Campus and Community Crises Chris Flynn, Ph.D. Karen Settle, Ph.D. Sherry Benton, Ph.D.
Field shaping crises <ul><li>UT Austin 1966 Tower shootings </li></ul><ul><li>Kent State 1970  4 students killed by Nation...
Population Exposure Model <ul><li>Community victims killed and seriously injured  Bereaved family members, loved ones, clo...
Model of Responses to Trauma & Bereavement Reclaiming Life Anxiety Intrusions Isolation Loneliness Depression Sadness Desp...
Mental Health Roles in Crisis Response <ul><ul><ul><ul><ul><li>Mental health consultation </li></ul></ul></ul></ul></ul><u...
Beware! Common Pitfalls And Risks <ul><ul><ul><ul><ul><li>Over-involvement, doing too much </li></ul></ul></ul></ul></ul><...
Cultural Competence <ul><ul><ul><ul><ul><li>Recognize the importance of culture and respect diversity </li></ul></ul></ul>...
Emergent Professional Issues <ul><li>1. The role and responsibility of the university counseling center in dealing with th...
Emergent issues cont’d <ul><li>5. Beware the “business” of violence prevention </li></ul><ul><li>6. The impending collisio...
After the Storm:  Katrina’s Impact on Psychological Practice in New Orleans Faust, D.S., Black, F.W., Abrahams, J.P., Warn...
Immediately Prior to Anticipated Disaster <ul><li>Arrange for contact person remote from anticipated site of impact. </li>...
2007 Gallagher National Survey Counseling  <ul><li>Greatest concern: </li></ul><ul><li>Finding referrals for long-term hel...
Students on Medication <ul><li>23% of center clients are on psychiatric medication—up from 17% in 2000 and 9% in 1994 </li...
Severe Psychological Problems <ul><li>91.5% of directors see a continuing trend of greater number of students with severe ...
What centers are doing <ul><li>Increase campus training for how to respond to students in trouble and  make appropriate re...
How VT impacted other centers <ul><li>Increase in calls from faculty, etc.   66% </li></ul><ul><li>Increased interest in c...
VT aftermath, continued <ul><li>Pressure to share more information  </li></ul><ul><li>with administration about “difficult...
Non survey suggestions <ul><li>Smith, R. & Fleming, D. (2007).  Student Suicide and Colleges’ Liability.  The Chronicle of...
Smith and Fleming article con’t <ul><li>Take a holistic view of students’ well being and use Screening Programs to help at...
New Eng. J. of Medicine <ul><li>Shuchman, M. (2007).  Falling through the cracks-Virginia Tech and the Restructuring of Co...
New Eng. J of Medicine, cont. <ul><li>Improve communication between physicians in health center who refer a client to the ...
Viewing crises in context <ul><li>Most violence in our society is perpetrated by those who do not have a psychological dis...
Level of Crisis <ul><li>Critical incident </li></ul><ul><li>student or faculty suicide, accidental deaths </li></ul><ul><l...
Campuses have on-going planning <ul><li>90% of college campuses have a Crisis Management team </li></ul><ul><li>80% of col...
Crisis Management <ul><li>Who is on the team? </li></ul><ul><li>Who is in charge? </li></ul><ul><li>Who provides coordinat...
Crisis Management plan <ul><li>Who makes it? </li></ul><ul><li>How is it disseminated? </li></ul><ul><li>How is it updated...
Psychological First Aid <ul><li>First Goal– Timely restoration of physical safety and emotional security </li></ul><ul><li...
Crisis Management Cycle Learning Planning Prevention Response Recovery Zdziarski, E.L., Dunkel, N.W., & Rollo, J.M. (2007 ...
