Supporting Neurodiverse Students on Campus

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Landmark College – Transition of Medical and Mental Health Care Guide

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Passaic County Community College – Mental Health & Basic Needs Resources for Community College Students

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Safe and Effective Messaging – The Jed Foundation

When sharing messages about mental health issues and suicide, it’s important to do so in a safe and effective way. You want to make sure you are helping people rather than discouraging them, especially in times of vulnerability. Here are some resources, guidelines and quick tips to learn more about safe and effective messaging.

Always Promote Help-Seeking

  • You are not alone
  • It’s ok to ask for help – it’s available and a sign of strength
  • Treatment works
  • If someone discusses their personal struggles/experiences, it’s important to say they were able to work through tough times because they reached out for help

Refer

Language for Talking about Suicide

  • Say, “died by suicide”; “lost to suicide” instead of “committed suicide” or “shot him/herself”; “killed him/herself”
  • Say, “suicide attempt survivor”; “did not die in a suicide attempt” instead of “failed suicide attempt”
  • Try not to discuss death in detail or means used
  • Avoid describing death by suicide as an “epidemic/crisis,” or using dramatic terms like “skyrocketing” or “trend”

Language for Talking about Mental Illness

  • Say “He is living with a mental health condition”; “She is afflicted with / suffers from”; “She is living with / She has been diagnosed with”; “She has schizophrenia / She is living with schizophrenia” instead of “He is mentally ill”; “She is schizophrenic”
  • Say, “He is experiencing symptoms of” instead of “He is psychotic / disturbed / crazy”

General Messaging

  • Everyone struggles at times, but if a problem is lasting too long, is too intense or feels like more than you can handle, reach out for help.
  • It’s important to learn the warning signs of suicide, self-harm, and substance abuse.
  • Look for changes in behavior, personality.
  • It’s ok to ask for help – it doesn’t mean that you’re weak, or just want attention. Everyone needs help from time to time, and if you or a friend is struggling, you should reach out to talk to someone right away.
  • Trust your gut – if you’re worried about yourself or a friend, don’t hesitate to act and get help. You don’t have to know what is wrong-just that they’re in trouble or struggling.
  • Be direct with your friends – tell them you’re worried and why, ask them how they’re feeling and offer to reach out to a professional and/or family member with them or for them.

More Info

  • Typically, there is mental illness in the context of suicide. Treatment of a mental health condition can make a tremendous difference in someone’s life.
  • Suicide is a tragic, permanent action and should never be the solution to a problem.

Click here to view the full Safe and Effective Messaging page from The Jed Foundation.

Prevention and Treatment of Anxiety, Depression, and Suicidal Thoughts and Behaviors Among College Students Guide – SAMHSA

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Voluntary Medical Leave for Students Experiencing Mental Health Difficulties at College

Many colleges struggle to understand how to enable their mental health leave of absence policies to meet the expectations inherent in the Americans with Disabilities Act (ADA). In this webinar, we will review the experience of one university that worked directly with the US Department of Education’s Office for Civil Rights (OCR) to construct a leave of absence policy. Presenters—SAMHSA and The Jed Foundation (JED)—will discuss the principles that emerged from the OCR’s oversight of developing this leave of absence policy and how these principles can inform colleges about meeting OCR’s expectations. Attendees will gain an understanding of how the OCR appears to interpret the ADA and how to best prepare policies and processes for mental health leaves of absence on your campus.

Click here to access the webinar via SPRC’s YouTube channel.

NaBITA Position Statement on Involuntary Withdrawal Best Practices

Ratified by the NaBITA Advisory Board on February 4, 2019, the following position statement provides recommendations on mandatory (or involuntary) leave, as well as the use of behavioral agreements. Remember to also refer to our JED Campus recommendations here when building your policies.

Click Here to Access the NaBITA Position Statement: Involuntary Withdrawal Best Practices

PsyberGuide

PsyberGuide is a non-profit website dedicated to consumers seeking to make responsible and informed decisions about computer and device-assisted therapies for mental illnesses. PsyberGuide is also intended for professionals and researchers seeking to enhance their knowledge in this area. PsyberGuide is not an industry website. PsyberGuide seeks to provide accurate and reliable information about software and apps designed to treat schizophrenia, bipolar disorder, depression and anxiety disorders. PsyberGuide also seeks to ensure that this information is available to all, and that it is free of preference, bias, or endorsement.

Click here to learn more about PsyberGuide on their website.

Sample counseling center satisfaction surveys

These are sample satisfaction surveys for mental health services / a counseling center that your school can use in updating or creating your own. Surveying your students about your campus programs is important in assessing their impact and effectiveness, as with most all objectives within your strategic planning.

Princeton University – CAPS satisfaction survey
University of Wisconsin – Madison: MHS satisfaction survey

Public Health Cannabis Campaign by University of Vermont

The following cannabis social marketing campaign, accessible from the link below, from the University of Vermont is primarily focused on raising awareness around cannabis misuse on campus. The themes in the posters come from focus groups held with UVM students who brought up the following topics as their motivation for change. You can view the posters, as well as a fact sheet that UVM developed for their students, on the Center for Health & Wellbeing at UVM website:

Click here to explore the campaign

Additionally, UVM developed T-Break: a guide to help support you on a cannabis tolerance break, which is a guide of daily practices with three weekly themes:

  1. Week 1- physical
  2. Week 2 – emotional
  3. Week 3 – spiritual / existential

DESCRIPTION FOR STUDENTS: It may be useful to read a few a days at once because there are practical things about sleep and appetite that may be helpful right away. Care has been put into the content and order, but you know what works best for you. Feel free to make this is a choose-your-own adventure guide.

JED Campus Discussion Call: Let’s Talk

On January 22, 2019, JED Campus hosted a call to discuss developing and implementing Let’s Talk programs. Greg Eells, PhD (Cornell University), Sudha Wadhwani, PsyD (Montclair State University), and Jude Uy, PhD (Montclair State University), presented how “Let’s Talk” has evolved at their institutions and shared their tips for success. Listen to the full audio recording below to hear why Dr. Eells says, “Even if I was a counseling center of one, I would make time for Let’s Talk – it’s that valuable.”

Click here to access the MP3 recording.

Expanding Access to Naloxone: Reducing Fatal Overdose, Saving Lives

Chief among today’s highly effective available practices to halt and reverse the growing toll of accidental overdose fatalities is naloxone hydrochloride (also known as Narcan™), a low-cost medicine available generically that was first approved by the FDA in 1971. Naloxone is an opioid antagonist that blocks the brain cell receptors activated by prescription opioids such as oxycodone, as well as by illicit opiates such as heroin. It temporarily restores normal breathing within two to three minutes of administration.

Naloxone is the first line of treatment for emergency room physicians and paramedics upon encountering a patient experiencing an overdose. Ideally, emergency medical responders are summoned as soon as an overdose is detected. A dose of naloxone is then administered and rescue breathing is initiated if necessary. If the victim has not been revived after two minutes, another dose of naloxone is administered and so on until the naloxone has the desired effect. Naloxone’s effects last for 30 to 75 minutes, allowing time for the arrival of emergency medical assistance. Though the research is contradictory, some studies suggest that once the naloxone effect wears off, opioids in the circulatory system may become toxic again and without medical attention victims can subsequently cease breathing again. However, naloxone can be administered repeatedly without harm.

Click here to read the issue brief from the Drug Policy Alliance.

Drinking to toxicity: college students referred for emergency medical evaluation

Abstract
Background: In 2009, a university adopted a policy of emergency department transport of students appearing intoxicated on campus. The objective was to describe the change in ED referrals after policy initiation and describe a group of students at risk for acute alcohol-related morbidity.
Methods: A retrospective cohort of university students during academic years 2007–2011 (September–June) transported to local ED’s was evaluated. Data were compared 2 years prior to initiation of the policy and 3 years after and included total number of ED transports and blood or breath alcohol level.
Results: 971 Students were transported to local ED’s. The mean number of yearly transports 2 years prior to policy initiation was 131 and 3 years after was 236 (56 % increase, p < 0.01). 92 % had a blood or breath alcohol level obtained. The mean alcohol level was 193 mg/dL. Twenty percent of students had alcohol levels greater than 250 mg/dL.
Conclusions: Adoption of a university alcohol policy was followed by a significant increase in ED transports of intoxicated students. College students identified as intoxicated frequently drank to toxicity.

Click here to view the full article from Addiction Science and Clinical Practice.

