What Can I Do?

Students Helping Students in Distress

Prepared by Washington University Student Health Services

Four Steps to Recognizing and Helping Students in Distress

Many college students with concerns about their emotional health are afraid to get the help they need. When students do reach out, they usually choose friends and family over RAs, staff, or faculty. During your time at Washington U, you may need to help a friend or another student in distress. This brochure is designed to help guide you through these important steps.

Step 1

Recognize the Warning Signs

Recognizing the warning signs of a student in distress does not require special training or expertise! It does, however, require an awareness of what to look for. A friend may not come right out and tell you that something is wrong but his/her language and behaviors often do. You may notice:

Withdrawal

Shows up for an event for a while, but leaves early
Is “too busy” studying or surfing the web to hang out
Just doesn’t seem to connect when with others
Skips class frequently
Stays in room or bed all day
Spends excessive amount of time on the computer
Avoids eye-contact

Disturbing Speech/Communication

Uses language indicating intention to harm self or someone else
Expresses a hopeless or negative outlook
Blames self or others for his/her mood/behavior (“I’m just lazy…”)

Significant Changes in Mood or Behavior

Used to seem happy but now seems agitated, depressed, “checked-out”
May have been easy-going but now seems uptight, aggressive, or “on edge”
Neglects personal hygiene or appearance
Increased use of alcohol or drugs
Significant weight gain or loss
Increased sleep or inability to sleep nearly every day
Decreased ability to concentrate

The greater the number of warning signs present, the greater the likelihood that the student needs assistance.

Step 2

Listen

Don’t be afraid to ask “What’s wrong?” or “What’s going on?” Simply asking the question won’t create a problem where there is none. Don’t underestimate the importance of listening. Without “doing” anything else, you are providing the support that could help your friend feel heard and understood (maybe for the first time). While it may be necessary or convenient to communicate electronically at times

(e-mail, text, or instant messaging), if at all possible, try to listen in person where it is easier to pick up on cues from facial expressions and other non-verbal language.

Effective listening requires:

Attentiveness

Maintain eye contact.
Ask for clarification when you don’t understand something that has been said.
Lean forward with open posture to indicate interest.

Attention to Verbal and Non-verbal Language

Pay attention to what is said and what is not said (i.e., tone of voice, posture, hand or facial gestures).
Notice when the non-verbal language doesn’t match the verbal language. Point out the disparity.

Accepting Attitude

Try not to judge or discount what you are hearing.
Don’t say: “You shouldn’t feel that way” or “You’ll be fine.”
Do say: “This sounds like a tough situation.”
If you find yourself slipping into an advice-giving or “fix it” mode, you may not be listening. Take a breath and refocus on what your friend is saying.

Step 3

Express Concern

It’s okay to express concern in a calm, non-judgmental way. However, be careful not to over-react with too much emotion or panic.

Acknowledge the struggle

You can do this by simply explaining without judgment that you are concerned.

Do say: “I’m worried about you. It seems like you haven’t been yourself lately.”
Don’t say: “It seems like your life’s a mess right now.”

Step 4

Make a Referral

Keep in mind that struggling with normal life events does not always require counseling. It is often the struggles in life that provide the most opportunity for growth. HOWEVER, if the situation seems to be triggering a more severe reaction (things seem to be spiraling out of control for the student) or it has been going on for more than a couple of weeks, then a referral to counseling may be appropriate.

Mental Health Services staff members are here to provide support for your friend and for you. If you would like to consult with a staff member about how to handle your concerns, call 935-6695 to speak to the mental health nurse and schedule a consultation.

When to Refer:

Review the Warning Signs to determine if any apply to the student (but always trust your own instincts even if there are no identifiable signs).
If you have immediate concerns about a student’s safety (i.e. you think he/she might cause harm to self or someone else), stay with your friend and call (on campus) WU Police 5-5555 or when off campus, 911. If it is not a life-threatening situation but you are still concerned, accompany the student to SHS during regular business hours or call 935-6695. If it is after hours, call 935-6666 and press option #1.
If you are feeling overwhelmed by the student’s situation, consider talking with a counselor about how you can take care of yourself and get support.

How to Refer:

Express concern again, “This sounds pretty difficult. There are more qualified experts who are available to help.”
Have the student make the appointment directly if possible. You may certainly offer to dial the number, wait while the appointment is made, or even walk over to SHS together to make the appointment in person.
Commend your friend for taking this first step.

Mental Health appointments are scheduled by calling 935-6695 8:30 a.m.-4:30 p.m. Monday-Friday. Emergency counseling and psychiatric appointments are available Monday-Friday at various times.

If you have immediate concerns about a student’s safety, stay with the student and notify SHS at (314) 935-6666. If you are unable to reach a staff member immediately, page Dr. Tom Brounk at (314) 670-7751. After alerting SHS, it is advisable to accompany the student to SHS. If the student refuses further assistance and his/her safety is at risk, contact the Washington University Police Department at (314) 935-5555.

MENTAL HEALTH SERVICES

A WORD ABOUT CONFIDENTIALITY

Confidentiality is almost always a concern of someone who is considering counseling. The mental health staff is firmly committed to the code of confidentiality and ethics of professional practice; therefore, complete privacy can be assured UNLESS the student is a danger to himself or others. Without permission of the student, mental health records are not available to anyone outside or within the University. Avoid assurances of confidentiality if the issues of suicide or harm to others are present.