Treatment Referral of Substance Abusing Students
Treatment Referral of Substance Abusing Students
1. INTRODUCTION
The starting point of Tampere University of Applied Sciences' substance abuse programme for students is to support student wellbeing. The substance abuse programme aims at an intoxicant-free studying environment, prevention of problems, recognision of substance abuse, and early intervention. The substance abuse programme also aims at increasing awareness of intoxicants' effects on individuals' wellbeing, studying and working life.
Intoxicants stand for alcohol, tobacco, drugs, as well as medicines and solvents used for the purpose of intoxication. The programme focuses on the use of alcohol and drugs. Tampere University of Applied Sciences also strives for becoming non-smoking. The injurious effects of smoking are well-known and the aim is to gradually reduce smoking.
One of the values directing TAMK's operation is sense of community. It includes joint responsibility, which is also emphasised in the substance abuse programme. Tampere University of Applied Sciences does not support or favour behaviour which encourages intoxicant use. Sense of community promotes intoxicant-free operation. When community members care about each other, they also notice substance abuse and intervene in it as early as possible and if necessary the student is referred to appropriate treatment.
The university of applied sciences' substance abuse programme is published for applicants and students in the university of applied sciences' study guide. As regards staff, TAMK follows the substance abuse programme for staff.
TAMK works for the best of students and working life. Competences given by the UAS education include taking care of personal working and studying ability.
2. SUBSTANCE ABUSE PROGRAMME STRUCTURE AND CONTENTS
Tampere University of Applied Sciences' multiprofessional student wellbeing group is in charge of constructing the substance abuse programme for students and promoting preventive substance abuse work. The student union Tamko and student health care participate in the student wellbeing group.
The substance abuse programme describes TAMK's procedures related to substance abuse situations, treatment referral guidelines, and different roles and duties in the programme implementation. The programme also describes potential sanctions and discipline related to substance abuse. The following table describes the substance abuse programme as a whole, different process phases, and duties (table 1). The table refers to the concerned section of the substance abuse programme. The SORA (solutions to unsuitability) legislation applies to applicants and students in the field of health care and social services. Its implementation is partly included in the substance abuse programme.
Table 1. Implementation of substance abuse programme for students at TAMK
| Student union Tamko and student tutors | Staff | Student health care | |
| PREVENTION OF SUBSTANCE ABUSE PROBLEMS AND EARLY INTERVENTION |
Tutor education
Informing
Promotion of intoxicant-free student culture
Wellbeing week
Early intervention |
Student counsellor in health care and social services: At the application phase informing and guidance related to health and functioning ability, student's health statement
Teacher tutor and student counsellor: Informing
Teacher tutor: Guidance and development discussion
All: Caring and expression of concern Early support If necessary contact to the student counsellor |
Online health survey during the first study year
Health examinations
Student health care's info for first-year students during the orientation week
Early recognition at the appointment and follow-up
Audit surveys |
| PROCEDURE WITH INTOXICATED STUDENTS |
1) Asking the intoxicated student to leave TAMK facilities, 2) The student is informed about the possibility to prove (s)he is sober. Student health care is contacted. 3) Notification of deviant situations (appendix 2) |
||
| INTERVENTION AND BROACHING IN RISK USE | Recognition and referral to student health care |
Student counsellor: Broaching and referral to student health care (appendix 3) |
Short intervention
Audit survey |
| DRUG TESTING |
Referral to drug testing on the head of degree programme's or director of education's decision
In the field of health care and social services, starting of the study entitlement cancellation process in accordance with the SORA legislation if necessary |
Completion of drug testing | |
| REFERRAL TO TREATMENT |
Student counsellor: referral to treatment and follow-up of situation
In the field of health care and social services, starting of the study entitlement cancellation process in accordance with the SORA legislation if necessary |
Expertise in referral to treatment
Planning and follow-up of treatment and rehabilitation |
|
| RETURN TO STUDY COMMUNITY AFTER INTERRUPTION OF STUDIES | Student community: Support to ensure successful return |
Support to ensure successful return
Student counsellor: plan on how to continue the studies, individual study plan |
Follow-up of treatment |
| SUBSTANCE ABUSE SANCTIONS AND DISCIPLINE |
President: written warning (TAMK's Disciplinary Regulations 9 §)
Board of TAMK: fixed-term expulsion, cancellation of study entitlement (TAMK's Disciplinary Regulations 9 §)
In the field of health care and social services, starting of the study entitlement cancellation process in accordance with the SORA legislation if necessary (and when the grounds no longer exist, potential return of the study entitlement) |
3. PREVENTION OF INTOXICANT-RELATED PROBLEMS AND EARLY INTERVENTION
Tampere University of Applied Sciences is committed to ensuring all students and employees have a safe, healthy and productive working and studying place. The substance abuse programme also contributes to this. Preventive substance abuse work is a part of wellbeing and health promotion and aims at preventing intoxicant-related problems and supporting intoxicant-free life style.