Advancing Integration of Behavioral Health into Primary Care: A Continuum-Based Framework

The need to bring high-quality treatment and management of depression, anxiety, and other common behavioral health conditions into primary care has been well documented, but for small to medium-size practices the complex models that are the standard for integrating medical and behavioral care are often beyond their resources. An innovative new framework, developed with support from a UHF grant, delineates a series of steps in eight key areas, or domains, that providers can take to move toward integration, allowing them to progress at a manageable pace in each of the areas independently, rather than attempting an all-or-nothing approach.

Click here to view the framework from United Hospital Fund.

myStrength | Digital Behavioral Health

The myStrength experience is based in clinical models like cognitive behavioral therapy, acceptance and commitment therapy, positive psychology, mindfulness, and motivational interviewing – proven interventions that have helped millions improve and sustain health and well-being. myStrength adjusts each day and with every interaction. Preferences and goals, current emotional and motivational states, ongoing life events are all captured. Sophisticated machine learning algorithms create individualized myStrength experiences which include interactive programs, in-the-moment coping tools, inspirational resources and community support. myStrength offers depth and breadth to build resiliency, manage stress, improve mood, sleep better or simply find daily inspiration. Their platform empowers users with individualized pathways incorporating multiple programs to help manage and overcome co-occurring challenges.

Click here to learn more about myStrength on their website.

Collegiate Recovery Programs: A Win-Win Proposition for Students and Colleges

Published in August 2016 from the Center of Young Adult Health and Development (CYAHD), this report explains collegiate recovery programs, and provides information on the benefits and the impact of collegiate recovery programs on the college campus.

Click here to view the full report.

Opioid Prescribing in College Health

The United States is facing a prescription opioid epidemic. The U.S. Centers for Disease Control and Prevention (CDC) has reported prescription and sales of opioid medication has quadrupled since 1999. Between the years of 1999 and 2014, 165,000 people have died from an overdose of opioid pain medication in the United States.

A majority of pain medication prescriptions written in the college health setting are for acute pain, though some students need pain management for more chronic issues. College health providers may not feel comfortable prescribing long term pain management, but smaller or more rural campuses may not have access to qualified pain management specialists; providers thus may feel both obligated and unprepared to prescribe.

The ACHA Task Force for Opioid Prescribing in College Health has created these guidelines to further an understanding of the issues surrounding opioid prescribing; review major concepts designed to maximize safety and reduce potential for abuse; and identify possible avenues to assist addicted students with rehabilitation, recovery, and return to the college environment. These guidelines are not intended to be comprehensive, and national issues and recommendations may change over time. Therefore, college health professionals are encouraged to seek additional resources and specific clinical advice as indicated.

Click here to view the full set of guidelines from the ACHA.

Alcohol Policies and Suicide: A Review of the Literature

Abstract

Both intoxication and chronic heavy alcohol use are associated with suicide. There is extensive population‐level evidence linking per capita alcohol consumption with suicide. While alcohol policies can reduce excessive alcohol consumption, the relationship between alcohol policies and suicide warrants a critical review of the literature. This review summarizes the associations between various types of alcohol policies and suicide, both in the United States and internationally, as presented in English‐language literature published between 1999 and 2014. Study designs, methodological challenges, and limitations in ascertaining the associations are discussed. Because of the substantial between‐states variation in alcohol policies, U.S.‐based studies contributed substantially to the literature. Repeated cross‐sectional designs at both the ecological level and decedent level were common among U.S.‐based studies. Non‐U.S. studies often used time series data to evaluate pre–post comparisons of a hybrid set of policy changes. Although inconsistency remained, the published literature in general supported the protective effect of restrictive alcohol policies on reducing suicide as well as the decreased level of alcohol involvement among suicide decedents. Common limitations included measurement and selection bias and a focus on effects of a limited number of alcohol policies without accounting for other alcohol policies. This review summarizes a number of studies that suggest restrictive alcohol policies may contribute to suicide prevention on a general population level and to a reduction of alcohol involvement among suicide deaths.

Click here to access the full article through your institution’s access to Wiley Online Library.

Higher Education Center | for Alcohol and Drug Misuse Prevention and Recovery

The Higher Education Center for Alcohol and Drug Misuse Prevention and Recovery (HECAOD) is the premier alcohol and drug misuse prevention and recovery resource for colleges and universities across the nation.  HECAOD is a joint collaboration between The Ohio State University’s College of Social Work, College of Pharmacy, Office of Student Life, Generation Rx, and the Collegiate Recovery Community.

Click here to navigate to the Higher Education Website.

College students at residential campuses benefit from access to student health insurance programs

JED recommends that schools research the feasibility of offering a school-sponsored health insurance policy. In alignment with this recommendation, HBC (Hodgkins Beckley Consulting) released study data in March 2017 affirming the benefits when students are provided health insurance by the university. A PDF copy of HBC’s press release can be found by clicking here.

Online resources for substance abuse education

JED Campus recommends that you educate your students about the risks and consequences of substance use/misuse. The following are educational resources you can use on your campus.

Data and Resource Pages:

SAMHSA – Alcohol, Tobacco, and Other Drugs
CDC – Fact Sheets: Alcohol and Caffeine

Alcohol and Its Effects with Other Drugs:

University of Michigan – The Effects of Combining Alcohol with Other Drugs

Student Toolkits:

Talkaboutrx.org – What You Can Do: Tips for Raising Awareness about Prescription Drug Abuse on Campus

Online resources for trauma informed care

According to SAMHSA’s concept of a trauma-informed approach, “A program, organization, or system that is trauma-informed:

  1. Realizes the widespread impact of trauma and understands potential paths for recovery;
  2. Recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system;
  3. Responds by fully integrating knowledge about trauma into policies, procedures, and practices; and
  4. Seeks to actively resist re-traumatization.”

The following resources provide good tools for enhancing services on campus through a trauma informed approach:

SAMHSA – Trauma-Informed Approach and Trauma-Specific Interventions
The Trauma Informed Care Project
ACEs Connection – Incorporating Trauma Informed Practice and ACEs into Professional Curricula: A Toolkit
ACHA – Trauma-Informed Care on a College Campus

 

Online resources for care/case management

Care/case management is crucial to the coordination of care of your students, such as with off-campus services. The following resources provide guidance and information on care/case management which you can use in creating and updating your own systems; you can also find sample descriptions of school care/case manager positions in the JED Campus playbook.

NaBITA/ACCA – Case Management in Higher Education
HECMA – Higher Education Case Managers Association
National Council for Behavioral Health – Case Management to Care Management

 

 

Suicide and Substance Use in Young People

“Suicide and Substance Use in Young People” provides an overview on the relationship between suicide and substance use among young people, and includes best practices in prevention and intervention. Click here to watch the webinar, hosted on SAMHSA’s YouTube page.

Suicide in National Collegiate Athletic Association (NCAA) Athletes

Background: The National Collegiate Athletic Association (NCAA) has recently highlighted mental health concerns in student athletes, though the incidence of suicide among NCAA athletes is unclear. The purpose of this study was to determine the rate of suicide among NCAA athletes.

Hypothesis: The incidence of suicide in NCAA athletes differs by sex, race, sport, and division.

Study Design: Retrospective cohort study.

Level of Evidence: Level 3.

Methods: NCAA Memorial Resolutions list and published NCAA demographic data were used to identify student-athlete deaths and total participant seasons from 2003-2004 through 2011-2012. Deaths were analyzed by age, sex, race, division, and sport.

Results: Over the 9-year study period, 35 cases of suicide were identified from a review of 477 student-athlete deaths during 3,773,309 individual participant seasons. The overall suicide rate was 0.93/100,000 per year. Suicide represented 7.3% (35/477) of all-cause mortality among NCAA student athletes. The annual incidence of suicide in male athletes was 1.35/100,000 and in female athletes was 0.37/100,000 (relative risk [RR], 3.7; P < 0.01). The incidence in African American athletes was 1.22/100,000 and in white athletes was 0.87/100,000 (RR, 1.4; P = 0.45). The highest rate of suicide occurred in men’s football (2.25/100,000), and football athletes had a relative risk of 2.2 (P = 0.03) of committing suicide compared with other male, nonfootball athletes.

Conclusion: The suicide rate in NCAA athletes appears to be lower than that of the general and collegiate population of similar age. NCAA male athletes have a significantly higher rate of suicide compared with female athletes, and football athletes appear to be at greatest risk.

Clinical Relevance: Suicide represents a preventable cause of death, and development of effective prevention programs is recommended.

Click here to view the full study through your institution’s subscription to Sage Journals.

