ACA Camp Crisis Hotline Annual Review 2016

November 2016

Since 1985, the American Camp Association® (ACA) has provided crisis support to camps through the confidential ACA Camp Crisis Hotline. This service is available 24 hours-a-day, every day of the year. Camps contact the Hotline to receive support, discuss options, or talk to an objective third party.

While Hotline team members do not provide legal or medical advice, we can connect camps with the resources they need and help them think through their options. A review of the summer 2016 calls shows a number of trends, lessons-learned, and case studies that are presented to assist camps in being better prepared should a similar crisis occur at their camp.

Register for the Camp Crisis Hotline Webinar on December 8.

Categories

2016 Health and Medical Issues

For the eighth consecutive year, the top category of calls was related to health and medical issues. This category grew from 31 percent of calls in 2015, to 38 percent in 2016. However, most notable is the increase in calls related to mental health issues in campers and staff, a category which fell into the "other" category of healthrelated calls in previous years. Forty-two percent of all the health and medical calls were related to mental health issues. Of these, 57 percent were related to campers and 43 percent were related to staff. In addition to mental health issues, the Health and Medical Issues category includes a broad range of topics from the treatment of common childhood illnesses (e.g., chicken pox) and infestations (e.g., bedbugs), to questions about procedures (e.g. how to perform a lice check). Tragically, it also includes ACA being notified of two deaths this summer. The deaths reported were: an adult camper that died in her sleep, and a day camp counselor who committed suicide off camp property.

Lessons Learned — Health and Medical Issues 

  1. Prepare for mental health concerns for campers and staff. The sharp increase in calls to the Hotline on this topic appears to mirror a societal trend. Camps need to have a mental health support system in place and should add mental health resources and experts to the team and healthcare plan.
  2. Have health and medical support systems in place. Before camp starts, identify the health and medical resources necessary to assist in whatever challenges may occur at camp. This plan includes on-site healthcare staff as well as a list of contacts (e.g., mental health professionals, dentist, etc.) who can be reached in the event of an unexpected incident.
  3. Distribution of medication laws vary by state. Often a caller will ask, "Can my counselors distribute medication if they are out on a night hike with campers?" Since these regulations vary, determine the rules that apply to your camp and establish appropriate procedures prior to the start of camp. All staff should understand the issues regarding distribution of medication.
  4. Lice outbreaks happen. Again this year, one of the most popular health and medical issue calls to the Hotline related to lice outbreaks, specifically whether to treat and keep those impacted at camp or send them home. What is important to remember is not that a lice outbreak occurs but how it is handled. Determine if your camp will be a "nits" or "no-nits" community. Know that new strains of lice evolve that are resistant to over-the-counter remedies, and prescription treatment may be required.
  5. It is critical that your healthcare staff be familiar with the most common childhood illnesses, injuries, and infestations. Many calls in this area came from camps that did not have knowledgeable healthcare staff. Camps had trained RNs on staff, but with specializations not regularly treated in the camp environment (e.g., operating room nurses, oncology nurses If your best choice for healthcare staff is lacking in childhood healthcare, it is imperative that they receive training and support prior to camp opening.
  6. Preventing the spread of disease starts before anyone enters your camp. Camps should advise parents not to send sick children to camp. All incoming campers should receive detailed health screenings (taking temperatures, lice head checks, recent exposure to communicable diseases, etc.) prior to arrival at camp, and camps should initiate stringent handwashing and camp sanitation procedures.
  7. Communicate, communicate, communicate. In the event of a serious accident, injury, or infestation, a comprehensive communications plan is critical. Many Hotline callers simply want help crafting messages about an incident that they can share with families, the media, and others.

