Recognizing and Referring Student in Distress

7965 MentalHealthCrisis FlowChart344

Behaviors/Symptoms that are concerning
  • Significant changes in behavior that are not characteristic of a person
  • Significant changes in appearance, social interaction, or observable mood
  • The presence of disruptive behaviors that interfere with the responsibilities of daily living/academic work/the residential community
  • Panic Attack/Anxiety Attack
  • Past or recent Trauma that is intruding on person’s thoughts
  • Poor ability to care for basic needs related to eating, sleeping, hygiene
  • Aggressive behaviors towards self or others that are not immediately threatening or dangerous
  • Self-injurious Behaviors (cutting, burning, hitting, etc.) that do not pose an immediate health risk.
  • Drug and Alcohol Use (if person is intoxicated they may need emergency medical assistance)

In addition to these mental health concerns that are more serious in nature, students may report to you that they are experiencing:

  • difficulty coping with negative emotions (anxiety, sadness, anger)
  • relationship difficulties or conflict
  • relationship loss
  • confusion related to aspects of their academic or personal identity
  • uncertainty about their motivation or choices related to their academic pursuits
  • past trauma or abuse
  • difficulty making decisions
  • grief
  • struggles related to maintaining self-esteem, self-confidence, or self-efficacy
  • lack of motivation to achieve goals
  • confusion about their values

Some of these experiences can be very normal parts of development and life. Most students will cope successfully on their own with the help of their natural support system. However, sometimes students experience serious symptoms or multiple difficulties at the same time, have on-going difficulty using healthy coping skills, become isolative, withdrawn, and avoidant, or lack natural support systems to help them through these experiences. When a student is experiencing difficulties for a prolonged period of time with no or little improvement or the difficulties are interfering with their daily functioning or ability to successfully pursue their goals, then they may benefit from the support of a mental health provider.

 

Suggested response to observing the above behaviors/symptoms

Validate

  • Request to see the student in private
  • Create a safe space: This happens through validation, empathy (non-judgement), and active listening
  • Validate the student’s feelings: what they are feeling is okay and you believe them
  • Validation is not agreement. It is your acceptance and support for their feelings whether or not you agree with their point of view or behaviors.
  • Listen to what the student is troubled about and try to see the issue from his/her point of view without necessarily agreeing or disagreeing. Use reassurance genuinely but be careful not to overuse it.
  • Remember that empathy is different than sympathy. It involves putting yourself in someone else’s shoes and feeling what they feel.
  • Empathy can serve as a guide to help us know how to help someone else. Remember a time in your own life when you felt a similar way and what you would have liked to have from someone else.
  • Active listening implies simply that listening is an active process. In other words, you are doing something when you are listening; and therefore, it involves attending, using silence when needed, paraphrasing, clarifying, summarizing, and reflecting.

Appreciate

  • Care through encouragement, helping actions, and maintain healthy boundaries
  • Express your appreciation to the student for being so open and explain that it takes courage to ask for help and express your struggles
  • Support this step they have taken in agreeing to speak with you and let them know they are doing a good thing for themselves
  • Use genuineness and kindness in expressing your concerns about what you have observed or been told: Acknowledge your observations and express your concerns directly and honestly (but without judgement or labeling)
  • Help them problem solve and explore options, solutions, and consequences related to their situation.
  • Offer them help that you can give or feel comfortable giving related to your role in their lives/the university.
  • Explain to them clearly why you are there and what you will be doing next. Having information tends to make people feel safer.
  • Involve yourself only as far as you can go in your role. At times, in an attempt to reach or help a troubled student, you may become more involved than time or skill permits. Be careful of this. On the otherhand, extending oneself to others often makes them feel safe enough to share vital information and may be what they need to get through this tough time.
  • Help them tolerate the distressing feelings by just being there with them through it as a calming, reassuring presence.
  • **If in a crisis situation, speak calmly, be clear and direct, show compassion and care, and call the Counselor on call right away and other staff as necessary.

Refer

  • Ask them what skills they have and what they do to deal with tough situations. See if they can call upon those skills/behaviors/self-care strategies
  • Connect student with supportive resources both internal and external to the university
  • Tell them about services offered on campus that can help them
  • Help them utilize or find out more information about that resource
  • When appropriate, inform them or educate them about other external resources that may be helpful to their situation.

 

More on Referring a Student to the Counseling Center

We encourage parents, faculty, staff, and peers to refer students to the Counseling Center. Due to confidentiality laws and our policies, a third party, including a parent, is prohibited from scheduling an appointment for a student. A student who wishes to visit the Counseling Center must contact the Counseling Center directly and voluntarily request services by booking an appointment and completing necessary paperwork. If you wish to help a student, you are welcome to assist the student in booking an appointment online. You can also contact the center to consult with a Counselor and give helpful information about the students and your concerns.

Ultimately, individuals can refuse counseling except in certain emergencies involving a danger to self or others. When recommending a referral to the Counseling Center, let the student know that you have heard their concerns and think that your recommendation to speak with someone in the Counseling Center is your best judgment based on your own observations of the student’s behavior. Avoid generalizations and be specific about the behaviors that concern you. (For example, “I can see how upset you are by this situation. I am glad that you felt you could talk to me about this, as I am extremely concerned for you when you are saying you are drinking too much every night. I think you might find it helpful also to talk to someone with more experience in this area than I have. The Counseling Center is a resource on campus….”).

If the student is reluctant to accept a referral (and they are not experiencing life-threatening thoughts or behaviors), offer your acceptance of those feelings. Perhaps offer the option for the student to think about it and get back to you in a day or so, in case they might want to "think it over."