Health Policies

DA Medication Policies

The Deerfield Academy medication policy has been developed to ensure the health and safety of all of our students. Per Massachusetts State Law, The Deerfield Academy Health Center must be notified of all student medications, including prescription, over-the-counter (OTC), and other types of medications, such as herbs, homeopathic and otherwise. The Medication Policy is also located in The DA Handbook for your review. Please complete this form.

Over-the-Counter (OTC) Medications: Includes all Non-Prescription Medications, herbal and nutritional supplements

  • The Health Center provides small amounts (usually 1-2 day supply) of routine OTC medications for our students 24/7 based on their presenting symptoms, medical history, reported allergies, our clinical evaluation, and the orders of the School Physician. Please review the OTC and Stock prescription medication formulary on the right side of this page.

  • The Health Center is open 24/7 during the school year and students are encouraged to drop by for any medical needs, questions or concerns they or their parents might have.

  • In addition, boarders may also have a small amount of FDA approved OTC medication in their room for the treatment of minor discomforts such as headache, menstrual cramps, cough, and stomach ache.

  • It is the parent’s responsibility to instruct and ensure their child knows how to properly self-administer OTC medication that their child has in their possession while at school that was not supplied by the Health Center. It is the student’s responsibility to inform their parents of any OTC medication they plan to purchase during the school year so that their parent may review the instructions and ensure their child takes it properly. If the parent has any concerns or questions about their child properly taking an OTC medication they should not send it to school with their child and instead have the child come to the Health Center as needed to receive OTC medication from our formulary.

  • A Medication Order Form does not have to be completed for OTC medications.

  • All medication in a student’s possession must be in English and be in the original manufacturer’s container.

  • Students may not share their medication.

Prescription Medications:

Please note:  any student who takes a prescription medication that is a controlled substance (i.e.. a narcotic, tranquilizer or stimulant) or for a psychological condition (also known as a psychotropic medication) such as for ADD/ADHD, Depression, Anxiety or Bipolar Disorder must receive those medications through the Health Center and adhere to and submit an additional and separate policy called the Deerfield Academy Psychotropic Medication Policy. If your child takes a psychotropic medication, please email our medication nurse, Ms. Caryn Gardner,  for further details and instructions regarding this separate policy.

  • Deerfield Academy does allow students who take non-psychotropic prescription medication (i.e. medication not for a psychological condition such as ADD/ADHD, Depression, Anxiety or Bipolar Disorder) to self- administer this medication under their parent’s purview and/or keep it in their room.
  • It is the parent’s responsibility to instruct and ensure their child knows how to properly take their prescription medication before sending them to boarding school. If a parent has any concern about a student’s ability to safely self-administer their medication they should ask their prescribing physician whether it is necessary for the child to take the medication while at boarding school. Additionally, parents may also reach out to the Health Center about supplying and dispensing the medication through the Health Center. Please understand that the Health Center wishes to be a resource for all our students and while it is our responsibility to dispense and administer medications safely, it is not the Health Center’s responsibility to make certain a child is taking their medications daily. Parents may always call the Health Center to ask how often a prescription medication supplied by the Health Center has been picked-up or taken by their child.

  • A Medication Order Form must be completed by a licensed prescriber for each prescription medication and submitted to the Health Center at the beginning of each academic year and during the year if the dose or frequency of the medication has changed. This form must be resubmitted at the beginning of each school year even if the dose and frequency of the medication has not changed from the previous year.

  • With parent approval and after a Medication Order Form has been submitted to the Health Center, self- administered non-psychotropic medications may be prescribed at and brought from home.

  • Medications that are ordered through the Health Center (i.e. psychotropic medications, antibiotics prescribed for a student by the Health Center for an acute illness) will be filled through the school-designated pharmacy unless it is after hours when an alternative pharmacy will be used. Your child’s insurance information will be shared with these pharmacies for billing purposes and parents are responsible for co-pays and other costs not covered by insurance.

  • If your child will be taking a prescription medication while at Deerfield Academy, an account with an associated credit card must be set up with the school designated pharmacy to pay for cost of medications not covered by insurance. Failure to do so may result in delays in your child receiving medications. To set up an account call Big Y Pharmacy in Greenfield, Massachusetts at 413-774-3858, say your child is going to Deerfield Academy and you wish to set up an account for them. If there are any questions ask for Lee Kimball, the pharmacy manager.

