In part one of this Tip of the Week series, we explored insights from the 2024 State of the Field Survey related to the structural aspects of team organization and formation. Now, in this second part, we turn our attention to the procedural elements, exploring how these teams function and collaborate.
Process Elements
NABITA’s survey evaluated respondents on their team’s processes, emphasizing the importance of objective, fair, and effective approaches to referrals. It examined every stage, from receiving and reviewing referrals to conducting meetings, assessing risks, managing cases, and maintaining records. Below, we highlight where teams align with the NABITA Standards, enabling teams to operate efficiently and seamlessly.
Referral Receipt and Review
The survey showed trends in how teams receive, review, and manage referrals. Nearly all respondents indicated using online referral or reporting forms as the primary referral method, supplemented by additional methods like direct emails, phone calls, and in-person conversations. This trend has remained consistent over the years. Surprisingly, few individuals reported using mobile apps despite the widespread availability of mobile technology. However, anonymous referrals are widely embraced, offering an additional layer of accessibility.
When reviewing and triaging referrals, most teams have a designated staff member, typically the team chair or case manager, managing this crucial task. This aligns with the Standards by ensuring a designated staff member reviews and triages referrals for urgent needs each workday. It demonstrates a strong commitment to taking swift action when necessary.
Want more good news? Many referrals are for low-risk behavior, allowing for early intervention that can prevent crises before they escalate. Emotional and mental health concerns are ranked as the top reasons for a referral or report, followed by academic, financial, and basic needs. This proactive approach to mental health strengthens prevention efforts and makes our communities safer.
Meeting Operations
Preparing for team meetings is a key function of a team’s success. Many teams enhance preparedness by sharing meeting agendas, providing access to referrals and case details, and holding weekly meetings. Almost all respondents noted adding emergency meetings as needed to address urgent matters. NABITA considers the ability to convene these meetings—whether in person or through tele/video conferencing—a best practice.
Risk Assessment
We were delighted to learn that 82.5% of respondents assess risk using an objective measurement tool. Nearly all of those respondents reported using the NABITA Risk Rubric as their objective measurement tool for general risk assessment.[1] Using an objective tool or risk rubric, applying it to all referrals and case discussions, and documenting the risk rating is a NABITA Standard. By objectively measuring risk, teams mitigate bias, reduce the likelihood they will over- or under-react to a case, and create a shared language for case discussions.
Most teams also incorporate advanced risk assessments, such as psychological and violence assessments. While threat assessments are excellent for establishing immediate safety concerns, psychological and violence risk assessments provide an opportunity to gather additional information about an individual’s broader risk. Most respondents’ teams engage in psychological assessments when they need to understand an individual’s risk of violence from suicidal ideation, self-harm, disconnection from reality, or other mental health conditions. The Standards recommend prioritizing violence risk assessments, which focus on potential threats to others and consider various risk and protective factors. Ninety percent of respondents reported using in-house staff for these assessments.
Interventions
The Standards emphasize the importance of defining available and appropriate interventions for each risk level outlined in the selected rubric. However, this is only the first step. Risk ratings should be used strategically to inform critical decisions, such as initiating mandated assessments, conducting welfare checks, contacting emergency contacts, creating case management plans, and determining how to follow up with referred individuals.
Most respondents demonstrated alignment with the Standards, ensuring BITs do not have the authority to issue an interim suspension, administrative leave, or other temporary requirement/restriction. Instead, BITs function as information hubs, updating the appropriate departments to support informed decision-making. While the line between providing information and making formal recommendations can be subtle, ensuring all procedures are grounded in due process, fairness, and equity is essential.
Case Management
The survey explored how teams assign cases for follow-up and what type of access they have to a designated Case Manager. An impressive 90% of teams align with the Standards by assigning individuals to coordinate follow-up on cases and interventions. This approach increases the likelihood of successful interventions and strengthens the connection with the referred individual, making a real difference where it matters most.
Most respondents have access to a Case Manager, but the Standards caution against assigning all case follow-ups exclusively to them. Not only does this practice contribute to potential burnout for the Case Manager, but it also overlooks the multidisciplinary nature of BITs. Other staff members may possess specific expertise or stronger relationships with the individual, making them better equipped to oversee follow-ups and coordinate effective interventions. Most Case Managers are typically within the Dean of Students or Student Services office. Clinical Case Managers are usually part of the counseling or health center, while non-clinical Case Managers are often in Student Services or a stand-alone office.
The Standards recommend that teams use a standardized protocol for deciding when and how to close a case and documenting whether a case stays open or moves to a closed status. For the 11% of teams that don’t determine open or closed case status, now is the time to adopt the practice. As for the third of teams without a set protocol, formalizing the process with written guidelines can improve the quality of case management.
Recordkeeping
Nearly all respondents reported relying on an electronic database or software program to track BIT referrals and cases. The Standards emphasize the importance of including key details in team records, such as the issue of concern, the individual’s name, and their referral history. Additional information like ongoing case notes, intervention plans, the assigned Case Manager, and risk ratings help illustrate how the team addressed each concern. Detailed documentation provides a valuable reference if the individual is referred again and ensures the team can confidently show that every case was managed carefully and precisely.
What This Means
The responses highlight the critical need to align with NABITA Standards to ensure fair, consistent, and effective practices in risk assessment, intervention, case management, and recordkeeping. By adopting objective tools and standardized protocols for every referral while promoting multidisciplinary collaboration, BITs can better navigate complex cases and provide meaningful support to students of concern. Upholding these principles not only strengthens safety and well-being but also fosters trust within the community. To achieve long-term success, teams must remain proactive, informed, and committed to continuously refining their practices.
[1] The NABITA Risk Rubric is a research-based expert system tool useful for the initial triaging of mental health concerns and threat potential.
[View source.]
