Reducing Risk Creation and Implementation of a Post-Secondary Violence Threat and Risk Assessment Protocol.

1. Reducing Risk Creation and Implementation of a Post-Secondary Violence Threat and Risk Assessment Protocol. Adam Gosney, Coordinator, Counselling, Mind & Wellness Catherine O’Rourke, Director, Student Services

2. Learning Outcomes • What is VTRA Protocol. • Why postsecondary institutions benefit from formal Violence Threat and Risk Assessment Protocol? • VTRA Protocol and congruency with Student Health, Student Success and Retention Initiatives • Importance of multi-disciplinary and multi-departmental collaboration.

3. Learning Outcomes • Loyalist College’s Protocol • Identifying “students of concern”. • Risk Assessment Review and Violence Threat and Risk Assessment Processes. • Historical barriers and success in implementation. • Confidentiality and Fair Notice • Duty to Accommodate

4. What is VTRA Protocol • A systematic response in policy and procedure to deal with incidents of high risk and threat making behaviour by members of the postsecondary community. • Seeks to assess for level of risk and/or threat. • Implementation of a “Risk Reducing Intervention” aimed at mitigating risk and increasing/restoring campus safety.

5. Why Institutions Benefit from a Formal VTRA Protocol • Acts of violence in post secondary settings are increasing in frequency(Drysdale, Modzeleski, & Simons. 2010). • Millennial Students • Greater impulsivity. • Low stress tolerance(Bland, et al, 2012). • Difficulty delaying gratification or coping with responsive anxiety.(American Psychological Association, 2012) • Greater propensity to engage in risk or threat making behaviour as a means of mitigating their anxiety response

6. Aggregate levels of violence remain stable since 1970’s. Serious violence becoming concentrated in youth populations.(Roher 2010). Increased enrollment in institutions correlates with increased incidents of violence (Drysdale, Modzeleski, & Simons. 2010).

7. Purpose of Formal VTRA Protocol • Primary Purpose • Determine if threat maker or student of concern poses a risk to the target or themselves. • Take measures to ensure the safety of the target or the threat maker. • Secondary Purpose • Determine course of intervention aimed at reducing risk and mitigating variables associated with risk. (CCTATR 2011)

8. Why Post Secondary Institutions Benefit from Formal VTRA Protocol • Data Driven Assessment. • Without formal training and protocol “there is a tendency to inadvertently engage in emotionally-driven assessments where level of risk is based on subjective responses (Cameron 2010). • Institutional dynamics and political optics have potential of influencing risk assessment. • Data driven assessments provide confirmed and factual evidence that can then be used to ascertain “known level of risk”

9. Congruency with Health, Success and Retention Efforts. • VTRA protocol is • Responsive, • Restorative • Preventative. • Primary assumption is a “cry for help hypothesis”. • Ethical responsibility to respond. • All efforts are made to keep the student engaged with the institution and appropriate services/resources. • Objective is to remediate the issue causing the behaviour and assist the student to restore functionality. • Expulsion is the less than ideal response.

10. Importance of Multi-Disciplinary/Departmental Collaboration • Adequate data can only come from multiple sources and points of interaction. • Faculty, Student Success, Residence, Registrar. • Primary “front line” points of contact for students. • Without adequate data the assesment may be flawed and inaccurate. • Allows institution members to feel that they are a part of the process designed to keep themselves safe. • Increases likelihood that Faculty/Staff will maintain a vested interest in participating in the identification of high risk/threat making behaviour. • Discourages the use of “interdepartmental measures” that do not involve the VTRA team.

11. Typical Composition of VTRA Team. Ty • Primary: • Security, Student Success, Dean/Provost, Chair, Faculty, Health Nurse, Mental Health/Disability Services Staff, Academic Advisors, Senior Mgmt., Police. • Secondary: • Community Mental Health/Health, Probation/Parole, Parents, Children's Aid Society (Crown Wards) • Important to have partner agencies sign off on protocol.

