Helping Hands Around the Globe Enhancing the Support Network for Students Studying Abroad and Their Program Coordinators June 2, 2011 Maureen Mahoney,

Helping Hands Around the Globe

Enhancing the Support Network for Students Studying Abroad and Their Program

Coordinators

June 2, 2011

Maureen Mahoney, Margaret Ross, Debra Terzian

Boston University Slideshow Title Goes Here

Trustees Presentation

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Who We Are….

Introductions of presenters Scope of BU’s International Programs

1500 BU students studying abroad every year, increasing 90 international programs, 16 sites totally staffed 800 students from 145 other universities and colleges Exchanges and consortia with other programs Changes in past few years in diversity of programs

Why this presentation? Discovery: Work in Progress!



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It Sounds Like Fun…What Is the Problem?

College Life these days…. Not so much this….



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More this…..



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More this….



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College Life 2011

Financial pressures, need for “practical” major “Should I take the time to go abroad or is it frivolous?” “Millennial Cohort”: less prepared to be away from

home, less hands-on life experience, less resilience Homesickness GPA requirement: students have often worked hard at

academics, less facile with life skills TECHNOLOGY: Double edged sword!!



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More Problems in going abroad

Adjustment to a new culture superimposed on the already stressful adjustment to college life may lead to worsening or new onset of eating disorder bipolar disorder depression anxiety disorder substance use dysregulated behavior



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Overview of Presentation

Potential Pitfalls (Expected, Unexpected) Advance Preparation:

How it Can Help What to Do

Practical Strategies How Mental Health Services can Help



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PITFALLS: Business as Usual

Medication: Losing it, having it stolen, not having enough, experimenting with dosages



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Pitfalls (the usual) Parents….

Parents may be part of the problem OR part of the solution.

In denial about problems child is having? Or overly anxious and wanting to bring student home

precipitously


Pitfalls: The Usual Getting There


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Pitfalls: Jet Lag, Arrival, Acculturation

Bipolar students Homesickness Acculturation: Customs, Money and Language Difficulty of communication between students,

coordinators, homestay, home, school


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Pitfalls: the Usual ALCOHOL

New cultural norms Availability and Access Perception of distance and invincibility


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Pitfalls: the UNUSUAL and AWFUL

Death Serious illness or accident Terrorism Local political and military unrest Legal trouble and arrest Natural disasters


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THE QUESTION:

What’s an Abroad Coordinator to Do?


Preparing Ahead

Short Break to explain “Work in Progress”! Example: A. in Geneva, winter 2011 Example: J. in Geneva, spring 2011


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Preparing AHEAD

Encourage students to disclose pre-existing mental health issues. However, this is VOLUNTARY and many students will not disclose.

New sentence has been added to acceptance letter. We ask at the time of acceptance whether the student has mental or medical health issues

WHO reviews the applications and health forms? What to do with the information?


Preparing AHEAD

Ask for/REQUIRE signed permission to speak with health care providers

Ask students to speak with health care providers about wisdom of the abroad plan…early on, if possible

Clearly, this is problematic piece of the puzzle. To be discussed!

Example: G, eating disorder, outside therapist, summer international program?


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ADVANCE STRATEGIES: Medication

Work in advance on medication issues! Murphy’s Law:

Anything that Anything that CANCAN go wrong, go wrong, WILLWILL go wrong go wrong

Will student be willing to disclose medication situation to coordinator of program?


Advance Strategies: Medication

Procurement of refills (Mail? Local clinician? Parents?) Airplane travel: it only gets more interesting (think

TSA) Lost, stolen luggage or pill bottles Will there be problem with having the medication in the

host country?


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Proper training for coordinators and proper materials available to them (on line, written): to be continued

Protocols for every contingency, and clear policies for terminating student from program as needed Behavioral, interpersonal Mental Health or physical health Academic

Policies, procedures, contracts all reviewed by legal counsel for university

Advance Strategies



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Advance Strategies

Basic training of the Study Abroad staff is invaluable and may be accomplished in coordination with Mental Health Service at the educational institution

Common signs of distress Knowing to whom to turn when problem arises What to do in case of true mental health emergency

such as mania, severe depression with suicidality, panic disorder with thoughts of self harm, worsening eating disorder, psychotic break


Advance Strategies:

Identify clinicians in the locality where student will be staying—eg. Student with eating disorder may need to be weighed, have simple check-in plan; depressed student may need therapy and possibly medication review

Are there clinicians who can assess a student’s safety if student must travel home?