 

Psychotropic medications are used for a variety of conditions. The most common psychotropic medications used in boarding schools fall into the following categories but please understand that the below list of examples is not exhaustive. While not all psychotropic medications are controlled substances and not all controlled substances are primarily psychotropic in nature, there is significant clinical overlap; therefore, for completeness and simplicity the regular use of both these classes of medications will be covered by what is labelled as the Psychotropic Medication Policy. If you are unsure whether your child’s medication is covered by Deerfield Academy’s Psychotropic Medication Policy please call Ms. Caryn Gardner, our Medication Nurse, at 413-774-1600 or email her at cgardner@deerfield.edu.

  1. Stimulants: medications used in the treatment of attention deficit disorder

    Ritalin, Dexedrine, Adderall, Concerta, Focalin, Vyvanse

  2. Tranquilizers and sedatives: medications commonly used for acute panic attacks and insomnia

    Valium, Xanax, Ativan, Klonopin, Ambien, Sonata

  3. Antidepressants and anti-anxiety medications: used in the treatment of depression and persistent anxiety, includes commonly known class of medications called SSRIs

    Amitriptyline, Nortriptyline, Prozac, Zoloft, Lexapro, Celexa, Wellbutrin, Serzone, Remeron,

    Buspar

  4. Mood stabilizers: used for labile mood, bipolar disorder and occasionally for insomnia

    Lithium, Depakote, Tegretol, Neurontin, Lamictal, Zyprexa, Risperdal, Seroquel, Abilify

For multiple reasons the use of psychotropic medications in a boarding school environment requires oversight and supervision. This policy outlines the expectations of the Health Center and of the school concerning the use of psychotropic medications by Deerfield Academy students. We believe that proper and consistent use of these medications requires a self-discipline that is difficult to maintain in the face of the multiple demands of a school such as Deerfield. The Health Center staff stands ready to help students and parents meet this challenge.

Policy

1. Acknowledgement of rules and parental authorization:
• Parents and students must sign the Psychotropic Medication Agreement, acknowledging the

expectations of the school concerning use of psychotropic medications while at Deerfield and authorizing the Health Center staff to administer psychotropic medication.

2. Physician authorization:
• A Prescription Medication Order Form must be fully completed by your prescribing physician for each

psychotropic medication your child will need during the school year. This form must be mailed or faxed to:

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Psychotropic Medication Policy 2020-2021 –2–

The Deerfield Academy Health Center
Attn: Ms. Caryn Gardner
7 Boyden Lane
Deerfield, Massachusetts 01342
Phone: 413-774-1600 Fax: 413-772-1118

  1. Dispensing Medication (UPDATED for COVID-19)

    • All psychotropic medications must be dispensed to students by the Health Center staff. Students may

      not bring psychotropic medications from home. Students may not have any psychotropic medication in their possession that has not been dispensed to them by the Health Center. Possession of psychotropic medication not dispensed by the Health Center is considered a major school rule violation and may result in disciplinary measures.

      • All stimulants, tranquilizers and sedatives (Categories I & II above) are dispensed on a daily dose- by-dose basis and must be taken by the student in the Health Center. Students should NEVER have stimulants, tranquilizers, or sedatives in their possession.

      • All other psychotropic medications (Categories III & IV above) are typically dispensed weekly. Students should not accumulate medication over time. They should never be in possession of more medication than is dispensed by the Health Center at one time.

      • Any and all medication changes must include a new physician order for our records and the new prescription sent to the school pharmacy.

    • Designated Walk-in Times for Students to take their medications:

      • Due to COVID-19, all appointment with the Health Center will be scheduled except for students

        on daily/weekly psychotropic medication.

      • Students on these medications may walk-in for their prescribed psychotropic medications only

        during designated times in the morning and evening. Outside of these designated times, students

        must call to schedule an appointment

      • Students entering the Chen for medications must wear a face covering at all times while within

        the health center except when briefly removing it to take their medication.

      • If a student shows up without their cloth mask they must return to their room to get one.

