Staff MESH Accomodations

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  • #59599
    Carrie Smith
    Participant

    Hi all – Long post alert, but hoping this will be helpful for others too!

    I’m wondering what others are providing regarding staff MESH accommodations during the busy months of summer as well as tips on getting staff health forms completed early for review.

    With the increase in young staff coming into our community with extensive MESH conditions and histories, we are evaluating what supports we may want to provide and/or others that, if needed, may indicate the staff member may not be in a stable state to be in charge of supervising children, so either need to leave or move into a non-leader role.

    Some examples/questions:

    1. We had six staff depart early this summer due to MESH concerns. Each self-exited, and a few went on to seek professional help after leaving. In each case, the staff member had an emotional event that looped in health, and it was disclosed that they had not shared significant information about their recent health history – to include psychiatric hospitalizations and suicide attempts – on their health forms (most did share a lot of relevant information, but left out other). These situations added stress to our community – both concern about each of these staff members, and also by leaving us short-staffed after departing, and utilized significant health team resources to manage, taking those away from campers.

    Question – how are you screening staff from a MESH perspective during the hiring process without discriminating against anyone? Does anyone have sample interview questions you will share, process of involving health in the interview process, etc? We currently ask the “essential functions to include resilience and emotional/mental health stamina in a busy work environment”, but this doesn’t seem to be hitting the mark.

    2. On their health form, the staff member writes they experience “multiple panic attacks on the daily, which they manage with self-care of time alone.” This person is supposed to co-lead 5-10 day trips in the backcountry with one other co-leader and a group of teens (no time to be alone other than in your tent at night). After review and conversation with the staff member, I suggested to their supervisor that they not be paired with another staff member who listed significant ongoing mental health conditions on their forms – citing the risk of them both spiraling at the same time without immediate access to help. I was met with resistance by the trip coordinator, who felt I (the nurse) was overstepping my role. We are grateful these staff are truthful about their histories with the health team, however it puts us in a difficult position when we then place them in knowingly stressful and remote situations with the campers in our care. I’m trying to navigate helping some of our non-healthcare staff understand our duty owed to the campers and parents, and in a culture where some terms like “panic attack” and anxiety have been normalized for many.

    Q: Does anyone have thoughts on helping non-healthcare staff understand the concerns those of us on the health team raise? For those of you who run tripping programs, do you have a process in place for pairing co-leaders based on health screening? It seems like it would make sense to approach it like skill-screening/pairing, but how to help non-healthcare staff understand this.

    3. Staff member wears the noise-canceling headphones in the dining hall, which have historically been provided for campers. Meals are a time of high social complexity for campers and also where we do the bulk of our group announcements.

    Does this sound like a reasonable accommodation for staff – to wear the headphones? Or does this potentially signify the staff is not managing well? Historically staff have not worn the headphones, but I realize needs may be different. Would love to hear how others are managing things like these in your programs.

    Hope this all makes sense! Thanks for your input/advice/thoughts!

    #59600
    Mary Marugg
    Keymaster

    Carrie, Thank you for your post, and for your vulnerability in the challenges that you are seeing. I believe it provides us a great opening to continue the conversation about some of the issues that are indeed being seen in many programs. Some of the over-arching questions you raise is how do camps accommodate for what may be viewed as “normal”, yet the staff member may not be emotionally equipped to fill the role of safely taking care of kids. Not easy answers, but as the ACH leadership team we’ll look at how to continue the conversation, and provide solid resources to ACH members. A couple notes, the ACH MESH Resource Guide does address some of these issues, and has some solid guidance on questions to ask for both campers and staff on health forms. https://allianceforcamphealth.org/product/mesh-document/ . The ACH Fall Coonference, “Tension of Care” will also includes sessions related to these issues.

    #59609

    Carrie:

    These are great questions and I am thrilled that that you are thinking about options and opportunities now instead of waiting to spring and try to iron out a plan. I do think there are opportunities to be proactive in identifying, preparing, and supporting staff as they come into the camp experience. Here are some high level thoughts.

    1. Provide more information on the website about what camp “looks like” – from the noise to the activity, to the long days, and other potential situations that may pose a challenge or trigger for staff.
    2. On the staff health history, be diligent in asking questions that get at your greatest concerns:
    Do you have any mental, emotional, or social health challenges that we need to be aware of?
    If you have MESH issues, how are you managing at home or school?
    Walk us through what a typical day looks like for you?
    How do you plan to take care of yourself while at camp?
    3. Consider having clear language on your staff health history that states that “information is truthful and accurate and that failure to provide a full health history is grounds for dismissal”
    4. Consider having specific and thoughtful conversations during the job interview including questions that get at MESH. You cannot ask about MESH diagnoses specifically, but you can ask about other aspects of potential performance:
    What is your typical response in a high stress experience?
    If we state that you need to be able to self-regulate your emotions, what does that mean to you?
    If for some reason you are not getting along with a peer counselor, how would you respond?
    (Hint: if a staff member states that their typical response is avoidance or walking away, think their ability to navigate difficult situations when they must stay present with others in uncomfortable situations).

    This is an important topics. Love for someone to consider writing about this for CompassPoint for the benefit of all members.

    Thanks Carrie for sparking good conversation.
    Tracey

    #59610
    Carrie Smith
    Participant

    Thank you both. I look forward to continuing the conversation in the coming weeks and months and hearing what others are doing as well.

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