crisis response & emergency protocol by: kevin cleland & erin ash

Crisis Response & Emergency ProtocolBY: KEVIN CLELAND & ERIN ASH

Crisis vs. EmergencyEmergency – An emergency is a singular event or situation in which immediate physical harm or the threat of immediate physical harm is present.

Crisis – A crisis describes any situation in which physical, mental or emotional harm is present or on-going, but is not necessarily characterized by a singular event. (All emergencies are crises but not all crises are emergencies)

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Responding to Crises: The 4 Steps of Crisis Assessment

Threat to Self

Immediate Harm

Third Party Impact

Informational Impact

Identifying Objectives Amidst a Crisis

Many crises are similar but no two crises are exactly the same◦ How you successfully resolve a crisis and the skills you use will vary depending on the

situation

Similar crisis have the same objectives◦ You will use your training, personal skills and judgement to determine how to achieve those

objectives in a given crisis

Universal Rules for Crisis Response in Residential Education

1. Calling Up - Absolutely always call up to Senior Staff if you ever in doubt. You will never get in trouble for calling the Senior Staff on call if you are uncertain about how to handle a particular situation.

2. Parents – As an RA you should not be dealing with parents. If a parent contacts you regarding a resident, you cannot give them any information. Refer all parents to your Senior Staff member or the Senior Staff on Call.

3. Know Your Resources – Almost all crisis will require that you know both how to communicate with and what services are provided by various campus resources. In order to be effective at responding to crises make sure that you are well versed in USC campus and community resources.

1. Including: DPS, OWHP, Center for Women & Men, Title IX Office, Housing, Cultural Centers, Health Center, Counseling Center, etc.


Medical Emergencies

Hospital Transports All of the following types of incidents are scenarios where an resident will likely be transported to the hospital. In the event that a resident is transported remember the following:

1. Any time a resident is transported to the hospital for any reason, you must call up to Senior Staff on Call.

2. You should never ride along with the resident to hospital

3. Give basic information to roommates so they do not panic if their roommate does not return home that night, but do not share any sensitive information (i.e. alcohol use, drug use, etc.)

InjuryLIST OF OBJECTIVES

Objective 1: Reduce potential for further injury or harm

Objective 2: Determine severity

Objective 3: Seek medical attention best suited to the severity and type of injury

TIPS, SKILLS AND ADDITIONAL INFO

a. If the injury is life threatening, the best way to reduce the potential for future harm is to contact DPS immediately

b. Do not touch any resident, unless absolutely necessary to prevent further harm or fatality. Guide the injured resident or other supporting third parties in how to help the situation.

Alcohol OverdoseLIST OF OBJECTIVES

Objective 1: Reduce potential for further harm


Objective 3: (If potentially severe enough for transport) Contact DPS immediately

Objective 3: (If not potentially severe enough for transport) Find a third party to watch over the resident in question until they are sober


a. Signs of an alcohol overdose:a. Nausea, Vomiting, Incoherence,

Unconsciousness, Lowered Body Temp., Blue/Pale Skin, Slow/Ragged/Irregular Breathing, Seizures

b. When in doubt always call DPS for medical support

c. Make sure that if left in care of third party, the third party is informed to call for help if the intoxicated resident worsens.

Drug OverdoseLIST OF OBJECTIVES

Objective 1: Reduce potential for further harm


Objective 3: Contact DPS immediately regardless of severity


a. Common drug overdose amongst college students (By frequency)

a. Antidepressants/Prescription Drugs, Cocaine, Ecstacy/MDMA (Molly)

b. Signs of a drug overdose:a. Nausea, Vomiting, Incoherence,

Unconsciousness, Increased Body Temp., Dilated Pupils, Chest Pain, Seizures, Panic Attack

Infectious DiseaseLIST OF OBJECTIVES


Objective 2: Determine if symptoms of common severe infectious diseases are present

Objective 3: Seek appropriate medical attention

Objective 4: Reduce potential for harm to third parties (Roommates, etc.)


a. Common Serious Infectious Diseases Amongst College Students and Symptoms:

a. Meningitis: Headache/Migraine, Dehydration, Stiffness in the neck/Pain when turning head side to side

b. Mononucleosis (Mono): Sore throat, Chronic Exhaustion/Fatigue, Fever, Headache

c. Strep Throat: Severe Sore Throat, Sudden Fever, Chills, Headache, Swollen Lymph Nodes

