University f Wiscnsin Superir Emergency Abrad Respnse Plan fr Faculty-Led Prgrams Addendum: Mental Health Issues General Security Precautins All students are asked t cmplete a self-assessment f medical needs which includes infrmatin pertaining t mental health issues in advance f study abrad. T cnfrm t ADA regulatins, this step happens after a student has already been accepted t a prgram. The Office f Internatinal Prgrams (OIP) will cver infrmatin related t bringing prescriptins abrad during rientatin. Faculty leaders will give students the CISI card, which includes cntact infrmatin fr Assist America. The OIP will give students an emergency cntact card t carry in their wallets/purses that includes n-site and U.S. phne/fax/e-mail. The OIP will encurage students t develp a reasnable family cmmunicatins plan that includes cntingencies fr emergency situatins. Safety Precautins fr Individual Students The OIP will wrk with the Dean f Students ffice t access educatin recrds and recrds pertaining t cnduct n campus, in residence halls and ff campus fr the purpse f determining eligibility t participate n a UW Superir-spnsred study abrad prgram. Students may nt be eligible t participate based n their recrds r may be required t sign a behaviral cntract. Students will sign a waiver allwing the sharing f this infrmatin. All students sign the fllwing statements in the Unifrm Statement f Respnsibility. All UW-Superir faculty and staff are held t the same standards. 16) I affirm that there are n mental health-related reasns r prblems that preclude my participatin n this Prgram. 17) (This paragraph applies nly if yu have cnsulted with a health prfessinal abut a mental health issue in the past). I have cnsulted with a psychiatrist, medical prvider and/r mental health prfessinal with regard t my mental health needs. I affirm that I am stable n my current medicatins and that my dctr is willing t prescribe enugh medicatin t last fr the duratin f my planned prgram abrad. I agree t take all prescribed medicatins exactly as prescribed by my dctr and that I will carry bth the riginal prescriptin with me and a nte frm my dctr explaining the situatins in which I can self-regulate dsages. I have arranged, thrugh insurance r therwise, t meet any and all needs fr payment f mental health care, if needed, while I participate in the Prgram. I recgnize that neither the University nr my hsts abrad are bligated t attend t any f my mental health needs, and I assume all risk and respnsibility theref. If I require treatment r hspital care, in a freign cuntry r in the United States, during the Prgram, the University is nt respnsible fr the cst r quality f such treatment r care. I understand that the insurance available t me thrugh the UW System plicy may nt cver all expenses fr mental health care. 1
I understand that I will be withdrawn frm the prgram abrad and required t return hme, at my wn expense, if I d nt take my medicatin as prescribed r if my mental health negatively affects my wn stability, ther students, my hsts, r, if n a faculty-led prgram, the ability f the grup leader/s t teach curses and attend t the grup. I understand and agree that the UW-Superir Dean s Cuncil will becme invlved if I exhibit symptms f mental health prblems. I further understand that this infrmatin will be held in strict cnfidentiality and maintained nly fr the purpses f the study abrad prgram. Index t Emergency Levels Arrest r impending arrest (3) Hmesickness, minr (1) Self-mutilatin (2) Culture shck, minr (1) Hmicide attempts/threats (3) Severe depressin (3) Death (3) Inability t care fr self (3) Sexual assault (3) Depressin, severe (3) Incapacitatin (3) Stalking, nn-vilent (2) Discriminatin, nn-vilent (2) Intlerance, nn-vilent (2) Stress, minr (1) Disruptive behavir (2) Instability, shwing signs f (2) Suicide ideatin/gesture nt imminent (2) attempts r threats (3) cmpleted (level 3) Distress, minr (anxiety r temprary nt chrnic) (1) Mental health needs, requiring leaders/students t attend t (2) Eating disrder (2) Prescriptins, self-regulating (2) Harassment, nn-vilent (2) Psychsis (3) Vilence, acts f (3) Emergency Level 1 An ccurrence r the ptential fr an