News, Views and Careers for All of Higher Education
May 17, 2007
One of the major questions to emerge from last month’s Virginia Tech shootings is whether colleges are prepared to handle a situation in which a student with mental illness is identified as posing a potential threat to campus.
An advocacy group for people with mental disabilities says there is no consensus among college leaders on how to respond. Many campuses have free counseling services, but when a student’s behavior raises red flags, colleges often worry about legal liability, lack a comprehensive plan or have one that is overly punitive, according to officials at the Bazelon Center for Mental Health Law.
In “Supporting Students: A Model Policy for Colleges and Universities,” a new report, the center outlines what it describes as best practices for colleges when dealing with the above scenario and others. The policy, which Bazelon officials hope colleges use as a model, calls on institutions to stay away from rigid rules that could discourage students from seeking treatment but that still allow campus officials to intervene when necessary.
“One of our goals here is to send a clear message to students that they can seek help early on and not be penalized,” said Robert Bernstein, the center’s executive director.
Late last month, center officials said they were troubled by the response to Virginia Tech, which Bernstein called a “hunger for quick fixes and quick legislation” instead of a closer look at what could have been done to treat the gunman long before he attacked. (The center began work on its policy before the Virginia Tech tragedy, although Bernstein said that event makes the recommendations “timely.")
In dealing with cases of troubled students, the report says that colleges should make clear all counseling options and allow them to voluntarily decide whether to seek help. Colleges should suggest that students visit a counseling center when it learns that the student shows academic or behavioral difficulties that “appear to be due to depression or another mental health condition,” or when the student has known to have contemplated suicide.
If a referred student doesn’t proactively seek the help, the center officials should then reach out. As state law permits, colleges may seek involuntary treatment of the student in “exceptional circumstances,” which the report doesn’t define in order to “encompass a range of behaviors,” said Karen Bower, senior staff attorney at Bazelon. As a last resort, a college can consider using an outside crisis outreach team to contact the student.
Bower said the policy addresses the two areas that are often the stickiest for colleges: confidentiality and student leaves of absences. The report says that in almost all cases, the counseling center should not share information about a student with faculty, staff, administrators or others unless the student consents. When appropriate, the counseling center can encourage the student to consent to sharing the information.
Depending on state law, a center should only disclose information about a student “to the extent needed to protect the student or others from a serious and imminent threat to safety,” the report says, adding that “disclosures are permitted only if the student will not consent to interventions that will ameliorate the risk.”
Colleges should “reasonably” accommodate students who are mentally ill by allowing them to remain enrolled, or make concessions such as allowing them to take a reduced course load and work from home, according to the report.
Bower said it’s also important that colleges don’t take disciplinary action against students who choose to take time off or who display “self-injurious” behavior. A counselor’s role is to help the student decide whether to take a leave, and in some cases to help the student secure time off. The report says the student should be able to attend campus events while on leave, unless there are documented safety concerns.
Only in “uncommon circumstances” in which students cannot remain safely on campus or meet academic standards should a college require a student to take a leave — and the decision should be made by a committee that includes the counseling center director, the report says. (It adds that the committee can look into the student’s mental condition and seek records, but the search should be limited to essential documents and not rely on access to all confidential records.)
Robb Jones, senior vice president and general counsel for claims management and risk research at United Educators, an insurance company for colleges, said that while he supports the idea of a policy that promotes the individual rights of mentally ill students, colleges should go beyond Bazelon’s guidelines by considering the rights of all students and faculty members, and by including safeguards for counselors who find it necessary to share student records.
It would be easier to agree with the report if its rules applied only to cases of depression, Jones said. “But since colleges are often dealing with more serious forms of mental health problems, and determining a student’s prognosis can be difficult, there’s a problem with coming up with guidelines that will apply to virtually all cases,” he added.
Jones said a complete report would go further to note that in some cases, students are better off seeking treatment away from campus, and that the campus would be better off without the student’s presence. The company agrees with Bazelon that the best practice is to begin with a voluntary leave policy, and that involuntary removal should be the last resort.
