Working with Students with Mental Health Challenges Deb Broderick, Psy.D. LP, Counseling and Psychological Services Kim Schumann, Disability Resources Chirayu Dongre, Academic Counseling

Today’s Goals Increase awareness of general signs and symptoms of mental health issues (depression and anxiety). Learn what you, as an advisor, can to do help students with mental health needs. Learn when/where to refer students for help with mental health issues.

Why should I know this? To be a source of help and support for students with mental health issues. See changes in academic performance, behavior, mood, and personality. Students with mental health disorders may receive reasonable accommodations that do not violate the essential elements of the academic program

Causes of depression and anxiety? Medical conditions Inherited vulnerability Cognitive inflexibility (perfectionism) Chronic negative cognitions Substance use/abuse/addiction Trauma Sleep Problems ADHD/ADD Traumatic Brain Injury or concussion Thyroid problems Other mental health disorders: eating disorders

What to Look For: Depression & Anxiety Loss of interest in classes, major, career plans. Negative changes in usual performance or behavior. Statements of helplessness or hopelessness to solve problems or change behaviors. References to suicide, homicide or death General changes to take notice of

What to Look For: Depression & Anxiety Marked decrease in performance and/or preparation. No/slow response to emails/requests/or deadlines. Excessive absence or tardiness from classes. Repeated requests for special considerations. Irritable or angry responses to requests or problems. Noticeable sad mood/affect/tearfulness More specific behaviors you might notice. Avoidance of class or meeting with professors or you.

What to Look For: Depression and Anxiety Marked increase or decrease in activity Conversations that do not make sense. Marked decline in personal hygiene Dramatic weight loss or gain Coming to class or events intoxicated/high. Difficulty concentrating. Mental health issues may look different person to person, especially when we take into account cultural differences. For international students, problems with mental health may manifest differently than US students.

Consider Cultural Differences Students from non-Western cultures may have different beliefs about mental health Some cultures have stigma associated with mental health issues meaning students avoid asking for help The student’s own perception of the problem Some students view mental illness as a fiction or a weakness The challenge can be convincing a student that the illness is real and treatable

Consider Cultural Differences Look for distress signs (as covered in previous slides) Students may express their mental distress through somatic complaints International Students: many factors combine to create depression, such as, the language barrier, isolation in a new culture, family expectations, etc Engage student in conversation; gauge willingness to go to the counseling center Demystifying counseling Framing it is an American or Western custom worth trying

Consider Cultural Differences Sometimes, students just need someone to listen Consider connecting with the OISS office as well if you have serious concerns Send an Academic Alert; Flag Team https://www.nafsa.org/findresources/Default.aspx?id =27117

What Can You Do? Talk Listen Communicate Maintain Boundaries Refer 5 general guidelines to use to be a helping resource to your advisees.

Talk, Listen and Communicate Talk to the student in private. Give your undivided attention. Effective listening helps the student feel cared about and more confident about what to do If you feel anxious, keep your door open or meet the student in a public place

Talk, Listen and Communicate Listen closely to the student in a non-threatening way. Express your concerns in behavioral, observable, non-judgmental terms. “I’ve noticed you’ve been absent from class over the last two weeks and I’m concerned.” Ask how you can be helpful. Communicate understanding by summarizing what the student told you. Try to include both content and feelings for example “It sounds like you haven’t made new friends since you’ve been here and are feeling lonely and worried.”

Talk, Listen and Communicate Help them realize there are options and things won’t always seem hopeless. Suggest resources: family, friends, clergy or professionals on campus. Let them know you’re available if/when they want to talk. Try not to fall into advice-giving or “should” or “need to”. Your role is to be supportive of their experience; help them problem-solve; provide resources if necessary. If the student doesn’t engage or denies that anything is wrong - don’t push - let them know you’re available if they do wish to talk and will help them.

Maintain Boundaries Keep clear & consistent advisor-student boundaries. Maintain academic expectations (exam schedules, class, registration, etc). If necessary, consider other academic options (withdrawal, incomplete). Don’t be a lone wolf! Consult with colleagues and/or campus resources. You are the professor/advisor., not their counselor, parent or friend. You don’t need to solve the student’s problems - often situations are more complex than they look and it doesn’t help the student learn problem-solving skills, emotional management, and effective coping skills. Use others for support, ideas, resources. Consult with Academic Counseling, CAPS, Dean of Students, FLAG committee

When to Refer Need specific help from other campus resources. Disability Resources http://www.stthomas.edu/enhancementprog/ You feel overwhelmed or worried about the student’s safety or well-being. Counseling & Psychological Services http://www.stthomas.edu/counseling/

Disability Resources Responsible for compliance with Americans with Disabilities Act regarding accommodations for students with disabilities Provide all qualified students with disabilities equal access to all university courses, services, programs, employment, and facilities Provide consultation to faculty and staff

Mental health and the ADA Students don’t always realize that mental health diagnoses are disabilities for which they may qualify for accommodations Stigma may prevent students from disclosing mental health diagnoses and getting registered Remind students of confidentiality Explain that it’s about access, not unfair advantage

How does a student register? Contact Disability Resources for initial appointment and have first meeting Submit documentation (required to determine eligibility for services) Staff determine accommodation plan and send notification to faculty Students required to request accommodations each semester

Accommodations Attendance/deadline/exam flexibility Exams (extended time, distraction reduced space) Test anxiety not a disability Note taking software Audio recording lecture

Counseling & Psychological Services Located on the 3rd floor MHC - (651) 962-6780 Individual counseling (12 sessions) Group counseling Pathways psychoeducation group. “Let’s Talk” – brief, drop-in consultation service Free Call or walk in to schedule appointments. Crisis walk-in appointments M-F, 8:00 – 4:30 pm

Urgent or Crisis Crisis: expresses suicidality/homicidality, disorganized thinking or presentation, not able to manage emotions (excessive crying, anger, or sadness). Call CAPS: 2-6780 for a “crisis walk-in appointment” or to speak to a counselor. After hours, call UST Public Safety 2-5100 to assist in helping the student.

“I don’t want to go to CAPS.” Compare going to CAPS like going to Health Services, Academic Counseling, or seeing you. Tell the student what you know about the staff and the services. Remind them it is confidential. Collaborate on another “point of entry” for help; Health Services, Dean of Students, Campus Ministry, “Let’s Talk”. Acknowledge the resistance/ambivalence to counseling, including differing cultural views of counseling. Students are often reluctant to let others know they are struggling: fear of negative judgment, their concerns will be dismissed as minor, will be told to “deal with it”, or other negative responses from “adults”. Suggest they take it one step at a time - first visit is 30 minutes - easy!

Other Campus Services Dean of Students 962-6050 Flag Team UST Health Services 962-6750 Learn to Live: online therapy for anxiety and depression http://www.stthomas.edu/counseling/selfhelp/learnto live/ Faculty Tip Sheet: http://www.stthomas.edu/media/academiccounseling support/files/studentinformation/StudentswithMental HealthChallenges.pdf