• August 1, 2014

Study-Abroad Missteps Remind Colleges of Need to Train Trip Leaders

A short-term study-abroad trip to Costa Rica run by Laramie County Community College was disrupted when the care of a student feared to be at risk of suicide was entrusted to other students on the August 2008 program. An internal review panel's report, part of which was leaked to a Wyoming newspaper, sharply criticizes decisions by college officials, including the president, who was on the trip.

The missteps by trip organizers, international-education experts say, underscore the need for proper training on health and safety issues, including mental-health concerns, for faculty members, who are leading trips overseas in greater numbers. The incident also highlights the challenge of the screening and supervision of mentally troubled students, who are studying abroad with greater frequency.

The community college had tried to block the Wyoming Tribune Eagle from publishing articles about the report, which admonished the president, Darrel L. Hammon, and other trip leaders for their handling of the situation. Their actions, the report says, endangered the at-risk student and impaired the educational experience for other participants. College officials had argued that news reports could violate student privacy.

A woman in Mr. Hammon's office said the president would not comment on the trip or on other actions taken in the wake of the trip. She referred calls to the chairwoman of the college's Board of Trustees, Brenda Lyttle. Ms. Lyttle, who had first read the full report on Tuesday, said she could not comment on the report itself because the board had not yet met to discuss it.

10 Anxious Days

According to a summary of the report, posted on the Web site of The Cheyenne Herald, the student exhibited the potential to harm herself on the first night of the 10-day course, "Field Methods in Biological Sciences."

Chaperones on the trip, including Mr. Hammon, who was listed as a course editor/instructor, did not send the student home or apparently consult with mental-health professionals, either in Costa Rica or Wyoming, the Herald reported.

Instead, they designated another student on the trip, who was an emergency medical technician, to act as a "pharmacist," meting out prescription medications to the troubled student after she attempted to take an overdose. But the student/EMT did not have the proper credentials to do such work, the report notes, and the college could have faced significant liability if the student had been wrongly medicated.

Another student who was assigned to room with the suicidal student told the review committee she put wet towels and suitcases in front of the door so that she would be awakened if her roommate tried to leave. She also slept wearing a headlamp so she could check on the woman.

In letters to the panel, known as the Care Team, participants on the trip said they knew the student was a "cutter" and that they were constantly taking knives and glasses away from her during meals and in hotel rooms. One of the students was given the troubled student's razors and observed the woman trying to "cut open her arms by rubbing them on the pipes under the sink."

Mr. Hammon, the students wrote, allowed the suicidal student to buy a knife from a souvenir shop. In his own letter, Mr. Hammon wrote that "after some negotiation and compromise and against better judgment," he permitted the purchase. The student ran into traffic with the knife after others tried to take it from her, according to students' accounts.

Mr. Hammon also wrote that he was prepared to send the student home but allowed her to stay after she met several conditions. But he said that if he had known more about the student's mental-health status, he would not have allowed the woman to travel to Costa Rica in the first place.

Challenges for Study-Abroad Planners

Study-abroad experts say that colleges should have policies and procedures in place to screen students for mental-health issues and to determine how to handle such problems overseas. "There's a growing need for study abroad to deal with mental-health issues, which mirrors the growing challenges on campus," says Gary Rhodes, director of the Center for Global Education at Loyola Marymount University, an online clearinghouse for information about health and safety in education abroad.

At Eastern Illinois University, the study-abroad application asks students to check a box stating if they have had mental-health problems, now or in the past, says Wendy S. Williamson, the director of study abroad there. Students who check the box are then evaluated by college mental-health counselors, who determine whether they can go overseas. Students might be encouraged to participate in another, less-stressful trip, or they could be allowed to go on the trip but with special accommodations or monitoring, she says.

Before Eastern Illinois faculty members can teach courses overseas, they must complete a workshop on risk management and student health and safety, says Ms. Williamson, who also is a founder of Facultyled.com, an online resource for education abroad.