Even if individuals' responsibility for their decisions should be emphasised, the higher education community also has an important role in prevention of substance abuse problems and early intervention. All staff members and students have to take care of other members of the community when notising intoxicant-related problems. Early intervention means that substance abuse consequences are noticed, they are intervened, and solutions are searched as early as possible.
3.1 Student union Tamko's and student tutors' role in preventing intoxicant-related problems
The student union Tamko participates in promoting Tampere University of Applied Sciences students' wellbeing through preventive substance abuse work. Tamko informs students of local and national campaigns and organisations which aim at promoting intoxicant freeness and social drinking only. The student union encourages to intoxicant freeness and organises intoxicant-free events as a part of its operation. Substance abuse work is also discussed during Tamko's annual student wellbeing week.
From their first study day all students have a student tutor. The student tutors may be peer, degree or international tutors. The student tutors introduce students to the student community at the beginning of the studies and preventive substance abuse work has a role in it. Abstinence from alcohol and drugs is also encouraged in student tutoring and the student tutors can work in accordance with the substance abuse programme.
Students often spend leisure time together, work as a group during the studies, and see each other's everyday life from nearby. That is why they are often the first to notice a substance abuse problem. Student tutors or fellow students can express their concern for substance abuse to the student and if necessary to Tamko's tutor coordinator, teacher tutor or student counsellor. Students are also encouraged to broach their suspicion or concern for a teacher's or other staff member's substance abuse.
3.2 Staff's role and duties in implementation of substance abuse programme
All students have a teacher tutor from the beginning of the studies. The teacher tutor is the student's closest supervisor. Teacher tutors meet their students both individually and in groups. The teacher tutor goes through the substance abuse programme with the students at the beginning of the studies. The student's wellbeing and resources are also discussed in the individual meetings. If necessary, the teacher tutor broaches substance abuse, as well as its effects on completion of the studies and student wellbeing.
If the higher education staff have reason to believe that a student has a substance abuse problem, it has to be broached and intervened in immediately. The detailed guidelines for such situations can be found in the sections 5 and 6.
In the field of health care and social services, applicants are in advance informed of health and other requirements. It is stated that the field is not applicable for drug users or problem users of alcohol or medicines. They are also informed of in which situations they have to present an extract from the criminal record or a drug test certificate. The applicants themselves assess their state of health and functioning ability and bring a health statement to the entrance examination.
3.3 Student health care's duties and responsibilities
Student health care makes a health survey for new students and based on the responses invites students to a health examination, if necessary. Other students are also offered the possibility to have a health examination. Substance use is always discussed during the health examination. The Audit test is used to map risk use of alcohol and drug abuse is asked in detail. The study time and related leisure activities, such as parties, and the risk of increasing alcohol use are discussed with the student.
If based on the substance abuse mapping completed in student health care the student's alcohol abuse risks have grown, the means to reduce them are considered together. If the risks are high or the public health nurse is otherwise concerned about the student, follow-up visits are agreed on or the student is referred to treatment. If necessary, the public health nurse refers and encourages the student to discuss study-related matters with the student counsellor or teacher tutor.
Substance abuse may also come up in connection with another student health care visit, particularly if the student is often ill or has problems with e.g. completion of studies, mood or relationships. The student health care aims at recognising risk use and related symptoms as a part of everyday health care and nursing.