Staff Training Questions — Health and Medical Issues

  • What would you do if one of your counselors committed suicide on their time off from camp?
  • How would you address a medication-management-mishap? For example, one day a camper receives the wrong medication, the next day a camper receives medication at the wrong time.
  • What would you do if you discovered four of your cabins had bedbugs and there is no place to put campers until the situation resolves? To add to the challenge, the exterminator can't come for another five days.
  • How would you manage the situation if a 14-year-old camper disclosed an attempted suicide the week prior to coming to camp?
  • What would you do with a staff person (new to camp) who has a panic attack on the very first day of staff training?
  • What if a 16-year-old camper disclosed she was three months pregnant and does not want camp staff to tell her parents?
  • How would you respond to a parent who has authorized the camp to give their son Benadryl® to help him sleep?
  • What would you do if a staff member noticed a camper with a series of uniform cuts on her thigh while campers were changing for swimming?
  • What would you do with a staff member who expresses a desire to commit self-harm?
  • How would you respond to a CIT who has not been eating much and recently passed out?
  • What would you do if you had a lice outbreak? What is your policy on lice? (Nits vs no-nits?)
  • What would you do if your nurse resigned with two weeks remaining in the camp season?

Resources — Health and Medical Issues

Allegations of Abuse

The 26 percent of Hotline calls related to allegations of abuse broke out into three major categories.

Allegations of Camper to Camper Abuse (33% of Calls) 

Hotline calls related to allegations of camper to camper abuse have shown a marked increase over the past few years, from 3 percent in 2014, to 11 percent in 2015, to the present 33 percent. While most of these calls are to clarify mandated reporter laws and whether or not to call the authorities, often the conversation leads to identifying the need for techniques and tips to manage the way campers treat one another. A number of calls in this category concern alleged consensual sexual acts between two or more campers. This category also includes acts of bullying among campers.

Allegations of Abuse at Home (25% of Calls) 

Revelations by campers that they are being abused at home are a very difficult situation to handle for any camp. It has been ACA's experience that children who are the victims of abuse or neglect at home (or some other place outside of camp) will sometimes reveal their abusive situation to a caring adult at camp. When this occurs, camp directors have many questions about what to do, whom to call, and so on.

Allegations of Staff to Camper Abuse (25% of Calls) 

Twenty-five percent of the abuserelated calls this summer were allegations of abuse of a camper by a staff member, ranging from aggressive reactions to campers to inappropriate touching. This number has risen over the past few years. While the callers in this category understood and complied with mandated reporting laws, they often wanted to discuss policies, procedures, and staff training ideas that keep their campers safe at camp.

Lessons Learned — Allegations of Abuse

  1. The law is clear. You MUST contact authorities if there is an allegation of abuse. All camps fall into the category of a mandated reporter. While state laws vary, camp professionals generally serve in loco parentis (in place of the parent), and must call the proper authorities in their state when allegations of abuse are revealed. Camps have a very clear focus and responsibility to protect the children in their care. Camp professionals can be arrested for disregarding these laws. It does not matter whether the allegation is that the abuse occurred at camp by another camper, by a staff member, or at home. Make the call to authorities if you suspect that a child is the victim of abuse. If the child lives in another state, you may be asked by your state to contact authorities in the other state as well.
  2. Leave the investigating to the authorities. While it is tempting to start your own "investigation" prior to contacting the authorities — especially if you think it is possible that the child is "making it up" — resist this temptation. Let the proper authorities step in and take control of the matter. Documentation is critical. As with any important issue at camp, documentation is key to ensuring that the authorities have what they need to proceed with their investigation.
  3. Vigilant staff supervision is key to keeping campers from harming each other. In most of the situations explained by callers, the allegation of camper-to-camper abuse came in those moments when staff were not directly engaged with campers — shower time, trips to the restroom, changing for the pool, and so on. It is imperative that your staff be trained to be even more attentive, active, and involved during these vulnerable times. If your camp does not have staff sleeping in the same room with campers, you must consider what you are doing to ensure no inappropriate behavior occurs during nighttime hours. 
  4. See something, say something. Teach your staff to question what they see. It takes just one person to step up and question when they see something is not right about the way an adult is interacting with a child. You may be the one who is able to free a child from serial abuse. Always have the best interest of the child in mind!
  5. Establish and enforce policies regarding staff never being alone with a camper. Your supervision and counseling policies should ensure that one staff person is never alone and out of sight of others with one camper. Is your staff-to-camper ratio high enough to ensure that one staff person cannot be alone with a camper, especially in unique times such as the middle of the night when a camper needs to use the restroom? Develop policies and procedures that support staff in avoiding one-on-one situations, and practice strategies for avoiding these types of situations.
  6. Establish clear policies regarding appropriate physical interaction between staff and campers. Staff members need to understand the camp's policies on physical contact between campers and staff. Do you allow contact such as hugging, lap-sitting, back-patting, high-fiving, tickling? If so, be very clear about what is and is not acceptable. Consider using role-playing during staff training to convey and practice your policies.
  7. Because you have created an emotionally safe environment at your camp, children who are in an abusive situation at home may reveal that abuse to you. In these situations, children often say, "Please don't tell anyone." You cannot promise them that. Instead assure them that you care and that you must tell the people who can help.
  8. Make bullying prevention a priority from the first day of camp, and let all campers and staff know that bullying behavior is unacceptable. All campers need to feel safe both emotionally and physically. One person's description of bullying is another person's description of abuse. Set bunk and group rules with explicit examples of acceptable and unacceptable behaviors regarding bullying. Post these rules, and have staff and campers review them together.
  9. Teach and model respectful behavior. To prevent bullying and abuse, and to build respect and inclusiveness, staff must commit to matching actions to words. If your staff are overheard "teasing" or bullying one another — what example does that set? Be clear with your staff that you have a no-tolerance policy on any type of bullying, belittling, or physical abuse. Staff orientation should include training on behavior that addresses the types of bullying counselors might see, what to do when they see it, and how to be vigilant with these issues during the season. Ensure staff behavior matches core camp values.
  10. One in four girls and one in six boys are the victim of abuse before they reach age 18. Many children (and staff) may arrive at your camp already the victims of abuse. The U.S. Department of Health and Human Services has excellent resources to help you recognize the signs of abuse. Become knowledgeable.
  11. Keep the phone number of your local child abuse reporting authority readily accessible. Many calls to the ACA Camp Crisis Hotline are simply to ask for help finding the correct phone number. If you don't know who to call (generally you call the locality where the abuse is alleged to have occurred), don't hesitate to call your own local authority and ask for guidance.