      • When waiting to pick up medication students must practice social distancing of at least six feet

        from others. If they fail to do so they will have a discussion with Ms. Gardner or Dr. Benson about upholding their responsibilities as a member of the Deerfield community. They may also lose their privilege of walking in for medications and instead be required to schedule an appointment.

  2. Ordering, packaging and transporting medication:

    ➢ Stimulants (i.e. Adderall, Concerta , etc) and Tranquilizers/Sedatives (Categories I & II above)

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No medication will be dispensed until this form is received. The prescribing physician must renew and

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resubmit this order each year prior to the beginning of fall term or anytime there is a change.

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o Must have our Prescription Medication Order Form completed by the ordering home physician

and submitted to The Deerfield Academy Health Center (Attn: Caryn Gardner).

o The ordering physician will be required to mail or ePrescribe refills monthly or as needed to the

ATHOL Pharmacy.

o The pharmacist will reach out 5-7 days to the ordering physician for refills when needed.

o Parents must fill out appropriate insurance and co-pay information with the pharmacy.

Psychotropic Medication Policy 2020-2021 –3–

➢ Antidepressants, anti-anxiety (including all SSRIs) and Mood stabilizers (categories III & IV)

o Must have a Prescription Medication Order Form completed by the ordering home physician o Must have the ordering physician either fax, mail or ePrescribe the prescription to the school-

designated pharmacy below. The physician must include on the prescription “DA Student” School-Designated Pharmacy for Psychotropic Medications:

o The school-designated pharmacy will package these medications as a one-week supply and students will pick up their medications weekly.

  • ❖  For non-US-based physicians who cannot prescribe in the United States, the home physician should complete the Prescription Medication Order Form and send it to The Deerfield Academy Health and Wellness Center.

  • ❖  All psychotropic medications must be purchased through the school-designated pharmacy. We will not accept medications from outside pharmacies.

  • ❖  Psychotropic medication, particularly stimulant medication, will not routinely be dispensed for use over school vacations. Parents must keep a sufficient supply at home for use during vacations.

  • ❖  At the end of the academic year, current psychotropic medications will be packaged and given to parents or if parents unable to pick up the medication will be wasted.

  • ❖  If during the course of the year, the medication is changed, any discontinued medications will be destroyed.

5. Privacy and need to know:

  • Confidentiality with respect to psychotropic medication is an important issue.

  • The Health Center will not notify anyone concerning which students are taking antidepressants or

    other non-stimulant psychotropic medicines without parent and/or student permission.

  • With respect to Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder, it is helpful for those responsible in the academic setting to be fully informed of the student’s learning profile.

    For this reason, we routinely notify the Study Skills Coordinator/Assistant Academic Dean of students we know to be diagnosed with Attention Deficit Disorder, unless specifically asked not to do so. We have found that sharing this information is useful to the student and expected by parents.

  • In the dormitory setting, we feel it is necessary at times to notify the adults responsible for the dormitory if stimulant medications are used. Specifically, the Advisor, the Faculty Resident and the Associate Faculty Resident may be notified if a student is taking stimulant medication.

  • Since it is usually helpful for adults involved in the lives of students to be aware of what medications a student is taking and why, parents and students are encouraged to strategize with the Health Center staff concerning who should be notified.

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Athol Pharmacy

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290 Main Street

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Athol, MA 01331

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Phone: (978) 830-0427 Fax (978) 830-0430

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Psychotropic Medication Policy 2020-2021 –4–

6. Misuse and abuse:
• Misuse and abuse of psychotropic medication can be dangerous. It is a major school rule violation

and will result in disciplinary action. Examples of misuse and abuse include:

  1. giving or selling one’s medication to another student;

  2. being in possession of an inappropriately large amount of medication;

  3. taking significantly higher doses than prescribed;

  4. crushing and snorting stimulant medication;

  5. Bringing medication from home and not bringing it first to the Health Center.

  1. Use of alcohol and illicit drugs

    • Safe use of psychotropic medications is NOT compatible with the use of alcohol or illicit drugs such

      as marijuana.

    • If concern arises that a student is using alcohol or illicit drugs while taking a psychotropic

      medication, urine drug testing will be performed. The results of this testing will be communicated to parents and treated as confidential medical information (i.e., it will not be released to other parties such as the Dean of Students). However, if testing is positive, a program of regular random testing will be implemented and evidence of continued use of illicit drugs or alcohol may result in a medical leave of absence from school or other appropriate and substantial responses.