A growing number of colleges are requiring faculty leaders to go through special training to avert problems like those encountered on the Laramie trip or on a 2007 University of Washington program in Ghana, in which half of the participants had to be airlifted out due to medical concerns.

The report by the Laramie review panel calls on college officials to prepare instructors and chaperones to manage mental-health and other emergencies abroad.

It also says the college should be more rigorous in selecting and training faculty and administrative leaders, and recommends that students participating on overseas programs be asked to sign medical-release forms so instructors and chaperones are aware of any mental-health problems that could arise.

Ms. Lyttle, the board chairwoman, said the college has approved a new student travel policy incorporating some of the recommendations since the report was written, in January 2009, although she said she did not know the details of that new policy.

Ms. Williamson says it is impossible to train faculty leaders for every problem that could arise on a trip overseas. What's most important, she says, is to make sure they are aware of the wealth of resources and expertise back on campus that they can turn to in an emergency.

"If a student breaks a leg, you wouldn't try to operate on her yourself," Ms. Williamson says. "But somehow we think we can handle mental-health issues on our own."

Comments

1. raymond_j_ritchie - May 27, 2010 at 06:30 am

This is a true horror story that could happen to anyone who organises a field-trip, even one as innocent as a trip to the local farm pond.
As an Aquatic Biologist I routinely take students on trips to river rapids, swamps and intertidal rock platforms. You have to run a continuous head count and have at least two other staff. A single student deciding unilaterally to go home early and not telling anyone can create a nightmare for you, let alone a "mentally-troubled" student.
Unfortunately, you never know if you have a "problem student" until you get there.
The organiser of the trip should have sent the student home immediately after the first bad experience.
One should insist that all students (and staff) buy a ticket with an open return date so they can be bundled onto a plane and send home as quickly as possible for whatever reason. Under medical escort if necessary.
I think the organiser of this trip to Costa Rica was very very lucky.

2. hlsimmons - May 27, 2010 at 07:16 am

hlsimmons

It wouldn't happen if the properly trained personnel were in charge of the groups. The Middle States Commission on Higher Education trained both the leaders and the novice students before going. They have been authorizing such trips for many decades and without serious incident. There was a person whose name was Dr.Matson who engaged in this training. Call the Commission to get the details.

3. your_rights - May 27, 2010 at 08:51 am

1) EIU = expecting a student to answer truthfully about their mental health is as stupid as the U.S. government questionaire asking foriegn travellers if they ever....

2) are the parents being held accountable for the harm their child caused and why did the parents agree to allow their child to go on such a trip?

3) Stop taking students on overseas trips.

4. jffoster - May 27, 2010 at 09:26 am

Mental health "issues"?

Mental health problems.

5. lantanatx - May 27, 2010 at 09:49 am

As a previous poster pointed out it is not necessary for a field trip to be out of the country for things to go wrong quickly, but true emergencies are rare events in my experence. I'm a field biologist who rarely takes students out in the field anymore primarily because of the liability issues, lack of adequate staffing to properly supervise students and the attitudes of the students themselves. Univ. rules on field trips have become draconian requiring reams of paperwork filled out weeks in advance, submitted and approved by multiple offices for the simplest trip off campus. The university is increasingly trying to shift all liability from the institution on to the faculty/staff, making it financially unwise to agree to supervise a student trip of any sort.

Legitimate medical issues have proved rare fortunately, but I have had real problems with students "crying wolf" over minor discomforts, such as being hot in the desert becoming cries of "heat stroke" in order to avoid assigned work. Even when the student shows no independently verifiable symptoms, everything must come to a halt to deal with the "drama llama". Of course that means an incident report must be filled out and submitted, which typically means new restrictions and rules handed down from above, which further limit our ability to provide legitimate experiences for the students who actually want to learn. Students are the real losers as field and study abroad experiences are some of the greatest learning experiences higher education offers.

6. louisie - May 27, 2010 at 10:43 am

@your_rights

Why describe this student as a child? She may be 35 years old! Also, why are parents being held accountable for any student over the age of 18? I'm sorry but if the federal government considers you legally competent to sign contracts, make medical decisions, freely enter military service, vote, et. al., why do we make these references to parents?