ccurrence that culd be cnsidered rutine (examples include signs f wrries, sadness, difficulty adjusting, minr stress, hmesickness, r culture shck). Respnsibility: Handled directly by the affected individual. The faculty leader may als assist, if necessary and apprpriate. Reprting: OIP: nt required. Dean s Cuncil: nt required Assist America: nt required Actin: determined by the affected individual. Faculty Leader: The faculty leader shuld advise the affected individual, including prviding infrmatin n the ptin t call Assist America cllect 24/7/365 #: +1-(609)-986-1234. Assist America can als be emailed at medservices@assistamerica.cm. The faculty leader may als call the UWS Health and Cunseling Services at (715) 394-8236 r (715) 394-8394 (Crdinatr s direct line) fr infrmatin n supprting students if there is ptential fr mvement frm minr stress, hmesickness r culture shck t severe stress. These numbers are answered during nrmal business hurs. Affected Individual: The affected individual may cnsider calling the UW-Superir Health and Cunseling Services at (715) 394-8236 r (715) 394-8394 (Crdinatr s direct line) during nrmal business hurs. 2
UWS Health and Cunseling Services: May, after getting student release, cnsult with Study Away Crdinatr, Office f Internatinal Prgrams and/r faculty leader. Emergency Level 2 An ccurrence r the ptential fr an ccurrence that requires a respnse beynd a rutine capacity (examples include nn-vilent acts f intlerance, discriminatin, harassment; lack f self-care (self-mutilatin, eating disrder); individual shwing signs f instability r ther behavirs which may lead t an increase in health r safety risk fr the individual r any member f the grup r cmmunity; suicide ideatin withut current intent; disruptive behavir; individual indicating that s/he is nt taking medicatins regularly as prescribed; individual requiring the faculty leader, ther students n the prgram r ther UW staff t attend t mental health needs; etc.). If the subject has threatened vilence, wrk under the guidelines f Level 3 belw. Respnsibility: Handled by the faculty leader, the Study Away Crdinatr, OIP Directr (as needed), the UWS Health and Cunseling Services Crdinatr, and Assist America when apprpriate. Reprting: The faculty leader reprts the ccurrence r the ptential fr an ccurrence t the Study Away Crdinatr immediately. The Study Away Crdinatr. If immediate ntificatin is nt pssible, the faculty leader ntifies the OIP as sn as can be arranged and dcuments the reasn fr delayed reprting. The Study Away Crdinatr reprts the ccurrence r the ptential fr an ccurrence f mental health cncerns t the UWS Health and Cunseling Services Crdinatr, which may in turn reprt t the Dean f Students r ther services. The Study Away Crdinatr reprts the ccurrence r the ptential fr an ccurrence f discipline issues t the Assciate Dean f Students respnsible fr the Student Discipline Cde. The Study Away Crdinatr reprts the ccurrence r the ptential fr an ccurrence f issues related t faculty t the Office f Human Resurces and the faculty member s supervisr. The Study Away Crdinatr MAY cntact an Accused s emergency cntact if the Accused is engaged in nn-vilent acts f intlerance, discriminatin, stalking r harassment. The Study Away Crdinatr will cntact a Victim r alleged Victim s emergency cntact ONLY with the written prir apprval f the reprting Victim. 3
Actin: 1. Immediately begin lgging infrmatin related t the situatin, including infrmatin received frm the individual, thers in r utside f the grup (include their names when lgging) and persnal bservatins. 2. When apprpriate, apprach the individual in a setting which is nt public t address the behaviral cncern and hear the individual s explanatin. 3. Cnsult with the Study Away Crdinatr t frmulate a respnse t the student (if pssible). 4. If apprpriate, give the individual a behavir cntract. The behavir cntract shuld include a prepared written statement, ready fr the individual s signature, detailing the behavirs which must change and the cnsequences f nt changing thse behavirs. The Study Away Crdinatr will prvide a sample statement fr yu in advance. The Study Away Crdinatr r the Assciate Dean f Students respnsible fr the Student Discipline Cde can als create tailred statements fr yu while yu are abrad, t be sent via email. 