Staff Training Questions — Allegations of Abuse

  • What would you do if two junior high female campers kissed? It appeared that the kiss was consensual as both girls said they wanted to see what it was like to kiss a girl, so they did. Then one of girls expressed that she was very uncomfortable.
  • What would you do if you discovered two 15-year-old campers were having intercourse at camp?
  • How would you handle a shower-time situation where one 13-year-old boy (Boy A) stuck his head under the shower wall of another 13-year-old boy (Boy B) and was staring at him? Boy B was very upset and started crying.
  • What would you do if you discovered a "rumor" going around camp that two minor campers — one male and one female — had oral sex? Upon further investigation, you were told, "You have a supervision problem. These things are happening all the time."
  • If your camp serves campers with special needs that require personal care (e.g., toileting, bathing), how are you training staff and monitoring interaction to eliminate the risk of abuse?
  • If your camp does not have staff sleeping in the same room as campers, how do you prevent your campers from harming one another in the middle of the night?
  • If your camp uses a buddy system whereby campers have a buddy to go places such as the restroom, what are you doing to make sure that those buddies are not harming each other when they are alone?
  • What would you do if the family of a camper from last summer contacts you because they found out that their daughter is in an "inappropriate relationship" with a child she met at camp? They want to know what the camp is going to do about it, and they want the contact information for the other family.
  • What would you do if an older male wrangler has been accused of inappropriate touching of female campers he is working with in the riding program (e.g. shoulder rubs, touching legs, touching an inner thigh, rubbing a camper's waist) and you've learned that he is giving out his card and inviting female campers to contact him outside of camp for private lessons?
  • How would you handle a staff member who reacts aggressively to a bear hug from a nonverbal camper?
  • What would you do if a camper reported that he woke up in the middle of the night to see his counselor standing by the bunk of another camper, fondling that camper in his sleep?

Resources — Allegations of Abuse

Personnel and Staff Issues 

Personnel-related calls accounted for 14 percent of the calls in 2016. In some cases, camps are simply looking for resources to hire an emergency staff replacement due to an unexpected resignation or termination. In other cases, camps are searching for resources to help them make legal decisions regarding the hiring or release of a staff person. However, many calls related to staff behaving inappropriately.

