Hypothetical Scenario: Suicidal Student. What would you do?

[smallcleanrat]

You are on a Zoom call with a student who is visibly distressed, and in tears. They tell you that they have no worth as a human being, that they can no longer endure their pain, and that they see no reason to continue living. They say there is no future for them; no hope.

What do you do?

[polly_mer]

Cancel the rest of my obligations and stay on the line with the student to help the human in pain.

I have done this is person, even blowing off an appointment with the dean because the student is more important.

[Puget]

The same thing we do in person-- try to keep the student there and talking while we contact the student counseling center and then get the student safely handed off to the counseling center. Faculty are resource connectors, not therapists, so it is our job to express empathy and make sure the student gets connected to appropriate care, but not to try to be their therapist. These days the counseling center is doing all telehealth, and could jump right onto the zoom call with them. What happens next depends on their risk assessment and the location of the student, but would always include a safety plan and a plan for either outpatient or inpatient  care as needed. As faculty we wouldn't know about any of this unless the student chose to tell us later.

(This is not hypothetical in my case-- we do this at least a couple times a semester with research participants who disclose suicidal thoughts in our diagnostic interviews in my lab, and occasionally with students during office hours). 

[mamselle]

As above.

When in person, awhile ago, I walked the student over to the counseling center because they asked me to, and sat with them in the waiting area until the intake person could talk with them.

M.

[Aster]

The same thing we do in person-- try to keep the student there and talking while we contact the student counseling center and then get the student safely handed off to the counseling center. Faculty are resource connectors, not therapists, so it is our job to express empathy and make sure the student gets connected to appropriate care, but not to try to be their therapist.

We are required to follow a protocol almost identically to this at Big Urban College. Unfortunately, we don't seem to keep our counseling center reliably staffed (it's not viewed by some of our political appointees as an important budgetary item) so a lot of calls go to voicemail at an empty desk.

Zoom calls provide an interesting dilemma. The student is possibly off campus and may not even be in the area. I don't think I've been informed what to do in this particular scenario. Probably the same thing (call the empty counseling center office), and then call either Campus Police or 911.

[Puget]

We are required to follow a protocol almost identically to this at Big Urban College. Unfortunately, we don't seem to keep our counseling center reliably staffed (it's not viewed by some of our political appointees as an important budgetary item) so a lot of calls go to voicemail at an empty desk.

Zoom calls provide an interesting dilemma. The student is possibly off campus and may not even be in the area. I don't think I've been informed what to do in this particular scenario. Probably the same thing (call the empty counseling center office), and then call either Campus Police or 911.

Has anyone pointed out the sort of liability this opens them up to, let alone the moral problem? We have an after hours emergency number-- someone is always on call.

For students who are not in the area, our counseling center would try to connect them to a local service provider and try to make sure they are with someone responsible in the meantime,  or in a true emergency call 911 (but in general you REALLY do not want police responding to a mental health situation).

Providing ongoing care through the counseling center to someone out of state is problematic because licensure is state-specific-- this is a real problem now with students studying from home and also a barrier for all sorts of folks in under-served areas that could otherwise take advantage of tele-therapy from anywhere. The licensure requirement for clinical psychologists and clinical social workers are the same in all states (since they are administered by professional bodies, not the states), so there is no good reason for the states not to recognize each other's licenses-- this could have been solved already if the state governments cared to act on it.

[smallcleanrat]

The same thing we do in person-- try to keep the student there and talking while we contact the student counseling center and then get the student safely handed off to the counseling center. Faculty are resource connectors, not therapists, so it is our job to express empathy and make sure the student gets connected to appropriate care, but not to try to be their therapist.

We are required to follow a protocol almost identically to this at Big Urban College. Unfortunately, we don't seem to keep our counseling center reliably staffed (it's not viewed by some of our political appointees as an important budgetary item) so a lot of calls go to voicemail at an empty desk.

Zoom calls provide an interesting dilemma. The student is possibly off campus and may not even be in the area. I don't think I've been informed what to do in this particular scenario. Probably the same thing (call the empty counseling center office), and then call either Campus Police or 911.

I was wondering how university policies like this work. Does anything happen administratively if a faculty member doesn't follow the policy? Some kind of mandatory training, similar to the ones for lab safety or for sexual harassment policies? Does it make a difference whether the student lives or dies?

[downer]

First of all, you don't freak out. You also don't try to be a therapist. You tell them to seek help, and then notify the department chairl, unless, you have been given instrucitons about what to do, which you haven't.

This will at most places get them removed from the school. Too much liability for the school.

[smallcleanrat]

This will at most places get them removed from the school. Too much liability for the school.

I presume you mean this would get the student removed from the school?

[downer]

This will at most places get them removed from the school. Too much liability for the school.