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Campus and Community Crises

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  • This theoretical model--developed by Zunin and Meyers in California--outlines phases of a disaster in terms of individual and collective emotional response in the community. After the initial shock of a disaster, there is often an emotional “high” period--sometimes referred to as the “heroic” phase. This is the time in which people are still running on the adrenaline of the event. Community members and emergency workers may bond together in immediate response activities. This heroic phase often culminates in a honeymoon period, in which there is great optimism. Media may celebrate stories of dramatic rescues, survival, community spirit, volunteerism and donations of money and resources. Depending on the disaster, this phase may last for a few weeks or months. Next however, there is typically a time of disillusionment as the true extent of loss sinks in. The spirit of community cohesion may diminish as some aspects of the community recover faster than others. There may be competition for resources. Some may a sense of unfairness or anger at the bureaucracy. Over time--the healthy emotional recovery process can lead to predisaster emotional functioning--or higher--but on a steady course . . . Our job is to help that happen.
  • Campus and Community Crises

    1. 1. Campus and Community Crises Chris Flynn, Ph.D. Karen Settle, Ph.D. Sherry Benton, Ph.D.
    2. 2. Field shaping crises <ul><li>UT Austin 1966 Tower shootings </li></ul><ul><li>Kent State 1970 4 students killed by National Guard </li></ul><ul><li>Pan Am Flight 103, 1988 25 Syracuse U students killed </li></ul><ul><li>Univ. of Florida 1990 Serial murderer </li></ul><ul><li>U. Of Illinois, 1991-1992 Menningitis outbreak </li></ul><ul><li>Cal State Northridge, 1994 Earthquake </li></ul><ul><li>Univ. of Wyoming, 1998 Matthew Shepard </li></ul><ul><li>Texas A& M, 1999 Bonfire </li></ul><ul><li>9/11 Pace University, New York U and others </li></ul><ul><li>Hurricane Katrina, 2005 </li></ul><ul><li>VTU, 2007 campus shootings </li></ul>
    3. 3. Population Exposure Model <ul><li>Community victims killed and seriously injured Bereaved family members, loved ones, close friends </li></ul><ul><li>Community victims exposed to the incident and disaster scene, but not injured. </li></ul><ul><li>Bereaved extended family members and friends Residents in disaster zone whose homes were destroyed, First responders, rescue and recovery workers Medical examiner’s office staff Service providers immediately involved with bereaved families, obtaining information for body identification and death notification </li></ul><ul><li>Mental health and crime victims assistance providers Clergy, chaplains Emergency health care providers Government officials Members of the media </li></ul><ul><li>Groups that identify with the target-victim group Business with financial impact Community–at-large </li></ul>B C D E A
    4. 4. Model of Responses to Trauma & Bereavement Reclaiming Life Anxiety Intrusions Isolation Loneliness Depression Sadness Despair Guilt Shock Denial Disorientation Disbelief Outcry Heroism Rage Anger Blame Reconstructing A New Life Event 0 to 7 Days TIME 2 to 5 Years Coming to Terms with New Realities Numbing Avoidance Hypervigilance Searching for Meaning
    5. 5. Mental Health Roles in Crisis Response <ul><ul><ul><ul><ul><li>Mental health consultation </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Liaison with key agencies </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Psych-education through media </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Mental health services with survivors, families </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Mental health services with responders </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Stress management support </li></ul></ul></ul></ul></ul>
    6. 6. Beware! Common Pitfalls And Risks <ul><ul><ul><ul><ul><li>Over-involvement, doing too much </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Confusing friend and counselor roles </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Becoming lax about confidentiality </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Providing services beyond competency </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>“ I’m the only one who can…” syndrome </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Disengaging from family and own life </li></ul></ul></ul></ul></ul>