Bernstein said the center is working on another guide that covers what students should know about their rights in mental health cases.
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The world is expressing bewilderment at the actions of Cho Seung-Hui, the Virginia Tech student who shot and killed 32 people in the largest campus massacre in history. However, it seems that at least some explanation for his horrific crime is slowly emerging. Cho’s story is a classic portrait of a young man who lost all sense of connection to the people around him and became capable of mass murder.
The New York Times (April 22, 2007) reported that Cho led a lifetime of excruciating silence: “From the beginning, he did not talk. Not to other children, not to his own family. … [In high school] he was unresponsive in class, and unwilling to speak. … Classmates recall some teasing and bullying over his taciturn nature. The few times he was required to speak for a class assignment, students mocked his poor English and deep-throated voice.” Recently at Virginia Tech, as Cho’s behavior grew ever stranger and the writing he submitted in class became more violent and obscene, he “was allowed to remain in the seminar but was placed off to the side, where, [his teacher] said, he did not speak. She did not share his writings with the class. … And then he stopped going to class” (NY Times, April 19, 2007).
It is a pattern that has been repeated too many times, in too many school tragedies. When society isolates social offenders, it only decreases their desire to behave appropriately. They lose their sense of “connectedness” to their fellow human beings and lash out violently, a reaction that the world — rightly — finds shocking and appalling.
This is not a crisis that can be solved by tougher enforcement of “zero tolerance” policies, which studies (such as a recent report from the American Psychological Association) have shown to be ineffective at best and further damaging to social relationships at worst. Rather, it is restoration of the sense of connectedness, essential for social and emotional health, which is critical.
The National Longitudinal Study of Adolescent Health (1994–present), a large federally funded research project, found that where school environments promote connectedness, there are significant positive outcomes among students, such as less violence, less drug and alcohol use and less teen pregnancy. The need for children and young people (and, indeed, all people), to feel they belong and are cared for is one of the most crucial requirements for good health and well-being.
But how can schools create connectedness, while at the same time addressing serious behavioral problems?
The emerging social science known as “restorative practices,” which is spreading throughout education, criminal justice, and child and family services across the world, speaks directly to this issue. As a proactive expansion of “restorative justice,” a collaborative process involving those most directly affected by a crime in determining how best to repair the harm caused by the offense, “restorative practices” posits that the best way to help troubled people is to directly engage them in a restorative environment, one that fosters that essential sense of connectedness.
In a restorative environment, such as those that have been created at the alternative schools my wife and I started 30 years ago for delinquent and high-risk youth, “restorative practices” are systematically applied. These practices help create a supportive, caring environment for youth who have been rejected by other schools and the world at large. Above all, restorative practices are about engaging people. “Check-in” groups are held several times a day, so that every student may speak about his or her feelings and experiences. In this way, everyone feels heard and understood, building that all-important sense of community and connectedness. When students in these alternative schools misbehave, problems are neither swept under the rug nor handled rigidly. Instead, the students are asked to take responsibility for their actions. They must reflect on their own behavior, hear how their behavior has affected others and find ways to repair harm caused by their actions. A connection is again made, this time between action and consequence, and with a supportive group of peers and staff that, however, insists on accountability.
Empirical research has shown that restorative practices produce remarkably positive outcomes in the behavior and attitudes of young people who attend the alternative schools where the practices are consistently applied. Similar positive outcomes have been seen in public schools that have embraced restorative practices throughout the world, including those in Australia, Canada, the Netherlands, New Zealand, the United Kingdom and the United States. Research suggests that restorative practices are effective in dealing with bullying, and in lowering suspension, expulsion and truancy rates. A new graduate school, the International Institute for Restorative Practices, has been founded to provide education and research and to help foster this emerging social science.
