Thursday, October 22, 2015

Saturday, October 17, 2015

Creating Compassion Contagion on the UHM Campus

As a Professor of English and a writer, I believe that words matter. Unlike sticks and stones, they might not break my bones, but they can certainly hurt me. Words can also reassure me that I'm cared for, whether by a family member or by the institution to which I belong. But the words that express personal caring--those by family members and friends--are not the same words as those that express the caring of an institution. There's a big difference between individual compassion and that of an organization. We can find that difference in the current debate over student death protocols at UHM. Over a year ago, I and members of a group that has formed around mental health issues at UHM, went to the administration to request that there be more communication between them and us after a student death. We were assured then, as we are still being assured, that UHM handles on-campus tragedies well, and that administrators are compassionate in their attention to students.

I have no argument with their claims to be compassionate. No one who is not a caring person goes into education. But I do have an argument with their elision of personal with institutional compassion. In my experience, students and faculty at UHM do not feel that the the university cares about or for them. In large numbers, they don't know where the Counseling Center is on campus (see here). In the cases of deaths on campus, they often don't know, except from social media or the rumor mill, that someone they know, or know of, has died. And, if they are traumatized by that loss, unless the administration finds them--on the floor of the dorm where the dead student lived, in clubs, on teams--they don't know that counseling is available to them. Faculty, who are in a profound sense the first responders to tragedy on campus, often have no idea how to deal with distressed students.

As I lobbied for the protocol over this past year, I've learned that UHM does some things very well. They have a Counselor-in-Residence program in the dorms; they do their best to "target" friends of the deceased; they provide emergency/crisis counseling. Someone from counseling came to my department to talk about how to deal with "distressed students." I learned that counselors have been coming for years to talk to grad student instructors; this was the first time all of us were invited (by one of our Mental Health Hui members is in my department).. But even where they are doing a good job, communicating the availability of their services is a weak link. If you're a student in crisis, do you know that you need to tell the person at the CDSC desk that you need to see a counselor immediately? If you're a faculty member with a suicidal student, do you know to call CDSC yourself? If you have a friend in distress, do you know that you can reach out for them? Increasingly, I think that the fundamental problem is one of communication. Who died? How many each year? (At a recent meeting, administrators could not answer this question.) Who is left grieving? Where do they go? How can I help? These are among the questions that need to be answered. To pose them is not to attack the Counseling Center; in point of fact, we are trying to get more people to use their services.

And the UHM Counseling Center is in a very difficult position. According to the Council for the Advancement of Standards in Higher Education, "The level of severity of college students' presenting concerns is also much greater than the traditional presenting problems of adjustment issues and individuation that were typically identified in counseling center research from the 1950s through the early 1980s." Mental health issues are becoming more frequent, and more serious, across the United States. "According to a survey of over 100,000 U.S. college students at 130 universities conducted by teh Center for Collegiate Mental Health (CCMH), 1 in 5 students report having experienced sexual assault, 1 in 10 have attempted suicide, 1 in 3 take psychiatric medication, 1 in 4 have self-injufred and 1 in 3 have experienced a traumatic event." This report goes on to argue: "it is increasingly important for college counseling professionals to be prepared to work with physicians, community mental health providers, other campus departments, and health care professional to create an appropriate systemic response to student's needs." These are dry words, but behind them lies a great deal of anguish and a terrific need for care. According to their Director, UHM's Counseling Center already has a backlog of students needing their services. So, when I argue that we need to send more students there, I also want to insist that the legislature provide more funding for mental health services in the UH system. If we can afford frequent pay-offs for administrators and coaches who leave under ethical clouds, surely we can afford some ethical and much needed funding to care for  the young people who attend our state university.