    7. 7. Cultural Competence <ul><ul><ul><ul><ul><li>Recognize the importance of culture and respect diversity </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Maintain a current profile of the cultural composition of the community </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Recruit disaster workers who are representative of the community or service area </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Provide ongoing cultural competence training to disaster mental health staff </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Ensure that services are accessible, appropriate, and equitable </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Recognize the role of help-seeking behaviors, customs and traditions, and natural support networks </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Involve as “cultural brokers’ community leaders and organizations representing diverse cultural groups </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Ensure that services and information are culturally and linguistically competent </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Assess and evaluate the program’s level of cultural competence </li></ul></ul></ul></ul></ul>(CMHS, 2003)
    8. 8. Emergent Professional Issues <ul><li>1. The role and responsibility of the university counseling center in dealing with the seriously mentally ill. </li></ul><ul><li>2. Student privacy and the critical role of consultation. </li></ul><ul><li>3. The emergence of the threat assessment team. </li></ul><ul><li>4. Advocacy for the emotionally challenged. </li></ul>
    9. 9. Emergent issues cont’d <ul><li>5. Beware the “business” of violence prevention </li></ul><ul><li>6. The impending collision between privacy/confidentiality and crisis prevention/management. </li></ul><ul><li>7. The need for comprehensive data and trend analysis on college student mental health. </li></ul><ul><li>8. Restoring peace, harmony, and a sense of safety on our campuses. </li></ul>
    10. 10. After the Storm: Katrina’s Impact on Psychological Practice in New Orleans Faust, D.S., Black, F.W., Abrahams, J.P., Warner, M.W. & Bellando, B.J. Professional Psychology: Research and Practice , 2008, 39 , 1-6. <ul><li>Long-Term Planning </li></ul><ul><li>Develop a disaster plan. </li></ul><ul><li>Coordinate the organization of a disaster plan with fellow professionals. </li></ul><ul><li>Establish a decision tree for evacuation planning. </li></ul><ul><li>Bank documents through the Association of State and Provincial Psychology Boards or establish multistate licensure. </li></ul><ul><li>Make provision for portability of financial issues, including billing, personal and business accounts, and employee information. Consider one out-of-city account </li></ul><ul><li>Routinely back up patient records electronically and store off-site </li></ul>
    11. 11. Immediately Prior to Anticipated Disaster <ul><li>Arrange for contact person remote from anticipated site of impact. </li></ul><ul><li>Contact patients to cancel appointments. </li></ul><ul><li>Make provision for later follow-up. </li></ul><ul><li>When necessary, make provision for referral of patients. </li></ul><ul><li>Ensure electronic back up of current records, staff and patient contact information, referral contact information, billing files, email addresses, and phone numbers. </li></ul><ul><li>Place all office equipment, tests, recording forms in location least likely to sustain damage. </li></ul><ul><li>Secure insurance and other documentation. </li></ul><ul><li>Bring laptop and cell phones with extra batteries and chargers. </li></ul>
    12. 12. 2007 Gallagher National Survey Counseling <ul><li>Greatest concern: </li></ul><ul><li>Finding referrals for long-term help 62% </li></ul><ul><li>Administrative issues re serious path 61% </li></ul><ul><li>Growing demand for services w/o </li></ul><ul><li>increase in resources 59% </li></ul>
    13. 13. Students on Medication <ul><li>23% of center clients are on psychiatric medication—up from 17% in 2000 and 9% in 1994 </li></ul><ul><li>87.5% of directors see increase in # of students coming to campus on medication </li></ul><ul><li>63% of schools offer psychiatric services </li></ul>
    14. 14. Severe Psychological Problems <ul><li>91.5% of directors see a continuing trend of greater number of students with severe psychological problems </li></ul><ul><li>49% of counseling center clients have severe psychological problems </li></ul><ul><li>87% of campuses hospitalized a student last year for psychological reasons </li></ul>
    15. 15. What centers are doing <ul><li>Increase campus training for how to respond to students in trouble and make appropriate referrals 67% </li></ul><ul><li>Increase staff training re: difficult </li></ul><ul><li>cases 58% </li></ul><ul><li>Psycho-education info. on website 55% </li></ul><ul><li>Expanding external referral network 48% </li></ul><ul><li>Student asked to give EM contact 54% </li></ul>