Sometimes academe reeks of paternalism.

/stepping off my high horse and apologies for the random der

7. 11236504 - May 27, 2010 at 10:49 am

Oversight by someone with a strong backbone is required for these experiences to be safe and academically strong. When State institutions permit 15 and 16 year old students to be part of a group of 20+ traveling with only one adult, everyone is in danger. Develop strong guidelines prior to implementing the program, review and uphold them by personnel not impacted by the success or numbers of the program seems logical but no matter how many questions are raised, it seems to continue. Number and money games seem to always win over common sense.

8. panchowendy - May 27, 2010 at 10:49 am

To the person who said "EIU = expecting a student to answer truthfully about their mental health is as stupid as...".

Thank you for being so kindhearted and thoughtful. So your solution is to stop sending students overseas? Wow, how brilliant is that in an age of globalization?

9. 11336803 - May 27, 2010 at 11:15 am

Things can and do happen here and abroad. Ms. Fischer highlights one instance when nearly 300,000 students study abroad each year. Most institutions do have procedures to deal witrh these things and have been training faculty directors for many years.

10. richardtaborgreene - May 27, 2010 at 12:30 pm

I like raymond's response a lot-----exposure to the quality of person the American and world populations are now generating puts everyone at personal and career risk. At some point it is just not worth it to invest in educating such low and variable quality people. That is what "selective" universities were all about underneath other cover stories---they selected in people you could and would want to do educative things with and they selected out people you would end up in jail over their unannounced drug-induced hysteric suicide attempts, etc. etc. etc. Quality of person sent to college and quality of person accepted into college is a MAJOR part of the job satisfaction and viability for us all---as professors---we sometimes forget that.

11. 11336803 - May 27, 2010 at 01:42 pm

Well Professor Richard Tabor Greene you certainly have a better crystal ball than most. With your innnate and well honed ability to pick winners, perhaps you could be put in charge of identifying those who could benefit from your learned preachings. Will you at the same time send off the rest to jail in advance of the actual crime thus sparing society the painful episode. I am old enough to remember when large groups of people were considered to be those you could not do "educative things with." And all for your job satisfaction. What a load of rot.

12. khung - May 27, 2010 at 01:53 pm

richardtaborgreene said on May 27, 2010 at 12:30 pm:

"That is what "selective" universities were all about underneath other cover stories---they selected in people you could and would want to do educative things with and they selected out people you would end up in jail over their unannounced drug-induced hysteric suicide attempts, etc. etc. etc."


First of all, selective schools have students with mental illnesses, too, you know.

Second, aptitude and academic credential are not the only reasons why some students may not attend a selective school. Sometimes, financial concerns and geographical concerns are important factors affecting how students choose a college.

But even if we were to ignore that, it would still be outrageous to equate inability to be accepted into selective schools with unsuitability to participating in "educative things." Students mature at different rates, and some don't have good high school credential not because of lack of aptitude. Further, the absence of excellent grade records does not always reflect a disinterest in learning. It could simply be that they have not yet met a teacher who can make the subject come alive for them. Some students have learning disabilities, and some have difficulties with timed, standardized testing conditions. Just because someone has not performed in the top 10% before does not mean that they never will, or that they have a disinterest in learning.

As educators, I think our task is to help each student, regardless of inherent talent, to reach their full potential. Not everyone can become the next Nobel Laureate, but all of us deserve a good education.

13. lisaannbrown - May 27, 2010 at 04:27 pm

@your_rights:

One thing that you might or might not realize is that students are legally entitled to their medical privacy under FERPA and HIPAA; therefore, study abroad offices don't have access to students' medical information.

It's for this reason that we as study abroad professionals have to ask them to self-disclose. As other commenters have pointed out, these students are adults, so the onus is on them to take responsibility for their health, and this includes disclosing information that would be important for faculty leaders to know.

