At Ashland University, the ACs are the individuals that are responsible for assessing whether or not a student needs to be transported to the hospital for suicidal ideation or other mental health concerns during the times when the counseling office is closed.  This was not a responsibility that I was comfortable with, but the counseling office only has two full-time staff members, and the ACs were told that we were not to call them after hours.

Our protocol for instances of suicidal ideation or threat is to immediately notify the senior level administrator on-call and relay all gathered information from the distraught individual including the reason for the threat, plan, and individual's condition.  We are to attempt to keep the individual contained in the area until assistance arrives.  While working with the individual, the ACs are to check is suicidal ideations is present (Are you think of killing yourself via suicide?), determine if they have a method (Do you have a plan for committing suicide?), determine if they have a means for carrying out a plan and confiscate it if possible, and determine if they have the drive / motivation to commit suicide.  If they answer yes to most of the questions, we are to have the individual transported to the emergency room.  If the individual is not willing to be transported to counseling or the hospital or represents a threat to themselves or staff, the Ashland City Police are to be called to transport the individual to the hospital.  After the situation is resolved we are to immediately submit an incident report and forward a PDF of the completed report to counseling services and the senior level administrator on-call.

In the fall of 2016, I had a student who was in distress on multiple occasions.  They would publicly express suicidal ideation and go to public areas and be visually upset and agitated in a manner that disturbed or distress residents on the floor.  However, when I responded to these situations the resident (S) would calm down but refuse to go to a more confidential or private location.  Also, when I did my check for ideation, S would deny being serious about their ideation and blame the residents who called me in or sent me screenshots of S's public displays of suicidal ideation.  This was very frustrating to navigate in trying to do what was best for the student and for the floor.  Their behavior caused many other residents to feel anxious and overwhelmed while others became burnt out and either started ignoring her behavior or were outright hostile to her expressions of suicidal ideation.  In one particular incident I was called to address another situation where S was crying loudly in the floor lobby and displayed erratic physical behavior that caused several residents concern.  However, when they tried to talk to them, S lashed out at them.  When I arrived and worked to rectify the situation, as stated in the incident report, I was given a lot of information that concerned me.  It came to a point where I stated that the absence of a negative in answer my questions would be considered a positive.  In my opinion, we had been through similar situations in the past not to elevate the level of response.  Originally, I had stated that from my assessment, S would be transported to the emergency room.  After speaking with my supervisor who was the senior-level administrator on-call, that plan was changed to contact the parents to come and take S home.  What was not included in the incident report was the amount of follow-up that the RA and I did with the floor residents.  I had several one-on-one's and group discussions not about the specific resident or incident but about how the students could set up appropriate boundaries in order to address similar behavior in the future.  This is just one example of how I handled emergency/crisis response protocols, reacted to behaviors that are not covered in our written procedure, and adapted my approach when more senior level staff members changed the response plan.