5. Send a cpy f the signed behavir cntract t the Study Away Crdinatr unless technlgical limitatins make this impssible. After the statement has been signed by the student, the faculty leader shuld: 6. Cntinue t lg infrmatin related t the student s behavir. If the behavir cntinues, the faculty member may elect t: 7. Send the student hme at his/her wn expense. AND/OR Reprt the student s behavir prblems t the Assciate Dean f Students wh is respnsible fr the Student Discipline Cde. The Assciate Dean f Students will then fllw the prcedures fr n-campus vilatins in its fllw-up. Faculty leaders will advise Accused staff wh may be engaged in nn-vilent acts f intlerance, discriminatin, stalking r harassment t leave the prgram site, having n further student cntact, immediately. If allegatins are drpped and thse wh frwarded the allegatin attest t this in writing, the staff member may return t the prgram site. If the allegatins are nt drpped, the staff member must remain away frm the prgram site and may nt have further cntact with the students. Reprting Victims may decide whether t cntinue participatin n the prgram r return t the U.S. Thse wh chse t return t the U.S. shuld d s with the help f Assist America but are nt required t use their services. Other Actin: The fllwing are actins that may be taken by the student(s) (unless inapprpriate) and must be taken by the faculty leader, the Study Away Crdinatr, Office f 4
Internatinal Prgrams, and the UWS Health and Cunseling Services Crdinatr r Dean f Students accrding t UW-Superir prcedures/plicies. Victims and alleged victims: Reprting Victims shuld call the UWS Health and Cunseling Services at (715) 394-8236 r 394-8394 (Crdinatr s direct line) and/r the HDC Crisis Line at 1-800-634-8775. Reimbursement fr phne calls will be pssible thrugh the CISI insurance plicy r thrugh the UW-Superir emergency reserve fund. Nte that the UWS Health and Cunseling Services ffice is available nly during nrmal business hurs. At all ther times, please call the HDC Crisis Line. Accused: Accused individuals shuld call the UWS Health and Cunseling Services at (715) 394-8236 r (715) 394-8394 (Crdinatr s direct line) and/r HDC Crisis Line at. 1-800-634-8775. Reimbursement fr phne calls will be pssible thrugh the CISI insurance plicy r thrugh the UW Superir emergency reserve fund. Nte that the UWS Health and Cunseling Services ffice is available nly during nrmal business hurs. At all ther times, please call the HDC Crisis Line. Faculty Leader: will request supprt frm Assist America in identifying lcal resurces fr Reprting Victims; remving persn(s)/the grup (Accused and/r Reprting Victim(s)) frm the prgram site r t the U.S., etc. Study Away Crdinatr, Office f Internatinal Prgrams: will wrk with the faculty leader, Assist America and, when apprpriate, U.S. gvernment and ther resurces abrad t supprt students wh return hme befre the fficial prgram end date. Health and UWS Health and Cunseling Services Crdinatr and Dean f Students: The Health and UWS Health and Cunseling Services Crdinatr and/r Dean f Students will identify a staff member r anther service ffice either n r ff campus t wrk directly with the individual abrad unless technlgically impssible. This designated staff member will crdinate reprting t ther UW-Superir ffices as required/recmmended by UW-Superir plicy. This designated staff member will als wrk as a member f a team cnsisting f the Study Away Crdinatr, the faculty leader and Assist America. 5