HIPAA Privacy Rule and Sharing Information Related to Mental Health

The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule provides consumers with important privacy rights and protections with respect to their health information,
including important controls over how their health information is used and disclosed by health plans and health care providers. Ensuring strong privacy protections is critical to maintaining individuals’ trust in their health care providers and willingness to obtain needed health care services, and these protections are especially important where very sensitive information is concerned, such as mental health information. At the same time, the Privacy Rule recognizes circumstances arise where health information may need to be shared to ensure the patient receives the best treatment and for other important purposes, such as for the health and safety of the patient or others. The Rule is carefully balanced to allow uses and disclosures of information—including mental health information—for treatment and these other purposes with appropriate protections.

Click here to access the full guide.

Start Your Recovery

StartYourRecovery.org provides helpful information for people who are dealing with substance use issues — and their family members, friends, and co-workers, too. SYR knows that there is no one-size-fits-all solution to the challenges faced by those who misuse alcohol, prescription or illegal drugs, or other substances, and they aim to break through the clutter to help people at any stage of recovery. SYR’s goal is to offer people who are dealing with substance use issues a single source of reputable, objective information about signs, symptoms, conditions, treatment options, and resources — presented in a user-friendly format and in language that’s easy to understand.

Click here to visit the Start Your Recovery website.

Comparison of Collaborative Care and Colocation Treatment for Patients With Clinically Significant Depression Symptoms in Primary Care

Objective: The study compared clinical outcomes of depression treatment in primary care with a colocation model versus a collaborative care model (CoCM).

Methods: Patients (N=240) with Patient Health Questionnaire-9 (PHQ-9) scores of ≥10 treated for clinically significant depression symptoms in primary care sites implementing the CoCM or a colocation model were compared. PHQ-9 scores were collected at baseline and 12 weeks.

Results: From baseline to follow-up, reductions in PHQ-9 scores were 33% for the CoCM sites and 14% for the colocation sites, with an unadjusted mean difference in scores of 2.81 (p=.001).

Conclusions: More patients treated in sites that used the CoCM experienced a significantly greater reduction in depression symptoms, compared with patients in sites with the colocation model. As greater adoption of integration models in primary care occurs, it will be important to consider potential implications of these results for promoting adoption of CoCM elements. Further replication of these findings is warranted.

Click here to access the full article through your institution’s access to Psychiatry Online.

Effectiveness of Online Collaborative Care for Treating Mood and Anxiety Disorders in Primary Care

Questions  Is combining an internet support group (ISG) with a care manager–guided computerized cognitive behavioral therapy (CCBT) program better at treating depression and anxiety than CCBT alone and better than primary care physicians’ usual care for these conditions?

Findings  Among 704 patients randomized to CCBT+ISG, CCBT alone, or their primary care physicians’ usual care, patients in the CCBT+ISG and CCBT alone cohorts reported similar improvements in mental health–related quality of life, mood, and anxiety symptoms, while patients in the CCBT alone cohort reported greater improvements in mood and anxiety than usual care.

Meaning  Providing moderated access to ISG provided no measurable benefit at treating depression and anxiety over care manager–supported CCBT; however, care manager–supported CCBT was more effective than primary care physicians’ usual care for these conditions.

Click here to access the full study from JAMA Network.

Opioid Overdose Prevention Programs Providing Naloxone to Laypersons

Drug overdose deaths in the United States have more than doubled since 1999, reaching a total of 43,982 in 2013. Heroin and prescription opioids are major causes of drug overdose deaths. Naloxone is the standard medication used for reversal of the potentially fatal respiratory depression caused by opioid overdose. From 1996 through June 2014, a total of 644 local sites in 30 states and the District of Columbia reported providing naloxone kits to 152,283 laypersons and receiving reports of 26,463 drug overdose reversals using naloxone from 1996 through June 2014. Most laypersons who reported using the kits to reverse an overdose were persons who use drugs, and many of the reported reversals involved heroin overdoses. Medical clinics and pharmacies have started providing naloxone kits to laypersons, and the reported number of organizations providing kits almost doubled from January 2013 through June 2014. Organizations training and providing naloxone kits to laypersons can reach large numbers of potential overdose witnesses and result in many reported overdose reversals. Comprehensive prevention measures that include teaching laypersons how to respond to overdoses and administer naloxone prevent opioid-related drug overdose deaths. Additional methods are needed to provide naloxone kits to persons who might witness prescription opioid analgesic overdoses.

Click here to read the full article, published by the CDC in 2015.

Online resources for opioid overdose response (and naloxone)

The following resources provide information about responding to opioid overdoses, including first responder training for naloxone:

Harm Reduction Coalition – Responding to Opioid Overdose
Mass.gov – Opioid Overdose Prevention Information
National Institute on Drug Abuse – Naloxone: A Potential Lifesaver

SAMHSA – Substance Abuse and Mental Health Services Administration

The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. SAMHSA’s mission is to reduce the impact of substance abuse and mental illness on America’s communities. SAMHSA produces various programs, publications, and reports, and provides grants to support mental health services such as the Garrett Lee Smith (GLS) grant.

Click here to navigate to the SAMHSA website.

 

SAMHSA Opioid Overdose Prevention Toolkit

This toolkit offers strategies to health care providers, communities, and local governments for developing practices and policies to help prevent opioid-related overdoses and deaths. Access reports for community members, prescribers, patients and families, and those recovering from opioid overdose.

Click here to view and/or download the full toolkit.

Sample counseling center triage systems

JED Campuses should develop/refine a triage system in their counseling centers for those in serious or urgent need of care. The following schools have good triage systems that you can use as examples for creating or modifying your own.

University of Pittsburgh – How to Make an Appointment
UMass Amherst – Getting Started

The Implementation of Mental Health Clinical Triage Systems in University Health Services

Click here to access the full article through your institution’s access to Taylor and Francis Online.

Listening Hours by Barnard College

JED Campus recommends that you provide counseling services outside of the counseling center. “Listening Hours” is an example program by Barnard College that provides free drop-in counseling at various residence halls. Feel free to use this program as an example as you seek to create similar programs on your campus.

Click here to visit Barnard’s page on Listening Hours.

SIGMA Threat Management

SIGMA helps colleges and universities develop and implement a threat assessment capacity that fits within their unique cultures and that is effective in both preventing violence and helping persons in need. They train higher education institutions on how to establish and operate a threat assessment team (or add threat assessment capabilities to an existing team) and how to identify, investigate, evaluate, and intervene with persons and situations that raise concern on campus. For institutions with existing threat assessment teams, they help evaluate and enhance current procedures and resources to be consistent with the new national standard. SIGMA consults on individual threat cases and provides guidance on crafting or revising institutional policies and procedures to facilitate effective threat assessment and collaborative case management.

Click here to read more about SIGMA on their website.

You can also learn more about SIGMA via this article by the APA on Marisa Reddy Randazzo, their founder.

myPlaybook | Online Program for Student-Athletes

myPlaybook is a web-based program designed specifically to help student-athletes reach their full potential. Student-athletes encounter risks to their health and well-being on a daily basis. Common risks can include alcohol abuse, access to performance enhancing drugs, the stress of balancing academic and athletic commitments, and the challenge of healthy eating as a college student. myPlaybook will introduce simple, yet effective strategies to enhance the student-athlete experience.

Click here to access myPlaybook.

NIDA – National Institute on Drug Abuse

NIDA’s mission is to advance science on the causes and consequences of drug use and addiction and to apply that knowledge to improve individual and public health.

This involves:

  • Strategically supporting and conducting basic and clinical research on drug use (including nicotine), its consequences, and the underlying neurobiological, behavioral, and social mechanisms involved.
  • Ensuring the effective translation, implementation, and dissemination of scientific research findings to improve the prevention and treatment of substance use disorders and enhance public awareness of addiction as a brain disorder.

You can link the NIDA website on your school’s counseling and health service websites to increase help-seeking behavior, or use NIDA to inform your substance abuse policies.

SBIRT – Screening, Brief Intervention, and Referral to Treatment by SAMHSA

SBIRT is a comprehensive, integrated, public health approach to the delivery of early intervention and treatment services for persons with substance use disorders, as well as those who are at risk of developing these disorders. Primary care centers, hospital emergency rooms, trauma centers, and other community settings provide opportunities for early intervention with at-risk substance users before more severe consequences occur.

  • Screening quickly assesses the severity of substance use and identifies the appropriate level of treatment.
  • Brief intervention focuses on increasing insight and awareness regarding substance use and motivation toward behavioral change.
  • Referral to treatment provides those identified as needing more extensive treatment with access to specialty care.

Click here to view more information about SBIRT on the SAMHSA website.

