</li></li></ul><li>Responsiveness: The CADAP Program<br />Level I Intervention: Counselingand Continued Random Drug Testing <br /><ul><li>If positive in the first confirmatory test but assessed as a non-drug dependent
  57. 57. Under the care of the school physician (Director of LS Health Services Office/DT Coordinator)</li></ul>i.e. It is NOT a disciplinary matter; names are kept confidential<br /><ul><li>Student will be subject to RDT at any time for the remainder of his stay with the university, as required by school personnel</li></li></ul><li>Responsiveness: The CADAP Program<br /><ul><li>Non-cooperation Discipline case (“Offenses Against Order” under the Code of Discipline in the Student Handbook)</li></ul>“ Violation of official policies and measures implemented against the use of dangerous drugs.” <br /><ul><li>If already confirmed positive through RDT (not necessarily as a drug dependent) but tests positive AGAIN in the confirmatory test of any subsequent RDT  Discipline Case ( “Offenses Against Security”)</li></ul>“Possession, use, or distribution of dangerous drugs (according to RA 9165) for something other than their intended medical purpose.” <br />
  58. 58. Responsiveness: The CADAP Program<br />Level II Intervention: Drug Rehabilitation for the Drug Dependent<br />Provide options (of rehab services) to the student and family concerned<br />Sept 2006: CADAP Council Roadshow of Rehab Centers<br />March 2007: 3 separate, whole-day site visits to rehab centers to the south, north and around Metro Manila<br />
  59. 59. Responsiveness: The CADAP Program<br /><ul><li>Criteria for evaluating (three major clusters):</li></ul>Compatibility with core values<br />Technical competencies <br />competency in handling of adolescents and family issues, <br />relevant training and experience, <br />flexibility in addressing different levels of substance abuse<br />Staff-patient ratio<br />Pharmacological capability<br />Substance of inpatient and outpatient program<br />Practical concerns<br />Affordability<br />Adequacy of space<br />Gender sensitivity<br />Safety measures <br />
  60. 60. Responsiveness: The CADAP Program<br /><ul><li>Centers which passed the criteria were divided into two categories: (1) for Primary Consideration, and (2) for Secondary Consideration</li></ul>The list is NOT equal to an endorsement<br />The list is a guide. Where to send a dependent for rehabilitation and what program to avail of is a decision for the dependent’s family and their chosen doctors<br />The list is important because<br /><ul><li> Volume of options
  61. 61. Lack of articulation of the merits of one versus another
  62. 62. Deplorable state of even some of those accredited by the government
  63. 63. Give options: Of cost, of location, of philosophy/treatment modality, of the range of treatment (in-patient/out-patient)</li></li></ul><li>Responsiveness: Structural Changes<br />Important structural changes<br />Out of the ADSA (Discipline) Office <br />Honor the spirit of the law/anti-drug effort<br />Conflict of interest <br />Confidentiality of medical records<br />Infirmary  LS Health Services Office (3 years ago)<br />
  64. 64. Responsiveness: Structural Changes<br />Code of Discipline<br /><ul><li>Reworded existent provisions to be compatible with the language of RA 9165
  65. 65. Added offense against order  compliance w/ procedures
  66. 66. Added to the “Student Responsibility”, not just “Student Offenses”</li></ul>Communal responsibility to keep the school drug free<br />Keep their information updated<br />
  67. 67. Post-partum Updates<br /><ul><li>Some queries
  68. 68. Some complaints</li></ul>Other priorities<br />Personal constraints<br /><ul><li>Difficulties</li></ul>Contacting students to get them to receive their DTOS<br />Occurrences of diluting the sample<br /><ul><li>The random testing works</li></ul>Has been able to identify students within the population norms<br />
  69. 69. Assertions<br />It is necessary for an educational institution to address the drug question among its student population, no matter its complexity. This includes:<br /> the promotion of a healthy, drug-free lifestyle, <br />the safeguarding of the common good through random drug testing and the institutionalization of responsibilities and rules that govern behavior, and <br />support of those in recovery by enabling wellness given the various levels of the problem, within the context of a caring learning community. <br />
  70. 70. Assertions<br />The core of an effective anti-drug abuse campaign in the tertiary level is responsibility. This means regarding students:<br />as agents who have the capacity to govern their responses, apart from mere compliance to a set of rules, <br />who should also be accountable for those responses.<br />
  71. 71. Assertions<br />No anti-drug program will succeed without the provision of structural support:<br />the identification of the capable individuals who are in the best position to lead the program, <br />the allotment of resources, and <br />the amendment of internal legislation in support of the spirit and letter of the anti-drug initiative.<br />
  72. 72. Assertions<br />It is not enough to be responsible; one must be responsive – which is to say that we need to continually account for real needs, consider real constraints, and aim at concrete results. <br />
  73. 73. Assertions<br />The journey to responsiveness is one of continual evolution.<br />