Communicating with a Student in Distress

Recognizing and Helping Distressed Students

Sponsored by:

Provosts Office &Student Health Services

April 2nd and 4th, 2013

Overview:Statistics re: college students and mental health

Recognizing warning signs of distress

Communicating with a student in distress

Referring students for help

Managing student requests and situationsTop 5 Academic ImpactsMSUB ACHA-NCHA II Fall 2012 (N=588)

1. Stress 26.6%2. Sleep 21.5%3. Work 21.1%4. Anxiety 20.4%5. Depression 13.4%

National Data Spring 2012 (N= 90,666)

1. Stress 29.0%2. Sleep 20.6%3. Anxiety 20.2%4. Cold/Flu/Sore Throat 15.6%5. Work 13.9%

Academic ImpactReceived a lower grade on an exam, or an important project;

Received a lower grade in the course;

Received an incomplete or dropped the course;

Or experienced a significant disruption in thesis, dissertation, research, or practicum workStress and Sleep48% rated their overall level of stress as more than average

63% felt tired, dragged out, or sleepy at least 3 days/week

54% felt they did not get enough sleep to feel rested in the morning at least 3 of the past 7 days

Mental HealthWithin the last 12 months, % of students who said the following has been traumatic or very difficult to handle:

Finances 47%Academics 40%Family problems 33%Sleep difficulties 31%Intimate relationships 29%Career-related issue 29%National Data:

Academics 46%Finances34%Intimate Relationships 32%Family problems 28%Sleep difficulties 26%Other social relationships 25%Mental HealthWithin the last 12 months:

85% felt overwhelmed by all they had to do31% felt so depressed it was hard to function49% felt overwhelming anxiety36% felt overwhelming anger7% seriously considered suicide

* Note: What may be the unintended message we send students when we craft and ask these questions (vs. questions that focus on resiliency)?

National Data:

86% felt overwhelmed by all they had to do31% felt so depressed it was hard to function51% felt overwhelming anxiety37% felt overwhelming anger7% seriously considered suicide

NAMI Survey data64% of students who experience mental health problems end up withdrawing

50% of students who withdrew from school never accessed college mental health services and support

78% believe mental health training very important for faculty/staff

22% learned about college services through faculty or staff

National Alliance on Mental Illness web-based survey August-November 2011 N=765

Recognizing Students in DistressStudents in mild distress may exhibit behaviors that do not disrupt others but may indicate something is wrong and that assistance is needed.

Behaviors may include:Serious grade problems or a change from consistently passing grades to unaccountably poor performance.

Excessive absences, especially if the student has previously demonstrated consistent attendance.

Unusual or markedly changed patterns of interaction

Other characteristics that suggest the student is having trouble managing stress successfully Adapted from University of Michigan (2008)

Recognizing Students in DistressStudents in moderate distress may exhibit behaviors that indicate significant emotional distress. They may also be reluctant or unable to acknowledge a need for personal help.

Behaviors include:Repeated requests for special consideration, especially if the student appears uncomfortable or highly emotional.

New or repeated behavior which interferes with effective management of the immediate environment.

Unusual or exaggerated emotional responses that are obviously inappropriate to the situation.

Adapted from University of Michigan (2008)

Recognizing Students in DistressStudents in severe distress exhibit behaviors that signify a crisis and that necessitate emergency care. Behaviors include:Highly disruptive behavior Inability to communicate clearly Loss of contact with reality Stalking behaviors.Inappropriate communications Overtly suicidal thoughts or threats to harm othersAdapted from University of Michigan (2008)

Recognizing Students In DistressSymptoms of DepressionPersistent sadnessFeelings of hopelessness, worthlessness, guiltLack of motivationLack of enjoyment of activities or class material the person previously enjoyedSleep disturbanceSignificant weight gain or lossSuicidal ideation

Recognizing Students in DistressSymptoms of AnxietyExcessive worry that is difficult to controlRestlessnessFatigueDifficulty concentratingIrritabilityMuscle tensionSleep disturbancePanic attacks

