Suicide attempt as code of conduct violation

The Swan

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Jun 19, 2014
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    Hey all,

    Currently a clinical psychology student. More or less, went through a very rough period, had a suicide attempt.

    School found out- they subsequently charged me with a code of conduct violation- "Endangering any persons" [myself]. Found me "guilty" and now this will be on my record with the Dean that I have a conduct violation. They said it could be expunged in six years, and that it will NOT go on the academic transcript.

    How do I deal with this while applying for practicuum sites, internship, post-doc, etc? I wasn't criminally charged for anything, but I have no idea if something like this would show up on a background check, how I should address it if it does.

    1) Will it affect my ability to get positions?
    2) How should I deal with this?
    3) Anyone go through a similar situation and have advice?
     

    OneNeuroDoctor

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      With all the privacy laws a prior suicide attempt would never be revealed by a university or a mental health or hospital. I believe it would never come up in an application or interview unless you brought it up. What matters is how your functioning is now.

      Unfortunately we seem to almost be at epidemic proportions with military and college age students having suicide or suicide attempts.

      Working in a city with a major university, we commonly have a number of students in our inpatient unit and in outpatient treatment. Normally, most students return to college and I have never heard of them being placed on probation unless they are failing there classes.




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      WisNeuro

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        I don't think the case was that anyone would specifically bring up the suicide per se, rather that the code of conduct violation would make it into the records somehow. Or if someone would mention a code of conduct violation in a letter. First, it seems unusual that this would be a conduct violation in the first place. If you didn't receive help for it, it could be an ethical violation technically.

        Since it was in grad school, there is always the outside chance that a mention will be made (of a conduct violation) so you may want to be prepared to address it somehow if you are asked about a violation that appears somewhere.
         

        CheetahGirl

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          I'm confused by this situation. As if there's not enough to worry about in graduate school in clinical psych without having the program itself impose whatever they did.

          Sounds like the university is covering their own behinds, but placing a conduct violation that cannot be expunged for 6-years sounds a bit harsh, especially given the nature of the situation. I agree with OneNeuroDoctor...make sure you are getting assistance now, The Swan. I'm forever looking at positive spins to complicated situations (a strength but also a limitation of mine). If you are in your own treatment, you can always use those experiences to your benefit as a therapist-in-training, right? Deeply understanding your countertransferential issues (for those psychodynamic folks), but also opening new perspectives from the patient's side of therapy. Plus any capacity that deepens your introspection is always useful in clinical psychology.

          You asked:
          1) Will it affect my ability to get positions?
          2) How should I deal with this?
          3) Anyone go through a similar situation and have advice?

          1) I don't think so...like others responded above, if it is not on your academic record, practicum sites usually don't look at your transcripts (only letters of recommendations, your cover letters, CV & meeting you during interviews), background checks are usually legal (and this is not a legal violation), and APPIC may never know about it when time for internship applications, especially if you & your program director agree it was something in past and not reportable on the APPIC application (after all, it is private & personal).
          2) I would deal with this very privately, like you and your therapist ONLY (provided you have one of your own, now) and not share much more with faculty other than to let them know how you are improving and adjusting (after all it is none of their business unless it is actively interfering with your work from this point forward).
          3) I have not gone through this situation, but I had an intense personal and familial situation during my 4th year of graduate school that required me to take time off (well, not really because I was writing my dissertation chapters then...but I seriously lightened my workload to only work about 25-30 hrs/week, rather than the intensity of the 40+ hours/week the first couple of years). However, my program directors were very understanding and no actions were taken against me. So, I'm curious about how and why your program handled this situation the way they did and I can only think it was because they needed to cover themselves legally...just in case you could not perform in the capacity necessary (especially if it was a funded program in which you signed a contractual agreement). Perhaps taking time off may help, but only you will know what is best for you.

          Good luck to you, and take care.:luck:
           
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          The Swan

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            Hey all-

            Just to clarify some things:

            1) The program did not take action against me. The dean of students/ Student Affairs office for the school did. It does appear to be completely legal at this point, as there have been a lot of other recent suicides/attempts on my particular campus-- so I think the school is going to be under a lot of scrutiny in the very very near future.