12. Risk Reduction vs. Elimination • Risk reduction is often the ideal outcome. • Complex variables preclude VTRA from being a definitive “Risk Eliminating” solution. • Often a “best case” scenario. • Control for as many variables as possible

13. Case Example • Student. Male, 23yrs. • Cited for use of substances in Residence. • Questioned about possession of several knives (claimed to be a personal knife collection). • Residence staff also found anti-depressant medication along with the knives and substances. • Residence staff questioned about the risk of self harm after finding the knives and the anti-depressants. • Student comes to Counselling Services is highly agitated about the “judgments about my mental health” and treatment by Residence staff. • Demonstrating highly aggressive, irrational and fixated thinking. (Only outcome to punch someone or punch a wall and harm self).

14. Case Example • Residence Staff debriefed. • Didn’t appear agitated at the time of the reprimand. • Did not appear distressed or in duress. • Staff didn’t feel unsafe in his presence. • He’s not a physically intimidating guy. • Didn’t get a bad gut feeling about him. • Seems to be a nice guy. • Staff felt bad about having to discipline him. • Staff didn’t confiscate the knives based on assumption's contained in their. . . EMOTIONALLLY DRIVEN ASSESMENT

15. Case Example Data Driven Assessment • Highly agitated person who's sense of personal stigma has just been activated. • Demonstrating irrational and fixated beliefs • About the events that caused him to be offended. • About ways to mange his current emotional distress. • About ways to maintain his and others emotional and physical safety. • Is in possession of several knives large enough to be considered weapons. • Is a daily substance user. • Is struggling with mental health issues. • Has low familial support and no friends on campus. • Just broke up with his girlfriend. • No structured recreation other than marijuana and videogames. • Is struggling academically. • Unknown history of violence. Unknown previous school history.

16. Loyalist College. RAR-VTRA Protocol Overview • Formal VTRA Post-Secondary protocol. • Reviewed and sanctioned by Kevin Cameron and CCTATR. • Signed with multiple community partners including local Public School Board and Police

17. Loyalist VTRA Protocol RAR-VTRA Process Tree

18. Loyalist VTRA Protocol Vessels of Identification. • Incident Report Form • Available to all faculty, staff and students. • Collaborative response by Director Student Success and Dean. • Risk Assessment Review • Weekly meeting to discuss incidents of Risk and Threat Making behaviors. • Security, Student Success, Health, and HR. • Behaviour benchmarks established by Student Code of Conduct and Behavioral Responsibility Protocol.

19. Risk Assesment Review Process • Incidents and students of concern brought forward from any team members. • Details of known interactions discussed. • Innocuous incidents can appear much more involved and problematic once all information is shared. • Further data gathering commitments delegated. • Discussion of other parties who need to be involved (Dean, Registrar, Police) • Interventions proposed or reported on. • Decision about Student Intervention Plan or escalation to formal VTRA.

20. RAR to VTRA Triage Checklist • Adapted from the HCR 20 Triage Considerations (Douglas et al, 2010). • Purpose to analyze specific data relevant to high risk/threat making behaviour. • Provides predictive outcome of Negative, Possible or Probable. • Can be employed as a data based tool to inform escalation from RAR to VTRA where uncertainty exists.

21. RAR to VTRA Triage. • Negative • Continue to Monitor • Possible • Gather additional Data. • Risk Reducing intervention (SIP) • Consider necessity to convene VTRA • Probable. • Convene VTRA • Involve Police • Address immediate risk to campus safety. • Risk reducing intervention (SIP) • Monitor, reevaluate on weekly basis.

22. Student Intervention Plan • Outlines the activities the student of concern will participate in as part of the risk reducing intervention. • Participation in on and off campus services. • Can restrict or redirect on-campus movement. • Conditions regarding substance use and consumption of alcohol on campus. • Academic performance and attendance. • Behavioral expectations. • Time frame and consequences for not following through.

23. Disciplinary Sanction • Not the first line of response but sometimes indicated based on the violation or the participation/demeanor of the student of concern. • Financial penalty, suspension, work-study position loss, participation in restorative mediation, involuntary leave of absence, expulsion.

24. Confidentiality • Ontario’s Freedom of Information and Protection of Privacy Act (Ontario FIPPA) (Ontario MFIPPA) • Permits the disclosure of personal information “in compelling circumstances affecting the health or safety of an individual.” • Allows for disclosure “in compassionate circumstances, to facilitate contact with the spouse, a close relative or a friend of an individual who is injured, ill or deceased.”