I do not believe that the people who comprised Cho Seung-Hui’s community at Virginia Tech are to blame for what happened there. I only want to suggest, for the sake of the future, that if people like Cho Seung-Hui experienced restorative practices as part of their educational environment, it would enhance and sustain that critical sense of connectedness — crucial to all human health and well-being — so that hideous tragedies like this would be far less likely.
Ted Wachtel, President at International Institute for Restorative Practices, at 9:15 am EDT on May 17, 2007
Wow, this is some double-speak. “Colleges should go beyond Bazelon’s guidelines by considering the rights of all students and faculty members”
Essentially what he is saying is that colleges should ignore everything that the Bazelon center has to say and err on the side of ignoring any guarantees about confidentiality in the name of “safety.” Strangely, this will probably result in more liability to the institution then the Bazelon Center’s proposal, but insurance companies and health-care providers, and lawyers have always looked at things differently. (I agree that some people should be treated off campus, but I think that everyone agrees that in every field some problems can’t be handled in house. Plumbers, lawyers, doctors, and everyone else agrees.)
Larry, at 10:40 am EDT on May 17, 2007
Two of the commentators have picked up on similar and important themes:
In another generation, there were (often middle aged) housemothers (I will say it, they were often called Mom Smith or Mom Wilson) in the student dorms. I wonder if their steadying presence offered some benefits unavailable to students now.
[I]t is restoration of the sense of connectedness, essential for social and emotional health, which is critical.
It would be hard to imagine an environment with less social stability and less connectedness than a generic dormitory on a big university campus. I have heard (responsible and successful) students describe such places as providing “the worst living experience of my life.” There is an international movement underway to repair the decay of campus residential life through the creation of small, decentralized, faculty-led residential colleges, written about here at Inside Higher Ed a few months ago:
http://insidehighered.com/views/2006/11/28/ohara
Is this a cure for mass murderers? Of course not. A determined criminal is very hard to stop, and everyone who works with undergraduates know that many them arrive on campus with years of psychological baggage that even the best environment can’t always lift from them. But the violent criminal represents the end of the tail of a very broad distribution that ranges from students who commit vandalism, to those who are angry and abusive to their neighbors, to those who drop out, to those who misbehave in class, those who move off campus because the on-campus environment is so unpleasant, to those who disengage from the life of the institution, to those who do make it through but then spend the rest of their lives talking about how terrible their university was. This is the “abandoned generation” that Willimon and Naylor wrote about a decade ago:
http://rjohara.net/reviews/willimon-naylor
The criminal tail of the distribution has been around from the dawn of human history, and many features of Cho’s crime are mirrored in detail in the earliest Western literature:
http://collegiateway.org/news/2007-virginia-tech
But as specialists in the protective effects of cohesive communities have long known, social cohesion, in contrast to social isolation, is a strength multiplier:
http://collegiateway.org/news/2003-social-cohesion
It doesn’t simply prevent bad things from happening, it positively promotes the good. But constructive social cohesion of this kind, overseen by the academic leadership, has been all too rare on campus for more than a generation.
R.J. O’Hara, The Collegiate Way, at 12:55 pm EDT on May 17, 2007
My apologies to those offended by a sharp tongue, but the following seems fair.
____
When society isolates social offenders,
Excuse me, but where is the evidence that his isolation was not self-imposed? If news accounts are to be believed, this young man hardly spoke to his own mother and the efforts of his roommates to put him into circulation came a-cropper because of bizarre things he would say in social settings.
But how can schools create connectedness, while at the same time addressing serious behavioral problems?
Is it too much to ask how academic institutions, whose essential purpose is to nurture the intellect, got stuck with the task of ‘creting connectedness’.
The emerging social science known as “restorative practices,” which is spreading throughout education, criminal justice, and child and family services across the world, speaks directly to this issue. As a proactive expansion of “restorative justice,” a collaborative process involving those most directly affected by a crime in determining how best to repair the harm caused by the offense, “restorative practices” posits that the best way to help troubled people is to directly engage them in a restorative environment, one that fosters that essential sense of connectedness.
