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Supporting an International Student Through a Mental Health Crisis. NAFSA: Association of International Educators 2012 Annual Conference Houston, Texas May 30, 2012. PRESENTERS. Elaine del Rossi, HTH Worldwide Insurance edelrossi@hthworldwide.com
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Supporting an International Student Through a Mental Health Crisis NAFSA: Association of International Educators 2012 Annual Conference Houston, Texas May 30, 2012
PRESENTERS Elaine del Rossi, HTH Worldwide Insurance edelrossi@hthworldwide.com Trisha Marrapese, University of Texas-Austin trisha@austin.utexas.edu Chair: Patricia Burak, Syracuse University paburak@syr.edu
Stats on Mental Illness and College Students One out of every five young people and one out of every four college students or adults suffers from some form of diagnosable mental illness. Nearly 50% of all college students report feeling so depressed that they have had trouble functioning, and 15% meet the criteria for depression
Suicide is the third leading cause of death among people ages 15-24, and the second leading cause of death in college students ages 20-24 Over 66 percent of young people with a substance use disorder have a co-occurring mental health problem. About 19 percent of young people contemplate or attempt suicide each year
Four out of every five young people that contemplate or attempt suicide exhibit clear warning signs. An estimated 5 million young females suffer from eating disorders each year, and eatingdisorders are the deadliest mental illness, claiming more lives than any other illness.
CASE STUDY I A young international Ph.D. student has attempted suicide. He continues to profess suicidal thoughts, and seeks assistance with the Counseling Center. At the same time, other actions result in the student’s expulsion from campus. He is committed to a mental health facility.
Things to Consider…. Does the student have insurance? If so, does he have proof of insurance in his possession? Has anyone been contacted on the student’s behalf? Who are the student’s emergency contacts and do they speak English?
What is the state of the student’s current physical and mental health? How does FERPA come into play What are the immigration consequences related to the student’s expulsion? What are the possible treatment options for the student once they depart the U.S.? (is there social stigma to account for)
The Facts of the Case The student has health insurance coverage, including medical evacuation and repatriation The student’s family is from Indonesia and does not speak English (nor has he given permission to contact them)
In the Hospital The student is placed in a ward with an empty bed, which happened to be far away from campus, but close to where someone from your office happened to be visiting on the night of the incident (the very person who was notified of the recent chain of events by university police)
The individual who was contacted from the University went to visit the student in the facility The student appeared to be of sound mind at this time. The actions that had warranted his expulsion had not been criminal in nature, and the student pleaded with the University official to sign him out of the Mental Health facility….which he did.
Little Did He Know… Unfortunately, upon signing the student out of the institution, the University had nullified any possibility for Medical Evacuation insurance to be utilized (for which he would have been eligible, due to his current condition)
As the student was expelled, and no longer able to remain in the US in F-1 status, the University had assumed responsibility (and expense) for the student’s safe return home.
The Student Now Needs to Return to Indonesia…. …and guess who was chosen to accompany him?
Things to Consider When Planning an Impromptu Trip to Indonesia…(or anywhere) • Flight logistics and cost on two-days notice • Visas….do you need one for your destination country? How about the countries you will hit in transit? • The purchase of your own insurance for the trip • How to safely communicate the student’s situation with their family back home
Is the student’s passport valid? The purchase of your own insurance for the trip How to safely communicate the student’s situation with their family back home
Things Even The Most Seasoned Traveler Can’t Plan For: Lack of sleep: Total travel time was 27 hours Erratic behavior: The student tried to open the emergency exit on the airplane, mid flight
Weather conditions: We made an unplanned landing in Taiwan because a minor Tsunami had struck Jakarta, Indonesia, so we were unable to land
All’s Well That Ends Well • The student was successfully returned to his father’s care in Indonesia (despite a misunderstanding at the airport over my use of the word “escort”) • The student was able to seek the counseling that he needed (with the support of his family, despite the social stigma and the financial hardship), which enabled him to apply for readmission to the university two years later
How could this have played out differently if the student had been able to utilize his medical evacuation insurance?
The “Cup Half Full” Outcome: Greater collaboration with other offices on campus (Counseling Center, Dean of Students Office, International Office, etc…) in the creation of a “Mental Health Crisis Response Checklist” A better understanding of the benefits offered by most health insurance providers, including but not limited to protocol on medical evacuation, availability of translators, and other such immensely valuable resources
CASE STUDY II You receive a phone call from a concerned parent who has been unable to reach his daughter for the past four days. As this is not typical behavior, he is very concerned.
Your phone calls to the residence hall and academic department confirm that she has not been on campus for the past four days
Whom else do you contact? • Is there a Crisis Team/protocol that needs to be followed?
The father has made contact with the president of the national group. A graduate student, he has found out from friends that the student was taken to the hospital
You contact the hospital and identify yourself as the international student advisor-they are willing to give you information regarding the student Now what do you do?
Guidelines for Visiting Psychiatric Unit • Cannot bring anything glass (ie Flower Vase) • Patient cannot have a computer, cellphone, pens or pencils (only crayons) • HIPAA Release needed for insurance company to begin a claim (very important for future medical evacuation)
Health Insurance: What you need to know to help HIPAA requirements: what is needed? Medical evacuation: how does it work? • Escort to home country • Family member travelling to USA Repatriation
Supporting the Student • Academic Notifications • Health Center Notifications • Residence Hall Notifications *Consent of the student is required
Friends Favorite Foods Clothing Books
Preparing for Hospital Release • Return to Home Country • Return to Campus • Return to Residence Hall
Medical Evacuation • Medical Escort • Airfare/Passport/Visa? • Leave of Absence
SEVIS Actions • RCL for Medical Reasons • Leave of Absence • Discontinue Program
Social Stigmas • Cultural Taboos Surround Mental Health • Shame in Front of Peers • Denial
Comprehensive Resource on Crisis Management for the International Student and Scholar Services Office • NAFSA Website
Resource Bibliography • International Student Resources bibliography.docx
Don’t we wish that this was “THE END”? Such cases will continue as long as we have students….. Being prepared to work through a mental health situation is your best solution. This powerpoint is posted at http://international.syr.edu/ be used with the permission of the presenters.
