Appendix M: Guidance Document

Advance Planning
1. Ask program leaders and/or the study abroad unit to identify mental health resources in their program location prior to taking a group overseas.
     a. Sources of this information may include:
        i. US Embassy physician lists
        ii. GeoBlue Insurance’s mobile phone application  for managing your healthcare
        iii. Local contacts
2. Discuss crisis management with campus units that could be called upon to respond to a crisis and think proactively about responding to crises on overseas programs.
     a. This team might include representatives from:
        i. Education Abroad/Study Abroad
        ii. Counseling and Psychological Services  
        iii. General Counsel iv. Student Health v. Dean of Students 

Structure of Incidents *  
Level 1 – most common, least serious, not life threatening, little impact on program participation presently- some concern that the issue could intensify 
Examples – relationship problems, insomnia, anxiety attack  
Immediate Action Steps:
• Mental health issues should be addressed by employing active listening and basic helping skills.
• Staff should promptly contact the study abroad office.  Campus units will be consulted on best next steps.
• Program leaders will implement the plan onsite. 

Level 2 – less common, more serious, some impact on program participation  
Examples –students struggling with past trauma, chronic depression or anxiety  
Immediate Action Steps:
• Issues should be addressed by talking with the affected student and providing immediate support.
• Staff should promptly contact the study abroad office and arrange for medical treatment if necessary.  
• Campus units will be brought in for assessment and support as appropriate.
• Program leaders will implement the plan onsite. 

Level 3 – least common, most serious, significant impact on program participation  
Examples –recent sexual assault, suicidal ideation/attempt, consistent irrational dissociative behavior  Immediate Action Steps: • Don’t leave the student alone.
• Talk with student and provide immediate support as possible.
• Staff should immediately contact the study abroad office.  Campus units will be brought in for assessment and support as appropriate.
• In the case of suicidal ideation with plan, access to means, and immediate intention - Call the police or ambulance for immediate transport to a health care facility.
• In the case of sexual assault:
     o report the incident to IU’s Title IX Coordinator
     o assist the survivor in contacting law enforcement, as appropriate, in conjunction with the Title IX Coordinator’s guidance
     o assist the survivor in contacting medical and mental health services as appropriate
• Program leaders will implement the plan onsite. 

Further Considerations
1) Determine what might be a reasonable timeframe to expect the student’s condition to be stabilized and for them to resume full engagement in the program.  
For a short-term, faculty-led program that timeframe might be 24-48 hours.  
For a longer program or a program with an institutional base in country, a longer timeframe may be appropriate.  

2) Program leaders and campus units should regularly communicate and re-assess the situation:
• Is the student returning to full participation in program activities or maintaining full participation in program activities?
• Is the student obtaining medical treatment, if recommended?  Is the student responding positively to any such medical treatment?
• Is any additional assistance/accommodation being provided reasonable to sustain over the course of the program?
• Are the student’s needs or behavior unreasonably interfering with learning opportunities of the other program participants?
• Is there a reduction in suicidal ideation/risk/danger?  
• Is the student engaged in maintaining their safety? 

If necessary, program leaders and campus units should identify options for sending the student home.  If the situation does not stabilize within a reasonable timeframe, the student should be sent home if feasible. 

When a decision is made that a student should return home:
1. Medical evacuation to the student’s home country through GeoBlue Insurance should be explored.  In this situation, it would be expected that a trained professional would accompany the student home, assuming the case qualifies for GeoBlue support.  
2. If medical evacuation is not possible, communicate with the student’s emergency contact about coming to the program site and escorting the student home.  The university will provide information and support as is possible through this process.  

*Incident categories adapted from the Mental Health Pyramid developed by Gary Robinson/P3 Mental Health Advisors, LLC  

[IUPUI Study Abroad Office Resource Document]