Significant Medical, Mental Health and Community Threat Response and Assessment

Introduction

Biola University desires that students thrive holistically during their time as a student and beyond. The University cares deeply about the physical and mental health of its students and provides supportive resources for our students’ overall wellbeing, including health and counseling services. At times a student may experience medical or psychological conditions that significantly impair the individual’s ability to function successfully or safely as a student. Students are encouraged to prioritize their wellbeing and take steps towards health and stability, even if academic progress must be delayed. The University will support student-initiated self-care plans and/or at times may initiate such plans. In doing so, it will consider both the welfare of the individual student and the University community. 

Integrated Health Assessment Team

Integrated Health Assessment Team (“IHAT”) has been established to assist students who are experiencing a significant medical condition or psychological concern, particularly when it may affect the ability to safely continue as a student at the University. In these moments, the team will assess what is needed to improve a student’s academic and personal success at the University or if a leave/withdrawal would be most appropriate. When making any assessment of student wellbeing, the University will implement an individual assessment model. Members of this team include representatives from the Department of Student Care, the Counseling Center, and the Health Center. Where appropriate, depending on the situation, the team will also include Campus Safety, the Learning Center, Commuter Life, Residence Life, and/or the Title IX Coordinator.

Student situations that might be considered by the IHAT include, but are not limited to, the following:

  • Acute decline in physical health;
  • Suicidal ideation, intent and/or behavior;
  • Self-injurious behavior;
  • Destructive, threatening, or other disruptive behavior (see Community Threat Policy);
  • Drug and alcohol abuse, including overdose or misuse of over-the-counter or prescription medications;
  • Eating disorders which are not responding to treatment and/or are posing safety concerns;
  • Any physical or mental health problem that points to possible imminent or foreseeable danger to oneself or another member of the University community, or requires intensive monitoring to prevent such danger.

In responding to these situations, the IHAT reserves the right to determine appropriate response including, but not limited to, the following options:

  • Allow the student to remain in school, but require a specific physical health or mental health evaluation, within a certain period of time. The student may be referred to the Health Center, Counseling Center and/or off-campus options (e.g., licensed mental health or physical health care providers, eating disorder or substance abuse programs/hospitals). The student will be responsible for any cost incurred by the evaluation and/or treatment. In the interest of gaining a better understanding of the student's ability to function in the University community, the University may require the student to sign appropriate release forms allowing designated Biola staff to consult with the evaluating and/or treating clinician(s) serving the student. Based on the evaluation results, the IHAT will determine appropriate next steps, including the possibility of allowing the student to remain on campus if a commitment is made to the recommended treatment plan. Please note that students who are experiencing suicidal ideation, intent and/or behavior will be required to go through the University’s Suicide Assessment Process (see below).
  • Invoke a Medical Interim Restriction; encourage a Voluntary Medical Withdrawal; or invoke an Involuntary Medical Withdrawal (see below).
  • Notify the student's listed emergency contact and appropriate University officials (e.g., the student's professors, Registrar's Office, etc.) about a mental or physical health or safety emergency.

Procedures

Suicide Assessment Process

To assist in facilitating student safety and community wellness, Student Development administers a formal process of suicide assessment for students who evidence suicidal ideation, intent or behavior. Incidents will be evaluated on a case-by-case basis and will require students who evidence suicidal ideation, intent or behavior to undergo a required assessment through the Biola Counseling Center or other approved provider. Students who are required to participate in the process will not be subject to disciplinary action unless violations of other behavioral or community standards have occurred, or unless the student fails to complete the clearance process discussed below. 

Medical Interim Restriction

The IHAT may invoke a Medical Interim Restriction when a student is hospitalized or presents with a medical or psychological emergency, or during a medical evaluation period. Students who are medically restricted will be notified by a member of the IHAT and will have the opportunity to address the basis for the restriction by contacting their assigned team member. Students who are medically restricted for any health reason are temporarily not allowed to participate in any University activities, attend classes, reside in or visit on-campus student housing, and may not be on campus except to attend meetings related to his/her case. This interim period allows time for a student to receive the needed medical and/or psychological care, and for all parties to consider an evaluation of the student’s readiness to return to the University. The student must follow the clearance procedures imposed before returning. A decision to place a student on a Medical Interim Restriction that does not become an Involuntary Medical Withdrawal (as described below) is not appealable. 

Withdrawals

At times, taking a temporary leave in order to focus on health and wellness is the best option for long term academic and personal success. When students take a withdrawal, Biola’s hope is that they will be able to return once it has been determined that they are in a healthy and safe place. Biola is committed to providing support and resources to help students thrive upon their return. As appropriate, the IHAT will recommend assessment and/or treatment conditions needed to return to Biola. The student must follow the clearance process listed below. 