In the event that they don't disclose, however, faculty leaders need to be trained in how to handle these situations. This, in my view, was the point of this article. Had the faculty member in question sent this student home immediately upon observing dangerous behavior, the rest of the students could have had a very pleasant, once-in-a-lifetime learning experience.

Forbidding everyone to go abroad because a very small percentage are not healthy enough to go is not the answer. As professionals, we simply need to give our faculty the resources to deal with these issues so that all students receive the most benefit out of their study abroad experiences.

14. angustias - May 27, 2010 at 06:00 pm

Students are asked to "self-disclose" but often do not. We have been informed that it is illegal to discriminate against the mentally ill. I know we are supposed to be compassionate and PC about mental illness, but no pre-departure training or other "resource" can equip study abroad faculty for dealing with neurotic students let alone the psychotic.
I speak from bitter experience of dealing with a young woman who should not have been let out of the house, let alone into the jungle. Afterward, her suitemates confessed that they wanted to "rat" on her, but were afraid to. And naturally her parents blemed the faculty, the study abroad provider, the other students (for being "unfeeling"). We all had sympaty for her evident distress, but it wore thin as she became increasingly demanding (everyone had to stay together and be in her presence) and basically ruined the trip.
There has got to be a way to just tell people no.

15. your_rights - May 28, 2010 at 08:15 am

#8 "So your solution is to stop sending students overseas? Wow, how brilliant is that in an age of globalization?"

There are many ways for students to experience other cultures. For example:
1) a student exchange program where they have an entire university to watch over them
2) a bonding trip with their parents
3) a packaged trip provided by a reputable travel agency,
4) volunteer to serve in the armed forces, etc.

The fact is that one or two faculty members with a one week training course are not equipped to handle simple problems let alone life and death situations.

#7: You are right. A group of 18 and under combined with older people is a disaster waiting to happen.

#8: If you do not have extensive traveling and living experience overseas why don't you go live in some terrorist third world country for one year or more. Like civilians who make comments about how the military should be run and have never experienced the combat theater you should stop talking.



16. mystery345 - May 28, 2010 at 01:52 pm

Gosh where to start with this one.

I have been a part of a college study abroad, much like the one that this article discusses. I have also lived and worked abroad. I have a very severe mental illness and take three medications daily...

@your_rights - #3
I have always disclosed my illness. I would never even consider not disclosing if asked. I have a thick skin, however. If a student felt that he or she would be forbidden from going on a trip simply because of mental illness I can see why someone would lie. If that student was ensured that disclosing was not reason for automatic exclusion then I would guess that most would disclose.

@richardtaborgreene #10 - Are you actually stating that because I have a mental illness that I should be barred from a selective institution? I wonder how many people at selective institutions are actually mentally ill but controlled by medication. I would assume quite a few. I am sure that you speak to these people regularly but you don't realize it. Your statement was so stupid I won't give it any more thought.

What is interesting to me is that everyone here is assuming that this student had a true mental illness. Colleges have more than their share of young students trying to find their place in the world. Suicidal thoughts and cutting are not confined those with documented mental illness. Those who are diagnosed, who would check that box on an application, are the ones who are aware of their illnesses and are usually medicated and under a doctor's care. The students who would be problems are those who have yet to be diagnosed (no box to check) or not mentally ill but still suffering from reactive symptoms. Suicidal thoughts can hit a person who has just broken up from a relationship (especially at the college age) or who have experienced some kind of emotional set back. These people are not mentally ill. They are in temporary crisis.

You simply cannot try to exclude those with mental illnesses. You will exclude the wrong people. You can train your staff, but there is not enough training that can be given to a layperson that would give them the ability to work with a student in crisis. Send the student home, even if this means sending a chaperone home with them. It is the only option.

17. mmcorrigan - May 28, 2010 at 04:23 pm

I'm wondering about how you send someone home who refuses to go, as in my experience many students on study abroad have. I can see expelling them, refusing to grant academic credit, contacting parents to convince the student it would be best to go home, but how can you get a student to get on a plane if he or she refuses to? What are the mechanics of it? What is the leverage?

