Sponsored by:
Provost’s 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 situations
Top 5 Academic Impacts
 MSUB ACHA-NCHA II Fall 2012 (N=588)
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1.
2.
3.
4.
5.
Stress 26.6%
Sleep 21.5%
Work 21.1%
Anxiety 20.4%
Depression 13.4%
 National Data Spring 2012 (N= 90,666)


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1.
2.
3.
4.
5.
Stress 29.0%
Sleep 20.6%
Anxiety 20.2%
Cold/Flu/Sore Throat 15.6%
Work 13.9%
 “Academic Impact”
 Received 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
work
Stress and Sleep
 48% 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 Health
 Within the last 12 months, %
of students who said the
following has been traumatic
or very difficult to handle:
 National Data:
 Finances
 Academics
 Family problems
 Sleep difficulties
 Intimate relationships
 Career-related issue
47%
40%
33%
31%
29%
29%
 Academics
 Finances
 Intimate Relationships
 Family problems
 Sleep difficulties
 Other social relationships
46%
34%
32%
28%
26%
25%
Mental Health
 Within the last 12 months:
 85% felt overwhelmed by all they




had to do
31% felt so depressed it was
hard to function
49% felt overwhelming anxiety
36% felt overwhelming anger
7% 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 do
31% felt so depressed it was
hard to function
51% felt overwhelming anxiety
37% felt overwhelming anger
7% seriously considered
suicide
NAMI Survey data
 64% 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 Distress
 Students 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 Distress
 Students 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 Distress
 Students 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 others

Adapted from University of Michigan (2008)
Recognizing Students In Distress
 Symptoms of Depression
 Persistent sadness
 Feelings of hopelessness, worthlessness, guilt
 Lack of motivation
 Lack of enjoyment of activities or class material the
person previously enjoyed
 Sleep disturbance
 Significant weight gain or loss
 Suicidal ideation
Recognizing Students in Distress
 Symptoms of Anxiety
 Excessive worry that is difficult to control
 Restlessness
 Fatigue
 Difficulty concentrating
 Irritability
 Muscle tension
 Sleep disturbance
 Panic attacks
Recognizing Students in Distress
 Symptoms of Psychosis
 Delusions (false beliefs)
 Hallucinations (false sensory experiences)
 Disorganized speech
 Disorganized behavior
 Flat or inappropriate affect (emotional display)
 Absence of motivation
 Speech disturbances
 Change in hygiene and appearance
Recognizing Students in Distress
 Counseling isn’t just for mental illness!
 Time management techniques
 Stress management techniques
 Sleep hygiene
 Balancing work/family/school
 Help managing significant life events (e.g., break-ups,
homesickness, roommate difficulties)
 Communication and interpersonal skills
 Relationship issues
Communicating with a Student
in Distress
 Move 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
student’s value system even if you disagree
 Listen attentively
 Give 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 honesty
 Remain calm and respond in a soothing manner
 Validate the student’s feelings and experiences
 Take the student seriously
 Be supportive and express your concern about the
situation
A Victimized Student
 Recognize the student may be vulnerable and
experiencing a range of intense feelings, including
shame, anger, fear and denial
 Believe the student
 Respect the student’s right to make his/her own decision
 Let the student know that you must, as a university
employee, report any abuse, but it can be reported as a
“Jane or John Doe”
 Refer to MSUB Student in Distress Guide

www.msubillings.edu/VCSA/PDF/GuideforFacStaffStudentBehavior.pdf
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•
•
•
•
A Severely Disoriented or
Psychotic Student
Recognize that psychotic states can involve extreme
emotion or lack of emotion and intense fear to the
point of paranoia
Recognize that a student in this state may be
dangerous to self or others
Call Campus Police (2222) before you see the student
so they can be in the area in case you need them
Alert 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
environment
The Aggressive, Angry or
Potentially Violent Student
•
•
•
Assess 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 unacceptable
• Stay 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
Student
•
•
•
•
Let 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 student’s disclosure as a serious plea for
help
Express care and concern and assure the student
that you will help him/her reach a professional
Distance Education
•
•
If 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 person
You could look online for resources in the student’s
geographical area and refer them
Recommendations
 Do not become involved with a student beyond your level of
expertise or comfort
 Do not ignore comments such as, “I won’t be a problem much longer”
 Do not become anxious or overwhelmed yourself
 Do not minimize the seriousness of the student’s 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 assumptions
Referring a Student For
Professional Help
 WHEN TO REFER
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•
•
•
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Student remains distressed following repeated attempts by
you and others to be helpful
Student becomes increasingly isolated, unkempt, irritable
or disconnected
Student’s academic or social performance deteriorates
Student behavior reflects increased hopelessness or
helplessness
You are doing on-going counseling rather than advising
How to Refer
 Speak 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 Services
Student Health Services
The 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 & Counseling
Monday-Friday 8:00a - 5:00p 2nd Floor Petro Hall
 City College
Clinic: Mon, 1p-4:30p; Wed, 9a - 12p; Tue & Thu, 11p - 2p Tech Bldg. 2nd Floor
Counseling: Mon, 9a-4p; Wed 9a-12 noon; Thu, 8a - 11a
Phone:
 University Campus: (406) 657-2153
 City College Phone: (406) 247-3027
www.msubillings.edu/studenthealth
Campus Police
 For 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 SOS
 Provides 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 activity
club
 Student Opportunity Services/TRIO
Library, LI 141
 Phone: (406) 657-2162
Fax: (406) 657-1667
Office Hours: 8:00 am to 5:00 pm M-F
 www.msubillings.edu/sos/
ASC – Academic Support Center
 Offers 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 Services
 Works 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 &
Situations—Some Key Components
 Location
 Safety
 Thorough Assessment
 Problem Solving
 Referral
 Clear Communication
 Avoid Judgment
 Boundaries & Competence
 Active Listening & Validation
 Supports/Consultation
 TAKE CARE OF YOURSELF!
Unconfirmed Diagnosis
 “I think I’m bipolar.”
 “I’m pretty sure I have ADHD.”
 “I have test anxiety.”
 Think about student welfare
 Take them seriously – refer them for diagnosis & treatment

Win-win
 Let them know about DSS & other supportive programs
Refusal to Work with Medical/
Mental Health
 “They don’t understand me.”
 “They say I’m faking it.”
 Any accommodation should go through some path
(e.g., SHS, DSS, etc.)
 Acknowledge & validate fears/concerns
 Encourage referral
Excessive Requests
 “Can 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 Assistance
 Student Health Services Mental Health Counselors
657-2153
 Linda Crummett
 Judy Silverman
 Amber McDermott (also in Dept of Rehab & Human Services)
 Kim Waldmann
 Department of Psychology
657-2242 or 657-2250 (direct #)
 Marie Schaaf Gallagher
Resources
 Helping Students in Distress--A Faculty and Staff Guide for Assisting Students in Need
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
University of Maryland Counseling Center
http://www.cte.umd.edu/HSID.pdf
 Reaching Out Resources for Responding to Students in Distress
 Boise State University Health and Recreation Counseling Services
 http://healthservices.boisestate.edu/resources/materials/reachingOutHandbook.pdf
 Student in Distress and Sexual Harassment: A Guide for Faculty and Staff
 MSU Billings
 http://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/NAM
I_Survey_on_College_Students/collegereport.pdf
Discussion:
 Other Student Requests/Situations?