Voluntary Medical Withdrawal

On occasion, students may experience health needs requiring a level of care that exceeds what the University can appropriately provide. In such circumstances, students may take a voluntary leave of absence. Students are encouraged to request this type of withdrawal when they believe their physical or mental health problems are preventing successful engagement in, and completion of, academic coursework; when safety is in question; or when the demands of university life are interfering with the ability to recover from, or adjust to, a significant physical or mental health challenge. Students interested in pursuing a Voluntary Medical Withdrawal may wish to discuss this option with staff in the Department of Student Care, the Health Center or the Counseling Center. They may also independently initiate the process through the Registrar’s Office or the Learning Center. After the voluntary withdrawal is approved, the person is no longer considered a student and is required to officially check out of on-campus housing (if applicable).

Involuntary Medical Withdrawal

In situations where a student is unable or unwilling to carry out appropriate self-care obligations, where current medical knowledge and/or the best available objective evidence indicates that a student poses a significant risk to the health or safety of others, or where a student poses an actual risk to his/her own safety not based on mere speculation, stereotypes, or generalizations about individuals with disabilities, and the student does not want to take a leave voluntarily, the University has the authority to impose an Involuntary Medical Withdrawal and place the student on a mandatory leave of absence. Before placing any student on a mandatory leave of absence, the University will perform an individualized assessment to determine if there are reasonable accommodations that would permit the student to continue to participate in the campus community without taking a leave of absence. A student wishing to appeal a decision to place him/her on an Involuntary Medical Withdrawal may do so in writing to the Vice President of Student Development (See appeals process below). Examples of situations that might result in an Involuntary Medical Withdrawal include but are not limited to the following:

  • Professional evaluations following a Medical Interim Restriction do not support a student's readiness to return;
  • A student fails to complete the required assessment/clearance process during a Medical Interim Suspension;
  • A known condition has deteriorated (e.g., a student with an eating disorder), rendering the student to be in possible imminent danger and/or incapable of functioning as a student.

Clearance Procedures

Any student who has been placed on a Medical Interim Restriction or an Involuntary or Voluntary Medical Withdrawal will need to complete the following clearance procedures before being allowed to return to the University. The IHAT may also require a student who takes a Voluntary Medical Withdrawal to complete the clearance procedures. The following steps are designed to determine if the effects of a major health condition or concern are either resolved or are not likely to interfere with the wellbeing of the student and Biola community. This would include having in place a treatment plan for continuing good health and safety. Note: Depending on the situation, students may complete these procedures on different timelines. 

  1. The student must be assessed by an appropriate professional, whose opinions will be advisory to the University (“Advisory Provider”). The Advisory Provider shall be selected by the student but must be a licensed psychologist or psychiatrist if evaluating mental health concerns, and must be a licensed physician if the evaluation is regarding other medical concerns. Further, all Advisory Providers must be unrelated to the student and must have specialty/credentials appropriate for the condition of concern (e.g., an eating disorder or substance abuse specialist). To make an accurate assessment, before conducting the evaluation the Advisory Provider must be given information related to the precipitating events that led to the leave. This typically would involve the student signing a release allowing the University (e.g., the Health Center, Counseling Center, or Department of Student Care) to share information regarding relevant incidents or concerns, and if applicable, recent hospital records. The student shall sign a release permitting two-way communication between the Advisory Provider and the University IHAT representatives, and allowing all relevant information to be provided to the University representatives who are involved in the decision-making and review process.
  2. The Advisory Provider must provide an assessment of current functioning of the student and provide written recommendations regarding: a) given the precipitating events, the student's readiness to return to the academic and co-curricular demands of university life; b) the student's readiness to live in the on-campus residential community; c) ongoing treatment or testing needs; d) any conditions, restrictions or accommodations that the University should provide. 
  3. After the evaluation results and treatment documentation have been provided, the student must meet with a IHAT representative. The evaluation, the student's own perception regarding readiness to return, the student’s individual needs, and the plans for treatment will be discussed. Additionally, the representative will consider how the Advisory Provider’s recommendations fit with the realities of student life at Biola and services that are available on campus or in the community.
  4. The IHAT will meet and consider the outside evaluator's recommendation and the results of the student's meeting with the IHAT representative to inform its re-entry decision. Students will receive written notification of the decision.

Notes

  • There may be occasions in which the IHAT requires, and may pay for, an additional evaluation.
  • The IHAT reserves the right to require the student to comply with a treatment plan recommended by the Advisory Provider and/or Biola healthcare/mental health professional as a condition of returning to, or remaining in, the campus community. Review and monitoring of the student's required treatment plan may be assigned to a University designee assigned by the IHAT. Failure to comply with requirements may result in the University issuing an Involuntary Medical Withdrawal.
  • If a student was previously living on-campus, approval for return to the University usually includes approval to return to housing. However, a student's on-campus housing status may be restricted if the student's condition or behavior poses a health or safety threat to him/herself or others.
  • If a student was required to complete specific treatment (e.g, eating disorder or substance abuse treatment), the student must provide documentation regarding the completion of this requirement. Biola reserves the right to use reasonable efforts to verify the accuracy and reliability of the provided documentation before deeming the requirement completed.

