Leadership Exchange

could expose colleges and universities to legal liability. It is worth noting, however, that the disruption to the community that accompanies repeated SIB could support the pursuit of an individual’s involuntary leave of absence from the institution.

Suicidal Thoughts or Gestures

Reported suicidal thoughts or gestures are common concerns on college and university campuses. While counseling center staff members historically relied on no-harm or no-suicide contracts to address suicide threats, more recent evidence suggests that such contracts are not clinically useful in preventing suicide, and they could actually expose clinicians and higher education institutions to increased legal liability. Other research on suicide indicates that a large cluster of completed suicides are impulsive decisions that have not been planned (see related sidebar, p 6). Counselors can utilize safety plans to outline actions students should take if they feel suicidal. Student affairs professionals may also use behavioral contracts that list conditions students must comply with to avoid more invasive responses such as separation from the

perceived self-defense. If a student’s odd or aberrant behavior includes threats, those threats are more likely to be carried out if the student is not concerned about hiding his or her identity, if the threat is made in person, and if the threat is very specific. Clinically, the threat assessment should shift the student away from the pleasure derived from the possibility of revenge and refocus on the potential consequences of violent actions. Risk is typically greater in situations where the student seems unconcerned about the potential consequences of his or her behavior.

Find the Right Balance

The principles, responses, and considerations outlined in this article represent potential courses of action and processes when responding to situations where students exhibit high levels of acuity. They further illustrate the complex decisionmaking methods that are employed on our campuses on a regular basis in response to various students presenting a wide range of concerns. When applying

Risk is typically greater in situations where
the student seems unconcerned about the
consequences of his or her behavior.

university. In working with students with suicidal thoughts or gestures, staff should assess the students for instability of behavior; unwillingness or extreme reluctance to commit to safety; inability to make progress within an existing treatment program; concomitant psychosis and substance use issues; and impulsiveness.

Odd or Aberrant Behavior

Odd or aberrant behavior is a particularly challenging category to address because the same behavior could be an indication of: normal boundary exploration by the typical student, the result of an Asperger’s spectrum disorder, the onset of schizophrenia, untreated bipolar disorder, a substance-induced psychosis, or some other more serious mental health condition. On rare occasions, the odd or aberrant behavior could include the onset of psychosis or other conditions that could precipitate violent behavior. Considerations when assessing these risks include: social isolation; depression or suicidal thoughts and gestures; grandiosity; and/or overall suspiciousness. If the odd or aberrant behavior includes any ideas or threats of revenge against a rejecting world, concern should be heightened. If a student has actually developed a paranoid psychosis, he or she may actually act out violently in

the continuum of available responses, it is important to be flexible in moving up and down that continuum. It is also essential to employ a wide-angle lens in the thought process, considering the bigger picture of the need for transparent systems as the rights of students are balanced with the rights of communities. Continued consultation among the network of relationships formed on campuses is the best way to maintain the safety of both.

Availability to students, campus constituencies, and families makes SSAOs and counseling center staff integral parts of the university community. It is very likely that as students affairs staff work collaboratively to ensure the health of students in these changing times, it will strengthen their abilities to carry out the missions of institutions. _LE

Gregory T. Eells is the director of counseling and psychological services at Cornell University and president of the Association for University and College Counseling Center Directors.