Dr.SuzanneA.Black,Psy.D.- ClinicalPsychologist inPrivatePractice,Paris,FranceandNewYorkCarolFoley- Director,GlobalAssistanceServicesandInternationalAlliances,HTHWorldwide/GeoBlueKareyFuhs- AssociateDirectorforStudyAbroadintheOfficeofInternationalProgramDevelopment(IPD)atNorthwestern UniversityJoshTaylor- AssociateViceChancellor,GlobalPrograms, NewYorkUniversity

MentalHealth&TraumaticEventsAbroad:LessonsLearnedfromthe2015ParisAttacks

DraftSchedule3:30to3:40– Introduction (CarolFoley)

3:40to4:05–PsychologicalResponsetoTerrorIncidents (Suzanne Black,Psy.D.)

4:05to4:25– NewYorkUniversityResponse(JoshTaylor)Questions forNewYorkUniversity

4:25to4:45– Northwestern UniversityResponse(Karey Fuhs)QuestionsforNorthwesternUniversity

4:45to5:00– GeneralQuestions

• TheterroristattacksinParisonNovember13,2015arebeingusedasabackdroptodiscusstheimportanceofaccesstomentalhealthresourcesabroad.

• FranceisthefourthmostpopulardestinationforU.S.studyabroadstudents,with17,597students reportedbyOpenDoors in2013-2014.

• CollegesandUniversitiesfocusonemotionalandphysicalsafetyofstudentsinParisduringthetimeofextremeuncertainty.

Overview

TerrorismTerrorism’sessenceisthecreationofpervasive,unrelentingfear.

• Wearefarmorelikelytodieincarcrashesforexample,thanfromactsofterrorism.

• Terrorismorthefearof,cancausesustainedemotionalandbehavioralconsequences.

Terrorismstealsoursenseofagency.

• Ourdailylivesandthebeliefinourabilitytofunctionisdisrupted.

• Thisinducesavarietyofimmediateemotionalreactionsandpsychiatricstressphenomena:

– Panic– Severeanxiety– Depressedmood

Dr. Suzanne A. Black, Psy.D.Clinical Psychologist

Tiedtotheperception:

– “Limitedopportunity forescape.“– “Riskofbeinghurtorkilledishigh.”

Hallmarksofpanic:

– Acutefear– Extremehypervigilance– Highanxiety

.

Panic

.

Panicmaycause:

• Posttraumaticstressdisorder• Depression• Generalizedanxiety

*Pre-existingpsychiatricconditionscanalsobeexacerbatedbyexposuretotrauma.

SupportforStudents

Studentscanreducesubjectivefearbybecomingpartners inthemonitoringandmanagementofrisk. Students willbere-assuredthat itisnormalforpeopletofeeltraumatizedundersuchcircumstances.

• Practicalinformationabout personalsafety• General,“common-sense” adviceaboutmanagingbothrealriskandsubjectivefear• Awarenessofpsychologicalfactorsinvolved• Automatedinformationline• Asystemofnotificationprotocols suchasuse ofsocialmedia,email,SMS, instantmessaging,

telephone treesanddesignationofprogrampersonnelresponsibleforbeingavailable 24/7 toanswerquestions andprovideresources.

• Buddysystem

.

PsychologicalSupportforStudents

Studentsmayfeel embarrassed bytheir emotional reactions totrauma;

• Implement plans andprotocols for acutemanagement of both risk andfear.• Administer psychological “firstaid” toreduce theinitial traumaticstress reaction

causedby thecrisis event.• Assess the need forfurther intervention, e.g.,referralforthose in inneedofacute

caretomental health professionals.

• Encourage students totalkabout theirfeelings andthoughts related tothetrauma.

*Expressing stresslegitimizes, i.e., "normalizes" theexperience inreaction tothetraumatic eventwhich cancreateachain reaction among students ofreducing shameand fear.

SignsofHeightenedDifficulty

• Anxiety• Fear• Panic• Sadnessordepression• Nightmares• Sleepdifficulties• Somnolenceduringclass• Appetitechanges• Noticeableweightgainorweightloss

• Unkempt appearance• Absencefromclass• Restlessnessandagitation• Somaticsymptoms• Appearing"out ofit"• Socialwithdrawal• Uncharacteristicangeror

belligerence• Violentbehavior• Substanceuse

*AlertnesstosymptomsnecessarytointerveneearlyandtoheadoffthedevelopmentofPTSD.

Institutional Model

• NYUhasthreedegree-grantingcampuses,and11globalacademiccenters

• NYUstudents fromthethreedegree-grantingcampusesmakeuptheoverwhelmingmajorityofthosestudyingatitsglobalacademiccenters

• Atmostglobalsites,NYUeithermaintainsitsownresidencehalls,orleasesroomsfromlocalproviders.AsmallminorityofNYUstudyawaystudents liveinexternalhousing.

• Students studyatNYU-operatedacademiccenters,andaretaughtbyfacultythatareappointed inpartnershipwithdepartmentsatitsNewYorkcampus.

• NYUhaswellnesscounselorsonstaffatmostsites(includingParis),andallthreecampuses.