Appeals Process

Students may appeal the decision of an Involuntary Medical Withdrawal on the basis of: (1) newly discussed facts that were not known or not reasonably available at the time the decision was made and the new information is sufficiently material that it would impact the decision; or (2) if the process was unfair or inequitable. Once notified in writing of the Involuntary Medical Withdrawal, the student has five business days to submit his/her appeal. The appeal must be made in writing to the Vice President for Student Development. Appeals should state what facts the student believes were not considered and when they were learned, or explain what procedures he/she believes were unfair. The Vice President (or designee) will respond to the student in writing with his or her decision within five business days. The Vice President's (or designee's) decision is final.

Additional Considerations

Academic Credit, Tuition and Housing and Residence Life

For all approved medical withdrawals, the student will receive W’s on the academic transcript (or, if the withdrawal occurs during the add/drop period, will be completely dropped from classes, without any notation on the transcript of having left for medical reasons). Thus, a medical withdrawal will not affect the student's grade point average. Upon withdrawing from the University, students are subject to the student housing and meal plan cancellation policy. It is the student’s responsibility to contact Housing and Dining Services to inquire about the cancellation policy. A student should contact the Registrar and Financial Aid/Accounting Offices for questions regarding transcripts and tuition.

Financial Hardship

Every effort will be made to consider a student's financial situation and insurance coverage in making referrals for treatment or evaluation. Students who may need additional financial assistance or other consideration in meeting the requirements should let his/her IHAT member know about his/her needs.

Community Threat

Biola University seeks to provide a safe and healthy environment in which all members of the University Community are able to pursue their academic and personal development. In doing so, it reserves the right to implement a process, which may culminate in the temporary removal, interim suspension, suspension or dismissal of any student in circumstances seriously affecting the health or wellbeing of all members of the University community, or where physical safety is seriously threatened. Additionally, the University may seek action to prevent any member of the University community from jeopardizing the educational process.

Danger to University Community

Danger to the health or safety of the University community is defined as any act, or planned act, that places any student, member of the administration, faculty or staff, or any campus visitor at reasonable risk of bodily harm, exposure to illness, loss of life, or destruction of property. Further, a student may be considered to pose a direct threat to the health of others if current medical information indicates that the student's behavior and/or medical condition could reasonably expose others to illness or disease. This exposure risk must exceed that commonly found in community environments and would include a student's possession of a presently contagious illness or disease and/or failure to maintain appropriate hygiene.

Jeopardizing the Educational Process

Jeopardizing the educational process is defined as any disruptive act that within reason impedes a student's functioning within an academic or community life setting. A violation may include a single disruptive act or ongoing acts and will usually involve complaints from students, faculty, or staff. In determining violations, an assessment will be made of the nature of the disruption, the content and frequency of the complaint(s), and the number of complainants.

University Response

While Biola University expects all students to meet its Standards of Conduct, it recognizes that some students possess medical or psychological conditions that may affect functioning within these Standards. Additionally, students may not be discriminated against on the basis of verified physical or psychological disability as determined according to applicable federal and/or state law provided that they remain otherwise qualified, which is defined as being able to meet the fundamental academic and behavioral standards of the University. When making any assessment of a student’s wellbeing, the University will implement an individual assessment model. These models will assess observable conduct that affects the health, safety, or welfare of the campus community. Biola adopts a holistic approach, which utilizes available individual medical documentation from appropriate University professionals as well as the assessments of the student’s treating health care professionals.

If medical or psychological intervention is needed to secure the wellbeing of members of the University community, the University may choose to offer the student a variety of voluntary options prior to any involuntary action imposed by the University. If the student fails to meet the behavioral standards or refuses to accept voluntary action, the University may take action up to, and including, suspension or dismissal. However, involuntary removal is to be used only in emergency or direct threat situations determined based on a reasonable assessment of the current circumstances.

In any University investigation, the student has a right to a fair and reasonable process that attempts to secure the health and safety of the University community and respects and considers the student’s interests. A student facing voluntary or involuntary action will be given notice by the Vice President of Student Development or his/her designee of all concerns and proceedings against him/her. Additionally, the student will be given an opportunity to present information on his/her behalf. Furthermore, if the student is unsatisfied with the University decision, he/she may file a complaint or appeal pursuant to the appropriate University process stated in the student handbook.

Return Policy

Subsequent to action taken by the University addressing a danger or threat to the University community by a student, whether voluntarily undertaken by the student or involuntarily imposed on the student, the individual student will be required to proceed through a clearance process before returning to enrollment, residential living, or other University activities. The process will be based upon an individual assessment of the circumstances surrounding the student and actions taken. The University retains broad discretion in imposing requirements for students to rejoin the University community in order to ensure the entire University community remains in a safe, healthy, and encouraging environment. Any “behavioral contract” will include terms tailored to the individual student to whom it applies.

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