Online programs for substance abuse education

JED Campus recommends that you provide messaging to your students about the risks and consequences of substance use/misuse. The following are programs you can use on your campus.

  • Vector Solutions- AlcoholEdu
    • Alcohol misuse doesn’t just put college students’ safety and health at risk, but greatly threatens the ability of colleges and universities to achieve their missions. And while today’s students are increasingly drinking less or not at all, alcohol and other drugs continue to negatively impact student well-being.
    • AlcoholEdu® for College is an interactive online program that uses the latest evidence-based prevention methods to create a highly engaging learning experience, inspiring students to make healthier decisions related to alcohol and other drugs.
    • This course has been taken by more than 11 million first-year college students since its launch in 2000.
    • Click here to learn more about the AlcoholEdu course. 
  • Additionally, you can view the Alcohol and Drug Abuse Institute (ADAI) Library Database to find more tools used for screening and assessment of substance use and substance use disorders.

ULifeline [JED]

ULifeline is a project of The Jed Foundation (JED) dedicated to giving students and counselors access to specific resources accessible on their respective campuses. ULifeline includes a library of information on different mental health conditions focused on the university student experience, as well as giving school counselors analytics about how students access these resources.

ULifeline includes the “Self Evaluator,” which helps provide students with information about available resources at their school. The ULifeline Self Evaluator can become an invaluable resource towards your efforts to increase help-seeking behavior on your campus.

 

To sign up your school for the ULifeline program, register here.

Click here to view the ULifeline website.

Consequences of Receipt of a Psychiatric Diagnosis for Completion of College

This study provides new data on DSM-IV diagnoses associated with the failure to complete postsecondary education. The findings suggest that psychiatric factors play a significant role in college academic performance, and the benefits of prevention, detection, and treatment of psychiatric illness may therefore include higher college graduation rates.

Read the full study here.

College Parents Matter (Maryland Collaborative)

This online tool center provides an array of resources to help parents’ ongoing communication with their children during their time in college that is developmentally appropriate, and can help their student make rational decisions regarding college drinking and related problems.

Navigate to the College Parents Matter website by clicking here.

Change IS Possible: Reducing High-Risk Drinking Using a Collaborative Improvement Model

Published in January 2015 in the Journal of American College Health, below you can view a summary and a link to view the full article through your institution’s login:

To describe the adoption of public health and improvement methodologies to address college students’ high-risk drinking behaviors and to aid in prevention efforts.Members of 32 colleges and universities, content experts, and staff members of the National College Health Improvement Program (NCHIP). A 2-year learning collaborative developed by NCHIP trained individuals from 32 different college and universities in using the Plan-Do-Study-Act cycle as a method to create and implement initiatives aimed at reducing students’ high-risk drinking behaviors and related harms. Participants experienced success ranging from noteworthy increases in type and amount of interventions directed at reducing high-risk drinking, to creating collaboratives across campus, the local community, and stakeholders. Challenges related to data collection and creating lasting cultural change remain. The use of quality improvement methodologies and creation of a national collaborative successfully effected meaningful change in high-risk drinking behaviors on college campuses.

Click here to access the article through your institution’s access to Taylor and Francis Online.

The Academic Opportunity Costs of Substance Abuse During College

Published in May 2013 from the Center of Young Adult Health and Development (CYAHD), you can view the summary and a link to view the full report, below:

Summary

Excessive drinking and drug use remain significant problems on many college campuses. Contrary to the popular perception that substance use is a “normal” rite of passage endemic to the college experience, the more likely scenario—according to research evidence—is that it undermines students’ ability to succeed academically. Given the new research evidence, it behooves college leaders to recognize the connection between alcohol and drug use and academic retention, readiness and motivation to succeed, and view substance use prevention and intervention as a viable strategy to promote student success. More attention should be focused on identifying existing successful intervention models and designing innovative comprehensive approaches to promote student success.

Click here to view the full report.

School research on university-sponsored health insurance

The University of Washington’s Director of Health Promotion did research with students in public health and put together this amazing slide deck with data, testimonials and why it’s important that they consider JED’s recommendation to implement an insurance plan for all full-time students.

Click below to view the presentation for examples and insights into implementing an insurance plan for all full-time students on your campus.

UW SHIP Presentation: June 2018

Sample medical amnesty policies

These schools have solid medical amnesty policies that you can reference when creating and/or updating your own.  JED’s recommendations regarding medical amnesty policies are:

The policy includes:

  • Assurance that students who utilize emergency services or report a friend who is in need of emergency services due to intoxication and/or potential overdose will be subject to minimal or no disciplinary sanctions
  • An education/prevention/treatment response that includes clinical follow-up
  • Amnesty exclusion criteria for students who have utilized emergency services more than a certain number of times
  • The policy will be well publicized in the student handbook, faculty handbook, publicly in the residence halls, if applicable, and within three clicks of the school homepage

William and Mary’s Good Griffin Policy (formerly Medical Amnesty)

Florida State’s Medical Amnesty Policy

Towson University Responsible Tiger Protocol Amnesty Program

College Re-Entry Program by Fountain House

Based in NYC, College Re-Entry helps academically engaged 18-30 year-old college students, who withdraw from their studies due to mental health challenges, return to college and successfully reach their educational goals. Their expertise lies in helping students build and implement an action plan to get back to college and develop capacities to do well, both in and outside of the classroom. The Core Program begins with an integrated 14-week (15 hours per week) curriculum that helps a small cohort of students regain academic skills, restore physical wellness, and reclaim social community. Students have the opportunity to work with expert instructors in classes aimed at introducing and strengthening practical skills needed to succeed.

This is a great program for students looking to return to college after taking a medical leave.

Learn more at www.collegereentry.org

TAO – Therapy Assistance Online

TAO is a robust behavioral health digital solution that many institutions are using to augment their own services. The TAO tools and platform were built to meet many students’ skill development & educational needs in well-being and behavioral health.

TAO can be used to provide self-help when students need support and education for common issues, and to provide professionally guided help when the student’s problems require a higher level of care. The TAO platform includes a measure of resilience that allows administrators to track the utilization and effectiveness of the tools in various use cases on campus.

Click here to learn more about TAO – Therapy Assistance Online.

SMART Recovery

SMART Recovery is an abstinence-based, not-for-profit organization with a sensible self-help program for people having problems with drinking and using. It includes many ideas and techniques to help you change your life from one that is self-destructive and unhappy to one that is constructive and satisfying. SMART Recovery is not a spin-off of Alcoholics Anonymous. SMART Recovery is a meeting-based, mental health and educational program, focused on changing human behavior related to alcohol and drug use. Facilitators can be trained for a small fee and then access handbooks to use in the facilitation of group meetings.

Visit the SMART Recovery website.

Online Suicide Risk Screening and Intervention With College Students

This pilot randomized controlled trial examined the effect of an online intervention for college students at risk for suicide, Electronic Bridge to Mental Health Services (eBridge), which included personalized feedback and optional online counseling delivered in accordance with motivational interviewing principles. Primary outcomes were readiness to seek information or talk with family and friends about mental health treatment, readiness to seek mental health treatment, and actual treatment linkage.

Abstract:

Method: Participants were 76 college students (45 women, 31 men; mean age = 22.9 years, SD = 5.0 years) at a large public university who screened positive for suicide risk, defined by at least 2 of the following: suicidal thoughts, history of suicide attempt, depression, and alcohol abuse. Racial/ethnic self-identifications were primarily Caucasian (n = 54) and Asian (n = 21). Students were randomized to eBridge or the control condition (personalized feedback only, offered in plain report format). Outcomes were measured at 2-month follow-up.
Results: Despite relatively modest engagement in online counseling (29% of students posted ≥1 message), students assigned to eBridge reported significantly higher readiness for help-seeking scores, especially readiness to talk to family, talk to friends, and see a mental health professional. Students assigned to eBridge also reported lower stigma levels and were more likely to link to mental health treatment.
Conclusions: Findings suggest that offering students personalized feedback and the option of online counseling, using motivational interviewing principles, has a positive impact on students’ readiness to consider and engage in mental health treatment. Further research is warranted to determine the robustness of this effect, the mechanism by which improved readiness and treatment linkage occurs, and the longer term impact on student mental health outcomes.

Click here to purchase the full article.

Prescription Stimulant Medication Misuse, Abuse and Diversion: A Survey of College Students’ Behaviors, Attitudes, and Perceptions

This study was conducted by the University of Washington Center for the Study of Health and Risk Behaviors in partnership with NASPA and the Coalition for the Prevention of ADHD Medication Misuse (CPAMM).  This slide deck and summary fact sheet detail the findings from the study which drew random samples of students from 7 campuses. The results highlight potential correlations between other risky behaviors and stimulant misuse as well as details groups of students who may be more likely than others to misuse stimulants.