Recognizing Students in DistressSymptoms of PsychosisDelusions (false beliefs)Hallucinations (false sensory experiences)Disorganized speechDisorganized behaviorFlat or inappropriate affect (emotional display)Absence of motivationSpeech disturbancesChange in hygiene and appearance

Recognizing Students in DistressCounseling isnt just for mental illness!Time management techniquesStress management techniquesSleep hygieneBalancing work/family/schoolHelp managing significant life events (e.g., break-ups, homesickness, roommate difficulties)Communication and interpersonal skillsRelationship issues

Communicating with a Student in DistressMove the student to a quiet and secure location

Express your concerns in behavioral, nonjudgmental terms

Be direct and specific

Avoid judging, evaluating or criticizing respect the students value system even if you disagree

Listen attentivelyGive student your undivided attention

Communicate understanding by repeating what he/she has told you

Let the student talk

Do not minimize or immediately provide reassurance

Praise student for openness and honestyRemain calm and respond in a soothing manner

Validate the students feelings and experiences

Take the student seriously

Be supportive and express your concern about the situation A Victimized StudentRecognize the student may be vulnerable and experiencing a range of intense feelings, including shame, anger, fear and denialBelieve the studentRespect the students right to make his/her own decisionLet the student know that you must, as a university employee, report any abuse, but it can be reported as a Jane or John DoeRefer to MSUB Student in Distress Guidewww.msubillings.edu/VCSA/PDF/GuideforFacStaff-StudentBehavior.pdf

A Severely Disoriented or Psychotic StudentRecognize that psychotic states can involve extreme emotion or lack of emotion and intense fear to the point of paranoiaRecognize that a student in this state may be dangerous to self or othersCall Campus Police (2222) before you see the student so they can be in the area in case you need themAlert someone else near you that you are seeing a student and may need assistance Speak to the student in a direct and concrete manner regarding your plan for getting him/her to a safe environmentThe Aggressive, Angry or Potentially Violent StudentAssess your level of safety Call 911 or Campus Police at 2222 if you feel in danger (9911 if on campus)

Remain in an open area with a visible means of escape

Explain to the student the behaviors that are unacceptableStay calm and gain control of the situation by setting limits

Use a time-out strategy (that is, ask the student to reschedule a meeting with you once he/she has calmed down) if the student refuses to cooperate and remains aggressive or agitated

The Depressed or Suicidal StudentLet the student know you are aware he/she is feeling down and you would like to provide support and assistance

Ask the student if he/she has thoughts of suicide

Take the students disclosure as a serious plea for help

Express care and concern and assure the student that you will help him/her reach a professionalDistance EducationIf any of the situations discussed here are expressed by your online students, the same communication skills apply. The referral information, however, changes. Mental Health counseling is not available over the phone to students.

You could ask the student if they have ever seen a counselor and suggest he/she call that personYou could look online for resources in the students geographical area and refer themRecommendationsDo not become involved with a student beyond your level of expertise or comfort

Do not ignore comments such as, I wont be a problem much longer

Do not become anxious or overwhelmed yourself

Do not minimize the seriousness of the students behavior

Do not become defensive or get into an argument or shouting match

Do not convey judgment or criticism

Do not act hostile or punitive

Do not make assumptionsReferring a Student For Professional HelpWHEN TO REFERStudent remains distressed following repeated attempts by you and others to be helpful

Student becomes increasingly isolated, unkempt, irritable or disconnected

Students academic or social performance deteriorates

Student behavior reflects increased hopelessness or helplessness

You are doing on-going counseling rather than advising

How to ReferSpeak to student in direct concerned straightforward manner

Be caring but firm in recommending counseling. Be clear about reasons concerned

Be knowledgeable in advance about services and procedures of SHS Counseling or other campus agencies

Suggest student make an appointment and provide phone number for referral

Remind student that counseling is free and confidential

You may need to be more active in assisting student in making appointment, or walk them to Student Health ServicesStudent Health ServicesThe Student Health Services provides high-quality, cost-effective health care and mental health counseling with an emphasis on health education and wellness initiatives to promote and enhance student success.