    16. 16. How VT impacted other centers <ul><li>Increase in calls from faculty, etc. 66% </li></ul><ul><li>Increased interest in crisis mgt. team or redesigning current one 61% </li></ul><ul><li>Requests by higher ups for reports 50% </li></ul><ul><li>Greater interest from student leaders 46% </li></ul><ul><li>Policies being revised for communicating </li></ul><ul><li>with parents of students in crisis 31% </li></ul>
    17. 17. VT aftermath, continued <ul><li>Pressure to share more information </li></ul><ul><li>with administration about “difficult” </li></ul><ul><li>cases is increasing 30% </li></ul><ul><li>Calls from parents re: counseling </li></ul><ul><li>services have increased 23% </li></ul><ul><li>Directors spending more time </li></ul><ul><li>discussing limits of confidentiality </li></ul><ul><li>with their bosses 26% </li></ul>
    18. 18. Non survey suggestions <ul><li>Smith, R. & Fleming, D. (2007). Student Suicide and Colleges’ Liability. The Chronicle of Higher Education, The Chronicle Review, 53 , 24-26 . </li></ul><ul><li>Better define Ferpa’s emergency exception to permit disclosures to administrators and others </li></ul>
    19. 19. Smith and Fleming article con’t <ul><li>Take a holistic view of students’ well being and use Screening Programs to help at-risk students </li></ul><ul><li>Require students to report mental illness during application to help the university anticipate needs and development long-term treatment plans where appropriate. </li></ul>
    20. 20. New Eng. J. of Medicine <ul><li>Shuchman, M. (2007). Falling through the cracks-Virginia Tech and the Restructuring of College Mental Health Services, The New England Journal of Medicine, 357, 105-110 . </li></ul><ul><li>Outreach </li></ul><ul><li>Univ. of Illinois suicide evaluation policy </li></ul><ul><li>Improve triaging methods for wait lists </li></ul>
    21. 21. New Eng. J of Medicine, cont. <ul><li>Improve communication between physicians in health center who refer a client to the counseling center </li></ul><ul><li><65% of college counseling centers have no relationship with the college health ctr. </li></ul><ul><li>SMU CAPS consent, “I understand that CAPS may share my records with SMU’s Health Center physicians if beneficial for continuation of care.” </li></ul>
    22. 22. Viewing crises in context <ul><li>Most violence in our society is perpetrated by those who do not have a psychological disorder </li></ul><ul><li>Most of those who have psychological disorders will never become violent </li></ul><ul><li>Vehicle driving, accidents, alcohol poisoning, and suicide are far more likely to lead to untimely death of students than campus shooters </li></ul><ul><li>Most campuses have dealt with students who may be a danger to themselves and others every year for many years. </li></ul>
    23. 23. Level of Crisis <ul><li>Critical incident </li></ul><ul><li>student or faculty suicide, accidental deaths </li></ul><ul><li>Campus Emergency </li></ul><ul><li>suicide pact, public suicide, power outage, 1993 flood </li></ul><ul><li>Disaster </li></ul><ul><li>Community wide– Earthquake, VT </li></ul>
    24. 24. Campuses have on-going planning <ul><li>90% of college campuses have a Crisis Management team </li></ul><ul><li>80% of college counseling centers have after hours coverage </li></ul>
    25. 25. Crisis Management <ul><li>Who is on the team? </li></ul><ul><li>Who is in charge? </li></ul><ul><li>Who provides coordination and communication? </li></ul><ul><li>How is communication maintained </li></ul><ul><li>How is team training provided and maintained? </li></ul>
    26. 26. Crisis Management plan <ul><li>Who makes it? </li></ul><ul><li>How is it disseminated? </li></ul><ul><li>How is it updated? </li></ul><ul><li>How are roles and responsibilities defined? </li></ul>
    27. 27. Psychological First Aid <ul><li>First Goal– Timely restoration of physical safety and emotional security </li></ul><ul><li>2) Help anyone effected cope and adapt </li></ul><ul><li>3) Respond effectively to everyone in the larger community in relation to the incident. </li></ul><ul><li>Remember most people have natural coping ability and participation in crisis debriefing. </li></ul><ul><li>Response should be on-going, a one shot approach can do as much harm as good </li></ul>
    28. 28. Crisis Management Cycle Learning Planning Prevention Response Recovery Zdziarski, E.L., Dunkel, N.W., & Rollo, J.M. (2007 ). Campus Crisis Management: A comprehensive Guide to Planning, Prevention, Response, and Recovery. Josey-Bass, San Francisco, CA.

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