Download slide deck.

Sample memoranda of understanding documents (MOUs)

JED Campus recommends that IHEs develop or refine memoranda of understanding (MOUs) with local emergency and mental health services that they regularly interact with or rely on in the pursuit of well-coordinated access to care. Below are sample MOUs that you can use as models in developing your own:

 

Considerations for developing an MOU with a local emergency service:

  • It is important for emergency room personnel to make all reasonable attempts to have a student sign a release to notify the school when the student is treated in the emergency department or is admitted to the hospital
    • It is important for emergency room personnel to encourage students to sign a release to communicate with the school, especially if the student is hoping to return to school upon discharge.  This way the school understands the student’s status and needs and can work with the student to effectively re-engage them on campus. Emergency room personnel and the designated contact at the college’s counseling center need to discuss discharge planning prior to the student’s discharge in order to determine whether the student can be serviced on campus or will require a referral to a community provider.
  • Designate a point person on campus as the contact person for communication with the hospital
    • If the school initiates a student hospitalization, this point person is responsible for sending the student to the emergency room with appropriate documentation (i.e. referral and insurance information) and the contact information for the school’s point person.
  • Negotiate a plan to avoid discharging students at odd hours (i.e. in the middle of the night) when few resources are available to help with transition back to campus
  • If possible, develop an arrangement whereby students are fast-tracked in emergency room

 

Considerations for developing an MOU with community mental health providers

  • If possible, develop an arrangement for provider to expedite seeing students referred from the school.  You may establish a relationship with several providers who can be relied upon to accommodate situations in which a student needs to be seen quickly and who are willing to accept students who are considered high-risk
  • Negotiate a plan for provider to offer a sliding scale fee or a reduced fee when necessary for students referred from the school
  • Community clinicians need to be informed and sensitive around student schedules.  For example, have the ability to accommodate/reschedule sessions during exam times and maintain flexibility about sessions missed because of school vacation or summer break
  • It is valuable to identify providers within specific specialty areas-especially those that may complement the staffing profile of the campus service (e.g., substance abuse, trauma, eating disorders, borderline personality disorder and sexual identity concern specialists)
  • As part of the agreement, develop a  tracking system for students who are considered high-risk as well as a plan for providers to communicate student emergencies to the school’s counseling center, with the consent of the student
  • Determine a plan with community providers to establish a communication plan that facilitates collaborative care between the community provider and the school (i.e. medication management, therapy, disability services, etc.)
  • Designate methods and protocols for communication between counseling center staff and community providers
  • Provide an opportunity for community therapists and clinic staff to come to campus annually to meet with counseling and health center staff to develop ongoing working relationships – this is a valuable chance to get to know the local providers and to update them on campus trends and college mental health issues

 

Additional guidelines for creating MOUs

CPAMM – The Coalition to Prevent ADHD Medication Misuse

CPAMM works to help prevent the misuse, abuse and diversion of prescription stimulant medication, with an initial focus on college students. In 2013, 9.3% of students in one large university study reported using a prescription stimulant for non-medical use in the past year. CPAMM has excellent resources for college administrators, health professionals, and parents, including some useful infographics.

Visit the CPAMM website.

Sample care/case manager job descriptions

These are sample descriptions of a position within a counseling or wellness center at a university. A “care manager” (or “case manager”) deals with students with the most severe psychiatric illnesses. The care/case manager develops a relationship with these students and oversees/aids in their usage of different community and external resources.

Sample job description #1.

Sample job description #2

Sample job description #3

Reducing High-Risk Drinking Among Student-Athletes: The Effects of a Targeted Athlete-Specific Brief Intervention

In this study in the Journal of American College Health, researchers conducted a personalized intervention for D1 athletes at the University at Albany who showed tendencies toward heavy episodic drinking. The intervention highlighted the relationship between alcohol use and athletic performance and showed positive results that the intervention may contribute toward less heavy alcohol use. Presented here are the research article, a presentation slide deck, a sample feedback report provided to student participants, and a copy of the athlete survey.

Abstract:

Objective: This study examined the effects of a single session motivational interviewing–based in-person brief alcohol intervention that contained student-athlete–specific personalized drinking feedback.
Participants: Participants were 170 National Collegiate Athletic Association Division I student-athletes meeting
screening criteria for heavy episodic drinking.
Methods: Baseline assessments of alcohol use frequency and quantity, norm perceptions of peers’ alcohol use, experiences of negative consequences, and use of protective behaviors were administered to student-athletes prior to a 1-session brief intervention containing personalized feedback highlighting the relationship between alcohol use and athletic performance. Follow-up assessment was conducted
3 months post intervention.
Results: Student-athletes participating in the athlete-specific brief intervention showed significant reductions in their alcohol use and alcohol-related negative consequences, increases in use of protective behavioral strategies, and corrections in norm misperceptions at 3 months post intervention relative to a no treatment comparison group.
Conclusions: Student-athlete–specific brief alcohol interventions show promise in addressing high-risk drinking, reducing associated harms, and supporting health.

Download the full article.

Get Naloxone Now

Get Naloxone Now is an online resource to train people to respond effectively to an opioid-associated overdose emergency through the use of online training modules. Get Naloxone Now advocates for widespread access to overdose education and training in how to administer naloxone, the life-saving antidote for opioid-associated overdose, thus increasing the number of lives saved by bystanders and professional first responders (police officers, firefighters and EMTs).

Visit Get Naloxone Now.

Mental Health and Academic Success in College

This article in the B.E. Journal of Economic Analysis & Policy examines the connection between mental health and academic success as well as the economic benefit of attending to student mental health.

Abstract:

Mental health problems represent a potentially important but relatively unexplored factor in explaining human capital accumulation during college. We conduct the first study, to our knowledge, of how mental health predicts academic success during college in a random longitudinal sample of students. We find that depression is a significant predictor of lower GPA and higher probability of dropping out, particularly among students who also have a positive screen for an anxiety disorder. In within-person estimates using our longitudinal sample, we find again that co-occurring depression and anxiety are associated with lower GPA, and we find that symptoms of eating disorders are also associated with lower GPA. This descriptive study suggests potentially large economic returns from programs to prevent and treat mental health problems among college students, and highlights the policy relevance of evaluating the impact of such programs on academic outcomes using randomized trials.

Click here to access the full article through your institution’s access to De Gruyter Online.

CollegeAIM: Alcohol Intervention Matrix [NIAAA]

The National Institute on Alcohol Abuse and Alcoholism’s (NIAAA) College Alcohol Intervention Matrix (CollegeAIM) was developed for higher education officials, particularly alcohol and other drug program and student life staff, who seek to address harmful and underage drinking among their students. CollegeAIM is intended to inform and guide officials as they choose interventions for their campus communities.

View the CollegeAIM.

Evaluation of College Alcohol Policies: An Evaluation of College Online Alcohol-Policy Information

This article found that many alcohol policies were difficult to find on campus websites and offers suggestions on how better to educate and inform college students regarding institutional policies. JED Campus also believes that policies should be easily accessed on the website and cross referenced from multiple campus offices.

Abstract:

Excessive and underage drinking by US college and university students continues to be a significant problem. Curtailing the misuse of alcohol on college campuses is an important goal of college and university administrators because of the many negative consequences resulting from alcohol misuse. As part of their prevention programs, U.S. colleges and universities are required by law to make information about their alcohol policies available to students. Often the source of this information is the school’s Web site. The authors evaluated the alcohol-policy information that is available on the Web sites of the 52 top national universities listed in the 2002 rankings of US News and World Report. In general, they found that the information was difficult to find, was located in many areas of the Web site, and did not provide complete information about the school’s alcohol policy.

Click here to access the full article.

Direct Threat and Caring for Students at Risk for Self Harm: Where We Stand Now

This resource, published by the National Association of College and University Attorneys in 2014, proposes some guidelines for safeguarding students and avoiding disability discrimination claims in the absence of formal or clear federal guidance.

View the full document here.

Sample medical leave policies

These are examples of medical leave policies that JED Campus staff feel are strong. Feel free to reference them when you are working on creating or updating your own policies. Remember to also refer to our JED Campus recommendations here when building your policies.

