Recognizing Students in Distress
It’s common for college students to experience considerable personal and school-related stress. In attempt to juggle the demands of college and their personal lives, sometimes students may act out in self-destructive ways and aggressively. Strong feelings of anger, depression and anxiety are common. Sometimes an additional issue or stressor can precipitate a crisis.
By the Numbers
Studies indicate that in a group 100 college students (50 men and 50 women) at least:
- 25 will have parents who are divorced
- 15 will have a substance-abusing parent
- 10 will have a substance-abuse problem
- 15 females will be victims of rape or sexual abuse
- 6 females will have an eating disorder
- 4 males will be victims of sexual abuse
- 3 females will have an unplanned pregnancy during college
- Isolation and loneliness
- Death of a loved one
- Breakup of an intimate relationship
- Serious illness
- Feelings of rejection by family
- Academic pressure or failure
- Identity confusion
- Cultural oppression/discrimination
- Low motivation or inability to establish goals
- Outside work pressures
- Parenting responsibility
As a Faculty or Staff Member, You Can Help!
Students experiencing distress may turn to you for help, due to your position, status and visibility on campus. You may also find yourself in a situation where a distressed student needs assistance. Your response in these situations could significantly impact the student’s ability to deal constructively with her or his problems.
There are specific guidelines you can use to help students get the assistance they need.
Recognizing Students in Distress
Everyone feels stressed, depressed or anxious from time to time. However, some behaviors occurring over a period of time can suggest that the problems with which the student is dealing are beyond his or her ability to cope. The following three levels of behaviors indicate relative severity of distress.
Level 1: Although not disruptive to others, these behaviors may indicate that intervention is needed:
- Seriously poor grades or a change from consistently good to unaccountably poor performance
- Despite satisfactory performance, a student who appears anxious, constantly seeks you out and is concerned about grades
- Excessive absences, especially if the student previously demonstrated consistent class and/or work attendance
- Unusual or markedly changed pattern of interaction (e.g. totally avoiding participation, becoming excessively anxious when called upon, dominating discussion, withdrawal from social contact, etc.)
- Depressed mood, excessive crying and/or inability to make transition to school environment
- Other characteristics, such as lethargic behavior, excessive activity and very rapid speech; swollen, red eyes; marked change in personal dress or hygiene; anxious behavior; and falling asleep in class or at work
Level 2: These behaviors may reflect significant emotional distress, a need for intervention, as well as a reluctance or inability to acknowledge a need for personal help:
- Repeated requests for special consideration, such as deadline extensions (especially if the student appears uncomfortable or highly emotional disclosing the circumstances prompting the request)
- New or consistent behavior which pushes the limits of decorum and which interferes with the effective management of your class, work setting or living arrangements
- An unusual or exaggerated emotional response that is obviously inappropriate to the situation
- A student with no apparent physical illness loses a dramatic amount of weight in a short time period
- A student seems agitated and restless in class, constantly argues with you and is shunned by classmates
Level 3: These behaviors usually suggest a student is in crisis and requires emergency intervention:
- Highly disruptive behavior (hostile, aggressive, violent, etc.)
- Inability to communicate clearly (garbled or slurred speech, disjointed thoughts)
- Loss of contact with reality (seeing/hearing things that are not present, beliefs or actions greatly at odds with reality or probability)
- Overtly suicidal thoughts (referring to suicide as current option)
- Homicidal threats
What You Can Do (Intervention)
Staying calm, being willing to help and knowing whom to call is important in any of these situations. You may choose to approach the student or the student may seek your help with a problem. Below are some suggestions that might help you deal with a distressed student.
Listening and talking (at all levels):
- Demonstrate your respect for the student by talking to the student when both of you have sufficient time and are in a private place free from disturbance by others
- Be matter-of-fact. Controlling your emotions may help the student to do the same
- Give the student your undivided attention
- Express concern for the student in clear, direct, behavioral, non-judgmental terms (e.g., “I’ve noticed you’ve been absent from class lately, and I’m concerned,” rather than “Why haven’t you been in class?” or “Where have you been lately?”)
- Listen in a respectful, non-threatening way to the student’s description of the problems. Let the student talk
- Convey support and understanding by summarizing what you hear the student saying by including both content and feelings (“It sounds as if the experience of moving away from home was a big change and now you’re feeling lonely and isolated.”)