Hours :University Campus Clinic & CounselingMonday-Friday 8:00a - 5:00p 2nd Floor Petro Hall

City CollegeClinic: Mon, 1p-4:30p; Wed, 9a - 12p; Tue & Thu, 11p - 2p Tech Bldg. 2nd FloorCounseling: Mon, 9a-4p; Wed 9a-12 noon; Thu, 8a - 11a

Phone: University Campus: (406) 657-2153City College Phone: (406) 247-3027

www.msubillings.edu/studenthealth

Campus PoliceFor emergencies dial extension 2222

For Billings Police emergencies and medical emergencies dial 911 (9911 if on campus)

Sign up for MSUB alerts http://www.msubillings.edu/msubalert/

www.msubillings.edu/police/

TRIO and SOSProvides academic support and individualized assistance to first generation, low income or students with disabilities

Services include:Peer mentoring, study groups/tutors, access to cultural events, workshops, financial information, counseling and referral, midterm evaluations, newsletters, assistance in graduation preparation, return to learn and SOS activityclub

Student Opportunity Services/TRIOLibrary, LI 141

Phone: (406) 657-2162Fax: (406) 657-1667Office Hours: 8:00 am to 5:00 pm M-F

www.msubillings.edu/sos/

ASC Academic Support CenterOffers classes in reading, developmental math and developmental reading

Tutoring for math, writing, reading, science, psychology and foreign languages

Services are FREE (prepaid in tuition)

University ASC front desk 657-1641

City College ASC front desk 247-3022

www.msubillings.edu/asc/

DSS Disability Support ServicesWorks with issues related to physical access and issues related to course content

Accessible technology

4 testing rooms

DSS does not offer tutoring, mental health counseling, financial assistance, personal care attendants or mobility equipment

DSS cannot by law contact a student but you can refer

College of Education Room 135 657-2161

City College Room A008 247-3029

www.msubillings.edu/dss/

Managing Student Requests & SituationsSome Key ComponentsLocation

Safety

Thorough Assessment

Problem SolvingReferral

Clear CommunicationAvoid Judgment

Boundaries & Competence

Active Listening & Validation

Supports/Consultation

TAKE CARE OF YOURSELF!

Unconfirmed DiagnosisI think Im bipolar.Im pretty sure I have ADHD.I have test anxiety.

Think about student welfareTake them seriously refer them for diagnosis & treatmentWin-winLet them know about DSS & other supportive programs

Refusal to Work with Medical/ Mental HealthThey dont understand me.They say Im faking it.

Any accommodation should go through some path (e.g., SHS, DSS, etc.)

Acknowledge & validate fears/concerns

Encourage referral

Excessive RequestsCan I do a special study session with you instead of the TA?

Will you change my grade for the last exam? My bipolar was really acting up that day.

My social anxiety is really bad. Can I skip the required presentation for this class?

Excessive Requests (Continued)Here are some UNreasonable accommodations:

Anything that poses a threat to health/safety of others

Substantial change in essential element of curriculum (e.g., dropping presentation requirement for speech course)

Altering course objectives (e.g., waiving the writing element of a course)

Undue financial/administrative burden to institution

For Additional AssistanceStudent Health Services Mental Health Counselors657-2153Linda CrummettJudy SilvermanAmber McDermott (also in Dept of Rehab & Human Services)Kim Waldmann

Department of Psychology657-2242 or 657-2250 (direct #)Marie Schaaf GallagherResourcesHelping Students in Distress--A Faculty and Staff Guide for Assisting Students in NeedUniversity of Maryland Counseling Centerhttp://www.cte.umd.edu/HSID.pdf

Reaching Out Resources for Responding to Students in DistressBoise State University Health and Recreation Counseling Serviceshttp://healthservices.boisestate.edu/resources/materials/reachingOutHandbook.pdf

Student in Distress and Sexual Harassment: A Guide for Faculty and StaffMSU Billingshttp://www.msubillings.edu/VCSA/PDF/GuideforFacStaff-StudentBehavior.pdf

National Alliance on Mental Illness web-based survey August-November 2011 N=765 http://www.nami.org/Content/NavigationMenu/Find_Support/NAMI_on_Campus1/NAMI_Survey_on_College_Students/collegereport.pdf

Discussion:Other Student Requests/Situations?