1. NCHERM CUBIT MODEL TRAINING SLIDES FOR THREAT ASSESSMENT TEAM MEMBERS © 2009 NCHERM AND NaBITA. ALL RIGHTS RESERVED.

2. UNDERSTANDING VIOLENCE Who are the predators we keep hearing about and what do They have in common? Very revealing are the first five Indicators identified by the Safe School Initiative Final Report by the U.S. Secret Service and U.S. Department of Education: Incidents of targeted violence at school rarely were sudden, impulsive acts. Prior to most incidents, other people knew about the attacker’s idea and/or plan to attack. Most attackers did not threaten their targets directly prior to advancing the attack. There is no accurate or useful “profile” of students who engaged in targeted school violence. Most attackers engaged in behavior prior to the incident that caused others concern or indicated a need for help.

3. What do we know? Roughly 80% of school violence perpetrators raised serious concerns about the potential for violence amongst friends, family, peers, or other community members prior to their acts Roughly 80% of school shooters and other violent campus actors shared their plans, or parts of their plans, with others prior to their acts.

4. What do we know? 91% of school violent actors are cognitive aggressors

5. Youth Risk Survey 2001 13,600 HS students 28.3% sad or hopeless almost every day> 2 wks stopped some activity due to symptoms 19 percent of students reported that they seriously considered attempting suicide 14.8 percent had made a specific plan to attempt suicide. 8.8 percent had attempted suicide in the previous year [Grunbaum et al 2002].

6. Recent Suicide Data 1 FTE per 1700 students. Higher ratio smaller schools 4 hours psychiatric consultation per week/ 1000 students, up from 2.1 in 2004 25% clients on meds 366 schools 154 suicides, adjusted rate is 6.6/100,000 10% of attempters die over 10 years 45 of 76 suicides occurred during first week post hospitalization

7. On the lookout for Icebergs In 2001, a study by David Lisak, Ph.D., at the Univ. of Massachusetts, Boston revealed: 120 male students (of a surveyed population of 1,882) were responsible for 483 total acts of sexual violence (Lisak & Miller, 2002). 76 of those 120 men were responsible for 439 of the acts of sexual aggression (6 acts each) (63% multiple perpetrators, 37% one-time perpetrators) and 1,045 total acts of physical violence. 76 men. 1,000+ crimes. 14 acts each. And, Lisak’s measures used very conservative definitions of crimes.

8. HIPAA HOW DO YOU KNOW IF HIPAA APPLIES TO YOUR CAMPUS HEALTH OR COUNSELING SERVICE? You may be surprised by the answer…do a two- level analysis: – –1) Does your counseling service or health service transmit electronic data about patients, such as health insurance or billing information? If not, HIPAA does not apply. If so, ask… – –2) Does your counseling or health service treat students only, or other community members as well?

9. HIPAA If you treat only students, HIPAA does not apply. If you treat other community members, HIPAA will apply. Here’s why…if you only treat students, the Department of Education has stated that FERPA is the governing law for these records, not HIPAA. So, let’s talk FERPA next…

10. FERPA If FERPA is the governing law for counseling and/or health service records, we recognize the FERPA specifically exempts health and counseling records from the definition of educational records protected by the Act. Thus, while FERPA is the governing law, it is inapplicable, and the only law governing the privacy of these records is the state statute on privilege of health and mental health records, and the professional ethical requirements imposed by licensure.

11. MORE ON FERPA Who’s your dependent? FPCO relaxed its stance on proof of dependency, and will allow us to use an opt in/out form at registration For students who indicate they are dependents, additional verification via tax returns in unnecessary. Even if a student does not indicate they are a dependent, a parent may still show they are via the tax return method.

12. MORE ON FERPA What is the consequence of dependency? Colleges and universities MAY share ANY information from a student’s educational record with any parent/custodian claiming the student as a dependent: – –Tommy got a D in biology – –Beth is cutting – –Pak is in fact a College Republican

13. MORE ON FERPA The Department of Education has liberalized the emergency health and safety exception to FERPA. FERPA allows us to share information as necessary in a crisis, and that will apply to most cases where a student is a potential harm to themselves or others.

14. MORE ON FERPA What college administrators observe about students (not sourced from protected records) is not protected by FERPA. FERPA covers written records and recorded media. What you see or what someone says to you is not an educational record. Internally, officials can communicate to each other when they find there is a “legitimate educational interest.”

15. PRIVILEGE Three types of jurisdictions: – –No warning (Texas and Virginia) – –May warn (majority) – –Duty to warn (must warn) Privilege (or confidentiality) can be waived when Tarasoff applies, or when a direct threat is posed (in non-Tarasoff jurisdictions) Can be waived by the client Confidential information can be shared between counselors and health providers

16. CLERY ACT TIMELY WARNING Was the Virginia Tech warning too little, too late? What should we do until the Department of Education decides? Use the standard law enforcement criteria for warning: – –Can we identify the nature of the threat? – –Can we identify the source of the threat? – –Can we give those being warned specific information about steps they can take to protect themselves from the threat posed? ngClery amended to require “immediate” warning

17. DISRUPTION UNPACKED Distressed – –Emotionally troubled – –Individuals impacted by situational stressors and traumatic events – –Psychiatrically symptomatic Disturbed – –Behaviorally disruptive, unusual, and/or bizarrely acting – –Destructive, apparently harmful to others – –Substance abusing Dysregulated/Medically Disabled* – –Suicidal – –Parasuicidal (self-injurious, eating disordered) – –Individuals engaging in risk-taking behaviors (e.g., substance abusing) – –Hostile, aggressive, relationally abusive – –Individuals deficient in skills that regulate emotion, cognition, self, behavior, and relationships – –*Unable to self-care/psychotic break

18. WHAT IS A RED FLAG? Distress-level behavior rarely results in violence Disturbed behavior, especially when repeated or rapidly escalating, can be a red flag. Dysregulated behavior is a red flag. – –A suicidal student may be a homicidal student – –A suicidal student may be willing to risk other lives to accomplish his or her mission

19. WHAT IS A RED FLAG? Alarming behavior that may show a lack of control by the actor (stereotype) More often, flat affect and calm planning are indicative. The “thousand-yard stare” shows a level of detachment from self that is concerning Suicidal threats or gestures – –“I don’t need my hard drive any more” – –“No one cares about me”

20. WHAT IS A RED FLAG? In addition to suicidality, there is a correlation between violence and a history of the actor being subject to extreme bullying. Look for patterns in writing, class discussion or class interaction. – –Themes of revenge – –Themes of annihilation – –Themes of “outsider” exclusion

21. REPORTING THESE BEHAVIORS Faculty have been reluctant to report disruptive activities in the classroom. In Coping With the Disruptive College Student (1994), Gerald Amada identified four possible (and typical) reasons: – –Faculty hope for a spontaneous resolution – –Faculty fear that they will not be supported by the administration – –Faculty fear that reporting will be viewed as a reflection of inadequacy as an educator – –Faculty fear retaliation.

22. What Does a BIT Do? Centralize reporting Triage reports Assess threat/risk Assess available resources Perform or empower interventions Coordinate follow-up Assess long-term success Educate community