The Bazelon Center for Mental Health Law has also created a model policy to help colleges and universities navigate these complex issues and develop a nondiscriminatory approach to a student who is in crisis because of a mental health problem. The model was developed after consultation with mental health experts, higher education administrators, counselors and students. It is a collection of best practices that all colleges and universities can and should adopt. It places particular emphasis on how to deal fairly and non-punitively with students in crisis, and how to support those whose mental health problems may be interfering with their academic, extracurricular or social lives. It addresses both voluntary and mandatory leave. View the full model policy here.

Tuition insurance programs

Tuition insurance plans refund a portion of unused annual tuition when students are withdrawn or dismissed for covered reasons. The following programs offer parity between medical leaves for physical and mental health concerns. Tuition insurance protects a family’s investment and can remove the fear of financial loss as a reason for a student to decide against getting the care they need (or medical leave). Remember to also refer to our JED Campus recommendations here, and you can view the following programs below:

Dewar – The Tuition Refund Plan

GradGuard – Insurance & Protection Products for College Life

GradGuard Tuition Protection Plan Policy from Allianz 2019 – 2020

Below you will find examples of how JED Campuses have advertised their tuition insurance policies.

Felician University — Tuition Insurance Flyer

Student Mental Health and the Law [JED]

This guide explains FERPA, HIPAA and disability law in addition to other complex legal topics schools can face related to student mental health.  The goal of this document is to provide all campus professionals with a summary of applicable laws and professional guidelines, as well as related good practice recommendations, to support well-informed decision making around students at risk. The good practice recommendations reflect input from round-table participants, key research findings, and previous work of JED and other organizations.

You can view the full guide here.

Framework for Developing Institutional Protocols for the Acutely Distressed or Suicidal College Student [JED]

This guide, developed by JED with input from expert professionals, provides your college or university community, regardless of its size, culture, and resources, with a list of issues to consider when drafting or revising protocols relating to the management of the student in acute distress or at risk for suicide. This document is a tool to aid your institution in developing or revising protocols related to response, emergency contact notification, and medical leave of absence.

View the full guide here.

Garrett Lee Smith (GLS) Suicide Prevention Grant

The purpose of this program is to develop a comprehensive, collaborative, well-coordinated, and evidence-based approach to: (1) enhance services for all college students, including those at risk for suicide, depression, serious mental illness, and/or substance use disorders that can lead to school failure; (2) prevent mental and substance use disorders; (3) promote help-seeking behavior and reduce stigma; and (4) improve the identification and treatment of at-risk college students so they can successfully complete their studies. It is expected that this program will reduce the adverse consequences of serious mental illness and substance use disorders, including suicidal behavior, substance-related injuries, and school failure.

The GLS grant is a great opportunity to enhance services on campus and aid in implementation of your strategic plans while in JED Campus.

Visit the SAMHSA website for more information on the 2018 grant period. Applications were closed as of February 20, 2018.

Reducing Alcohol Use and Related Problems Among College Students: A Guide to Best Practices

This guide, produced by the Maryland Collaborative to Reduce College Drinking and Related Problems, synthesizes the existing research on interventions that are and are not effective. Research studies during recent decades have demonstrated the comparative effectiveness of different approaches to reduce college student drinking. Some approaches, such as simply providing information to students about the risks of alcohol consumption, are not effective in changing behavior. This Guide describes the two major categories of interventions that seem to have the most promise. First, providing intensive personalized feedback and monitoring drinking patterns over time can help an individual to recognize the existence of a problem and modify his/her behavior. Second, on a more macro-level, changes in the environment to reduce the availability of alcohol as well as youth access to it are clearly effective ways to decrease excessive alcohol use and associated problems.

This Guide includes a detailed description of various strategies, a summary of the research supporting or
refuting their effectiveness, and tips for implementation. By clearly and concisely summarizing the evidence
regarding which approaches have been found to be effective or promising, and which have not, college administrators and community stakeholders can have a better idea of how to allocate resources more effectively.

Click here to access the guide.

The Family Educational Rights and Privacy Act: 7 Myths — and the Truth

Originally appearing in the Chronicle of Higher Education in 2008, this simple article clears up many of the misconceptions about FERPA and includes additional information about HIPAA and exceptions to FERPA.

The article can be found here.

Mind, Body, and Sport Handbook

A refreshing primer by the NCAA on the mental health aspects of the student athlete, that identifies the specific stressors for this population, and the different components of developing best practices to construct mental health services and support for student athletes. The chapters address:

  • Stressors specific to student-athlete identify, such as transition, performance, injury, academic stress and coach relations
  • Overview of clinical diagnoses, including depression, anxiety, eating disorders, substance abuse and gambling
  • Key components in developing best practices for constructing mental health services for student-athletes
  • The role and perspective of sports medicine staff in identification and referral
  • Cultural pressures and impacts on minority groups
  • How sexual assault, hazing and bullying affect mental health

Click here to download the guide.

New Data on the Nature of Suicidal Crises in College Students: Shifting the Paradigm

This study analyzes data and promotes a comprehensive approach to suicide prevention by redefining it as an institution centered problem. Hence the entire administrative structure of the university will have to be engaged to intervene at all points of the suicide continuum as is promoted in JED Campus.

Abstract:

This article presents new data on the nature of suicidal crises in college students. Data were collected from over 26,000 undergraduate and graduate students at 70 colleges and universities. An anonymous Web-based survey was designed to provide insight into the full spectrum of suicidal thought, intent, and action among college students. The authors discuss implications of these data and outline a new, problem-focused paradigm for conceptualizing the problem of college student suicidality and for guiding institutional policies and interventions at multiple points along the continuum of suicidal thoughts and behaviors. The proposed paradigm encompasses and expands on the current model of treating individuals in crisis in order to act preventively to reduce both prevalence and incidence of all forms of suicidality among college students.

Click here to purchase the full article.

JED Recommendations: PROVIDE MENTAL HEALTH AND SUBSTANCE USE SERVICES

PROVIDE MENTAL HEALTH AND SUBSTANCE USE SERVICES

Preserving a student’s mental health is critical in preventing substance use, risk for suicide and strengthening their academic success. Providing adequate on-site access to ongoing mental health prevention support and direct services is the backbone of any college mental health system. Ideally, on-campus services will include both basic primary care mental health and crisis support.

Additionally, providing substance use education, prevention and treatment is a fundamental component of college mental health services on college campuses.  Education about the dangers of substance misuse and drug diversion, the connection between substance use and relationship violence, academic performance and overall well-being, along with a variety of treatment options either on campus or in the community, is an important consideration for the college community.

There are five key objectives in the substance use and mental health domain:

  • Take an active role in helping students find adequate and comprehensive health insurance coveragethis allows students to seek and obtain the best optimal care for prevention and treatment of mental health issues and alleviates financial concerns while making treatment choices. Insurance coverage can favorably impact a student’s ability to remain in college.
  • Create and maintain leave policies and protocols supporting students in distress – Clear and well-publicized policies for leaves of absence can help reduce stress and anxiety when a student might be in the midst of a medical or mental health crisis and may need to consider a leave of absence. Clear policy can help reduce the perceived stigma of needing to ask for and/or considering a leave of absence.
  • Establish systems, protocols and processes that best help to coordinate necessary care for students – coordination of care between providers and services on/off campus facilitates continuity of care and a comprehensive/holistic approach to mental health treatment.
  • Seek to expedite, increase, and provide access to all necessary clinical care services, including after-hours carecampuses will engage in a variety of activities designed to increase the likelihood that a student in crisis, distress, with mental health issues, with alcohol or other drug problems, or experiencing suicidal thought will seek and receive help.
  • Create and maintain substance use policies and protocols supporting studentsPreserving a student’s mental health is critical in preventing substance use, risk for suicide and strengthening their academic success. It is essential to diagnose and treat students with alcohol and other drug use disorders and educate students on the dangers of recreational substance use (alcohol, drugs), substance use, misuse of prescription drugs and drug diversion.

THIS CONTENT CAN ALSO BE FOUND IN THE JED CAMPUS PLAYBOOK GUIDE.
To view all playbook resources within the Provide Mental Health and Substance Use Services domain, click here.