Immediate Response (First 24 Hours)

• Toppriority:Trackingstudents– accountedforallstudentswithin12hours

– NYUhadmorethan200studentsinParisatthetimeofthe2015attacks.– TheUniversitycollaboratedonashareddocumentcontainingstudentroster,dividingthat

listupbetweenstaffinParisandNY.– ForstudentsinoneofNYU’stworesidencehalls,staffwassentdoor-to-doortoconfirm

studentsweresafe.– NYUstafftookleadonhandlingincomingparentcalls,toensureParis-basedstaffcould

focusonstudents.– NYUSearchedsocialmediaforpostsfromstudentswhohadnotyetbeencontacted.– Sentoutinitialcommunicationstostudentsandfamilies

• ContactedNYU’sotherEuropeansitestoidentifystudentswhomightbevisitingParis.

• ContactedallNYUandvisitingacademicandstudyabroadadvisorstoprovideupdates,ensuringtheytoocouldrespondtoincomingparentinquiries.

DecisionPoints,Risk&FearManagement(1-5DaysLater)• Support AvailableforStudents:

– On-sitecounseling– 24/7counselingsupport,viaNYU’sWellnessExchangehotline.– AnadditionalcounselorfromNewYork’sStudentHealthCentertraveledtoParistoassist.

• AdayofprogrammingwasheldattheacademiccenteronthefollowingMonday,togetstudents outoftheirresidencehallsandapartments,andtoprovidethemwithaforumtoengagewithoneanotherandwithNYUParisstaff.

• Classesresumed onTuesday.• AnadministratorfromNYU’sGlobalProgramsOfficeinNewYorktraveledto

Paristoprovideadditionalsupport toParis-basedfacultyandstaff.• Continued e-mailcommunicationstostudents andfamilies

The“NewNormal”(5-10DaysLater)

• AhandfulofstudentsexpressedconcernsthatitwastoosoontoreturntoclassesonTuesday.TheUniversityexplainedthatareturntonormalcywasacriticalpartofthehealingprocess.

• DespitetheresourcesprovidedasmallgroupofstudentsfeltuncomfortableremaininginParis;NYUworkedwiththesestudentstodevelopindividualstudyplansthatenabledthemtocompletetheirsemesters.

InstitutionalModel

• Studyabroad=decentralized• Globalsafetyandsecurity=centralized• Internationalprogramtypes• Exposure:82totalundergraduatesinParis:

– 50studentsparticipatinginNUprograms– 11exchangestudents– 21studentsparticipatinginaffiliatedprogramsofferedby3third-partyproviders

– 6studentsatstadium;3studentsnearLePetitCambodge

ImmediateResponse (First24Hours)• Trackingstudents

– Complicationsofdecentralization,multipleprograms,andcoordination• Communicationsplan

– EmergencyAlert(website)– Identicalemailstostudents inParisand theirfamilies:Focusingon

accountingforstudents, safety/security information,NU’sapproachtoemergenciesabroadandresources

– Emailstootherstudents potentiallyaffected;prioritybasedonlevelofexposure(Paris>France>Europe)

– Engagingthehealthinsurance/securityassistanceprovider– On-campusCounselingandPsychologicalServices(CAPS)

• Lessons learned– Haveaplan,butprepareforittobeincomplete– Technologyandinformationmanagement– Templates

DecisionPoints,Risk&FearManagement(1-5DaysLater)• Supporting students

– Returningtoa“safe”space>ReturningtoParis>Returningtotheprogram– Individuals:

• Privateprofessionalcounseling• Individualfacultymeetings• Otherneeds/triggers

– Group:• Groupcounselingsession#1(hosted atstudent dorm)• ForNUprograms: Processingtimeinclass

• Supporting on-sitefacultyandstaff– Informationsharing:security,academicarrangements,mentalhealth

resources(conferencecallswithDr.Black)– VisitbyNUVicePresidentforInternationalRelations

• CommunicationPlan:– Identicalemailstostudents inParisandtheirfamilies1,3,and5dayslater:

Focus isonsecurityupdates,availableprogramsupport,counselingoptions,visitofNUinstitutional representative,academicconsiderationsandarrangements• Messagesbecomemoredetailedasarrangementsareconfirmed• SpecialstatementbyDirectorofCAPS

– Emailstootherstudyabroadstudents (outsideEurope)1daylater– NotificationstoNUcommunity

• Lessons learned– Time– Counselingrequests(traumaspecialization,degree,group>individual)– Self-care

DecisionPoints,Risk&FearManagement,cont(1-5 Days Later)

The“NewNormal”(5-10DaysLater)• Supporting students

– Returning toclass >Returning tolife(traveling home fortheThanksgiving holiday)– Individuals:

• Private, professional counseling• MeetingwiththeNUVPforInternational Relations

– Group:• Group counseling session #2(hosted bypartnerUniversity)• ForNUprograms: Group (re)negotiation of final deliverables

• Communications Plan– Emails tostudents inEurope: Focus ontravelsafety, reminders aboutNUapproach torisk

management, counseling services andresources– Communication withfamilies on anindividual basis

• Lessons Learned– Trauma+Academic anxiety=Requests forincompletes– Thanksgiving returns (2students onaffiliated programs, 1onNUprogram)– After-Thanksgiving returns (1on affiliatedprogram inItaly)

Questions?