4. RECOGNITION OF INTOXICANT-RELATED PROBLEMS
It is sometimes difficult to recognise or admit personal or some other community member's substance abuse problem. In the higher education community, related information and education sessions should be organised for both students and staff and the matter should be discussed at different forums. Everyone should know and recognise when it is about risk and problem use with clear intoxicant-related problems. As regards alcohol it is essential to recognise problem use. The aim is to recognise drug use already at the experiment and random use phase.
Substance abuse may show as:
- Difficulties in following agreed timetables due to dubious reasons.
- The student explains his/her absences in an avoiding manner and it is difficult to contact the student to establish the situation.
- The student has difficulties in arriving at or participating in learning and education situations in the mornings.
- A clear change has taken place in the student's behaviour or being. The student may behave in an inappropriate or rogue manner, e.g. aggressively.
- The student is anxious or restless in a manner that concerns people working with him/her.
- The student's substance abuse restricts everyday activities, harms relationships or impedes academic progress.
- The student is intoxicated or repeatedly crapulent in study-related learning situations
5. PROCEDURES CONCERNING INTOXICATED STUDENTS
In accordance with TAMK's disciplinary regulations, a person may be asked to leave TAMK facilities if suspected of being intoxicated. Every TAMK community member has the responsibility to act personally or notify caretakers immediately. The appendix 1 includes guidelines for intoxicant-related problem situations taking place at the higher education institution's facilities or education situations. An attending staff member reports the deviant situation through an online form (appendix 2).
If the student feels that the intervention or discussion on the matter is unjustifiable, (s)he has the right to prove that (s)he is sober by immediately going to a test in student health care.
6. INTERVENTION IN AND BROACHING OF RISK USE
Risk and problem use situations and their handling require responsible action which considers confidentiality, safety and all attending persons' dignity and equivality. It is important to ensure the student's legal protection at all phases and prevent branding.
After observing risk or problem use, the first phase is immediate intervention. The observer has the obligation to intervene, which means preliminary discussion. Attention should be paid on the safe environment of the discussion already at this phase. The observer tells about his/her observations to the student. The observer also tells that (s)he will notify the student counsellor.
The student counsellor continues the discussion with the student (broaching). The student counsellor contacts the student who has been seen intoxicated in TAMK's facilities, physical or virtual education situations or practical training and whose substance abuse has led to other problems (see section 4) for the broaching discussion. The enclosed broaching form (appendix 3) is used as the framework and help in the broaching discussion. The discussion is also documented with the form. The aim is to find a joint understanding for further action. The discussion atmosphere is open and appreciative, the concerning observations and the student's viewpoints on the situation are gone through. The student counsellor and student can together contact the student health care or the student can do it by himself/herself. The student counsellor may contact the student later to follow the situation.
In the field of health care and social services, it is possible to start the study entitlement cancellation process if the student's behaviour raises suspicion of the student not being suitable to social services and health care education. If necessary, the director of education refers the student to closer health and functioning ability examinations and requests the student to submit other further clarifications, such as a drug test certificate.
7. DRUG TESTING
Students who are under the influence of alcohol are asked to leave, they are not breathalysed at Tampere University of Applied Sciences. If the person is suspected of a crime, such as a drunk-driving, the police is to be called. In practical training, the training place's testing rules apply in addition to TAMK's guidelines.
If the student is suspected of using drugs and the student has denied it in the broaching discussion and refused to seek treatment, TAMK may oblige the student to present a drug test certificate when there are grounds to suspect that the student is under the influence of drugs in study-related practical duties or practical training or that the student has a drug addiction. Further prerequisites are that testing is necessary to establish the student's functioning ability and that the student works in duties which require particular precision, reliability, independent judgement or good reaction ability and where working under the influence of drugs
1. seriously endangers the health and safety of the student or other people
2. seriously endangers traffic safety
3. seriously endangers confidential data protection or integrity, or
4. significantly increases the risk of illegal traffic and distribution of drugs in the possession of the university of applied sciences, its maintaining organisation, or the training place. (Polytechnics Act 2014/932, 36 §.)
A justified suspicion may be a teacher's or training supervisor's observations of the student's behaviour or other people's reliable feedback.