Practice Scenario 1

While on duty, you receive a call from a resident saying to come to their room

immediately because they are worried one of their friends has drank too much. When you get to the room there are 5 people crowded around a student who is sitting against a wall

who appears to be having trouble holding their head up. You notice a trashcan next to them

and see vomit on their shirt. They don’t appear to be responding directly to people talking to

them but are muttering incoherently. The other people in the room seem somewhat

intoxicated and a few are visibly scared and emotional. Some people are trying to help by getting the resident to drink water and asking them questions. Others are apologizing to you

and asking they will get in trouble.


Mental Health Crises

Suicide IdeationLIST OF OBJECTIVES

Objective 1: Determine if intent to kill themself is present

Objective 2: Determine if the resident has a plan or has attempted to kill themself before

Objective 3: Get resident to agree to seek appropriate counseling or mental health service


a. If a resident has expressed any desire to kill themself, do not leave them alone, even when you call Senior Staff on Call or the Counselor on Call.

b. Be very direct in asking questions and don’t use euphemisms. Directly ask “Have you thought about killing yourself?”

c. If a resident will not seek counseling, but the potential for loss of life is too great, a resident can be involuntarily committed, but this is a last resort.

Self-HarmLIST OF OBJECTIVES

Objective 1: Identify and compassionately confront observed self harm

Objective 2: Determine motivation for self harm

Objective 3: Get resident to agree to seek appropriate counseling or mental health service


a. Self-harm is distinctly different from suicide ideation; self-harm is a means of coping

b. Self-harm is often the result of feeling a lack of control over one’s life; also described as feeling removed from one’s own life

c. Self harm is usually inflicted on commonly hidden areas of the body; self harm is not a plea for attention and there is often shame associated with the behavior

Eating or Exercise DisorderLIST OF OBJECTIVES

Objective 1: Engage resident in conversation about health and/or health goals

Objective 2: Identify motivations for particular eating or exercise behavior

Objective 3: Recommend professional resources to help the achieve goals in a healthy manner

(First attempt)


a. Eating and exercise disorders are not resolved in a single conversation; they can only be resolved through personal desire to change behavior

b. Do NOT tell the resident you think they have an eating or exercise disorder. Only engage with observable behaviors.

c. Mirror the language that the resident uses to describe their behavior

d. Eating and exercise disorders are most frequently tied to a distorted body image (Body dismorphia) – Trying to convince someone they are “fit”, “not fat” etc. is counterproductive.


Active Harm Crises

HarassmentLIST OF OBJECTIVES

Objective 1: Make sure the resident does not feel as if they are immediate danger

Objective 2: Disclose that you are not a confidential resource

Objective 3: Determine how you can best make the resident feel safe and secure in their community

Objective 4: Explain reporting options

Objective 5: Encourage resident to seek professional counseling or appropriate support


a. When offering reporting options, do so without displaying judgement or preference towards a particular option. Remember that not reporting is a viable option for the resident, but you MUST report.

b. Treat every allegation as serious

c. Do not make promises about how or if the alleged perpetrator will be held accountable – Focus on harm reduction

Sexual Assault LIST OF OBJECTIVES

Objective 1: Ensure the resident is physically okay and does not need immediate attention

Objective 2: Disclose that you are not a confidential resource

Objective 3: Determine how you can best make the resident feel safe and secure in their community


Objective 5: Encourage the resident to seek appropriate counseling and support


a. Your tone should be soft and non-judgmental

b. Do not ask the resident “Why” questions or probe them for too many details

c. Be conscious of your own gender identity and the dynamic it creates with the student in crisis

d. Use mirroring language – Do not use the terms “rape” or “sexual assault” unless the resident does. Let them name their own experience.