  2. Compliance and record keeping:

    • It is the responsibility of students to pick up their medication at the Health Center and not the

      Health Center’s responsibility to remind them. Consistently missed doses may result in an email message being sent to the student asking them to contact the Health Center. Although taking a psychotropic medication is always a voluntary decision, responding promptly to these requests to contact the Health Center is mandatory. Failure to comply with requests to contact the Health Center or to meet with the Health Center staff may result in accountability points (APs).

    • Records are kept in the Health Center of each medication pick-up and/or administration. Parents interested in a student’s record of medication pick-up are encouraged to call Caryn Gardner, the Medication Nurse.

  3. Regarding access to medications on school-sponsored off-campus trips

    • During off-campus school trips, the Health Center will provide enough of the student’s

      medication for the duration of the trip and give it to the trip chaperone for safe-keeping.

    • It is the student’s responsibility to find the chaperone at an appropriate and convenient time

      every day to self-administer their medication.

    • All medication checked-in and checked-out of the Health Center will be documented through the

      Electronic Medical Record by the Medication Nurse.

      10. Regarding Day Students on psychotropic medication

    • As with all Deerfield Students, Day Students should NEVER have stimulants, tranquilizers or

      sedatives in their possession while on campus. If a Day Student has a prescription for a stimulant, tranquilizer or sedative they take routinely or as needed (i.e. PRN) while on campus, this must be coordinated and provided through the Health Center per the above policy.

    • In addition, if a Day Student is:

i. on any psychotropic medication taken at home before or after coming to campus OR

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Psychotropic Medication Policy 2020-2021 –5–

ii. on a non-controlled psychotropic medication (i.e. NOT a stimulant, tranquilizer or sedative) taken while on campus,

the details of this prescription including medication name, dosage and the frequency of administration must be included on the medication list as part of the Medication OTC and Prescription Agreement and emailed, faxed or mailed to the Health Center.

• Any Day Student on a psychotropic medication(s) who goes on a school-sponsored trip will have to abide by Section 9 of the above policy.

Revised 7/20

All students with a medical condition requiring the self-administration of an injectable medication must abide by the following policy in order to be allowed to use such medication while attending Deerfield Academy.

Documentation must be received regarding the medication from the parent and student per Deerfield Academy’s “OTC and Prescription Medication Agreement and Policy”. Please list in the comments section any history of side effects or other pertinent issues related the medication. Please attach additional pages as necessary.

At the beginning of the academic year or upon the student’s return to campus after being prescribed the medication, the student must come to the Health Center and administer the medication at least once in the presence of a Health Center medical staff member to assure appropriate use and safety. The student may be required by Health Center staff to return and administer the medication again until it is deemed they are doing so appropriately.

Safe and appropriate disposal of needles and administration devices is the responsibility or the student and family. If a sharps/biohazard disposal container is not provided by the manufacturer of the administration device, an appropriate sharps/biohazard disposal container may be obtained from the Health Center. When the sharps/biohazard disposal container is full or near full the student will bring it to the Health Center for safe disposal. At NO time may hypodermic needles or other sharps be inappropriately stored or disposed of in the student’s room or elsewhere on campus.

Please contact the Deerfield Academy Health and Wellness Center with any questions. 413-774-1600

Deerfield Academy and its Health Center wish to be a resource for students with severe allergies that potentially result in anaphylaxis. In order to minimize the risk of anaphylaxis Deerfield has the following policy:

  • Epinephrine auto-injectors will be located at designated sites throughout campus including the Health Center and Dining Hall. Full list may be obtained through Security.
  • During the fall term, all students prescribed an epinephrine auto-injector by their home medical provider will meet with either the School Physician or Nurse Practitioner to review their medical history and Allergy Action Plan.
  • At the beginning of the academic year, a list of students with a history of anaphylaxis secondary to food allergies is compiled by the Health Center and shared with the Dining Hall Director so that reasonable attempts can be made to label foods containing these allergens. This list is resubmitted to the Dining Hall during the school year when the Health Center is made aware of a new significant allergy.
  • If a student with a history of anaphylaxis presents to the Health Center with allergic symptoms they are managed in accordance with the Health Center’s standing orders for anaphylaxis which includes clinical evaluation and intervention, reviewing the student’s Allergy Action Plan, contacting the School Physician or Nurse Practitioner on call immediately and informing the parents as soon as possible.
  • If an epinephrine auto injector is administered, per Massachusetts state regulations (CMR 210.100) emergency services (911) will be contacted and the student will be transported to a local emergency room for observation and treatment
  • For each episode of anaphylaxis on campus, an Anaphylaxis Incident Report is completed by Health Center staff which includes the student’s presentation, medical intervention and an evaluation of how to minimize future exposures and risk.