What about local hospital for mental health emergencies?


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Preparation

In a situation in which the student’s situation is at all tenuous: requirement that student sign an individualized contract in advance: permission to communicate with treaters at home and abroad, adherence with medication, appointments, weight maintenance, and reporting problems to coordinator.

Consequences of contract violation? Spell them out in advance!



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Preparation

KNOW INSURANCE SITUATION… Tricky enough in THIS country; how much more so abroad!



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An OUNCE of PREPARATION…………… Is WORTH a POUND of CURE:

Plan ahead for the coordination of International Programs and Mental Health Services



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Identification of Support Network

Working with other students in program who may have access to crucial information

Parents Working with local clinicians and hospital network Consultation with home educational institution—easier

with email and other newer technologies (Skype) Having the information ready at hand when an

emergency happens Having met with and trained with home institution

mental health clinicians so they are KNOWN



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More Examples from Real Life


Summary

International programs offices are dealing with students who arrive with more complex problems and who want to go out into all sectors of the global village, ever more fraught with problems of disease, conflict, terrorism…to mention a few

Directors and coordinators “in the field” are confronted with problems that are well out of their zones of comfort and expertise

Coordination between mental health services and offices for international programs is essential


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Summary

Advance preparation for situations, both common and unusual, can make a great difference in the quality of the experience for both students and coordinators

….and sometimes can make the difference between life and death.

Thanks, Bibliography, Questions and Answers


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Bibliography

A World Awaits You – Students With Non-Apparent Disabilities Go Abroad By Scheib, Michele. Eugene, OR: Mobility International USA. http://www.miusa.org/publications/books/nonapparentdisabilities Assessing Our Resources: Mental Health Considerations for Students in Education Abroad Programs Duston, Laurie http://www.forumea.org/documents/ForumStandardsInstitute-LaurieDuston.pdf

Managing Students in Crisis: Mental Health, Student Behavior, and Study Abroad Management Council on International Educational Exchange (CIEE). http://www.ciee.org/study/advisors/managing-crisis.aspx

Karin Fischer, The Chronicle of Higher Education; June 2 2010: Study-Abroad Programs Should Be Prepared for Mental Health Crises, Speakers Advise


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Bibliography, continued

Mental Health and Study Abroad: Responding to the Concern McCabe, L. International Educator, 14(6), 52-57. http://studyabroad.msu.edu/safety/presentations/MentalHealthEducationAbroadNovDec05.pdf

NAFSA’s Guide to Education Abroad for Advisors and Administrators Brockington, J.L., Hoffa, W.W., and Martin, P.C. (eds.). Washington, DC: NAFSA Association of International

Educators.

Over-Stressed, Overwhelmed, and Over Here: Resident Directors and the Challenges of Student Mental Health Abroad

Lucas, J. Frontiers: The Interdisciplinary Journal of Study Abroad, XVIII, Fall 2009 p187-215. Study Abroad and Mental Health: Identifying, Assisting, and Referring Students in Distress Settle, W. Safety Abroad First Educational Travel Information (SAFETI) On-Line Newsletter 3(1).

http://www.globaled.us/safeti/v3n1_settle.html


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Bibliography, continued

Columbia University Global Health Online Directory http://globalhealth.columbia.edu/sitemap Mental Health and Crisis Management: Assisting University of Notre Dame Study Abroad

Students. 2nd edition. www.nd.edu/%7Eucc/International_Eds_Hdbk__II.html Sample Study Abroad Handbook www.nafsa.org/about.sec/migs/opo_sig_net/document_library_26/sample_ea/ea_handbook


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Summary:


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Documents

Helping Hands Around the Globe Enhancing the Support Network for Students Studying Abroad and Their Program Coordinators June 2, 2011 Maureen Mahoney,