I presume you mean this would get the student removed from the school?

Yes.

[Puget]

This will at most places get them removed from the school. Too much liability for the school.

I presume you mean this would get the student removed from the school?

Yes.

Although some institutions do unfortunately still do this, it is far from universal, and has decreased quite a lot in recent years. Students can and sometimes do sue for mental health discrimination when such a policy is in effect.

What does happen most places is a risk assessment and a conversation between the student and care team (and parent(s) if the student wants to include them) about what would be best for the student. Sometimes that is a medical leave, but certainly not always or even the majority of the time. Something like 1 in 10 college students will have suicidal thoughts at least once in a given year-- it doesn't mean they all need to leave campus.

[polly_mer]

It's a pretty cold-hearted action to go full bureaucratic when the person is in active crisis and one knows that no one will be picking up at emergency services.

[Aster]

We are required to follow a protocol almost identically to this at Big Urban College. Unfortunately, we don't seem to keep our counseling center reliably staffed (it's not viewed by some of our political appointees as an important budgetary item) so a lot of calls go to voicemail at an empty desk.

Zoom calls provide an interesting dilemma. The student is possibly off campus and may not even be in the area. I don't think I've been informed what to do in this particular scenario. Probably the same thing (call the empty counseling center office), and then call either Campus Police or 911.

Has anyone pointed out the sort of liability this opens them up to, let alone the moral problem? We have an after hours emergency number-- someone is always on call.

For students who are not in the area, our counseling center would try to connect them to a local service provider and try to make sure they are with someone responsible in the meantime,  or in a true emergency call 911 (but in general you REALLY do not want police responding to a mental health situation).

Providing ongoing care through the counseling center to someone out of state is problematic because licensure is state-specific-- this is a real problem now with students studying from home and also a barrier for all sorts of folks in under-served areas that could otherwise take advantage of tele-therapy from anywhere. The licensure requirement for clinical psychologists and clinical social workers are the same in all states (since they are administered by professional bodies, not the states), so there is no good reason for the states not to recognize each other's licenses-- this could have been solved already if the state governments cared to act on it.

If your Board Members are hand-picked, governor-appointed dimwits with no qualifications, and told that keeping costs down will get them promoted to better jobs in state government, then it doesn't matter much what anyone else tells them. And, yes, people talk to the Board frequently about what is morally correct, legally prudent, and educationally responsible. However, we run into the problem where if anyone speaking up happens to also be a professor, there is an automatic assumption by most Board members that we are biased, antagonistic, self-serving, and our statements are immediately suspect. So, us talking to the Board sometimes just makes things worse than not talking at all. They may bunker down harder on their existing policies. It's stupid, but that's tribal politics.

Not all state governors are pro-education.

But yeah, in this part of the U.S. where healthcare services aren't so hot, it's pretty standard to call 911 for signs of severe depression. I don't know much how 911 calls work in other parts of the U.S., but here the EMS dispatcher determines what sort of emergency services should be dispatched. For medical-sounding stuff, the paramedics and/or fire department are sent. Police are usually also sent for potential suicide alerts, but they typically aren't the primary caregivers.

[Aster]

The same thing we do in person-- try to keep the student there and talking while we contact the student counseling center and then get the student safely handed off to the counseling center. Faculty are resource connectors, not therapists, so it is our job to express empathy and make sure the student gets connected to appropriate care, but not to try to be their therapist.

We are required to follow a protocol almost identically to this at Big Urban College. Unfortunately, we don't seem to keep our counseling center reliably staffed (it's not viewed by some of our political appointees as an important budgetary item) so a lot of calls go to voicemail at an empty desk.

Zoom calls provide an interesting dilemma. The student is possibly off campus and may not even be in the area. I don't think I've been informed what to do in this particular scenario. Probably the same thing (call the empty counseling center office), and then call either Campus Police or 911.

I was wondering how university policies like this work. Does anything happen administratively if a faculty member doesn't follow the policy? Some kind of mandatory training, similar to the ones for lab safety or for sexual harassment policies? Does it make a difference whether the student lives or dies?

Yes. If you work at a douchey institution that is buried in red tape, you can certainly be punished for "doing the right thing" if it violates "following procedure".

Such violations can result in actions ranging anywhere from disciplinary meetings to contract termination. Being on the receiving end of this on multiple occasions, it is a highly unpleasant experience.

So no, don't try to be a therapist if you have a student displaying alarming behaviors. Follow your institution's policy.

[Ruralguy]

Right, 911 calls don't automatically trigger the police, but yeah, if there's danger to an individual or others around them, police would likely be called in. (I imagine also EMT's). 

My school would not automatically dump such a student, but we might encourage a leave, or maybe medical withdrawal for the semester.