The director of education decides on sending the student to drug testing. In the training place the superior and the teacher in charge of the practical training are responsible for sending the student to drug testing after consulting the director of education. The practical training is interrupted until the drug test is ready. The student's functioning ability is assessed in the higher education institution or training place by filling in the form Data Transfer to Health Care (appendix 4) and describing the functioning ability in a free form. The student immediately goes to the student health care with the form and is sent to laboratory testing. If the student does not have a picture ID, a representative of the higher education institution or training place has to attend the testing situation to reliably prove the student's identity.
The director of education or a person authorised by the director of education informs the student health care if TAMK has obliged a student to present a drug test certificate. The drug test is made by the health care staff assigned by the higher education institution. The drug test certificate includes an account of if the student has used the drug for other than medical purposes in such a way that his/her functioning ability has weakened. The certificate is given in written to the tested person. The tested student presents the written certificate to the head of degree programme during the prescribed time. Tampere University of Applied Sciences pays the certificate expenses.
The drug test certificate includes delicate information referred to in the Personal Data Act, 11 §. Special attention has to be paid on confidential processing of the treatment referral and drug use data and careful disposal of testing certificates as soon as possible.
8. REFERRAL TO TREATMENT
If substance abuse impedes studying or the student is at risk of forming an addiction, referral to treatment is agreed on in the broaching discussion. Independent recognition of substance abuse and seeking of treatment promote treatment success. The study community members have to encourage the substance abuser to seek treatment as the primary objective is to encourage independent and voluntary seeking of treatment.
The student counsellor invites a case specific working group for referral to treatment. It comprises the student counsellor, student, student health care representative, and if necessary other concerned, such as a support person suggested by the student. In referral to treatment, the seriousness of the problem is established and the necessity of treatment is agreed on. Completion of the studies is agreed on as regards the treatment period and the effects of potential interruption of studies on subsistence are discussed. The student health care is an expert in treatment referral and is in charge of the treatment plan and its follow-up. If necessary, the student health care makes a rehabilitation plan for the student in cooperation with the student and university of applied sciences.
9. RETURN TO STUDY COMMUNITY AFTER INTERRUPTION OF STUDIES
Substance abuse probably affects the student's academic progress and thus subsistence. The effects can extend to recruitment to working life and the student's whole life. If the studies have been temporarily interrupted the whole university of applied sciences community comprising both students and staff should promote the student's return to a member of the community even after difficult situations. Successful return to the higher education institution and studies after a long absence requires activeness from the student but often also support from the teacher tutor and student counsellor in cooperation with the student health care. It is important to make a return plan to the studies with the student counsellor to ensure the student receives enough supervision and support and a concrete plan for completion of the studies.
10. SUBSTANCE ABUSE SANCTIONS AND DISCIPLINE
Discipline and other sanctions are based on the existing legislation, TAMK's degree regulations, and TAMK's disciplinary regulations.
If a person is suspected of being intoxicated, (s)he can be asked to leave TAMK's facilities. TAMK can oblige the student to present a drug test certificate if there are justifiable grounds to suspect the student is under the influence of drugs in study-related duties or practical training or the student has a drug addiction.
A warning may be given to the student if (s)he refuses to present a drug test certificate. If the deed or neglect is serious or if the student continues the above-mentioned behaviour after a written warning, the student can be expelled from the university of applied sciences for a fixed-term period, for a year at the most. The president decides on the written warning and TAMK's board on the fixed-term expulsion. TAMK's board decides on cancellation of the study entitlement.
In the field of health care and social services, substance abuse may start the study entitlement cancellation process in accordance with the SORA legislation. If the study entitlement has been cancelled on health or functioning ability grounds and the student demonstrates that the grounds for the study entitlement cancellation no longer exist, the student can apply for return of the study entitlement. The guidelines can be found in the SORA procedures in Compass.
APPENDICES
Appendix 1. Guidelines Concerning Suspicion of Being Under Influence of Intoxicants
Appendix 2. Substance Abuse Broaching Form
Appendix 3. Data Transfer to Health Care
Appendix 4. Treatment Referral Agreement
Appendix 5. Treatment Referral Plan in Student Health Care