Your first reaction to the title is likely, "send them home and get them help." And you wouldn't necessarily be wrong. But statements, threats, and sometimes casual talk about self-harm and suicide seems to be on the rise with kids. This is anything but a black and white subject. There are many nuances to explore.
When I was directing camp, it was with a population that was marginalized and vulnerable, and thus campers often came into camp with depression and anxiety due to how they were treated in the outside world. My social work license immediately came in handy; kids were discussing some of their dark thoughts within the safe confines of camp. This was over 15 years ago. Suffice it to say, I got a lot of practice over those years in trying to assess what was said (or what was done), what it meant to that child, and what it meant for their time at an overnight camp that was purposely not a therapeutic space, but rather, "just a camp." Some years later, when I was regularly connecting with more and more directors, I began to hear similar stories from their camps. Now, talk of self-harm, suicidality, and similar issues is so commonplace that I know it to be an issue with nearly 100 percent of the camps I work with. (And this is when I'm speaking to them about camp in general, not just about mental health.)
The vast majority of camps should provide general support to campers and staff, but should not be providing active psychotherapy or therapeutic care in the mental health space. We're all in this business to give kids an amazing experience that they can't have anywhere else. But how are directors, let alone frontline staff, supposed to know what to do when a child casually says "I'm so mad, I just want to kill myself," or "sometimes I think it would be better if I didn't wake up tomorrow," or if they have new cuts or scratches that look intentional but they are denying it? You want to think about these issues well before camp, and ask yourself what your feeling and assumption of risk might be.
Kids are hearing and using therapeutic jargon everywhere. There are trends on various social media sites that encourage kids to diagnose themselves with disorders based on symptoms that almost anyone could have at one time or another. Youth are using words, phrases, and even these diagnoses in a casual manner. For some, these self diagnoses can become an important part of their identity. It is not your job to figure out what these diagnoses or identities mean, but it is your job to figure out how they might play out at camp.
It is very important to do pre-camp screening to learn as much as possible about children who are both new and returning (a lot can happen in one school year). Many simple open-ended questions on application or health forms aren't enough anymore. Questions like "does your child have any needs or behaviors we should know about?" are too easy for parents to skip or leave blank. Once you have more pinpointed questions, your team should be following up with therapists or school counselors where appropriate. These conversations between directors and mental health professionals are not typically needed for most children, but can be very helpful for both child and camp when they are warranted.
Parents/guardians will need to sign a release in order for a mental health care professional to speak with you about a child. Directors or team members speaking with mental health professionals should be very up front about the camp experience. I have made many of these calls in my career. I find that most mental health professionals do not have camp experience, much like the general population. They may unequivocally advocate for their client to be able to participate, but they need to understand what the environment is like - and not the way you sell it to parents. They need to hear about the organized chaos, stress, constant socializing, minimal alone time, and need for teamwork and proper conflict-resolution skills. Both your camp and the child's family deserve to have the most information possible so that you can make decisions about how to help a child when they get to camp, or, in some cases, to decide whether your camp is truly the right fit for each child. As I like to say, there is a camp for everyone, but your camp is not necessarily for everyone.
Establishing your camp's safety boundaries is extremely important. As my friend Bob Ditter once said to me, and I'm paraphrasing, "There is a reason that amusement parks have certain restrictions for certain rides. It's a matter of safety. Camps are no different."
Kids have to be mentally healthy enough to be at camp*. What that means may be different for each camp. Having a specific diagnosis or a history of certain behaviors should not warrant exclusion from camp; you should try to include every child that you possibly can, that works within the confines of what your camp can do. Do your homework. You will need to find out more by contacting the family and potentially a professional who works with the child. Is the child safe enough to be at camp? If so, how can you help support this child?
You must think about whom is and is not going to be safe at camp based on your what your camp is capable of providing. How recent are the child's struggles? If there is a history of self-harm, is it well-controlled or are there still active occurrences? What is your camp's risk tolerance on mental health and safety? Your policies and procedures regarding mental health incidents should reflect your safety boundaries.
Takeaways: What should directors do?
Helping camps with all of the above is one of the things I do. I work with camps on all four of the above because I see them as extremely important in ensuring that your camp runs safely. I write policies and procedures for mental health events based on the camps' needs and desires, and I work as an on-call consultant with camps that both do and do not have on-site mental health professionals. My role is talking through a given scenario with a director and advising on what steps to take as I see fit. It works much like having a physician on-call for physical health issues.
Stay tuned for an upcoming webinar on this topic regarding both campers and staff, presented by me and two excellent camp-based attorneys, Isaac Mamaysky and Rachel Fendell Satinsky. If you would like more info on the webinar, please email me at nick@fairwindsconsult.com.
Wishing you a Happy Thanksgiving season!
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