            2) The rationale was that I was "endangering myself" by having a suicide attempt, and the school felt justified in giving me *conduct* sanctions given that their police were notified of my emergency.

            ----------------

            Just a sidebar, but thank you all for the helpful input. Feel free to message if you don't feel comfortable sharing publicly.

            Also- agreed as for the way this was handled. The school's response was completely hypocritical/ counterintuitive:
            "We want you to get help"**
            **but we don't want to give it
            **also you shouldn't come to us if you're having a medical emergency because we'll sanction you for it, rather than give you something like medical amnesty for seeking care
             

            oathkeeper

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              This does sound really harsh and incredibly counter intuitive- also why were your records not kept confidential, even if the police were notified? As in why would the dean be notified? I myself haven't been in the situation but a friend from my cohort was- it's hard because at this point you probably have a lot of professional relationships (or hope to) with nearby hospitals making it hard to have access to crisis services (eg psych er). Can you discuss with a member of the psych dept who are is of this situation how it will impact those areas you mentioned? Hopefully they can either reassure you that it won't make a difference, or can help you manage the situation and decrease anxiety. Our school also has low cost referrals available for therapists who are not associated with the program so that we have access to treatment. A lot of therapists may also be able to work with you on a sliding scale if you let them know you're a student.
               

              futureapppsy2

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                OP, I'm somewhat familiar with university policies surrounding threat assessment, especially in relation to suicide and NSSI, as I work with college students and research those topics. Recent OCR rulings have generally held that colleges and universities can not count suicidality/suicide attempts/NSSI as code of conduct violations *unless* the college has taken extensive and well-documented steps to mitigate the behavior (e.g., multiple behavioral contracts). This came on the heels of several DOJ court cases where schools did treat suicidality/suicide attempts as code of conduct violations and were found in violation of the Americans with Disabilities Act. Here's a really good white paper on the topic, though I don't care for the tone in places: http://nabita.org/documents/2012NCHERMWHITEPAPERTHEDIRECTTHREATSTANDARDFINAL_001.pdf

                In general, provided there weren't mitigating circumstances like multiple behavioral interventions with explicit consequence chains, it sounds like your university could be looking at an OCR violation. Of course, OCR complaints can take a while to process. so may not be of immediate help, and there's no 100% guarantee that your name won't end up attached to it via Google. Still, it bothers me a whole lot to here that some universities may still be treating suicide/suicidality as conduct code violations. Civil rights perspective aside, that places a horrible stigma on people experiencing suicidality (and there's enough of one already!) and probably decreases help-seeking and thus decreases student safety, rather than increasing it.

                Please feel free to PM me if you have any questions!

                Edit: As to @oathkeeper 's question of why the school was notified, from the OP's post, it sounds like the *campus* police were involved. Post-Virginia Tech, most colleges/universities developed threat assessment/behavioral intervention teams that have the goal of increasing communication and transparency across university agencies (counseling services, security, disability services, legal, etc) in order to better address students who are risk of harm to self or others. One side effect of this is that intra-campus confidentiality is greatly decreased when it comes to any situations involving harm to self or others or ideation thereof, especially if this ideation or behavior is comes to light outside of a counseling context (as in the OP's case). As I understand it, this is largely due to the difference between HIPAA (counseling and health services) and FERPA (most anything else at a university) protections, though counseling center staff definitely can and do report students to these teams, especially if there was a hospitalization, imminent threat of harm to self or others, or indication of intent to harm others. Done well, these teams have the potential to improve safety, coordinate care and follow-up, and connect students to resources, but they also have the potential to walk all over vulnerable students' privacy, because there are a good number of people on these teams.

                I'm personally of the (minority) opinion that suicide/self-harm should be handled separately from threat of harm to others, because this blurring of the lines sometimes does lead to suicidal students or those who engage in NSSI but have no homicidal ideation or inclinations being treated like they do. Like the OP's situation demonstrates, this can lead universities down the path of treating suicidal and self-injurious behavior like conduct code violations. It's rare, but I do know of a couple of universities that explicitly state that their threat assessment teams do NOT treat self-harm and suicidal ideation, absent threat to others, as conduct issues in any way and that the goal of the team in these cases is to link the student up with efficient, appropriate care and resources.
                 
