Psycho-medical management of
different types of crises involving
students
Rikka De Roy, MD, KU Leuven Student Health Centre
[email protected]
Importance of appropriate local services to meet medical
or psychlogical needs off all students in distress
- Civil services: medical, psychological, emergencies (ambulance, ER)
- Campus services: complementary to civil services
- Guidance and access to services for local and international students
- Second line for students abroad
if all students on campus are well taken care of, we should worry less about our
students abroad
different types of crises require different management
At KU Leuven we experienced that not all urgent, complex or difficult cases should be referred to one
“crisis manager” but should be directed immediately to the most appropriate service.
We recognise 4 different situations:
1. Individual problems of medical or psychological nature: accident, psychosis, suicide attempt, …
2. Unacceptable behaviour (physical, sexual, verbal harassment) in study context
3. Contamination risk: TB, meningitis, …
4. Shocking event in study context: death of a fellow student, fire, explosion, …
1. Individual medical or psychological problems
• Know services available to students and how to access them
• Campus based
• Public
• When confronted with a student with individual medical or psychological needs
• If life threatening: call emergency number
• If not urgent
• Express concern to student and advise or facilitate to seek appropriate help
• If not satisfied with student’s response and still worried: ask advice on or off campus
• Realise that students are adult intelligent individuals who are responsible for their own choices.
Outreaching help is seldom efficient or desirable, but should be considered.
• Your students abroad:
• Should find local help to deal with medical or psychological problems
• Should have health insurance that covers medical expenses abroad and repatriation
• Could contact you regarding academic needs if (temporary) drop out of programme
2. unacceptable behaviour in study context
• Express your institution’s point of view and expectations on equality, freedom and safety
• Provide a low-treshold contactpoint, paying attention to confidentiality, gender, academic rank,
availability, location, leverage
•
your students abroad:
• Should first try to contact the local harassment officer
• If unavailable, high treshold, unsuccessful: contact harassment officer at home university
• Should be offered academic alternative if situation abroad can’t be solved or causes drop out
of programme
• Should inform and get support from home university harassment officer upon return
3. Contamination risk
• Install a liaison between the university and the public health authorities
• Suspicion or knowledge of important communicable diseases should be reported to liaison:
• Meningitis is an emergency: health authorities identify which contacts should be treated or
informed within 24h
• TB, legionella, hepatitis are not urgent and can be taken care of during office hours
•
your students abroad:
• Should follow the recommendations of there host university
4. Shocking event within the university environment
Actions to be taken:
• Safety
• First responders in place: ambulance, police, fire brigade
• Communication
• With everyone directly affected
• With press
• Between services involved
• With authorities, embassy, police
• First shelter and aftercare for witnesses, bystanders and everyone directly and
indirectly involved
• Responsibles of different actions should get together ASAP under supervision of
the overall coordinator
Your students abroad: keep track of where and how they are!
Shocking events in study context
4.1. First shelter
• Preferably in a known friendly environment and taken care of by the “natural leader”: someone
they know and trust
• Provide safety and comfort to people on the scene
• Follow police recommendations and move to safe place if needed
• Provide water, coffee, tea, food, blankets
• Try to find answers
• Is it over? What exactly happened and/or is about to happen
• How and/or where are the other people?
• Help contact relatives and get home safe
• Most reactions are normal and don’t require immediate professional care. Inform people of
aftercare: where, when, by whom? Or put together list of people to be invited.
• The central responsible for first shelter and aftercare should be available for second line advice or
assistance on the spot when needed
4.2. aftercare step 1: within 72 hours
• Objective information about what happend by known responsible
• Ask what is expected from the organisation
• Psycho-education about many different but normal reactions to an unusual situation
• Individual differences due to personal features and involvement with situation
• Physical: transpiration, palpitations, nausea, sleeping problems, tiredness
• Emotional: anger, anxiety, disbelief, irritability, concentration problems, avoidance, guilt
• Which support do they have
• Symptoms are normal and should not be masked
• Expected to gradually diminish in frequency and intensity
• Advantages of group approach
• Recognise own feelings or worries in others
• Understand and accept differences
• Helping others
• Inform about second group intervention: when, where, by whom
4.3. aftercare step 2: after 2 weeks
• Check if all practical arrangements have been followed up and if other needs
• Assess course of different reactions: declining?
• Assess what is experienced as most difficult and find solutions together
• Psycho-education about coping:
• Regain confidence step by step, seek social support, postpone important decisions
• Talk: organise your thoughts for better processing
• Take care of yourself: fear and grief are exhausting
• Identify most vulnerable people and refer for professional care
• Inform about third group intervention: when, where, by whom
4.4. aftercare step 3: after 6 weeks
• What symptoms or complaints are still present
• How is re-integration in social, professional or school environment
• Refer for professional help if strong symptoms left