Parents/guardians are required to:

  • include on the submitted Deerfield Academy Health forms all their child’s allergies;
  • submit an Allergy Action Plan from their home physician if there is a history of anaphylaxis;
  • send their child to campus with an epinephrine auto-injector that is not expired;
  • ensure their child knows how to and can self-administer the epinephrine auto-injector.

Students prescribed an epinephrine auto-injector are required to carry it at ALL TIMES including school-sponsored trips off-campus. They should inform their resident Faculty about their allergy at the beginning of the year and let them know where their epinephrine auto-injector is located.

Parents/guardians of a child with a history of Anaphylaxis must complete this form.

At Deerfield Academy, a refrigerator in provided in each residence hall’s common room so that students can store items requiring refrigeration. We do not permit refrigerators in individual student rooms (See Rules and Expectations for Deerfield Academy Students, Section 4.11); however, occasionally there is a medical reason where an individual refrigerator should be permitted. The following is the policy to help clarify this process:

  • Refrigerator permits will be granted only by the school physician on a limited case-by-case basis for those students who have a medical condition where having access to particular foods or medications requiring refrigeration is necessary in order to prevent a potentially life-threatening or incapacitating complication.
  • To request a refrigerator permit the student’s parent/guardian must submit an email to Office Manager Carol Rogalski stating the medical reason for the request and the required documentation mentioned below. Dr. Benson will review the request and decide whether a permit will be granted. Considering the COVID-19 pandemic, in-person visits to discuss refrigerator permits are no longer required.
  • The school physician has sole authority to grant a refrigerator permit. He/she will base this decision on the student’s history, exam and consideration of recommendations from outside medical providers (medical provider is defined as either a MD, DO, MB BCh, NP or PA)
  • Documentation from an outside medical provider requesting the refrigerator must include a diagnosis, not a symptom (for example “Crohn’s Disease”, not “intestinal issues”) and the life-threatening or incapacitating complication that would occur if request is not granted.
  • The refrigerator permit will last for the remainder of the academic year unless otherwise noted and must be renewed annually.
  • Occasionally there will be certain requirements (i.e. follow-up appointments with the health center, documentation from outside health care providers) that must be fulfilled to maintain the permit during the academic year. Failure to fulfill these requirements will result in the permit being revoked and the refrigerator removed.
  • If the school physician authorizes the refrigerator permit, the student will be given a paper certificate that must be displayed on their refrigerator at all times.
  • If the school physician authorizes the refrigerator permit, a fee of $50 will be charge to the student’s account for the year.
  • Refrigerator may not be any larger than 2.7 cubic feet.

Please address any further questions to the Deerfield Academy Health and Wellness Center at 413-774-1600.

DA Formulary



Review the over-the-counter medications available through the Health Center.

There are forms that need to be filled out!



If a student is prescribed medication (including prescription, over-the-counter, and other types of medications)

If a student has a serious allergy and needs an epinephrine self-injector.

Other Health Policies

The Deerfield Academy Health Center wishes to collaborate with a student’s home physicians and other home health care providers to provide efficient, convenient and seamless care for our students. It is always best for lab work or testing ordered by a student’s primary care provider or specialist to be obtained while the student is at home; however, if this is not possible, the Deerfield Academy Health Center will attempt to facilitate these requests by obtaining the requested labs/testing at the Health Center or at another local facility. Please understand that due to the administrative and clinical burden of obtaining samples for analysis and diagnostic testing, there are certain parameters by which these requests must be made.

  • Any requested testing and the reasoning for the request, including diagnosis, must be submitted directly by the requesting medical provider via mail, email or fax to the Health Center. Parental consent must also be relayed either through conversation with Health Center staff, email or letter.

