Mental Health Incident - Emergency Guidelines

1. Purpose

   UCT offers a trauma response procedure/protocol which

   1. enables UCT to respond to the needs of employees following work-related traumatic events.
   2. ensures that UCT meets its statutory and ethical requirements.
2. Scope

   This procedure applies to all personnel employed by UCT.

   Should a serious traumatic event happen, it is likely that both students and staff will be impacted. Thus a combined response from student and staff support services will be required.

   The procedure application will include:

   1. Traumatic and/or violent events on campus, such as employees being the victim of or witnessing incidents such as rape, shooting incident, suicide, assault, violent fights, or serious injuries while on duty.
   2. Work-related off-campus events, such as hijacking of staff who are on UCT business when the event occurs.
   3. Emergency health/medical related events, e.g. stroke, heart attack.

   The procedure application will exclude:

   1. People who experience trauma in their private capacity. Should such individuals approach UCT for help, an appropriate and caring referral process does however need to be followed.
3. References

   The Compensation for Occupational Injuries and Diseases Act (COIDA) 30 0f 1993 (as amended, with regulations)

4. Principles
   1. UCT internal resources will provide first-line support, and refer people to external resources if and when necessary.
   2. In the case of a rape or serious sexual assault case, an outsourced offsite service provider, Rape Crisis or The Trauma Centre (Cape Town), can be employed to be the first line of support and post trauma counselling support. This will be a confidential service with only the occupational health medical practitioner involved in the submission to COIDA. UCT will only receive statistics, trends and appropriate risk management information from the service provider.
      Rape Crisis: 24 hour number - 021 447 9762
      The Trauma Centre: 021 465 7373
   3. In the case of criminal events, the protocols of SAPS will take precedence over UCT's trauma response to ensure that the opportunity to gather evidence is not lost. UCT will however support trauma victims and witnesses whilst they are interviewed by personnel of SAPS.
   4. Compliance with statutory and ethical requirements will at all times be maintained.
   5. The University will facilitate and bear the cost of the appropriate professional services to address post-trauma response to any victim/survivor/witness directly involved at the scene of the incident. The extent of this support is outlined in the trauma response procedure.
   6. The sensitivity and confidentiality of the case/incident will be maintained at all times without compromising the importance of the health and safety of the greater University community.
   7. The University will conduct an ongoing review of all incidents to establish mechanisms to prevent further such incidents from occurring, and thereby enhancing the safe and fulfilling work environment of this world-class African University.
5. Process

   The process following a work-related violent or traumatic incident is as follows:

