1. Supporting Students in Distress Maureen A. Windle, Psy.D. Associate Director/Clinical Director Counseling and Psychological Services (CAPS)

2. Introduction

3. Top five reasons why this topic is important  5. Most college students who commit suicide are not in treatment at their respective Counseling Center’s.  4. There is always a % of students on campus, who despite our best efforts, do not know that CAPS exists.  3. Many cultures continue to stigmatize mental health issues.  2. For many, college is the first time you really get to think about yourself separate from your family of origin.  1. Mental health issues can significantly impact academic success.

4. Overview  Indicators of Distress  Vignette & Group Discussion  Ways to Intervene  University Resources

5. Examining Signs of Distress  Areas of Observing Distress  Academic and Employment  Behavioral and Emotional  Physical  Culture  Race, Ethnicity, Gender, Sexual Orientation, Physical Abilities, Religion/Spirituality, Social Class, and other identities.  Informs how students experience and communicate distress

6. Student Distress: Academic/Employment Indicators  Repeated absences from class/employment  Missed assignments, meetings, apts.  Deterioration in quality or quantity of work  Extreme disorganization or erratic performance  Written or artistic expression of unusual violence, morbidity, isolation, despair  Continual seeking of special provisions  Overblown or disproportionate response to evaluations or requests for improvement

7. Student Distress: Behavioral and Emotional Indicators  Direct statements indicating distress, family problems or loss  Angry or hostile outbursts, yelling or aggressive comments  More withdrawn or animated than usual  Expressions of hopelessness or worthlessness; crying or tearfulness  Expressions of severe anxiety or irritability  Shakiness, tremors, fidgeting or pacing  Lack of response to outreach from staff  Excessively demanding or dependent behavior  Isolating self in residence hall room or apartment  References to a plan to “end all of their problems”

8. Student Distress: Physical Indicators  Deterioration in physical appearance or personal hygiene  Excessive fatigue, exhaustion; falling asleep during the day  Visible changes in weight; statements about change in appetite or sleep  Noticeable cuts, burns or bruises  Unusual inability to make eye contact  Frequent or chronic illness  Disorganized speech, rapid or slurred speech  Frequently bleary-eyed or smelling of alcohol

9. Vignette  It’s 4 PM on Friday. A student who you have chatted with several times in the past walks into the room and looks concerned. He is not making good eye contact, his clothes look disheveled, and he has dark circles under his eyes. This seems different than usual, as he is usually optimistic and full of energy. He tells you that he has not gone to class for the last 3 days and has had a hard time sleeping. He goes on to explain that his boyfriend recently broke up with him. On the verge of tears, he says that he doesn’t know how he can go on. He tells you that you are the first person he has told and that he doesn’t know what to do.

10. Group Discussion  How do you feel?  Physically?  What’s going through your body right now?  Emotionally?  What emotions are your feeling?  Cognitively?  What types of thoughts are you having? Being aware of your own reactions is important.

11. Let’s Chat  What are some of the warning signs that the student is in distress?  What else would you want to know about the student?  What are some protective factors you notice within the student?  How does your role influence what your responsibilities are?

12. What would you do?

13. Responding to Students in Distress  If you are engaged with the student  Speak directly  Begin with specific behaviors  If you are observing the student  Notice specific behaviors or concerns  Consider writing down what you observe in detail  Use judgment on the urgency of the concern  Immediate safety vs seeking consultation  *Air on the side of safety*  Talk to supervisor  Walk them to CAPS  Contact the Dean of Students office 919-966-4042  DPS 919-962-8100 or 911

14. Speaking Directly with the Student  Meet privately  Set a positive tone  Express your concern and care.  Point out specific things you’ve observed  Ask “How are things going for you?”  Ask open-ended questions; no judgment  If there are signs of safety risk, ask directly  Suggest resources, walk them to CAPS

15. Culture Informing Action  Be mindful of how communication intersects with the student’s culture and your own.  Eye contact, Personal space, Volume of speech, Etc.  Take cues from the student’s behavior  Disclosing problems may be seen as a sign of weakness or shame. Be sensitive in how sharing may feel like a risk.

16. Counseling and Psychological Services  Located on the 3 rd floor of Campus Health Services building  Walk-in to initiate services  Walk-in hours: Monday-Friday 9:00am- noon and 1:00pm-4:00pm  If you accompany a student to CAPS, please ask to speak with available triage therapist, or Avery Cook or Maureen Windle to provide additional information

17. Counseling and Psychological Services Confidentiality  All CAPS services are confidential  There are a few legally mandated exceptions to confidentiality including:  Danger of harm to self or others  Disclosure of abuse to children, people with disabilities, or elderly adults  If information was subpoenaed by a court

18. University Resources  Counseling and Psychological Services 919-966- 3658  Office of the Dean of Students 919-966-4042  Campus Health Services 919-966-2281  DPS 911 or 962-8100