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                KillerDiller

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                  I've worked in several university counseling centers, and just to add on to what Future said, it is often university policy that students who are admitted to the hospital for mental health reasons need to be assessed by campus personnel before they are allowed to return to classes/ the dorms. Often the university was involved in transporting the student to the hospital, which starts this process rolling. The assessment is usually conducted by the counseling center, but (at least in my current position), the ultimate decision rests with the dean of students. The students sign releases knowing that communication about the assessment is necessary if they want to return to the university.

                  That being said, suicide attempts are not a conduct violation at any of the places I've worked. Seems like a poorly thought out policy.
                   

                  futureapppsy2

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                    With regards to the OP's question about disclosure, I think they'll have to disclose if the application asks any questions about institutional action (which usually just equals conduct code violations) Of course, in this case, it also means that @The Swan will have disclose his or her medical history, which seems like it begins to constitute multiple ADA violations. I think APPIC acts about institutional action during grad school, but I am not 100% sure. Can anyone who applied last year confirm or deny?

                    I am definitely not a lawyer and this is in *no* way legal advice, but I'd definitely recommend contacting a lawyer, preferably one with experience in higher ed, to review your situation and, if they advise it, possibly see about getting the conduct violation expunged. Given that there's multiple, recent OCR/DOJ precedents about this, it may not even be necessary to file a formal compliant if there are no mitigating issues, such as threat of harm to others or a history of behavioral contracts specifically addressing harm to self. While I generally think discrimination lawsuits have more potential for backlash than they're worth, there are times when having legal counsel on your side can be a definite boon.
                     
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                    Birdstrike

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                      Hey all,

                      Currently a clinical psychology student. More or less, went through a very rough period, had a suicide attempt.

                      School found out- they subsequently charged me with a code of conduct violation- "Endangering any persons" [myself]. Found me "guilty" and now this will be on my record with the Dean that I have a conduct violation. They said it could be expunged in six years, and that it will NOT go on the academic transcript.

                      How do I deal with this while applying for practicuum sites, internship, post-doc, etc? I wasn't criminally charged for anything, but I have no idea if something like this would show up on a background check, how I should address it if it does.

                      1) Will it affect my ability to get positions?
                      2) How should I deal with this?
                      3) Anyone go through a similar situation and have advice?
                      This should not be construed as legal advice (because it's not) and I hate to get lawyers involved, but you might want to consider asking a lawyer if they may have violated HIPPA by placing your protected medical information somewhere other than your medical chart. As big as these fines can be for a hospital, and as afraid as I know all hospitals and universities are of violating them, you may have a shot at getting it to magically "disappear," with nothing more than a few hundred bucks and a certified letter from an attorney. Again, I hate to get down and dirty with lawyers, but unfortunately it seems the only way to get anything important done nowadays. Give it some thought.
                       
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                      futureapppsy2

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                        This should not be construed as legal advice (because it's not) and I hate to get lawyers involved, but you might want to consider asking a lawyer if they may have violated HIPPA by placing your protected medical information somewhere other than your medical chart. As big as these fines can be for a hospital, and as afraid as I know all hospitals and universities are of violating them, you may have a shot at getting it to magically "disappear," with nothing more than a few hundred bucks and a certified letter from an attorney. Again, I hate to get down and dirty with lawyers, but unfortunately it seems the only way to get anything important done nowadays. Give it some thought.

                        From the sound of the OP's post, though, it sounds like their medical record or medical personal may have never been involved in the university action. Rather, it sounds like the campus police (who, I'm guessing, were first responders) notified student affairs, and neither the campus police nor student affairs is under HIPPA.
                         

                        MCParent

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                          This should not be construed as legal advice (because it's not) and I hate to get lawyers involved, but you might want to consider asking a lawyer if they may have violated HIPPA by placing your protected medical information somewhere other than your medical chart. As big as these fines can be for a hospital, and as afraid as I know all hospitals and universities are of violating them, you may have a shot at getting it to magically "disappear," with nothing more than a few hundred bucks and a certified letter from an attorney. Again, I hate to get down and dirty with lawyers, but unfortunately it seems the only way to get anything important done nowadays. Give it some thought.

                          I agree with this, about medical information being shared inappropriately.