   1. The victim(s) or the first person to assist at the scene will notify Campus Protection Services on x2222 or x2223. Should the event warrant immediate response e.g. medical emergency, Campus Protection Services will initiate the action needed e.g. contact ER24, Fire department, On Campus Paramedics, Kaelo, Netcare 911 and SAPS.
   2. Campus Protection Services will notify a member(s) of the Immediate Response Support Team (IRST). The members are:
      1. Communications department; 
      2. Human Resource Department, Organisational Health (Blanche Claasen-Hoskins and/or Susan Williams.)
      3. Occupational Health and Safety (Michael Langley and Sue Key)
   3. The IRST member(s) offer support, assess the situation, contain the trauma victims and/or witnesses, and refer them for appropriate post-event professional counselling.
   4. In the case of sudden death of a staff member, contact Blanche Claasen-Hoskins on x5685 or blanche.claasen-hoskins@uct.ac.za for a referral for post-trauma counselling.
   5. The Line Manager/HOD will accompany the person(s) to official bodies such as Campus Protection Services, SAPS (to report a crime), trauma unit or trauma clinic.
   6. Once all official activities are completed, the Line Manager/HOD must ensure that the victim is not abandoned. The victim should be accompanied home or to a place where the victim feels safe.
   7. The Line Manager/HOD will keep in contact and provide support to the affected people until the case is closed.
   8. For all cases, an incident report (on an annexure 2 form) should be filled in by the Health and Safety representative.
   9. Following each incident, a risk analysis will be conducted together with appropriate and reasonable follow-up action, provided by risk management.
   10. If appropriate, e.g. in the case of an injury or event meeting the COIDA criteria, a COIDA case will be opened.
       1. The COIDA process is:
          • An employee accident report (WCL2) is to be filled in by the relevant Health and Safety representative and line manager. If this cannot be completed at the time of the event, it may be executed retrospectively and processed as a standard COIDA process.
          • The victim(s) will be referred to a medical practitioner/trauma unit for assessment and treatment, and a first medical report will be completed by the treating professional practitioner. Should the medical practitioner deem it necessary, the victim(s) will be referred for post-traumatic counselling.
          • The victim(s) will have to be referred to a post traumatic counselling facility accepted by COIDA (a psychologist or GP trained in post traumatic counselling).
   11. If appropriate, e.g. no physical injury, the victim will be referred by the IRST member to the trauma clinic and the occupational health medical practitioner will complete the first medical report retrospectively.
       1. On a case to case basis, either the criteria for COIDA acceptance will be applied or the medical advisor of COIDA will be consulted, in order to ascertain whether the case is eligible for submission to COIDA.
       2. The victim will have to be referred to a post-traumatic counselling facility accepted by COIDA (a psychologist or GP trained in post traumatic counselling).
       3. Should post traumatic stress disorder be suspected, even up to four weeks post-event, the victim will be referred to a psychiatrist for assessment and confirmation of diagnosis. A report will be forwarded to COIDA. Any management and further treatment may remain with the attending professional service provider, but monthly progress reports will have to be submitted to COIDA.
   12. Three post-traumatic counselling sessions with an approved service provider will be paid for by the University. The cost will be recouped once the claim has been accepted by COIDA. If the claim is not accepted by COIDA, any other costs incurred will either be covered by the victim's medical aid (when applicable), or for own expense.
   13. In the case of a rape or a serious sexual assault, the following alternate process can be used:
       1. The victim(s) may make immediate contact with The Trauma Centre/Rape Crisis, as this is the approved immediate response support service provider.
          Rape Crisis: 24 hour number - 021 447 9762
          The Trauma Centre: 021 465 7373
       2. The Trauma Centre/Rape Crisis support response will provide emergency response and containment, which includes accompanying the person(s) to official bodies such as SAPS to report a crime, and to a Trauma Centre/Rape Crisis unit to access appropriate forensic and medical care.
       3. The Trauma Centre/Rape Crisis will provide the post-traumatic counselling as outlined in this procedure.
       4. The Trauma Centre/Rape Crisis will initiate the COIDA process (first medical report etc.)
          • In order to provide a completely confidential and independent service, the COIDA application will be managed by the service provider and the UCT occupational health medical practitioner.
          • On reporting the event to the UCT occupational health medical practitioner, The Trauma Centre/Rape Crisis will be issued with a Campus Protection Services reference number. This number will be allocated to an event, not to an individual. UCT will not be held responsible if this process is not adhered to.
       5. Feedback reports will be provided to the University regarding trends, utilization of services and specific issues or problems. This will be done without revealing the identities of clients who use the service.
6. Resources Required
   1. Campus Protection Services
      1. Trained staff that understand the implications of traumatic events and who can initiate UCT's trauma response.
      2. Management of a database
         • Events tracking
         • Roster of Immediate Response Support Team
      3. Lay counsellors for the Immediate Response Support Team.
      4. Training resources.
      5. Referral network of appropriate professional psychologists and GPs. trained in post-traumatic stress management.
      6. Database of support services and places of safety for victims of trauma, for use in their private capacity.
7. Recruitment and training of the Immediate Response Support Team (IRST)
   1. The recruitment of volunteers will take place from all areas of UCT. Suitable recruitment criteria need to be set.
   2. Training for the lay trauma counsellors (Immediate Response Support Team) will be undertaken by people with the necessary experience and expertise, be they from UCT, an NGO or private service provider.
   3. Training programmes will be repeated to ensure that adequate numbers of lay trauma counsellors (Immediate Response Support Team) are available. Two annual refresher courses will be offered to all trauma counsellors and bi-monthly supervisory meetings will be held.
   4. The training of key personnel (particularly at Campus Protection Services) is important and ensures the understanding of the protocols/procedures and skills needed in dealing with the effects of traumatic events.
8. Budget
   1. Training costs for the IRST, as well as the ongoing costs of keeping numbers at the ideal level.
   2. Payment of professional service providers. Three sessions per individual will be charged to the UCT organisational health account.
   3. In the case of a traumatic event where a group of staff members were exposed to the event, three group counselling sessions will be paid for by the UCT Organisational Health department when deemed appropriate by the Organisational Health Manager. Please contact Blanche Claasen-Hoskins on x5685 or blanche.claasen-hoskins@uct.ac.za.
   4. When appropriate, a claim to cover counselling expenses will be submitted to the compensation commissioner.
   5. Cost of marketing/education material and ongoing awareness of the protocol and its focus.
   6. Petrol/transport costs for the IRST members.
9. Criteria for Specialist Service Provision

   Specialists who support the UCT trauma response team will

   1. Be registered with the Health Professions Council of South Africa.
   2. Provide 24-hour cover.
   3. Be in reasonable proximity to the UCT campus.
   4. Operate throughout the year, including vacation times.
   5. Have access to a network that can provide support in case of a mass incident.

Page last updated: 13 November 2023