Hate Crime/Bias Related Incident (Vandalism)LIST OF OBJECTIVES

Objective 1: Document the vandalism (Use camera on duty phone)

Objective 2: Cover up the vandalism as quickly as possible to prevent further harm

Objective 3: Determine the scope of the impact (Who has seen or was impacted by it)

Objective 4: Talk and listen to all impacted residents and refer them to appropriate resources

Objective 5: (Where appropriate) Create a community impact plan to address any community wide harm


a. Do not try to minimize the impact of a situation to a resident or tell a resident they are just being sensitive.

b. Do not make promises about finding out who did it or how the perpetrators will be held accountable – Focus on harm reduction

c. Be conscious of your identities

Hate Crime/Bias Related Incident (Direct)LIST OF OBJECTIVES

Objective 1: Ensure the resident is physically okay and does not need medical attention

Objective 2: Disclose that you are a mandatory reporter

Objective 3: Determine how you can make the resident feel safe and secure in their community


Objective 5: Refer resident to appropriate counseling resources


a. Do not try to determine if the incident was hate/bias motivated – If it is presented as such, treat it as such

b. Do not make promises about what will happen to the perpetrator(s) – Focus on harm reduction

c. Be conscious of your identities

AssaultLIST OF OBJECTIVES

Objective 1: Determine severity of injuries (if any) and seek appropriate medical attention

Objective 2: Determine is they know the assailant and if they feel in any immediate danger

Objective 2: Determine how you can make the resident feel safe and secure in their community


Objective 4: Refer resident to appropriate counseling resources


a. If you encounter a fight or assault in process, do not try to break it up or get in the middle of it – Call DPS immediately

b. Do not make promises about what will happen to the perpetrator(s) – Focus on harm reduction

Supporting an Alleged Perpetrator/Respondent

In many cases of active harm on campus, the alleged perpetrator may be a USC student who lives in our residential communities. As an RA you must be prepared to support them too. Below is important information to remember when supporting an alleged perpetrator:

1. An alleged perpetrator is also a student in crisis

2. Your support is not contingent upon their innocence

3. You should make efforts to ensure that an alleged perpetrator is seeking the appropriate counseling support resources

4. Make sure that the resident feels secure in their living community as well

5. Remember that, even if someone did actively harm another student, our goal is to educate the resident and mitigate any future harm but not to denigrate them for their actions

Missing StudentLIST OF OBJECTIVES

Objective 1: Make every attempt to contact the resident’s room, the floor/area RA, or any other reasonable contact

Objective 2: Determine when the resident was last seen

Objective 3: Determine if there are any aggravating factors that are cause for concern

Objective 4: Contact Senior Staff to report findings and determine next course of action


a. If parents/family call looking for a resident, remember that you cannot confirm a particular resident lives there even if you know they do. Refer them to the appropriate senior staff member.

b. If you are uncertain if a particular situation constitutes a “missing student”, contact Senior Staff

c. RAs should never key into a room looking for a resident by themselves. Welfare checks should only be conducted with professional staff present.

Death of a StudentLIST OF OBJECTIVES

Objective 1: Immediately call DPS and Senior Staff

Objective 2: Get all bystanders out of sight of the body

Objective 3: (After DPS and Senior Staff arrive) Talk to all bystanders and refer them to appropriate counseling resources

Objective 4: Wait for direction from DPS or Senior Staff


a. In any instance of death, consider all bystanders the “victims” in this crisis, including yourself.

b. Do not touch or move the body

c. Remember to practice self care – seek your own support in dealing with the impact of death following the incident.

Practice Scenario 2

You hear a knock on your door and open it to find four of your residents who all look very

upset. They tell you to come look what someone wrote. They take you to see a poster

with pictures of Laverne Cox and Caitlyn Jenner advertising an event discussing trans

icons and the portrayal of trans people in the media. Across the poster someone has

written “F****ts” with a sharpie. One of the residents that came to your door was one of the organizers of the program and appears to be on the verge of tears. The other residents

appear both hurt and angry and want to know what can be done.

Practice Scenario 3

You are in your room when you hear a loud knock. When you open the door it is one of your residents who has appears to have a bloody nose. They quickly say “Alex and

Robyn are in a fight down the hall. I tried to break it up and one of them elbowed me in the nose. Please come help!” You run down

to hall to see Alex and Robyn grappling, throwing punches at each other and yelling.

crisis response & emergency protocol by: kevin cleland & erin ash

Documents

situation similar crisis

injured resident

senior staff member

crisismany crises

emotional harm

future harm

alcohol use

particular situation