                          Also, where would this come up? I think on internship apps they ask about convicted felonies and being put on probation by your program so no need to include. It's not on OP's transcript; I don't know what a "record with the Dean" is, but it doesn't sound especially important.

                          Ask a lawyer, but I don't think it would be legal to ask about this in a job interview. I think they can only ask about convicted felonies (e.g., can't ask "were you arrested" either because you might have been wrongly arrested for something and that can't be a factor in a hiring decision).
                           

                          futureapppsy2

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                            Also, where would this come up? I think on internship apps they ask about convicted felonies and being put on probation by your program so no need to include. It's not on OP's transcript; I don't know what a "record with the Dean" is, but it doesn't sound especially important.

                            It would only come up in situations where the application asked about institutional action; if APPIC doesn't do that, then the OP may be in the clear (though prac sites may ask this as well). It will also likely have to be disclosed on licensure applications, though that would be true even if there was no code of conduct violation. Most state licensure applications ask about mental health treatment--and sometimes other medical treatment--within the past 5-10 years; however, they generally are okay with it as long the applicant can prove that it's resolved or well-controlled.

                            I agree with this, about medical information being shared inappropriately.

                            The sticky thing about situations like this is that that information may not have ever qualified as HIPPA-protected medical information, if it passed from the campus police to student affairs without a medical or counseling professional involved. Say, if the campus police were first responders and they notified student affairs directly, the information isn't technically "medical information" and thus falls under FERPA instead of HIPPA. FERPA allows intra-university sharing of information on a "need to know" basis, so the privacy guidelines are considerably less strict.
                             
                            "Of course, in this case, it also means that @The Swan will have disclose his or her medical history, which seems like it begins to constitute multiple ADA violations. I think APPIC acts about institutional action during grad school, but I am not 100% sure. Can anyone who applied last year confirm or deny?"

                            Looked at my AAPI from this past year, one of the questions that is relevant to the OP's situation – has disciplinary action, in writing, of any sort ever been taken against you by a supervisor, educational/training institution, health care institution, professional association, or licensing/certification board?

                            I think this is a completely messed up situation Swan, and agree with the others who have said that you should consult a lawyer (disclaimer: I am not a lawyer).
                             
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                            The Swan

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                              "Of course, in this case, it also means that @The Swan will have disclose his or her medical history, which seems like it begins to constitute multiple ADA violations. I think APPIC acts about institutional action during grad school, but I am not 100% sure. Can anyone who applied last year confirm or deny?"

                              Looked at my AAPI from this past year, one of the questions that is relevant to the OP's situation – has disciplinary action, in writing, of any sort ever been taken against you by a supervisor, educational/training institution, health care institution, professional association, or licensing/certification board?

                              I think this is a completely messed up situation Swan, and agree with the others who have said that you should consult a lawyer (disclaimer: I am not a lawyer).

                              Awesome. Legal counsel, it is
                               
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                              The Swan

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                                Could someone potentially help me walk through the psych. licensing application, and let me know whether I'd have to report a sanction from my higher education institution, according to this? I'm having a hard time understanding the extent of some of the questions--

                                if so, p.m. me!

                                Thanks so much, again.
                                 
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                                mandak

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                                  I am so glad that you wrote about this. I went through something very similar last semester; However, being a minor, I did reap the consequences of criminal charges. I am in the third year of my undergrad and I received countless threats of "not making it in this field" and "we will try to keep this off your record". Since I am going through a similar situation, I have much of the same questions as you and cannot offer much assistance. Just wanted to say thank you for sharing!
                                   

                                  futureapppsy2

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                                    I am so glad that you wrote about this. I went through something very similar last semester; However, being a minor, I did reap the consequences of criminal charges. I am in the third year of my undergrad and I received countless threats of "not making it in this field" and "we will try to keep this off your record". Since I am going through a similar situation, I have much of the same questions as you and cannot offer much assistance. Just wanted to say thank you for sharing!

                                    Criminal charges for a suicide attempt?
                                     

                                    The Swan

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                                      Hey mandak- I don't know the specifics of your situation, but please feel free to p.m. me at any time.