Emergency Level 3 An extrardinary event r the ptential fr an extrardinary event that requires a respnse beynd a rutine capacity (examples include indicatins that smene may be suffering frm severe depressin; severe agitatin; parania; delusins; suicide/hmicide attempts r threats; psychsis; incapacitatin r inability t care fr self; arrest r impending arrest; death, including cntemplated suicide; vilence and sexual assault; ther acts f vilence; etc.). Respnsibility: Handled by the faculty leader, the Study Away Crdinatr and/r OIP Directr, the UWS Health and Cunseling Services Crdinatr and/r Dean f Students, and Assist America. Reprting: The faculty leader reprts the ccurrence r the ptential fr an ccurrence t the Study Away Crdinatr immediately. If immediate ntificatin is nt pssible, the faculty leader ntifies the OIP as sn as can be arranged and dcuments the reasn fr delayed reprting. The Study Away Crdinatr reprts the ccurrence r the ptential fr an ccurrence t the OIP Directr, UWS Health and Cunseling Services Crdinatr and Dean f Students. UWS Health and Cunseling Services Crdinatr r Dean f Students: The UWS Health and Cunseling Services Crdinatr r Dean f Students will reprt incidents as required/recmmended by UW Superir plicy t the Assciate Dean f Students respnsible fr the Student Discipline Cde, and ther apprpriate ffices. The faculty leader als reprts the ccurrence t Assist America immediately in such cases as the fllwing: when there are indicatins that smene may be suffering frm severe depressin r having suicidal thughts; when there are indicatins that acts f vilence, stalking r harassment may require the remval f smene frm the prgram site (Accused and/r Reprting Victim); r a similar ccurrence. Emergency Cntact: The Study Away Crdinatr r OIP Directr will: a) cntact the individual s emergency cntact IMMEDIATELY in cases f individuals suffering frm severe depressin r having suicidal thughts. b) cntact an Accused individual s emergency cntact if the Accused individual may have been invlved in sexual vilence, ther acts f vilence r any ther actin which may be an arrestible ffence in the hst cuntry des nt agree t leave the cuntry IMMEDIATELY. c) cntact the emergency cntact f a reprting Victim ONLY with the written prir apprval f the reprting Victim. 6
Actin: Individuals wh are nt hspitalized but are suffering frm severe depressin r having suicidal thughts MUST return t the U.S. with assistance frm Assist America. Individuals accused f sexual vilence, ther acts f vilence r any ther actin which may be an arrestible ffense in the hst cuntry MUST return t the U.S. IMMEDIATELY. It is in the best interest f accused individuals t return immediately rather than risk facing arrest. Accused individuals may nt be given the pprtunity t prve their inncence at all, much less in a timely manner, in sme cuntries. Victims and alleged victims may decide whether t cntinue participatin n the prgram r return t the U.S. Thse wh chse t return t the U.S. shuld d s with the help f Assist America but are nt required t use their services. Other Actin: The fllwing are actins that may be taken by the student(s) (unless inapprpriate) and must be taken by the faculty leader, the Study Away Crdinatr, Office f Internatinal Prgrams, and the UWS Health and Cunseling Services Crdinatr r Dean f Students accrding t UW-Superir prcedures/plicies. A Suicidal Individual/Individual in Crisis shuld call Assist America cllect number at +1-(906) 986-1234 and/r the UW Superir Health and Cunseling Services at (715) 394-8236 r (715) 394-8394 (Crdinatr s direct line) r the Human Develpment Center Crisis Line at (800) 634-8775. Reimbursement fr phne calls will be pssible thrugh the CISI insurance plicy r thrugh the UW Superir emergency reserve fund. Nte that the UWS Health and Cunseling Services ffice is available nly during nrmal business hurs. At all ther times, please call the HDC Crisis Line. Reprting Victims shuld call the UW Superir Cunseling Center at (715) 394-8236 r (715) 394-8394 and/r Assist America cllect number at +1-(906) 986-1234 r the Human Develpment Center Crisis line at (800) 634-8775. Reimbursement fr phne calls will be pssible thrugh the CISI insurance plicy r thrugh the UW Superir emergency reserve fund. Nte that the UWS Health and Cunseling Services ffice is available nly during nrmal business hurs. At all ther times, please call the Crisis Line. Accused individuals shuld call the Assist America cllect number at +1-(906) 986-1234 and/r the UW Superir Health and Cunseling Services at (715) 394-8236 r (715) 394-8394 r the Human Develpment Center Crisis line at (800) 634-8775. Reimbursement fr phne calls will be pssible thrugh the CISI insurance plicy r thrugh the UW Superir emergency reserve fund. Nte that the UWS Health and Cunseling Services ffice is available nly during nrmal business hurs. At all ther times, please call the Crisis Line. The faculty leader must assess the individual s need fr hspitalizatin. The faculty leader will request supprt frm Assist America in identifying lcal resurces fr dealing with depressin r suicidal thughts; identifying lcal resurces fr reprting victims; 7