18. supertatie - May 28, 2010 at 05:46 pm

I sympathize with those students who have psychological illnesses - whether treated or untreated. But much of the handwringing over "the proper thing to do" could be avoided if the universities were somply NOT at risk of being sued - sued if the students go, and something happens; sued if the students aren't permitted to go; sued if they go and have to be sent home.

19. mystery345 - May 28, 2010 at 07:30 pm

17 @mmcorrigan

It is the same problem here or abroad. You cannot get a person help if they don't want it. Perhaps having a student sign a release that under specific situations they must go home. If that release is signed and they refuse, you have to turn them over to the local authorities. I know it is harsh but what else can you really do? You take your chances when you leave your own country. There is only so much protection your instructors can give you. As an adult student, it is your responsibility to take care of yourself. There is only so much responsibility an adult student can force upon an instructor whose job it is to guide not babysit.

20. studyabroadguru - May 30, 2010 at 06:35 am

A great resource for preparing faculty:
http://www.facultyled.com/study-abroad-faculty-preparation.php

21. gradace - June 01, 2010 at 10:41 am

I agree with Mystery 345. In my study abroad experience -- which included long periods where students were far from phones, roads, etc. -- the stress of what we generically call "culture shock" would often result in responses among otherwise mentally healthy students. Eating disorders that were considered long overcome would suddenly recur. Cultural transitions are inherently stressful, and it helps if faculty know what to expect. I find it sad that "study abroad" experiences are increasingly two- or three-week trips that gives students very little time to adjust and gain some perspective on their reactions. The cultural learning occurs during the reflection not during the experience itself. The maturity it takes to realize that is hard won, and cannot develop on what are essentially touristic excursions.

Also, nobody has mentioned the effect of medications, like anti-malarials. These drugs can produce reactions very much like psychosis. It takes an experienced leader to ask the right questions and get students the help they need, when they need it.

22. mfulmer - June 01, 2010 at 11:27 am

I completely sympathize with the organizers of this and other trips who have had to deal with a mentally unstable student. I've been on three such trips where there always seemed to be "one", some worse than others.

The first experience was the worst because the student was indeed suicidal, having had a panic attack getting on the plane for the longest leg of the trip (pre-9/11) and then within a couple of days of our arrival he began with psychotic behavior, hearing voices, fearing others were there to kill him, etc. He wrote a long letter to me which, upon reading I called his mother immediately.

We were in a third world country, more than 30 hours travel from home. Yes, I had the papers signed that said he would have to go home if his behavior was deemed unsuitable; and yes I had a health power-of-attorney signed by every student so I could act on their behalf if they were unable to.

Short story version:
1) On phone mother told me life would be easier with just one son (she had another at home) while suicidal son was waiting to speak with her.
2) mother's boyfriend called back to yell at me for having the nerve to suggest she deal with her son. There was no way he could go on a plane to fly home by himself.
3) insurance company called to say any treatment would have to be "pre-approved" by them, impossible since there were no "in network doctors" in this country.
4) I contacted and arranged for treatment by the only MD Psychiatrist in the country, and arranged for caretakers (not students) to watch him 24 hrs/day until we got to the airport.
5) NO parent met him at the airport, nor at the school at 2 am.
6) A month after we returned, he spent 2 weeks in an institution who released him (living on his own) because they deemed him no longer a threat to himself.
7) He committed suicide 3 months after we returned from the trip.

The problem is not that faculty and colleges are liable. The problem is that our society is not geared towards really helping people with mental illness.

23. gromet37 - June 01, 2010 at 11:57 pm

All study aboard trips should consist of professionals with a Master's in Student Personnal Administration and at least two years of residential life experience. Those of us who work in the residence halls or in the common venacular(dorms)have extensive training and experiencing working with students, including students with mental health issues. We also often work very closely with counseling services regarding student issues. The typical onset age for many mental health issues is between 18-24 just when many indivuals are in college and away from their home routines.

All colleges and universities have to be prepared to deal with students with mental health issues and have clear consistent policies in place for travel aboard trips that protect all parties involved.

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