The questions I posed above are answered at many other universities by a protocol. The UC-Berkeley protocol is on-line,  They also have a "Gold Folder," that includes an amazing brochure on how to deal with distressed students: find the link here. (Find another one from the University of Virginia here). It features compassionate language, as well as directions for everything from notifying the school of a death to dealing with grief. I'm told by administrators at our university that the protocol is awfully complicated and that, as one administrator said at a recent meeting, "they simply ignore it." After speaking for an hour with the woman who runs the "Guidelines for Responding to Death" website at Berkeley, I can assure that administrator that the protocol is used. The same for the College of William & Mary protocol, which runs to over 20-pages of guidelines and checklists (down to the tissues and mints an intern should have in a "grief kit" after a tragedy). A Faculty Senate committee on students was told by an administrator that parents of students who died at William & Mary were upset with the university for announcing their child's death. When I talked to Ginger Ambler, the Vice President for Student Affairs there, she assured me that they do nothing without the permission of the family, although they counsel each family that being open about suicide brings about needed conversations on campus. We were also told by an administrator at UHM that UH-Hilo, whose protocol is on-line, never approved it. When I emailed an administrator at UHH, I was assured that it was approved in 2010 and it's followed.

Now not all protocols say the same things. While William & Mary announces deaths by emails to the entire community, other schools do not. Berkeley is one of those. But Berkeley has an annual Memorial Service for everyone associated with the institution who died in the previous year. According to the website's administrator, Wendy Nishikawa, who also runs the Work/Life Balance website, they announce the memorial service to the entire community a couple of weeks before it happens, so that they can find out about deaths they might have missed (their website offers directions on how to notify the administration of a death). Then there's a one hour service, during which all the names are called out and so remembered. You can see a video of the most recent service here:

I don't know if the bagpipes are culturally appropriate for a similar service in Hawai`i, but the rest of the Berkeley service is respectful, sober, and offers solace to those who gather together. The video shows a goodly number of people present. There's a student newspaper report on the event, as well, which includes a list of those who died. The Berkeley student newspaper also ran a beautiful obituary for one of the students who'd died, Selam Sekuar. You can read that here. When I spoke to someone in the Counseling Center at the University of Virginia, (If you click on the UVA site, take a long look at the resources that they put on their webpage.) I was told that they report deaths with the help of the student newspaper. He meets with young reporters to make it clear how to report deaths in a way that does not cause "suicide contagion" (or the possibility that one suicide can become a model for others to follow). He distributes this document to young reporters:

But the mere fact that not all protocols are the same, or that they are not always followed to the letter, is not a good argument for not writing one. And that is the administration's stand at UHM right now, that every exception to a rule means that the rule itself is faulty, inapplicable to our situation, and so on. That, because all deaths are unique, our treatment of them must always be different. (To which my husband responds: firefighters know that every fire is unique, but they follow protocols in their attempts to put them out.) UHM is waiting for the crisis to happen before they respond. What we are suggesting is that they not wait so long as that. Come up with something on paper (something a lot better than the few pages I was sent when I asked) use some of the ideas that are brought to you, no matter where they come from (an English professor, a non-benchmark institution), and make a task force of interested parties from administration, the counseling center, the faculty and the students. Then put it on-line, so everyone can see it. Then revisit the protocol often, to make sure it works as well as it can.

The undergraduate government organization (ASUH) voted unanimously in favor of a protocol; the graduate group (GSO) voted overwhelmingly in favor. At these meetings, I found myself in an adversarial relationship with administrators: I argued for a protocol, and they argued against. I say there are problems; they say there are not. I'm wondering what it will take for us to sit down at the table and share our positive ideas about how better to communicate on campus, between administrators and students, but also between administrators and each other, administrators and faculty, faculty and students). I'm tired of showing up to put on yet another episode of Cross-Fire, whose major fascination was not how problems were resolved, but how dramatically they were perpetuated.

Back to the question of language, and how it can be used compassionately by an institution: the headnote to UC-Berkeley's "Guidelines to Responding to Death on the UC-Berkeley Campus," states: "The true character of our campus community is revealed in how we respond to challenges, adversity and loss." Chancellor Dirks  The first paragraph of the UH-Hilo Student Death protocol reads: "The death of a student can be deeply emotional and stressful for students, faculty, staff, and the family of the student. It is the aim of the University of Hawai'i at Hilo to respond appropriately and sensitively in the event of the death of a currently enrolled student. To that end, the following protocol has been developed to ensure a caring, professional, coordinated, and consistent response by the University administration." Even closer to home, and without a protocol in place (I'm told one is in the works), UH-West Oahu sends out occasional emails to their community about mental health, and I quote from one: "The 'Mental Health Moment' is brought to you by the University of Hawai'i – West O'ahu (UHWO) Counseling Services (CS). It is our hope to provide our UHWO 'ohana with information and resources needed to help our community live healthier and more meaningful lives. We encourage all of you to be agents of change in your families and friends by contacting CS if you know of anyone who may be dealing with emotional or psychological problems." What follows from this introduction is a list of reasons why a student might want to go in for counseling.