Lessons Learned — Personnel and Staff Issues 

  1. Enlist the services of an employment attorney. Identify this person before you begin the hiring cycle. An attorney with experience in labor laws, contracts, and employment issues who can be contacted for help at any time is an invaluable resource.
  2. Take any threat of suicide very seriously. As previously discussed in the health and medical section, suicide threats are a serious mental health issue. It is imperative to seek the help of mental health professionals and get the necessary help for the staff member.
  3. Set and enforce clear policies regarding acceptable relationships between staff while at camp. Callers frequently wanted to discuss sexual relationships between staff that include both consensual acts and allegations of forced relationships. Understand that if an allegation of force is made by adults, that situation is a police matter, and the alleged victim decides if they want to contact the authorities. If they do, the authorities will help navigate what happens next with the alleged victim and the alleged perpetrator.
  4. If you employ international staff, understand your obligations to the U.S. Department of State Cultural Exchange Program. By hiring international staff, you commit to meeting obligations required by law that focus on cultural experiences for those staff. It is critical that you understand and meet the visa requirements for international staff members.
  5. Understand the employment protection afforded in the Americans with Disabilities Act (ADA). ADA laws provide protection from discrimination in hiring people with a broad spectrum of physical challenges. Craft your job descriptions with the assistance of your attorney and get legal advice before beginning your hiring process.
  6. If an employee or potential employee shares with you that they are transgender, gender variant, gender nonconforming, or in the process of reassigning their gender, understand all the issues related to employment and privacy. ACA continues to see a rise in the number of calls regarding transgender staff. Camps want to know everything from "how do we accommodate transgender individuals?" to "are they protected by law and are we required to accommodate them?" We've also had this same type of call about campers. There are no definitive answers and laws vary by state so be sure to consult with your attorney.
  7. Regardless of state laws about marijuana use, it is still illegal according to federal law. Medical marijuana is considered a "Schedule I" controlled substance under federal law. Generally, employers can refuse to hire or choose to terminate an employee, or refuse to allow a camper to attend who is currently using marijuana — for medicinal reasons or otherwise.
  8. Have a back-up plan for staff coverage in an emergency or unexpected loss of staff. Supervision ratios are critical to ensuring the safety of your campers. In the event of a necessary staff termination, camps do not want to be stuck between considering not firing someone due to an inability to cover supervision ratios for campers or firing and risking the safety of campers. Consider what your camp would do if it suddenly lost one or more key staff members — especially those in critical roles such as your nurse or cook. Before the season begins, identify short-term options you can turn to for coverage in an emergency. Consider how properly trained volunteers might help you if you suddenly find yourself short-staffed.
  9. Set thresholds for acceptable criminal records BEFORE you conduct your criminal background checks. Protecting the safety of those in your care must be a top priority. Serving in loco parentis, camps and other youth-serving organizations need to use all the information at their disposal to screen applicants who will have access to children, youth, or vulnerable adults. Developing a threshold policy will allow camps to comply with the law and protect the safety of everyone participating in their programs. Although some organizations have set policies not to hire anyone with a criminal record of any kind, ACA's guidance is to establish a criminal background threshold for each position within your organization. Some states have already enacted laws regarding thresholds for individuals who work with children and vulnerable adults. A threshold policy should always be developed working in conjunction with your legal counsel.
  10. Enforce your personnel policies. It's not enough simply to have personnel policies — they must also be enforced. Establish a clear understanding of what the consequences are (e.g., reprimand, suspension, dismissal) for violation of the policies. If camps do not enforce their own policies, they are left open to a variety of risks, including lawsuits, especially if policies are not consistently enforced (e.g., treating one staff member differently than another when they have both ignored one of your policies).

Staff Training Questions — Personnel and Staff Issues

What if your staff asked about how to respond to a camper who "comes out" for the first time while at camp? How would you train your staff to talk with campers about being gay?