remving smene/the grup (Accused individuals and/r reprting Victims) frm the prgram site r t the U.S., etc. The Study Away Crdinatr and/r OIP Directr will wrk with the faculty leader, Assist America and, when apprpriate, U.S. gvernment and ther resurces abrad t supprt students wh return hme befre the fficial prgram end date. The Study Away Crdinatr and/r will begin the Actin Timeline fr Level Three Events (frm Emergency Abrad Respnse Plan) when apprpriate. UWS Health and Cunseling Services and Dean f Students will identify a staff member r anther service ffice either n r ff campus t wrk directly with the individual abrad unless technlgically impssible. This designated staff member will crdinate reprting t ther UW Superir ffices as required/recmmended by UW Superir plicy. This designated staff member will als wrk as a member f a team cnsisting f the Study Away Crdinatr, the faculty leader and Assist America. 8
University f Wiscnsin Superir Supprt Offices The UWS Health and Cunseling Services (715) 394-8394 Crisis supprt and individual cunseling t students while they make decisins abut hw t prceed after experiencing sexual assault, dmestic/dating vilence, stalking, sexual harassment r ther incidents f vilence. https://www.uwsuper.edu/shcs/index.cfm Human Develpment Center (HDC) Crisis line: 1-800-634-8775 The HDC prvides a 24 hur, seven days a week phne emergency service t assist anyne wh is in crisis. This tll free number is an pen line fr residents in the Nrthland t call when feeling verwhelmed by prblems that interfere with the ability t cpe with feelings, family, jb r ther relatinships. Cntact with the Crisis Team is made thrugh this number. The Crisis Team is available t respnd with mental health emergency services. https://www.humandevelpmentcenter.rg/ Center Against Sexual and Dmestic Abuse (CASDA) https://www.casda.rg CASDA is a private nn-prfit rganizatin serving survivrs f dmestic, sexual and child abuse in Nrthwestern Wiscnsin. Services are prvided t wmen, men, and children frm all walks f life. The main ffice f CASDA is lcated in Hawkes Hall n the University f Wiscnsin campus in Superir. Sme f the services they prvide include 24-Hur Crisis Line, 1-800-649-2921, Cunseling, guidance, emtinal supprt, crisis interventin and infrmatin and referral, and emergency shelter - designed t prvide a "safe space" fr individuals needing t escape frm r take time ut frm vilent hmes Prgram fr Aid t Victims f Sexual Assault (PAVSA) https://www.pavsa.rg/ Fr residents f suthern St. Luis Cunty, Minnesta Crisis line: (866) 229-7425 Dean f Student Life Office (715) 394-8241 / handers@uwsuper.edu / https://www.uwsuper.edu/directry/harry-andersn_handers Respnsible fr the administratin f the prcedures that invlve student cnduct. UW Superir Campus Safety (715) 394-8114 / campussafety@uwsuper.edu https://www.uwsuper.edu/safety/index.cfm The Human Resurces Office 715-394-8141 Assistance t individuals wh have cncerns and questins abut discriminatin and racial, ethnic, r sexual harassment. Administers internal discriminatin grievance and harassment prcedures and cnducts investigatins relative t cmplaints. https://www.uwsuper.edu/hr/index.cfm The Emplyee Assistance Prgram Helps emplyees psitively address persnal r wrk related prblems. https://www.uwsuper.edu/hr/plicies/eap.cfm 9
UW-Superir Emergency Abrad Dcumentatin Frm 1. Date f incident: 2. Wh was invlved:, 3. Lcatin: 4. Initial cntact at UW-Superir: Date: Time: Hw: Name and number f individual cntacted: 5. Initial cntact n lcatin: Date: Time: Hw: Name and number f individual cntacted: 6. List in chrnlgical rder steps taken t deal with the situatin: a) b) c) d) e) 7. List any ther pertinent infrmatin: CONTACT INFORMATION: Name E-mail Address Phne Number Fax Add additinal pages, if needed 10