Students in Distress: How to Recognize and What to Do

Student Mental Health and CARE Reports Webinar (August 2020, duration:  14:55)
This session will help you get ready to teach your first classes at Clemson by introducing new instructors to the CARE Network at Clemson and will overview resources to support student well-being.  The CARE Network is designed to be one of the ways to help connect current students with the resources to help support them. A CARE Network referral can include, but are not limited to: Academic Concerns, Adjustment Issues, Behavioral Concerns, Career or Graduation, Death or Grief, Financial, Personal Health or Wellness, Relationships or Student Engagement, and Other Concerns.

Presenter:
Alanna Landreth, Assistant Director, Office of Advocacy and Success (OAS)

College years are characterized by multiple transitions. Stress is a normal and expected reaction to these transitions. Students may experience stress associated with academic demands, family problems, social relations, work, financial concerns, and cultural experiences. Resources that students had while living at home are altered and they may find themselves isolated, lonely, and frustrated. While most students face stress and cope with the emerging demands of college life, for some, the pressures become overwhelming and unmanageable. The inability to cope effectively with emotional distress can lead to disruptions in a student’s overall functioning and pose a serious threat to academic success. As a community of faculty, staff, and students we are in a unique position to show concern and care. Proactive, timely, and at times reactive expressions of concern can be helpful in regulating and maintaining the emotional equilibrium that can lead to a successful college career for our students.

Faculty, teaching assistants, University staff members, and fellow students often become concerned about students who suddenly stop attending their classes or other campus activities, miss an exam, stop responding to emails, or otherwise exhibit changes in behavior.  The purpose of this guidance is to provide information that will assist in identifying students in distress and specific options for intervention and for referral to campus resources.  This guide outlines three Rs to help navigate courses of action in potential situations of student distress: RECOGNIZE, RESPOND, and RESOURCES.  This guide emphasizes the difference between an emergency and non-emergency situation.  Both situations require attention.  We encourage you to follow this process to support the health and safety of our students.

RECOGNIZE

EMERGENCY.  RECOGNIZE a Serious Mental Health Crisis

A crisis is a situation where a student’s usual coping style becomes overwhelmed and the emotional and physiological responses escalate. With increasing emotions, coping becomes less effective until the person may become disoriented, non-functional, or attempt harm. If a student is in serious mental health crisis, one might see the following:

• Highly disruptive behavior (physical/verbal aggression)
• Overt suicidal threats (written or verbal, suicide attempt)
• Homicidal threats (written or verbal, assault)
• Inability to communicate clearly (incoherent, garbled, slurred speech)
• Loss of contact with reality (seeing/hearing things that are not there, paranoia)

NON-EMERGENCY.  RECOGNIZE Students in Distress

Everyone experiences symptoms of distress at one time or another; however, if symptoms persist over time and/or increase in severity, this may indicate need for assistance.  A non-emergency may turn into an emergency.

Marked Changes in Attitude towards Academic Performance

• Poor preparation for class
• Drop in performance
• Expressions of non-caring about classes
• Excessive absences or tardiness to class
• Excessive anxiety about class work
• Strong reactions to class material
• Exaggerated emotional responses that are obviously inappropriate to the situation
• Exaggerated need to oppose the teaching or discussions
• Inability to communicate clearly
• Perfectionism and excessive worry

Changes in Behavior

• Depressed or lethargic mood
• Avoiding participation in class activities
• Unusual or changed pattern of interaction with others
• Apathy or “in a daze”
• Oversleeping or not sleeping enough
• Disruptive behavior
• Consistently avoiding eating with others
• Marked increase or decrease in energy level
• Marked increase in irritability
• Low tolerance for frustration

Unusual Appearance

• Changes in personal hygiene or dress style
• Dramatic weight loss or gain
• Swollen or red eyes

RESPOND

RESPOND Immediately to an Emergency Situation.  This is a Serious Mental Health Crisis

If there is immediate concern for a student’s health and safety or the safety of others, contact 911 or the Clemson University Police Department (CUPD) 864-656-2222 for immediate on-site assistance.

For consultation in assessing the situation, call Counseling and Psychological Services (CAPS) at 864-656-2451 during business hours (8:00-4:30 Monday-Friday).  Once you identify yourself and indicate that you need assistance with a crisis situation, your call will be routed to a counselor who will guide you.  Actions may include the counselor speaking with the student on the phone, initiating a Zoom meeting with you and the student, or asking you to walk the student over to CAPS.  Students in crisis will be served immediately to stabilize their safety.  If the emergency situation is after hours or on the weekend, contact 864-656-2222 and request that the CAPS counselor on-call be contacted.