  • How would you handle a staff member who is pulled over for a traffic violation while driving 13 kids in a van and is subsequently arrested for not having a class D chauffer's license?
  • What would you do if a male staff member who was terminated following inappropriate behavior during a skit (mooning the girls' village and making inappropriate sexual comments) requested copies of the incident reports regarding his dismissal?
  • What if someone reported to you that a male staff person left the camp property during an evening program to go to his car where he proceeded to smoke a joint? He was gone for almost an hour and left his co-counselor alone with all the campers.
  • Would you rehire an individual who had been a "great" counselor last summer but was known to use marijuana, which she claimed was for medicinal purposes without having a medicinal marijuana card?
  • Would you recognize the signs of depression or other mental health challenges in your staff? If so, how would you support these staff members?
  • What are your staff sexual harassment policies? What are your policies regarding relationships between staff? Does your staff know what to do if they are harassed by another staff member?
  • What would you do if a staff member threatens suicide?
  • What would you do if several staff members had money stolen from their cabins?

Resources — Personnel and Staff Issues

Camper Behavior

Calls related to inappropriate camper behavior rose from 7 to 10 percent of total calls over the last year. This category excludes allegations of camper-to-camper abuse, which was previously addressed in this article. Typically, this category focuses on an individual camper's behavior.

Lessons Learned — Camper Behavior

  1. Educate staff on the indicators and symptoms of mental health problems. Information breaks down the stigma surrounding mental health issues and enables staff and campers to recognize when to seek help. Your mental health professional network can provide useful information on symptoms of problems such as depression or suicide risk. These symptoms can include acting out, changes in eating or sleeping habits, withdrawal from others, decreased social functioning, erratic or changed behavior, and increased physical complaints.
  2. Take all comments about suicide seriously. ACA received an increase in calls from camps regarding campers making suicidal comments. Often the caller thought the comments were "just to get attention" or "just joking." Unless you are a trained mental health professional, assume the threat is serious. Educate staff on the indicators and symptoms of mental health problems.
  3. Attentive and engaged staff supervision is the key to reducing negative camper behavior. Almost all reported incidents of alleged bullying and inappropriate behavior occurred when staff members were not alert or in the area.
  4. Provide a positive camp environment. Feeling safe is critical to a child's learning and mental health. Promote positive behaviors such as respect, responsibility, and kindness. Provide easily understood rules of conduct and fair discipline practices. Teach campers to work together to stand up to a bully; encourage them to reach out to lonely or excluded peers, celebrate acts of kindness, and reinforce the availability of positive adult support.
  5. Camper (and staff) belongings can be searched if you suspect illegal or unsafe activity. It is a common question to the Hotline: "Can we search a camper's belongings?" Generally, the answer is "yes" with a few exceptions. Prior to the start of camp, determine your policies on if and when to search.

Staff Training Questions — Camper Behavior 

  • What would you do if a 16-yearold male camper disclosed to a staff member that he was engaged in "gang" activities at school (guns, selling drugs, etc.) but wants to get out of it? The session ends in two days. He does NOT want this info shared with his very ill mother.
  • How would you handle a 6-yearold female day camper who, in the past five weeks, has had ten incidents of soiling herself? The parents think it is "no big deal."
  • What would you do about a camper who grabbed razors (the type for shaving legs) and said she wanted to hurt herself? Then the next day, the same camper used a bug spray cap and cut herself.
  • What would you do about a 15-year-old female camper sexting a fourteen-year-old male camper a nude photo?
  • How would you manage a day camper traveling on the camp bus who really had to go to the bathroom? The camp's bus was "stuck in traffic" and couldn't get to a restroom, or even the side of the road.
  • What would you do if a 15-yearold camper enrolled last summer as John was registered for the coming season (still as a male), but with a new name, Lane. After being housed with boys the first session, Lane asked to be referred to as a female and requested female cabin mates. Lane's parents are out of the country and difficult to reach. Do you honor the camper registration as the parents completed or do you accommodate the teenager's request?

Resources — Camper Behavior

Miscellaneous Issues 

Eleven percent of the Hotline calls covered a myriad of other issues. These issues included handling a drone flying over camp, dealing with an active shooter in the area, managing a yellow jacket invasion, evacuating for a wildfire, answering questions about ACA's Standards, and discussing "hypothetical" questions. The most frequently referenced resources used by the Hotline team to answer these and other questions can be found online at www.ACAcamps.org/resource-library/camp-crisis-hotline.

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