No matter the procedures outlined in these documents or emails, the frame around them is compassionate. But compassion does not end with the frame; it emerges from the checklists featured in some of them; it emerges from the directions about how to talk to grieving families. It emerges in the very fact of there being such documents. It emerges when an institution allows itself to speak, rather than leaving cruel silences. That's what it means for institutions to have compassion.

Friday, October 9, 2015

Questions for Administration re: Student Death Protocols & Suicide Prevention (or the lack thereof)

I will write more soon about my recent adventures in admin. But for now, some questions. Please feel to ask them yourselves.

Questions for the Vice Chancellor of Students' Office & The Counseling Center

On the Student Death Protocol Issue

--How many UHM students die each year? Have you categorized or studied them? Please provide details and statistics.

--Describe the procedures you have for handling a death by natural or accidental causes, as opposed to suicides. Are they different procedures? (According to best practices (see links below), all deaths should be treated in the same way to avoid the risk of suicide contagion.) In these cases of natural or accidental deaths, how do you reach out to the friends and acquaintances and staff members? How do you notify them of them of services that are available, in case of trauma?

--How do students who do not live in the dorms receive notice of a fellow classmate's death? Do Counselors reach out to them in the same way as they do for Student Housing residents? Please verify.

--We were told that the administration sent out a notification of a student's death to the community once, in 2006, and the victim's sister was re-traumatized by it. Did you notify the family that you would be putting a notice out before you did so? What can you do to avoid re-traumatizing someone without simply remaining silent, bearing in mind that hearing of a death through the rumor mill is itself traumatizing?

--When there are memorial services for students who died, how were people notified of these services? How many people were notified and how were they chosen? How often has UHM assisted families and friends in having such services?

--It appears that you notify only the very easiest to reach students who might be acquainted with the victim--the people on the same floor, the people in their clubs, and professors of their classes. How do you think that this represents the important acquaintances and friends of this person? What more could you be doing?

--Granted, we cannot always "beat" the news cycle about deaths on campus, can we enter the news cycle as a compassionate institution, rather than saying nothing?

--How will the compassionate procedures now in place (but not published or available to us in any way) be passed on to the next administrators, given that people retire or leave Hawai'i for other jobs?

On Mental Health Issues and Counseling

--What fraction of students in crisis are you able to serve? How do you know this? How does the Counseling Center receive funding and additional resources if they are experiencing an influx of students in need of services?

--How many students are treated by the Counseling Center currently? Over the past year? The past decade? How many more resources are needed to provide services to those students in need who have not been served.
--What specifically was done with the grant money from SAMSHA that the Director of Counseling mentions at recent meetings with ASUH, GSO and the Faculty Senate committee (aside from buying an ad in Ka Leo to announce their table at campus center)? Please provide detailed examples and outcomes (i.e. the final report).
--Where can faculty easily access information on what you do, both in crisis, and in the day to day, to care for our students?
--How does the Counseling Center support national mental health programs such as National Suicide Prevention Month? Please provide examples.

--How does the Counseling Center use state and local mental health services to educate and support UH students?

Communications Issues

--Who is the Communications and Outreach person for the Counseling Center, and how do they communicate with a student body of roughly 20,000? Please provide examples of on-going efforts that span the academic or calendar year.

--Only about 1,500 students pay to participate in New Student Orientation each fall. How are students who do not pay to participate in New Student Orientation informed of Counseling Center services? Please provide examples of on-going efforts.

--How does a staff member first hear about the Counseling Center services on campus? Where is there information about this through OHR?

Some resources on dealing with suicide in schools (for those who don't know of them)