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

Adam Gosney, Coordinator, Counselling, Mind & WellnessCatherine O’Rourke, Director, Student Services

• 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.

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

Learning Outcomes

• 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.

What is 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

Why Institutions Benefit from a Formal VTRA Protocol

• 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).

• 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)

Purpose of Formal VTRA Protocol

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”

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.

• 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.

Importance of Multi-Disciplinary/Departmental Collaboration

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.

Typical Composition of VTRA Team.

• 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

Risk Reduction vs. Elimination

• 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).

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

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.

Case Example

• 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

Risk Assessment Review and

Violence Threat Risk Assessment Protocols

September 20, 2012

Loyalist College. RAR-VTRA Protocol Overview

Loyalist VTRA ProtocolRAR-VTRA Process Tree

Input Received.

Level 1 BRP Violation

Director Student Success and Dean to Evaluate

Risk Assesment Review Committee

Student Intervention Plan

Level 2 BRP Violation

Risk Assesment Review Committee

RAR to VTRA Triage Assesment

VIolence Threat Risk Assement

VTRA Student Intevention Plan

Student Intervention Plan

Level 3 BRP Violation

Risk Assesment Review Committee

RAR to VTRA Triage Assesment

Violence Threat Risk Assesment

VTRA Student Intervention Plan

Student Intervention Plan

Involuntary Leave of Absence

Return to Campus Mgmt Plan

Exit to Community Resoureces

Level 4 BRP Violation

Emergency Response Plan (911)

Expulsion

• 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.

Loyalist VTRA Protocol Vessels of Identification.

• 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.

Risk Assesment Review Process

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.

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.

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.

• 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.

Disciplinary Sanction

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.”

• 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.”

Confidentiality

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.

• 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).

Confidentiality

• 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.

Duty to Accommodate.

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.

• 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.

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

References