                                      I can't begin to understand how horrible it feels having criminal charges for something like this, nonetheless disciplinary actions from the school. It is very hard not to feel jaded about our field (and society) after experiences like this; suicidal acts/thoughts are still very much black-listed, and many people (including professionals, schools, law enforcement individuals) don't know how to respond appropriately/ sensitively... I've, likewise, had issues speaking about this at all levels -- with psychiatrists, law enforcement, individuals in the clinical psych field, even suicide hotline dispatchers (this was perhaps the most disheartening). As hard as it is, finding community in settings such as SDN -- where other individuals are available to hear your story, relate, and see some of these more societal/*big picture* issues impacting the mental health community, it helps. Please know that all of us are here to help and support in any way we can.

                                      :)


                                      Abuse of alcohol and prescriptions, and apparently "obstruction of peace"
                                       

                                      smalltownpsych

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                                        I am not too surprised by some of your experiences. Many of the people who work with those in mental health get frustrated by the patients. this includes the ER, EMTs, law enforcement, nurses, etc. They see a lot of human suffering and from their perspective it appears self-imposed. They see a revolving door of patients who struggle with poverty, mental illness, substance abuse, suicidality, self-harm, physical and sexual abuse. This often leads to a defense mechanism of blaming the victim. As psychologists, it has been my experience that we can help by providing both empathy and education for these people on the front lines. I also believe that we need to work to fight stigma and some of the advice on this board reflects the fear of stigma. Why do we as psychologists need to pretend to be "fine"? Before this gets misconstrued, I firmly believe that a psychologist needs to have good self-care and self-awareness and a way of communicating how we deal with whatever past problems we have had. I just worry about the mixed message we send when we have to hide our own pathology from each other in order to not be judged. I used to have debates with some in my cohort about depressed mood and how they defined it as something that patients have but that a healthy person such as themselves would not have. It made me wonder who was truly healthier, the person who can acknowledge their weaknesses or the one who was highly defended against them.
                                         
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                                        dale.gribble

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                                          Criminal charges for a suicide attempt?
                                          As ****ed as it is, this still happens. I don't know how it was resolved because I was too little to understand, but both my father and sister have had criminal charges brought against them for (unsuccessful) suicide attempts.

                                          In any event, I would bet my salary that this is, if not directly illegal, then indirectly so. There's no way that imposing academic sanctions based on PHI is legal (though I recognize that my lack of knowledge on the topic could engender some degree of idealism). If the campus police were involved and they're truly police, they're basically held to the same standards of privacy. If they're just security guards, then they may or may not be responsible, but I can guarantee you that someone in the chains of command involved in this misused their access to your PHI.
                                           

                                          Terri Dactyl

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                                            For practicum, the sites you apply to will not have access to your student record. Once the faculty find you ready for practicum (you will be given a letter of intent to apply by your training director), you send your cover letters and requested materials to the sites you're interested in and that's it.

                                            In regard to applying for internship, you will also receive a readiness letter from your training director to apply for internship (and your training director would approve your AAPI). I'm also inclined to think that sites you apply to would not be privy to this information as long as you're not on academic probation or a recorded remediation plan. I believe that is a question that is asked on the AAPI (e.g., are you in good academic standing; are you or have you ever been on academic probation), and then it's up to the student to answer the nature of the probation/remediation once granted an interview.
                                             

                                            WisNeuro

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                                              For practicum, the sites you apply to will not have access to your student record. Once the faculty find you ready for practicum (you will be given a letter of intent to apply by your training director), you send your cover letters and requested materials to the sites you're interested in and that's it.

                                              In regard to applying for internship, you will also receive a readiness letter from your training director to apply for internship (and your training director would approve your AAPI). I'm also inclined to think that sites you apply to would not be privy to this information as long as you're not on academic probation or a recorded remediation plan. I believe that is a question that is asked on the AAPI (e.g., are you in good academic standing; are you or have you ever been on academic probation), and then it's up to the student to answer the nature of the probation/remediation once granted an interview.

                                              It depends on how the institution records the incident, considering this question on the AAPI

                                              "Has disciplinary action, in writing, of any sort ever been taken against you by a supervisor,
                                              educational or training institution, health care institution, professional association, or
                                              licensing / certification board"

                                              It may get reported. I would just be prepared to cover it if it comes up. Also, you will have to ask your DCT how to fill out this particular question. You don't want to say "no" only to have the DCT or another letter writer mention it if it was supposed to be a yes.
                                               
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