Referring to Counseling and Psychological Services
Level 1: Suggest that the student call 402.472.5000 for an appointment during office hours.
Level 2: Suggest that the student use your telephone to arrange an appointment by calling 402.472.5000 while the student is still in your office. When the call is made from your office, you know that at least an appointment has been made. By making the student call her/himself, the student is more likely to follow through to get help. Your willingness to let her/him handle this part of the process affirms her/his positive coping capacities.
Level 2 and 3: Call Counseling and Psychological Services yourself at 402.472.5000 while the student is still in your office and arrange an appointment for the student. If you think this is an urgent situation, please indicate this when you contact us. Let the student know your willingness to provide Counseling and Psychological Services with information about the nature of the problem and the reason for your referral.
Level 3: In an urgent situation, you may decide to accompany the student to Counseling and Psychological Services (located inside the University Health Center) in person so that she/he may be seen immediately by the counselor who is available to handle emergencies (Monday through Friday, 8 a.m. to 5 p.m.). If possible, a call to 402.472.5000 indicating that you are bringing a student to Counseling and Psychological Services would be helpful.
**In an emergency, call the University Police: 402.472.2222.
When in Doubt, Consult
If you have specific questions about a student or are unsure about whether or how to approach an individual to make a referral, call Counseling and Psychological Services at 402.472.5000, indicate that you are concerned about a student and ask to speak to the case manager or director. The staff member will help you:
- Assess the seriousness of the situation
- Learn about resources, both on and off campus, so that you can provide the student with potential options for obtaining assistance
- Decide how best to initiate the referral process
- Clarify your own feelings regarding the student and consider how you can be most effective
What Happens When a Student Visits Counseling and Psychological Services
Generally, the first visit will be a 20 to 30 minute conversation with a counselor to assess the concerns and determine the best next step for the student. This brief appointment does not have a charge and does not count toward students’ four no-charge visits covered by the University Program and Facilities Fee, also known as “student fees.”
After this visit, the first four individual therapy sessions per academic lifetime are no additional cost. Additional visits are available for a fee, which can be submitted to insurance or paid out of pocket at a reduced rate. We collaborate with the psychiatric providers at the University Health Center; medication management appointments are provided as needed at a cost, which can be submitted to insurance. Students should be encouraged to make their own appointments by calling 402.472.5000 or stopping by the University Health Center during office hours. Due to heavy service demands, there may be a wait for several hours to several days before the first therapy intake appointment can be arranged. In emergency situations, however, a student will be seen as soon as possible.
At the student’s first therapy appointment, she/he will fill out confidential information forms before meeting with a mental health professional. During this appointment, the professional will assess the student’s concerns and needs. Communication with Counseling and Psychological Services is confidential. A student’s situation, or even the fact that counseling is being received at here, may not be shared without the student’s written permission. The main exceptions to this are imminent suicide, homicide or suspected child abuse.
If the counselor and student agree that individual counseling is appropriate, the student may choose to see a counselor on a regular basis, usually bi-weekly, for approximately 45 to 50 minutes each session. Other options include couple or group counseling, support and therapy groups, workshops, alcohol and other drug services, eating disorder services, referral to another campus or community agency and more. It’s possible the student may leave the initial appointment feeling able to handle the problem on her/his own. Counseling and Psychological Services has no authority to require a student to accept any suggestions that are made unless professional judgment indicates that psychiatric hospitalization is mandatory due to imminent harm.
How to Follow Up After a Referral
After a referral has been initiated, it can be helpful at times to follow up with the student to determine if she/he attended the appointment. Depending on the nature of your relationship with the student, you may also find yourself wondering, “How is it going?”. However, the student should be the one to initiate these types of conversations. The student’s rights to privacy should always be respected.
If you wish to share information with Counseling and Psychological Services about a student you referred, you may do so. Please remember that the counselor-client relationship is confidential. Therefore, counselors are not able to release information about a specific student without permission from the student.
If the behavioral warning signs of student distress are detected early and a positive, supportive referral is made, there is good chance that the problem can be addressed effectively. As faculty and staff members who care about the well-being of the campus community, you can make a major difference in the student’s success both personally and academically.