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Rapid Response BIT Meeting, Part III

By: Makenzie Schiemann, M.S. Executive Director, NaBITA

In the previous two Tips of the Week, we discussed rapid response meetings, including when to call them, who should attend them, and what to accomplish during them. In this Tip of the Week, we will discuss the operational logistics of calling a rapid response meeting, including notification of meeting, agenda, and process.

Initiating the Rapid Response Meeting

As mentioned in Part I of this series, someone (usually the BIT chair or designee) should be screening or triaging the referrals to the BIT on a regular basis. When this individual determines that referral to the BIT contains high-risk elements (such as those outlined in Part II of the series) that would potentially cause the referral to be rated at Elevated or Critical on the risk rubric, a rapid response meeting should be called. Rapid response meetings, as the name suggests, are designed to bring the BIT, or a subset of members who are available, together rapidly to address a high-risk case prior to the next meeting. Therefore, the BIT chair should attempt to bring the team together within a few hours, if not sooner, to discuss the referral.

Organizing the Rapid Response Meeting

As with any meeting, when the rapid response meeting is well-organized, it will run more smoothly and effectively. Team members need time to prepare their background information on the individual; therefore, the sooner they know about the rapid response meeting the better. Given that you already know who is to be discussed at the meeting, consider sending the agenda out to alert the team members to the BIT referral that is prompting a rapid response meeting, and asking them to review the referral and prepare information for the meeting. The agenda should contain the student name(s) to be discussed, the referral source, and the triaged risk rating. Following this alert to the team, the chair or designee should find available space to host the meeting, or plan to host the meeting virtually, and also identify times that team members are available. Recognizing that all members may not be available for a rapid response meeting, the team should aim to have at a minimum the chair, the mental health representative, law enforcement, and the conduct representative present. Once the meeting location and time is confirmed, notify the team and prepare to conduct the meeting.

Conducting the Rapid Response Meeting

Once in the rapid response meeting, remember to follow your process. Just because the case is high-risk, and the team was called together quickly, doesn’t mean you treat the case or the meeting any differently. This can be hard to remember and even hard to implement given that these rapid response meetings can elicit strong reactions from team members, and in some cases a sense of urgency, anxiety, or fear. The best way to combat this and to respond to the case effectively is to create a sense of normalcy and rely on your policies and processes. Remember, for every BIT case, teams should follow the 3-phase process:

First, gather data by sharing the initial referral and having the team members share the information and background they gathered on the individual. Once you have gathered the data and gained as full a picture as possible at that time, use the NaBITA Risk Rubric to determine the level of risk. Once the risk level has been established, the team can move to interventions that appropriate respond to the level of risk present. This three-phase process guides the flow of the rapid response meeting and provides structure to how the BIT operates. Although this three-phase process is often presented in a linear fashion, as it is here, the process is ongoing and cyclical. BITs should continue to gather data after interventions are deployed to assess their effectiveness and to determine if new data exists that would either increase or decrease the level of concern. This is especially important following rapid response meetings, as the team is assessing risk likely given limited information and prior to any large interventions have been implemented (hospitalization, conduct, arrest, etc.). Once more information has been gathered and those interventions have been put in place, the risk is likely to change, and the team should reapply the NABITA Risk Rubric to reassess the level of risk, given the new data and the outcomes of the first interventions.