Psychological Counseling and Guidance Center - Emergency Guide

There are certain emergency situations (most often involving a risk of the student harming themselves or others) that require immediate attention and action. Emergency situations may include:

A)A high level of aggression and/or a risk of harm to others (intentionally, due to impaired thought processes, or through neglect)

B)Strange behavior and speech indicating a loss of contact with reality (confusion, disorientation, disorganized thinking, delusions, hallucinations, incoherent or strange speech)

C)Intoxication – if the student is under the influence of alcohol or other substances

If you have suspicions of this kind, ask the student directly whether they are intoxicated, whether their thoughts are cloudy/confused, or whether they have thoughts of harming themselves. By asking, you will not “put thoughts into the student's head” that were not there. Knowing that someone has paid attention to and noticed their difficulty will be a relief to many students.

D)Suicide risk and attempts – if the student is threatening to harm themselves, talking or writing about it, or making implications; if they are openly talking about suicide; or if there are implicit nonverbal messages such as giving away belongings and/or saying goodbye.

WHAT TO DO IN CASES OF SUICIDE RISK OR ATTEMPTS:

I. Responsibilities of PDRM in Responding to Suicide Cases:
Any attempt by a person against their own physical integrity is a medical condition, and in such cases immediate medical first aid is required. In suicide cases, the student is referred to a psychiatric service at the healthcare institution to which they are taken. After the necessary “medical and psychiatric” interventions regarding the student's physical and mental health have been carried out, an evaluation is made, and if follow-up at the university counseling center is appropriate, the student may also be followed by PDRM psychologists in addition to psychiatric treatment.

a) If a student attending individual sessions at PDRM mentions suicide to the psychologist during the sessions:

• A risk assessment is carried out.
• If the risk level is low, a verbal or written contract is made with the student stating that they will not harm themselves, and they are referred for psychiatric support (if the student does not agree to see a psychiatrist, the family is informed after notifying the student).
• If the risk level is moderate or high, the family and the relevant administrative person are informed after notifying the student (at the beginning of counseling, all students read and sign a consent form stating that the principle of confidentiality will be waived when there is a possibility of the person harming themselves or someone else), and the process of urgently referring the student to a hospital psychiatric service is initiated.
• After the initial intervention, a joint evaluation is made with the psychiatric service, and if follow-up at the university counseling center is appropriate, the student is also followed there.

b) If it is learned through a third party (friends, academic or administrative staff) that a student has thoughts about suicide:

• The person who learns of these thoughts encourages the student to seek psychological help/support and refers them to PDRM. If the student agrees to individual sessions, PDRM psychologists carry out the necessary evaluation and the steps in item (a) are followed.
• If the student refuses the session, PDRM shares the situation with the family or close relatives and makes the necessary notifications (the principle of confidentiality does not apply when there is a possibility of the person harming themselves or others).
• At every step of the crisis intervention, the relevant individuals/units must stay in contact with one another. However, it should not be forgotten that, unfortunately, it is not 100% possible to prevent suicide even if the person is receiving psychological or psychiatric treatment!

c) If a suicide attempt has taken place on campus or in a dormitory:

Medical Intervention:

Any attempt by a person against their own physical integrity is a medical condition, and in such cases immediate medical first aid is required. The medical intervention includes first aid and life-saving procedures for the life-threatening condition of the student who has attempted suicide.

• In suicide attempts occurring in dormitories or on campus, the initial intervention is carried out by a doctor or nurse at the institution or at a healthcare facility/hospital outside the institution.
• Regardless of the extent of the suicide attempt, the student's family must be informed of the student's condition. When there is a possibility of a person harming their own or someone else's physical integrity, being over 18 years of age does not prevent the family from being informed.

II. If the emergency situations listed above occur on campus during working hours:
If you think the student may physically harm themselves or someone else at any moment, immediately contact PDRM, the Infirmary and/or the Security Unit. In such situations, the student's safety and physical health come first. Therefore, please do not hesitate to share the student's situation with the necessary people out of concern that you will betray the student's trust or upset them. Also, do not leave the student alone until you have ensured that they meet with a specialist from PDRM or the Infirmary.

Security Unit Contact Numbers

South Campus: 0212 381 0909/0911/0912

North Campus: 0212 381 0925/0933

Galata Campus: 0212 381 0908/0910
Göztepe Campus: 0216 381 8194/8195

Infirmary/Health Unit Contact Numbers

South Campus: 0212 381 0965

North Campus: 0212 381 0961/0967

Galata Campus: 0212 381 0964
Göztepe Campus: 0216 381 8172

If you encounter such a situation on campus outside working hours:

The best option is to contact the Security Unit and the Dean of Students Office and, with their help, take the student to the nearest hospital. Support may be obtained from the Infirmary if necessary.

The student should be referred via 112 Emergency Services to the nearest healthcare facilities (Taksim Training and Research Hospital, Şişli Etfal Training and Research Hospital, Istanbul Beşiktaş Sait Çiftçi State Hospital, etc.).

If the student lives in a dormitory, make sure the Dormitory Management is also informed of the situation.

If one of these situations occurs off campus:

Make sure the student is not left alone and is referred to the nearest healthcare facility, or, depending on the situation, contact 112 Emergency Services, 155 Police Emergency or the Dean of Students Office for administrative support, and finally inform the student's family.

References

American University Counseling Center

Bilgi University Psychological Counseling Unit, Guide to Helping Students for Academic Staff

Brooklyn College Personal Counseling Program University of Dayton Counseling Center

Kansas State University Counseling Services

Mersin University Psychological Counseling and Guidance Center, Guide for Student Advisors and Faculty Members on Referring Students to Psychological Help

New Mexico State University Counseling Center

Okan University Psychological Counseling and Education Center (OPDEM), Emergency Procedures Protocol

The George Washington University Counseling Center

Psychological Counseling Handbook at the University, Eds. F. Yurtseven, M. Paker