  • The Health Center will only accept such requests from a physician (MD or DO), Nurse Practitioner or Physician’s Assistant.

  • The Director of Medical Services will then determine if the requested testing will take place at the Health Center, a local hospital or other local medical facility.

  • The Deerfield Academy Health Center’s primary responsibility is the acute care needs of our students. Requests from outside providers are secondary to the immediate needs of our students and the Deerfield community. Therefore, a reasonable amount of time should be expected between when the outside medical provider makes the request and when the test is obtained. As much as we wish to accommodate and collaborate professionally with home medical providers, “same day service” should not be expected nor will it be provided. It is the responsibility of the parent and home medical provider to submit time sensitive requests at least several days before they must be obtained.

  • Any specialized collection material or media must be provided by the requesting physician and mailed to the Health Center by the parents or physician with what the Health Center staff deems to be clear instructions on how the specimen is to be obtained.

  • The Director of Medical Services reserves the right to defer responsibility for obtaining the requested testing to the parents and home care providers if he/she feels it is medically inappropriate or not possible considering the Health Center’s scope of practice and resources.

A concussion is a mild brain injury caused by a direct or indirect hit to the head causing temporary neurologic impairment. Deerfield Academy, through the Athletics Department and Health and Wellness Center, has evolved a robust program to minimize the impact of concussions on Deerfield Academy students.  This policy statement outlines our overall approach to concussions, which includes efforts to:

  • Educate coaches, athletes, parents and the school community to both minimize the occurrence of concussions in sports and to identify concussions promptly and accurately
  • Obtain baseline neurocognitive testing for all students
  • Provide standardized yet individualized clinical decision-making in the management of concussions, including the return-to-play decision
  • Provide reasonable educational adjustments to student’s academic responsibilities when indicated

 

Policy

  • All Deerfield Academy healthcare personnel (nurses, physician, nurse practitioner and athletic trainers), athletic administration (Athletic Director and Assistant Athletic Directors) and coaches will undergo annual education and training with respect to concussions.
  • All Deerfield Academy students and their parents will undergo education and training with respect to concussions prior to participation in athletic competition.
  • All Deerfield Academy students will undergo baseline neurocognitive testing prior to participation in athletic competition.
  • The Head Athletic Trainer will coordinate the process of verification that all students have undergone an education program and baseline neurocognitive testing prior to participation in athletics.
  • All Deerfield Academy coaches will remove students with a suspected head injury immediately from play and refer them to an athletic trainer or the Health and Wellness Center for evaluation. This evaluation will utilize the Deerfield Academy Concussion Management Protocol as a guideline for providing care to students with suspected or diagnosed concussion.
  • The School Physician and the staff at the Deerfield Academy Health and Wellness Center will work with teachers, advisors and school administrators to ensure that reasonable educational adjustments are provided when indicated to concussed students.
  • The Medical Director, Head Athletic Trainer, the Athletics Director and Director of Nursing will review and update this Concussion Policy and the Concussion Management Protocol yearly.

It is normal throughout the course of adolescent development for young people to have questions or concerns regarding eating, weight, exercise, and body image. We believe it’s critical for teenagers to have access to appropriate and accurate resources in order to address these concerns. These issues can also occasionally develop into patterns of unhealthy thoughts and behaviors, in which case more robust medical and mental health support is required. In order to address the entirety of these concerns, the D.S. Chen Health and Wellness Center provides access for our students to a variety of mental, medical and nutritional resources.

Eating disorders typically develop during adolescence, have serious long term health consequences, and are potentially life-threatening. Fortunately, eating disorders are also treatable when addressed early, holistically and with the appropriate level of therapy, support and intervention. In regards to students with known or suspected eating disorders, the health center is dedicated to working with our students and their families, primary care providers and outside specialists in recognizing, evaluating and managing these conditions.

If a student is demonstrating a concerning pattern of eating, restriction, exercise or purging, a health care provider or a counselor will discuss these concerns with the student and/or their parent/guardian so that these issues may be addressed as quickly as possible to ensure the best chance for a full recovery and prevent any long term health consequences.

