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Managing Emotional/Mental Health Situations

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General Procedures

Many students experience periods of psychological or emotional distress at some point during their college career. The vast majority of these students are able to continue their studies, and benefit from the structure and support of the University environment.

For certain students the severity of their emotional or psychological state may pose risks to themselves and may disrupt the academic environment of the University. These individuals may act out in ways that jeopardize academic pursuits, safety and/or well being of others at the University. When this occurs, individuals responsible for such behavior are typically brought to the attention of University administrators, counseling services, health services or discipline officers.

Students exhibiting moderate to serious behavior problems are referred to counseling as the preferred method for resolving the crisis. In rare situations, where a student incident can not be resolved through informal interventions, disciplinary action may follow when student misconduct is evident and the behaviors remain disruptive, or dangerous to the student or the academic community. Disciplinary action may also be applied when misconduct continues and a student fails to seek help or does not follow through on voluntary agreements. A student may also be removed on an interim basis when staff believes the student's condition meets the test of direct threat, where the student is at personal risk. In all instances efforts will be made to establish ongoing liaison between campus-based mental health professionals and those who oversee the management of these student cases on each campus.

Thus, in view of the above, after the occurrence of an incident and following any initial student intervention, the student may simply be referred to Counseling and Psychological Services. In other more serious situations, the case will be referred to the Assistant Vice President for Student Affairs at University Park or the Director of Student Affairs at the campus. Typically, these referrals would involve a student who exhibits at risk behaviors that are; on-going, where the student refuses to seek help, or at have reached the "direct threat" level. In these situations the designated Assistant Vice President for Student Affairs or the Director of Student Affairs/Director of Student Enrollment Services at the campus would act as the manager of the student case and steward protocols to be followed while considering the specific circumstances of each situation.

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Intervention and Referral

The staff responsible for coordinating referrals, interventions, and follow-up for distressed students will vary at each campus. At University Park, this person will be the designated Assistant Vice President for Student Affairs. At campuses other than University Park, this person would be the Director of Student Affairs or the Director of Student Enrollment Services.

It is recognized that limitations of on-campus counseling services at many of the Penn State campuses may make it difficult to respond to students in distress. Student Affairs staff at campus locations may need to consult with Counseling and Psychological Services staff at University Park campus or with local licensed mental health professionals in their communities.

Although it is expected that the largest number of referrals will be made by Residence Life staff (at residential campuses), reports involving distressed students who live off-campus will also be sent to and managed by Student Affairs staff.

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Initial Intervention

In response to student health and safety reports, at-risk students will be required to meet with the designated Assistant Vice President for Student Affairs at University Park or Director of Student Affairs/Director of Student Enrollment Services at the campus. The goal of this meeting is as follows:

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Residence Life Referrals

Residence Life staff is often in direct contact with students experiencing psychological or emotional distress. The staff is provided with training to recognize the signs of depression and suicide, and to intervene in response to self-hurt and suicide threats/gestures.

Residence Life staff consider all comments and communications about self-hurt, suicide or other worrisome behavior very seriously. In all cases, Residence Life staff will take immediate action and immediately speak with a student who exhibits distress. Since many of these incidents occur outside of normal business hours, the typical staff response involves efforts to ensure that the student is safe to remain in the residence halls and on campus. If that is not the case, Residence Life staff will assist the student in getting to an appropriate off campus medical facility. University or local police and the local county mental health office (e.g., CANHELP) may be involved in these efforts. Live-in Residence Life staff is instructed to inform their supervisors when working through such situations and to stay with the student in distress until the next steps have been identified.

Staff in Residence Life, Office of Student Conduct, and other Student Affairs administrators, are often involved in deciding on an appropriate follow-up plan with students in distress. Each campus should follow the established protocol while executing a staff response within the structure of their campus administration.

At residential campuses, the following protocol is in place for Residence Life staff to assist the designated Assistant Vice President for Student Affairs or the Director of Student Affairs/Director of Student Enrollment Services in meeting with students.

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Referral to Counseling

In non-critical cases, students may be referred to University Counseling and Psychological Services or another mental health agency. Students referred to University Counseling and Psychological Services will be provided an intake evaluation. If the intake evaluation yields that the student is fit to resume University activities recommendations for follow-up counseling will be made. Student meetings with counseling staff are confidential. In some cases, the student may be asked by Student Affairs staff to agree to provide a written release of information to their counseling provider for staff follow-up and consultation purposes.

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Referral to Assistant Vice President for Student Affairs or Director of Student Affairs/Director of Student Enrollment Services

In critical cases, but where after meeting with the designated Assistant Vice President for Student Affairs at University Park or Director of Student Affairs/Director of Student Enrollment Services at the campus, it is determined the student should remain in school, a retention plan of action will be developed between the student and the Student Affairs staff member. This plan may include such things as: psychological evaluation or assessment, on-going counseling or other agreed upon requirements for the student to remain enrolled. The designated Assistant Vice-President will also work with the student's college to ensure effective support regarding academic and other support resources.