JED Recommendations: Access to Care

PROVIDE MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES:
ACCESS TO CARE

 

A school should seek to expedite, increase, and facilitate access to all necessary clinical care services, including after-hours care.
This is one of five main objectives in the Mental Health and Substance Abuse Services domain.
Under this objective, schools should take the following action steps:

 

  • Offer clinical services outside of typical “business hours” (evenings, weekends, etc.)
  • Provide counseling services in alternative locations on campus. Examples include, but are not limited to:
    • Residence halls
    • Recreation areas
    • Student centers
  • Develop or refine a triage system in the counseling center for those in serious/urgent need of care.
  • Implement action steps to limit wait lists/wait times, such as:
    • daily walk-in hours for students with urgent concerns
    • extending time between appointments for established patients to open up time for new student appointments
    • increasing referrals during busy periods for students who need longer term therapy
    • establishing a set number of weekly intakes for each clinician to maintain space for new students
  •  Provide resources to manage after-hours care/emergency situations, such as:
    • on campus services to serve after-hours needs and/or
    • promoting community resource or hotline/text line for after-hours needs and/or
    • promoting a national 24-hour crisis or suicide prevention hotline/text line for after-hours needs
  • Develop or refine memoranda of understanding (MOUs) with local emergency and mental health services. These should include:
    • A protocol for sharing relevant information including discharge planning, treatment recommendations, and any academic accommodations that might be needed
    • A plan to accommodate the school’s limitations such as lack of supervision in dorms and limited counseling center hours on evenings/weekends, etc.

THIS CONTENT CAN ALSO BE FOUND IN THE JED CAMPUS PLAYBOOK GUIDE.
To view all playbook resources related to Access to Care, click here.

JED Recommendations: Coordination of Care

PROVIDE MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES:
COORDINATION OF CARE

 

A school should seek to establish systems, protocols and processes that coordinate necessary care for students.
This is one of five main objectives in the Mental Health and Substance Abuse Services domain.
Under this objective, schools should take the following action steps:

 

  • Develop or enhance clinical services for mental health and substance abuse, including:
    • Counseling/psychotherapy
    • Academic/career counseling
    • Group therapy
    • Psycho-educational groups
    • Online, email or chat services
  • Evaluate the staff-to-student ratio to adequately address the clinical needs of students; ideally, one FTE : 1,000-1,200 students for the services offered.
    • If under-utilized, consider:
      • increasing awareness of the counseling service
      • increasing advertising/outreach
      • diversifying staff
      • implementing programming to destigmatize use of counseling service
    • If over-utilized, consider:
      • hiring additional staff
      • incorporating graduate level interns/post-docs
      • teletherapy, online counseling options
  • Seek to facilitate access to psychiatric medication management (on- or off-campus) as indicated
  • Establish a system for coordination of care for shared patients between relevant campus service providers, such as:
    • Shared electronic records (respectful of HIPAA and confidentiality)
    • Formalized regular joint meetings between counseling and health services and other relevant service providers to discuss shared cases.
  • Coordinate care with off-campus services
    • Maintain an updated list of referrals for mental health and substance abuse services including information on types of accepted insurance, wait times, and cost.
    • Obtain consent for release of information so that basic information can be shared between school and provider, as appropriate and needed with due consideration for compliance with state and federal privacy law
    • Designate methods and protocols for communication and tracking between counseling center staff and community providers
  • Train primary health care providers on campus to assess, treat, and refer (if needed) for basic mental health, substance abuse and behavioral related concerns
  • Collect data on student utilization and incidents on campus related to mental health and substance abuse issues

THIS CONTENT CAN ALSO BE FOUND IN THE JED CAMPUS PLAYBOOK GUIDE.
To view all playbook resources related to Coordination of Care, click here.

JED Recommendations: Health Insurance Resources

PROVIDE MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES:
HEALTH INSURANCE RESOURCES

 

A school should take an active role in helping students find adequate and comprehensive health insurance coverage.
This is one of five main objectives in the Mental Health and Substance Abuse Services domain.
Under this objective, schools may take the following action steps:

 

  • Research the feasibility of offering a college-sponsored health insurance policy if one does not already exist.
    • A school sponsored plan should be affordable
    • A school sponsored plan should provide parity in coverage and be non-discriminatory between general physical health and mental health care and services.
  • If feasible, require health insurance for all full-time students requiring a hard-waiver such that personal insurance is equally comprehensive.
  • The school-sponsored health insurance plan is recommended to include comprehensive coverage for mental health and substance abuse services including:
    • inpatient hospitalization
    • partial hospitalization
    • intensive outpatient treatment
    • therapy sessions
    • addiction counseling
    • medication assisted treatment (buprenorphine, methadone, suboxone) for students with opioid use disorders
    • psychiatric medication management/psychiatry
    • adequate coverage for medication (i.e. little-to-no out-of-pocket expense for medication)
  • Develop a written resource to assist students and families in making informed decisions when choosing between the school-sponsored health insurance plan and other health insurance options. The resource ideally will prompt students and their families to ask specific questions of their insurance carrier and of themselves increasing the likelihood that the student will have adequate coverage while they are at school. These include:
    • Does the plan provide the same coverage for the student while they are out of state at college as it does in state or is coverage limited to urgent care?
    • Are there in-network providers near the college that the student will be attending?
    • How current is the list of in-network providers?
    • Are they accepting new patients?
    • Will the student require transportation to access the providers and if so, is transportation available?

THIS CONTENT CAN ALSO BE FOUND IN THE JED CAMPUS PLAYBOOK GUIDE.
To view all playbook resources related to Health Insurance Resources, click here.

JED Recommendations: Leave Policies and Protocols

PROVIDE MENTAL HEALTH AND SUBSTANCE USE/MISUSE SERVICES:
LEAVE POLICIES AND PROTOCOLS

 

A school will benefit from having leave policies and protocols support students in distress.
This is one of five main objectives in the Mental Health and Substance Abuse Services domain.
Under this objective, schools may take the following action steps:

 

  • Disclaimer:  These recommendations are high level in nature (not meant to be exhaustive)  and should not be construed as legal advice or guidance.  Campuses need to consult with their general counsel to determine if their policies and procedures are in alignment with rulings from the Department of Education, Office for Civil Rights, the United States Department of Justice, and/or other regulatory guidance.  Definitions
  • Voluntary Leave of absence:  A voluntary leave of absence (LOA) is granted by the college in which a student is enrolled.  A LOA is a temporary interruption of a student’s program during which the student is considered to be enrolled.  Under most federal and state requirements an LOA cannot exceed 180 days in any 12 month period without potential implications for financial aid repayment.  Please check with your local/federal financial aid regulations surrounding this.
    • Medical leave of absence:  A medical leave of absence (MLOA) is when a student needs to take a leave due to a mental health or physical health issue.  For more information on LOA’s see this guide here.   
  • Involuntary/Mandatory Leave of Absence: When a student is unwilling to take a voluntary leave of absence and an individualized assessment based on objective evidence indicates that they pose a serious risk to the health and safety of others in the community, the school should have a process in place requiring the student to take an involuntary leave of absence.  These policies should be used rarely and be a last resort as described below.
  • Withdrawal:  An official withdrawal is when an enrolled student decides to leave their college/university after their semester begins.  JED Campus Recommendations for Leave PoliciesDevelop/refine a written voluntary medical leave of absence policy consistent with the following recommendations:

    Establish a central office to administer and coordinate all leaves to ensure consistency and eliminate confusion for the student. In this office the students can discuss the decision to take a leave and/or consider possible accommodations that might allow them to remain in school. The central office should:

    • Review reasons for the leave request
    • Discuss potential accommodations to allow a student to remain in school and avert a leave of absence.
    • Discuss the impact on academics
    • Discuss financial considerations, including tuition insurance and tuition refunds
    • Review the student’s transcript and scholarship status.
    • Consider the specific issues for graduate/professional students such as, graduate assistantships, grants etc.
    • Discuss visa and insurance implications for international students
    • Discuss the possibility of a leave collaboratively with the student. If they decide to take a medical leave of absence, frame it as a positive step that the student is taking to support their wellbeing and overall success.

    Consider reasonable accommodations to allow a student to remain on campus and avert a medical leave.

    • Create virtual accommodations, where possible and reasonable, so that students can participate in social, academic, and other activities while off-campus (for example if a student is hospitalized with a mental health condition).
    • Encourage faculty to implement pass/fail grading/non punitive coursework options for students to help students stay on campus during difficult periods. 
    • Encourage faculty to provide flexible attendance policies.

    Seek to create and maintain leave policies that are transparent and easily accessible to the campus community. 

    • The policies need to be accessible via the student handbook, the faculty handbook and easily searchable. Consider disseminating the policy to parents/families, faculty, academic advisors, athletics, students, financial aid, etc. 
    • The medical leave of absence policy should include clear and concise explanation of the college’s expectations for the student while they are on leave that are fully and concretely explained. This should include a description of documentation required for a medical leave.
    • An individualized assessment should be done with each student to develop a wellness plan that might include clinical treatment. Work to ensure that any treatment is culturally and identity relevant.
      • Inquire about financial resources/insurance coverage to meet these goals. 
      • Encourage students to build social connections and sleep/nutrition/exercise practices into these plans.
    • School policies should allow for decisions about length of time and terms of medical leaves on a case-by-case basis.
    • The medical leave process should be well coordinated among relevant offices and the college should assist students in appeal processes for tuition and housing costs.
    • Provide the student with a written summary letter of the details of the voluntary leave process, the details for what they need to do to return to school, and any other details to which has been agreed.