Assuming the student in question is medically stable, a therapeutic plan will be developed by the health team in consultation with the student and family. It is the Academy’s expectation that the student will actively engage in and follow the provided therapeutic plan and timeline. The plan will include, but not be limited to, regular appointments with a counselor, nutritionist, nursing and health care provider.

It is important to understand that the D.S. Chen Health and Wellness Center does not provide the same level of expertise and treatment found at an eating disorder program (such as Walden or Centers for Discovery) or provided by an Adolescent Specialist (a pediatrician who is board-certified and specializes in the treatment of eating disorders). Therefore, a student known or suspected to have an eating disorder may be required by the Medical Director as a condition to remain in or return to the Academy have a full evaluation by a pediatrician board certified in Adolescent Medicine, a licensed eating disorder clinic/center, or other appropriate clinical program/facility approved by the Medical Director to clarify their diagnosis and make recommendations regarding the most appropriate course of treatment. The timing and clinical urgency of this evaluation will be determined by the Medical Director. If the need for evaluation is urgent but cannot be obtained in a timely manner, the student will require a Medical Leave until it is obtained. The family (or student if ≥ 18 years old) will be required to sign a medical release prior to their visit to any aforementioned provider or program so information—including their evaluation and recommendations—may be freely shared and communicated. If the recommendation from the specialist or program is for a level of care not compatible with the student remaining actively enrolled at Deerfield Academy and fulfilling their academic and extracurricular expectations, a Medical Leave will be necessary to allow the student to complete the entirety of their recommended treatment plan prior to their return to campus. We fully appreciate that conversations about Medical Leaves and the prospect of missing classes and campus life can bring up uncertainty and feelings of frustration. Even so, considering the serious long term and potentially fatal complications of this illness, it is far more important for a student to take the necessary time away from campus to fully establish themselves on the road to recovery as opposed to choosing a less intense and less effective route of treatment.

If a student cannot or does not comply with the treatment plan set forth by the health center, is not actively and genuinely engaged in treatment, shows evidence of mental or physical decline, or is assessed by the Medical Director to require a level of care outside the health center’s scope of practice, this is indicative that a higher level clinical evaluation and care will be necessary and a Medical Leave will most likely be required to receive appropriate care.

If a student with the above concerns is ever felt to be clinically unstable or to need inpatient hospitalization per AAP criteria (see below) or provider’s clinical assessment, health center staff will immediately contact a local hospital and/or emergency services for triage and evaluation.

From the American Academy of Pediatrics Criteria for Inpatient Hospitalization in Eating Disorders:

·       Heart Rate < 50 beats/minute; < 45 beats/min while asleep

·       Systolic Blood Pressure < 90 mm Hg

·       Orthostatic changes in pulse (> 20 beats/minute) or blood pressure (> 10 mm Hg)

·       Arrhythmia

·       Hypothermia (Temperature < 96⁰F)

·       < 75% ideal body weight or ongoing weight loss despite intensive management

·       Body fat < 10%

·       Refusal to eat

·       Failure to respond to outpatient treatment

·       Syncope

·       Serum Potassium < 3.2 mmol/L

·       Serum Chloride < 88 mmol/L

·       Esophageal tears or hematemesis

·       Suicide Risk

·       Bloody or Intractable vomiting

 

 

The student will not be allowed to return to campus until they have been evaluated at the local hospital, have complied with and completed all recommended treatment and vital signs are stable or other reason for emergency transfer has been resolved. If the family chooses not to comply with recommended evaluation treatment then a Medical Leave will be mandated until such treatment or appropriate alternative evaluation and treatment approved by the Medical Director is obtained.

Our overriding principle at the D.S. Chen Health and Wellness Center is always to provide robust and holistic support to our student body so that they might be their healthiest selves and realize growth and success while at Deerfield Academy and beyond. Our aim, therefore, is to assess and support any student who might be struggling with disordered eating behaviors, and to help them and their families access the most effective and long-lasting treatment possible, be that on or off campus.

——

References:

The Identification of Eating Disorders in Children and Adolescents; David S. Rosen and the Committee on Adolescence; Pediatrics December 2010, 126 (6) 1240-1253; DOI: https://doi.org/10.1542/peds.2010-2821  

National Eating Disorder Association (NEDA) Level of Care Guidelines