In the more serious cases, and where after the meeting with the designated Assistant Vice President for Student Affairs at University Park or Director of Student Affairs/Director of Student Enrollment Services at the campus, it is determined the student may present a continued direct threat, and that threat cannot be mitigated, the student may need to take a temporary leave of absence. In these instances, staff will first work with the student to leave under a voluntary basis. One option to the student is for the student to agree to take a voluntary medical withdrawal. This medical withdrawal may be for an undetermined or specific period of time. If the student medically withdraws, no forced interim removal actions, including charges or sanctions for misconduct would be assigned. In resolving incidents in this manner the designated Assistant Vice President for Student Affairs at University Park or Director of Student Affairs/Director of Student Enrollment Services at the campus would work directly with the student, their family, and their academic college to facilitate the withdrawal. When the student chooses to take a medical withdrawal, conditions of the withdrawal should include negotiating with the student agreed upon re-enrollment conditions such as; proof of psychological evaluation or assessment, on-going counseling, or other agreed upon requirements needed to transition the student back to campus. Staff may also have a role in helping the student locate appropriate counseling services in the community during their leave of absence. During the period of the medical withdrawal staff will not typically place a registration hold on the student's record. If necessary, re-enrollment actions from a medical withdrawal may be initiated through the University Counseling and Psychological Services or the University Health Service. When the student re-enrolls, they will do so as a previously admitted student.

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Referral to Office of Student Conduct

In rare circumstances, where the student refuses to seek help and misconduct is evident, a student may be referred to Office of Student Conduct by the designated Assistant Vice President for Student Affairs or the Director of Student Affairs/Director of Student Enrollment Services at the campus. In this circumstance, the student misconduct is documented and reviewed by the Senior Director of Office of Student Conduct or the campus Office of Student Conduct designee. In an effort to resolve the incident at the lowest level, and in the best interest of the student, it is suggested that consultation occurs with mental health professionals even if formal charges of the Code of Conduct are considered or forwarded to the student. In managing the discipline referral, options before the Office of Student Conduct designee are as follows:

a. Voluntary Withdrawal Due To Misconduct: the student may agree to take a misconduct related withdrawal from campus for an indefinite period of time. If the student agrees to a withdrawal due to misconduct (motivated by emotional or psychological crisis), formal charges would not be assigned to the student. Resolving conduct incidents in this manner, where the student agrees to leave for a period of time would be the preferred method for case resolution. When cases are resolved in this manner, certain agreed upon conditions would need to be met before the student would be allowed to return to school. These may include a specific plan for the student's return and not be limited to the following: re-enrollment only after having provided evidence of a psychological evaluation or assessment, on-going counseling from a licensed mental health professional, proof of a release of information to their provider, Office of Student Conduct designee receiving a favorable evaluation of services from a licensed mental health professional, and the student receives approval for re-enrollment from the Office of Student Conduct designee relating to the student's progress. During the period of the misconduct withdrawal, the student will agree to have a registration hold and a transcript notation placed on the student's record during the period of the withdrawal. During the leave of absence the student may not register for class, reside in University housing, or use or visit University facilities at any Penn State location without the expressed permission of the Senior Director of Office of Student Conduct or Office of Student Conduct designee.

b. Formal Disciplinary Action: the student may be removed from campus for misconduct exhibited during their enrollment. Resolving incidents in this manner include the filing of formal disciplinary charges related to violations of the student Code of Conduct. This action would include the creation of a formal disciplinary file and the pursuit of formal disciplinary sanctions. Formal disciplinary charges and sanctions would be filed as a last resort and would only be assigned when serious misconduct is present, the student is a risk to self or others, fails to voluntarily seek assistance, or fails to provide a medical release or other information to staff that would aid them in the student's mental health related evaluation. Formal discipline charges may also be filed when a student violates previously written agreements established between the student and Office of Student Conduct designee or when such conduct continues to disrupt the academic environment. If a student is removed from the University, more than likely, sanction conditions for re-enrollment may include, but not be limited to the following: providing evidence of a positive psychological evaluation, on-going counseling related to behavior from a licensed mental health professional and other related conditions such as a medical release of information.

*Direct Threat is defined in ADA regulations as: "significant risk of harm to the health and safety of the individuals and others that cannot be eliminated or reduced by reasonable accommodation." The Equal Employment Opportunity Commission (EEOC) Guidance states that a direct threat may be applied "to the safety of the individual." This allows universities and colleges the ability to apply direct threat to suicidal students. This position was upheld by the U.S. Supreme Court in Chevron USA v. Mario Echazabal (No 00-1406, 2002).

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