RESPOND to a Non-Emergency.  RESPOND to Students in Distress

If you choose to approach a student, or if a student comes to you for help with personal problems, the following suggestions are recommended.

CONSULT CAPS if you need guidance with the intervention.

TALK with the student in private. You may need to schedule a time to talk so that both of you are not rushed and preoccupied. Express your concern by referring to the student’s behavior in non-judgmental terms. Ask open-ended questions. Express empathy. Avoid asking “why” questions.

LISTEN actively and give the student your undivided attention. Communicate understanding by your verbal response, facial expression and body posture. Reflect feelings to make sure you understand.

INSTILL hope. Most situations have options. Assist the student by moving away from focusing exclusively on the problem. Suggest resources and support the student’s desire to move beyond the problem.

AVOID judgmental statements, evaluations, or criticism. Avoid comparisons that place the student at a disadvantage. Respect the student’s value system even if it is different from your own.

MAINTAIN clear professional boundaries. The focus of the contact is on the student. Avoid unnecessary self-disclosures. Clarify rules and enforce them in the same manner as you would with any other student.

REFER to adequate resources. Encourage accessing services and follow through as signs of strength and courage rather than signs of weakness or failure. Support a student’s timetable for accessing services. If needed, assist with setting up of appointment and/or going to the appointment.

FOLLOW-UP with the student and see if they followed through with referral. Allow the student to express reactions to the appointment.

CONSIDER filing a CARE Report through the Office of Advocacy and Success

RESOURCES

Referral to Counseling and Psychological Services (CAPS)

1. Call (864) 656-2451 and request to see a counselor.
2. You will be asked to leave your name and number and a counselor will call you back same day for a phone screen. Plan on about 10-15 minutes for this call.
3. During the phone screen, the counselor will inquire about your need and determine appropriateness for remote services. All of CAPS services are through telemental health utilizing Zoom videoconference or phone.  If your needs are such that you require in-person visits, you will be given further instructions.
4. You will be set up to complete all necessary forms online through MyHealth-e, the secure student web portal, prior to your next appointment for an Individual Assessment.
5. At the Individual Assessment, you and your counselor will explore your mental health needs and develop a treatment plan. This lasts about 45 minutes.
6. CAPS offers a continuum of services that tap on student’s strengths and may include, workshops for learning skills, online trainings, group therapy, individual therapy and medical/psychiatric consultations. For more information visit clemson.edu/caps.

Request for Consultation from Counseling and Psychological Services (CAPS)

1. Call (864) 656-2451 and request a consultation.
   1. If this is an emergency consultation, you will be kept on the line and your call will be transferred to a counselor.
   2. If this is not an emergency, you will be asked to leave your name and number and a counselor will call you back.  
2. If calling for an emergency consultation outside of business hours, you may reach the CAPS counselor on-call by calling Clemson University Police Department and asking for the CAPS counselor on-call. Be prepared to leave your name and number and the counselor on-call will call you back shortly.
3. If the emergency escalates and you need immediate assistance on-site, be prepared to call 911 or CUPD (864) 656-2222 for emergency assistance.

CARE Network

Filing a CARE Network Report on a student activates the Office of Advocacy and Success to follow up.

• Filing a CARE Network Report is not appropriate if the student or situation requires immediate attention or there is an emergency of any kind. Instead, please call 911 or the Clemson University Police Department at 864-656-2222.
• If a current student poses a threat of harm to self or others, please call the Clemson University Police Department immediately at 864-656-2222.
• CARE reports will be reviewed within one (1) business day; however, CARE reports are not reviewed outside of business hours (Monday – Friday 8:00 a.m.- 4:30 p.m.) or during holiday breaks.
• Once the CARE report has been reviewed, a clearly defined level of care protocol is used to determine the most appropriate steps.
• We will follow up with the person(s) who submit CARE reports only when additional information is needed.
• If you have submitted a CARE report and have more information to share or questions, please call us at 864-656-0935.
• Click for FAQs regarding CARE reports
• Click to view a list of resources and referrals the Office of Advocacy and Success frequently provides students.
• The CARE Network is designed to be one of the ways to help connect current students with the resources to help support them.  Common reasons for a CARE Network referral can include, but are not limited to the following:
  • Academic Concerns
  • Adjustment Issues
  • Behavioral Concerns
  • Career or Graduation
  • Death or Grief
  • Financial
  • Personal Health or Wellness
  • Relationships or Student Engagement
  • Other Concerns