And the responsibilities they incur from having received these gifts are...
In a restorative environment, such as those that have been created at the alternative schools my wife and I started 30 years ago for delinquent and high-risk youth, “restorative practices” are systematically applied. These practices help create a supportive, caring environment for youth who have been rejected by other schools and the world at large. Above all, restorative practices are about engaging people. “Check-in” groups are held several times a day, so that every student may speak about his or her feelings and experiences. In this way, everyone feels heard and understood, building that all-important sense of community and connectedness. When students in these alternative schools misbehave, problems are neither swept under the rug nor handled rigidly. Instead, the students are asked to take responsibility for their actions. They must reflect on their own behavior, hear how their behavior has affected others and find ways to repair harm caused by their actions. A connection is again made, this time between action and consequence, and with a supportive group of peers and staff that, however, insists on accountability.
Empirical research has shown that restorative practices produce remarkably positive outcomes in the behavior and attitudes of young people who attend the alternative schools where the practices are consistently applied. Similar positive outcomes have been seen in public schools that have embraced restorative practices throughout the world, including those in Australia, Canada, the Netherlands, New Zealand, the United Kingdom and the United States. Research suggests that restorative practices are effective in dealing with bullying, and in lowering suspension, expulsion and truancy rates. A new graduate school, the International Institute for Restorative Practices, has been founded to provide education and research and to help foster this emerging social science.
You mean be nice according to a rococo playbook composed by members of the mental health trade, and everything will go swimmingly. Interesting if true. [I have put the gentleman’s escape hatch in bold lettering].
I do not believe that the people who comprised Cho Seung-Hui’s community at Virginia Tech are to blame for what happened there.
Thank you very much.
I only want to suggest, for the sake of the future, that if people like Cho Seung-Hui experienced restorative practices as part of their educational environment, it would enhance and sustain that critical sense of connectedness — crucial to all human health and well-being — so that hideous tragedies like this would be far less likely.
You mean put your Big Idea in effect everywhere.
Again, his own conscientious and devoted family failed in efforts to ’sustain that critical sense of connectedness’. How is an apparat staffed with head-shrinkers who speak (and think?) in a decidedly cloying idiom supposed to reliably do better?
Art Deco, Garden Gnome at Whatsamatta U., at 7:05 pm EDT on May 17, 2007
Regarding student leaves of absence, Karen Bower noted in her May 1 article:
“Financial issues are often paramount. While students may have adequate health insurance covering inpatient and outpatient services while in college, coverage often terminates upon medical leave from the university. Health insurance may also exclude inpatient services and place limits on the number of outpatient visits. Colleges should be cognizant of this reality and work to assist students without coverage and advocate for expanded coverage.”
Why on earth is this “reality” acceptable to anyone? For years, we have been dangling our young adults over a chasm. This is as true of those tossing their graduation caps into the air as of those taking medical leave. They’re no longer eligible to be covered by a parent’s health insurance, and it’s mighty hard for them to get their own coverage without either a job with benefits or being in school.
Many of us adults with health insurance have at least the protection of COBRA from sudden loss of benefits. Our kids, it seems, get nothing. Certainly neither of my sons’ colleges did anything to suggest how, once the rug was pulled out from under them, they might go about obtaining coverage. Why is that OK?
Kathleen, at 9:00 am EDT on May 18, 2007
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In another generation, there were (often middle aged) housemothers (I will say it, they were often called Mom Smith or Mom Wilson) in the student dorms. I wonder if their steadying presence offered some benefits unavailable to students now. The concept is doubtless amusing to 21st century sensibilities. No indeed, mental health in the new millennium is retail now, available only from Professionally Trained Persons with Advanced Degrees who will Maintain Confidentiality and definitely NOT tell the student’s parents about any problems, no matter, what without a signed and witnessed Release Form.
bystander, at 7:50 am EDT on May 17, 2007