Over the past several years, college counseling centers across the U.S. have experienced striking increases in the number of students seeking treatment for psychological problems as well as amplification of symptom severity manifested by these students. Clark University is no exception. Utilization of our services at the Center for Counseling and Personal Growth (CPG) has increased by approximately 46% in the past two years (between 2013 and 2015). Several Clark students are hospitalized annually for psychiatric conditions, while others require psychiatrically–related medical leaves. Suicidal ideation and self-injurious behaviors are common here and on campuses nationwide. In a recent survey of college counseling centers, 80 of 274 (30%) of schools that responded experienced at least one student suicide in a one-year period. Despite increased utilization of psychological services, many students in distress neither seek nor receive treatment.
In the face of these national patterns and day-to-day experiences with troubled students, many faculty and staff members have expressed concern and requested information to assist them in identifying problems and helping students locate professional support. At Clark University, by virtue of our small size and academic values, we have committed ourselves to support students in their growth as total human beings. This document is designed to assist faculty and staff to recognize typical signs exhibited by students in distress, to communicate effectively with such students, and to refer them to appropriate campus resources.
Recognizing students in distress
Signs and behaviors listed under the following categories are often indicative of psychological distress.
Expressions of concern about a student by other students
Marked Changes in Academic Performance
- Excessive class absences or tardiness
- Avoidance of classroom participation
- Inappropriate disruption or monopolization of class time
- Significant deterioration in quality of work
- Frequent requests for special considerations, especially when this represents a change from previous functioning
- Consistently missed appointments and assignments
Unusual Behavior, Attitudes, or Appearance
- Depressed mood, lethargy, excessive fatigue
- Hyperactivity, very rapid speech, grandiosity
- Unprovoked irritability, angry outbursts, any form of physical aggression or violence
- Unexplained crying
- Visible anxiety, marked negativity, or obsessive thoughts
- Marked change in personal hygiene or dress
- Noticeable weight loss or gain
- Strange or bizarre behavior possibly indicating loss of contact with reality. (Rambling thoughts, laughing to self, disorganized thinking, suspiciousness, or prolonged vacant staring.)
Direct or Indirect References to Significant Distress, Suicide, or Homicide
- Expressed thoughts of helplessness or hopelessness
- Comments suggesting family problems or marked isolation from family or friends
- Reference to "voices" telling the student what to do
- Overt or indirect references to suicide (may appear in written assignments)
- Sharing of homicidal threats
Responding to students in distress
Clark University faculty and staff are neither expected nor encouraged to provide psychotherapy or clinical assessment services to students. Having said that, it is also evident that faculty and staff are often in an optimal position to notice students in distress, to engage them in conversations about their situations, and, ultimately, to refer them to appropriate resources for assistance.
If you are having difficulty deciding if, when, or how you should approach a student in apparent distress, individuals at the Center for Counseling and Personal Growth and Dean of Students office are available for consultation. If you feel that a student is in imminent danger or crisis, please alert the Dean of Students office immediately at (508)793-7423. If you believe a student may be experiencing psychological distress, the following guidelines will help facilitate effective communication:
- Speaking with a student out of genuine concern will usually be perceived as a kind and thoughtful gesture rather than an intrusion.
- When you address the student, offer non–judgmental descriptions of the behaviors/signs that have provoked your concern. Be as specific and concrete as possible (e.g. "I'm concerned that you've missed so many classes recently").
- Listen openly to the student's description of what's happening in his or her life. Acknowledge (validate) how the student is seeing things at this time so that he or she may know that you understand.
- If you have questions, ask them directly and non–judgmentally.
- Allow for silences.
- If you are concerned about the possibility of self–injury or suicide, ask directly if the student is considering hurting him/herself. Bringing up this subject will not "put ideas in the person's head". Often a student will be relieved to hear that someone is "tuned in" well enough to ask.
- Avoid making promises of confidentiality. If it turns out that the student is a potential danger to self or others, such promises cannot be kept.
- Try to determine the nature and extent of the student's friendships, family connections, and other sources of social support. Determine if he or she is reaching out for help from support systems.
- Be clear with the student (and yourself) about what support you can and cannot provide.
- Describe resources available on campus (e.g. Center for Counseling and Personal Growth, Dean of Students Office, Residential Life and Housing Office, Disability Services). Explain the potential benefits of professional support.
- Volunteer to help the student make an appointment with a counselor (if desired).
- Instill hope in the student that things can improve with a new course of action.
Connecting a student to help
While a student often feels much better after talking with an interested adult, you might sense that his or her problems are beyond the scope of your expertise. In such cases, it is helpful to encourage a student to seek assistance at the Center for Counseling and Personal Growth (CPG). Reassuring the student that it is normal to have some problems during the college years, stating the fact that a large number of Clark students seek contact with the CPG during their time here, and stressing that the CPG staff enjoy working with students and have a great deal of compassion for the student's experience (whatever it may be) can also help a student to feel more relaxed about asking for help.
Scheduling an Appointment (508–793–7678)
If you feel there is no immediate emergency and that counseling might be helpful, providing a student with information about accessing our services can facilitate the process. To schedule an appointment, a student should either email our general counseling inbox at email@example.com or call us at (508)793-7678 and leave a message in mailbox #1. In most cases, students can be seen within a week of scheduling their appointment, however it may be longer during our peak times of use (April and November). If you feel that the student is hesitant to schedule an appointment, a good approach is to encourage the student to call to make the appointment from your office. It is often helpful for a counselor to have information about a student's situation before the counselor sees the student. Students are usually willing, even relieved, for an initial conversation between the faculty or staff member and a counselor to take place. If you would like to speak with a counselor, ask the student's permission to do so when referring him or her.
In case of emergency, where you feel uneasy about letting a student leave your office, you may call the Dean of Students office (508-793-7423) to let them know about your immediate concerns. In cases that involve urgency, CPG has an "urgent" hour at 3pm each day that is filled by the Dean of Students. If you have referred a student who is in crisis, we appreciate your calling (508-793-7678) or emailing us (firstname.lastname@example.org) to let us know about your concerns.
After Hours Coverage
If you are confronted with an emergency situation outside of regular office hours (Monday — Friday 9:00 am – 5:00 pm) or on weekends, you can call Clark University Police at 508-793-7575. University Police will contact the on–call staff to let them know about the situation.
Getting Support and Professional Consultation
In addition to direct services to students, we offer consultation services to faculty and staff who have concerns about a student but feel uncertain about whether to act on their intuitions. You may arrange a consult, by calling our general phone number (508-793-7678) or email us (email@example.com) that you would like to talk with a counselor about a student. If you indicate that this is an emergency, a counselor will return your call as soon as possible. If it is not an emergency, we will get back to you as soon as we can. Situations involving student psychological issues can be complex and confusing. When in doubt, call!