    Once a student has decided to take a medical leave of absence, where possible, support for students while on leave might include: 

    • The facilitation of avenues for students to access mental health resources while on leave in their communities.
    • Virtual academic and community support for students while on leave.
    • Campus staff who can reach out to, and support students on leave.

    A return from leave policy should be established and a checklist should be provided to the student.

    • There should be clarity around timelines, deadlines, and documentation for returning from leave. The return from leave policy should include the following:
      • A requirement to submit a formal written request that includes:
        • The current status of the problem
        • Treatment received, or ongoing, for the problem
        • A supportive meeting with the student to review the recommendations regarding return, including treatment plan (can be in-person or via Zoom/phone)
          • The return from leave clinical documentation should be sent directly to the Health Center for physical conditions or the Counseling Center for mental health conditions (in cases where the Counseling Center was involved in student treatment before the leave).
          • The Health or Counseling Centers should make a recommendation regarding a student’s readiness to return from leave to the designated office who oversees the leave process (for example, Dean of Students, VP of Student Affairs)

    Upon return from leave, the college might support students in the following ways: 

    • Provide wellness coaching upon their return to the university that encourages students to adopt healthy habits, connect with their peers, set a workable schedule, and utilize mental health resources.
    • Ensure financial/personnel resources to provide counseling and support for returning students.

    There should be parity (non-discrimination) in policy/procedure for students leaving for physical and mental health issues.

    Offer a tuition insurance policy that has parity between medical leaves for physical and mental health concerns. Tuition insurance protects a family’s investment and can reduce the fear of financial loss as a reason for a student to decide against getting the care they need (or medical leave).

    • The school may write a letter to families that outlines the benefits of participating in a tuition reimbursement plan, specifically:
      • Very little cost for plan versus potential cost for loss of tuition
      • Covers unexpected occurrences
      • Encourages students to get the care they need when they need it without having to weigh significant financial loss as a factor in their decision
    • The tuition insurance plan will offer the same reimbursement coverage for leaves due to mental health issues as for leaves due to physical health issues
      • The tuition insurance plan will provide parity in conditions for reimbursement – for example, some policies require hospitalization for mental health issues as a precondition for reimbursement, but only a note for reimbursement for medical issues – this type of inequity should be avoided.
      • The school’s tuition reimbursement policies can also be established to provide a better reimbursement schedule for students who take legitimate medical leaves.

    Develop/refine a written involuntary/mandatory leave of absence policy consistent with the following recommendations:

    As discussed above, on the rare occasion that a student is refusing/unwilling to take a leave of absence and poses a serious risk to others and/or is causing serious campus disruption based on their behavior, it is important for schools to have a policy in place for involuntarily withdrawing the student and for addressing the disruptive behavior. Keep in mind that in 2011 the Department of Justice stated that these types of policies should be considered when there are concerns about danger toward others only.  There is still confusion/ambiguity as to when/how/if such policies may be implemented when there are concerns about a student’s potential danger toward self.  

     A few considerations when developing these policies are below:

    • Provide an individualized assessment  to evaluate whether an involuntary leave is indicated. The DOJ articulated how “direct threat standard” may apply and is central to making determinations about an involuntary leave. 
    • The policy will indicate that suicidal ideation ALONE is not a justification for mandatory leave. Schools and their legal counsel should review carefully the DOJ changes from 2011 on this topic.  
    • The policy should consider mandatory leave when:
      • The school has exhausted reasonable efforts and accommodations to assist a student’s ability to remain on campus
      • The student’s behavior is a material disruption of, or direct threat to the campus living and learning community and/or its members
    • The school will provide a clear process for appealing a leave decision
    • There will be policy in place to consider/encourage communication with families around plans for leave and return, consistent with state and federal privacy law requirements
    • A mandatory leave of absence should be rare and given only after all other efforts have been applied to keep a student in school.

THIS CONTENT CAN ALSO BE FOUND IN THE JED CAMPUS PLAYBOOK GUIDE.
To view all playbook resources related to Leave Policies and Protocols, click here.

JED Recommendations: Substance Abuse

PROVIDE MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES:
SUBSTANCE ABUSE

 

A school should seek to create and maintain substance abuse policies and protocols supporting all students.
This is one of five main objectives in the Mental Health and Substance Abuse Services domain.
Under this objective, schools may take the following action steps:

 

  • Develop/refine a policy on alcohol and other drugs that is consistent with the following recommendations:
    • Clear, explicit and communicated in several ways (online, in person, flyers around campus, etc.)
    • Disciplinary and clinical consequences need to be consistent with the severity of the substance-related event
    • In addition to disciplinary sanctions, policies need to include education, prevention and treatment options
    • Provide prompt and equitable processes for discipline
  • Develop/refine a “medical amnesty” policy that is consistent with the following recommendations:
    • The policy includes:
      • Assurance that students who utilize emergency services, or report a friend who is in need of emergency services, due to intoxication and/or potential overdose will be subject to diminished or no disciplinary sanctions
      • An education/prevention/treatment response that includes clinical follow-up
      • Amnesty exclusion criteria for students who have utilized emergency services more than a certain number of times
      • The policy will be well publicized in the student handbook, faculty handbook, publicly in the residence halls, if applicable, and within three clicks of the school homepage
  • Develop/refine protocols for responding to alcohol and drug overdoses that are consistent with the following recommendations:
    • The clearance process to return to campus preferably includes a clinical evaluation and targeted assessment, including the use of a motivational interview
    • Provide standards for communication regarding a student’s return among relevant campus offices including:
      • conduct or community standards
      • substance abuse services or clinical services
      • housing (if applicable)
    • For serious events, provide a process to follow-up and check in with the student after some time has passed to determine the student’s status
    • The student will face consequences for not following treatment recommendations, which may impact continued enrollment
    • Students who have not had prior transport to the hospital should be required to complete an educational program highlighting the dangers of substance abuse after a drug or alcohol infraction
    • There should be a clear policy regarding communication with family members when a student has had a substance related emergency. This policy should reflect applicable state and federal privacy law
    • The emergency policy/procedure should be documented in writing and shared with and appropriately reviewed by all offices/staff who might participate in a response
  • Publish all alcohol and other drug policies in the student handbook, faculty handbook, and within three clicks of the school homepage.
  • Establish or expand recovery community and/or support programs on campus
  • Provide programs at orientation to educate new students about school policies regarding substance use
  • Implement strategically timed messaging campaigns to remind students about the risks and consequences of substance use/misuse (for example, during exam times or certain events)
  • Implement messaging campaigns designed to educate students about the risks and dangers of opiate misuse, including the effects with other substances
  • Develop/refine policies and protocols for prescription of opiates, tranquilizers (benzodiazepines and sleep medicines) and stimulants, including:
    • Articulating appropriate requirements for health service and/or mental health clinicians so as to follow state requirements for prescription of controlled substances
    • Language in reference to students who are prescribed stimulants, tranquilizers/sleep medications or opiates to the effect that those students will be provided with appropriate information about the dangers, risks, and consequences of drug misuse and diversion
    • Potential language, consistent with medical privacy and any informed consent laws and regulations, that informs students who are prescribed these substances, that they may be asked or required to sign a voluntary consent document attesting that students understand policies, risks, and consequences of drug diversion
    • Language that encourages clinicians, when controlled or potentially dangerous/abused medications are prescribed, to consider the potential for abuse of prescribed medications and to provide students the lowest quantity of pills that are clinically necessary, while taking other medically appropriate steps to reduce the risk of such abuse
  • Avail emergency Naloxone doses to those at risk for overdose (as permitted by local law)
    • To help prevent death by opiate overdose, health service personnel, campus police, and other campus first responders should be trained on the administration of naloxone doses and supplies of naloxone should be reasonably available to those who are trained to use it in the performance of their duties. Schools may also consider training the general population and making naloxone doses available to individuals who may be at risk of overdose for themselves, or may be concerned about the potential for overdose of family members and/or peers

THIS CONTENT CAN ALSO BE FOUND IN THE JED CAMPUS PLAYBOOK GUIDE.
To view all playbook resources related to Substance Abuse, click here.