25. Confidentiality • Ontario Personal Health Information Protection Act (Ontario PHIPA) • Allows for disclosure of personal health information if • the health information custodian “believes on reasonable grounds that the disclosure is necessary for the purpose of eliminating or reducing a significant risk of serious bodily harm to a person or group of persons.”

26. Fair Notice Statement • Written into VTRA Protocol and Student Manual/Code of Conduct. • Distributed and electronically signed by all students prior to being able to log on to the computer system for the first time each year. • References code of conduct and outlines for students under which circumstances a VTRA will be conducted upon them. • References their mandatory participation in the VTRA process and Student Intervention Plan.

27. Confidentiality • PROFESSIONAL DISCRETION IS STILL REQUIRED REGARDING WHAT KINDS OF INFORMATION IS SHARED AND BY WHOM. • Paramount importance to have individuals skilled in the interpretation and application of privacy legislation at the table (ie.) Counsellors, Nurses. • These individuals need to spearhead and filter the sharing of Mental Health and Psychosocial related information as Personal Health Information Custodians or Agents (PHIPA 2004).

28. Duty to Accommodate. • Addressing the conduct of a student-of-concern can pose unique challenges to the College where that student has a learning, psychological, or physical disability that is contributing to the concerning behaviour. • College must accommodate to the point of “undue hardship” • “health and safety risks will amount to undue hardship if the degree of risk that remains after the accommodation has been made outweigh the benefits of enhancing equality for persons with disabilities”(pg. 28). The student seeking accommodation • Student must make full disclosure of the mental health issue and may be required to provide medication documentation/evidence.

29. Duty to Accommodate. • Student must agree to and have the capacity to participate in the accommodation process. • Accommodations offered must be accessed in a manner and on a timeline that maintains the health and safety of the campus environment. • Failure to participate does not necessitate an additional accommodation.

30. References • American Psychological Association. 2012. Stress by Generations. Retrieved from http://www.apa.org/news/press/releases/stress/2012/generation.pdf • Bland, H. W., Melton, B. F., Welle, P., & Bigham, L. 2012. Stress Tolerance: New challenges for millennial college students. College Student Journal, 46(2), p. 362-375. Retrieved from http://ehis.ebscohost.com/eds/pdfviewer/pdfviewer?sid=b8a6e499-03c2-4f52-b8eb-df80163d5f12%40sessionmgr113&vid=3&hid=104 • Cameron, K., J. (2010). Level II Violence Threat Risk Assessment (V-TRA): Data Analysis & Strategic Interviewing • Cameron, K., J. (2011, April 27). Violent Threat Risk Assessment Model (VTRA) [Webcast]. Retrieved from http://agrs.justice.alberta.ca/webcasts/webcast-j-kevin-cameron/ • Douglas, K. S., Webster, C. D., Hart, S. D., Eaves, D., & Ogloff, J. R. P. (Eds.) (2001). HCR-20: Violence risk management companion guide. Vancouver, BC/Tampa, FL: Mental Health, Law, and Policy Institute, Simon Fraser University/Department of Mental Health Law & Policy, University of South Florida.

31. References • Drysdale, D., Modzeleski, W., and Simons, A. (2010). Campus Attacks: Targeted Violence Affecting Institutions of Higher Education. U.S. Secret Service, U.S. Department of Homeland Security, Office of Safe and Drug-Free Schools, U.S. Department of Education, and Federal Bureau of Investigation, U.S. Department of Justice. Washington, D.C., 2010. Retrieved from http://www.secretservice.gov/ntac/CampusAttacks041610.pdf • Hartman, J. L., & McCambridge. 2011. Optimizing Millennials’ Communication Styles. Business Communication Quarterly, 74 (1), p22-44. DOI: 10.1177/1080569910395564 • Tice, D., M., Bratslavsky, E., & Baumeister, R., F. (2001) Emotional distress regulation takes precedence over impulse control: if you feel bad, do it. Journal of personality and social psychology, 80(1), p53-67. Retrieved from http://content.ebscohost.com.ezproxy.library.ubc.ca/pdf19_22/pdf/ddd/pdh/psp/psp-80-1-53.pdf?T=P&P=AN&K=2000-14236-004&S=L&D=pdh&EbscoContent=dGJyMMTo50Sep644y9f3OLCmr0uep69Ssqu4TLGWxWXS&ContentCustomer=dGJyMPGrtE%2Bwp7dMuePfgeyx44Dt6fIA