Duke’s Team Approach to Keeping Campus Safe

Behavioral assessment teams work to identify, address potential concerns

The Duke University and Duke University Hospital campuses from the air. Image courtesy of University Communications.
The Duke University and Duke University Hospital campuses from the air. Image courtesy of University Communications.

Recent tragic events around the nation underscore the importance of doing all that we can to prevent acts of violence at Duke. With thousands of staff, faculty, students, and patients at Duke each day, keeping everyone safe is a priority.

A crucial piece of that work is done by Duke’s three behavioral assessment teams, which identify and assess reports of threatening behavior.

Duke Interim Vice President for Human Resources Antwan Lofton. “When you look at what’s happened around the country, we can’t think like we’re in a bubble and nothing can ever happen at Duke,” said Duke Interim Vice President for Human Resources Antwan Lofton. “We are dealing with the lives of patients, employees and students, and we need to ensure that everyone’s safety is being thought of.”

The duty of noticing troubling behavior, or reporting potential concerns, is shared by everyone. But it’s the role of Duke’s three behavioral assessment teams to figure out how best to mitigate risk in a thorough and thoughtful way.

These teams became best practices after high-profile violent incidents in the 1990s and early 2000s. They are multidisciplinary teams made up of behavioral experts, campus safety officials, legal counsel and university and health system leaders, study reports of concerning behavior and decide which steps should be taken to reduce risk to the campus community.

“This is one of the most important tools the institution has to try and reduce the risk of targeted violence,” John Dailey, chief of Duke University Police said of the behavioral assessment system, which is separated into groups working with students, employees and health care providers.

These are the teams:

Employee Behavioral Assessment Team

Duke University Police Chief John Dailey.Duke University and Duke University Health System staff and faculty can report concerning behavior from a member of the campus community, or a potential threat they may face from someone in their life including co-workers, to their supervisor or their unit’s human resources team. They may also notify Duke Human Resources or send confidential concerns to Duke University Police,

After members of the team gathers information on the situation, the Employee Behavioral Assessment Team (EBAT) – which consists of leaders from Duke Human ResourcesPersonal Assistance Service, Duke University Police, Employee Occupational Health & Wellness and the Office of Counsel – will convene and determine what actions should be taken to ensure a safe path forward.

“Reporting a concern absolutely does not mean that anyone’s going to get in trouble,” Dailey said. “It means that trained individuals need to look and see if there’s something that can be done to help an individual and see what we can do to prevent violence from happening.”

Behavioral Emergency Response Team

Duke University Hospital Chief Medical Officer Dr. Lisa Clark Pickett.For those who serve in Duke’s three hospitals and clinics, Duke University Health System uses a multi-pronged approach to assess the risk posed by concerning behavior from patients and visitors. 

The Patient/Visitor behavioral assessment team (PBAT) consists of leaders from Duke University Health System and its hospitals and clinics, Duke Human Resources, Employee Occupational Health & Wellness, Duke University Police and the Office of Counsel, among others.

In accordance with Duke Health’s Disruptive Patient and Visitor Policy, when a patient or visitor shows potentially harmful behavior, caregivers, administrators, and unit leaders gather quickly to document the behavior and develop an approach for delivering care safely.

Roughly a month ago, the Duke University Health System unveiled another way to address concerning behavior with the Behavioral Emergency Response Team. Modeled after similar teams designed to respond to specific medical emergencies, the Behavioral Emergency Response Team consists of specially trained nurses, behavioral health clinicians, hospital and clinic administrators, and security personnel. Dispatched to situations where patients or visitors are displaying potentially harmful behavior, the team is trained to assess, deescalate and resolve potentially dangerous situations.

 “Our team can’t care for patients if they’re worried about their safety,” said Dr. Lisa Clark Pickett, assistant professor of surgery and medicine and chief medical officer of Duke University Hospital. “We have to empower them to maintain their safety in a difficult environment where sometimes the patients and family members have behavioral challenges or mental illness. In order to take the best care of them, we have to be sure that both they, and we, are safe.”

DukeReach and Student Behavioral Assessment Team

DukeReach provides comprehensive services to identify and support students in managing all aspects of well-being. Student Affairs provides case management services including coordination, advocacy, referrals, and follow-up services for students who are experiencing significant difficulties related to mental health, physical health, and/or psycho-social adjustment.

Students can confidentially report concerning behavior to their resident assistant or DukeReach. Student concerns are similarly investigated by Duke University Police and addressed by the Student Behavioral Assessment Team, which consists of leaders from Student AffairsCounseling & Psychological Services, Duke University Police and the Office of Counsel.

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