Helping Students In Distress

Introduction
The purpose of this guide is to provide faculty and professional staff members with information about the Counseling Center, referral information, and ideas about how to recognize and successfully interact with distressed students. University students experience significant stress of all kinds throughout the course of their education. Many students successfully cope with this pressure, but some find themselves overwhelmed or unable to manage. Because emotional distress often interferes with a student's academic performance and social interactions, faculty and staff members may sometimes be in a unique position to recognize students who are in trouble. Faculty and staff members can't identify every such student, nor will every student seek out or be willing to accept help. Awareness of the signs of psychological distress and knowing some guidelines for dealing with distressed students can help faculty and staff members be more in control of problematic situations when they arise.

Counseling Center Services and Structure
The Counseling Center is a division of the Office of Student Affairs and is located in the Baltimore Student Union, suite 218. It is open from 8:30 a.m. to 5 p.m. Monday through Friday, and until 7 p.m. two evenings. The center provides both professional counseling services for full- and part-time students and an Employee Assistance Program for faculty and staff members. It is the primary on campus resource for counseling services for students. Services available in the Counseling Center include short-term (12 sessions) counseling provided by social workers, a psychologist, and a substance abuse specialist and psychiatric and medication evaluation and monitoring provided by two part time psychiatrists. It is not a training site for any profession, and there is no out-of-pocket expense to students using these services. The Counseling Center is also available for consultation to faculty and staff members in situations where there is an interface between a student's personal problems and their academic experience.

Appointments
The Counseling Center works on an appointment basis. Students normally receive and appointment within one week of their initial call to the Counseling Center, unless there are truly unusual circumstances or scheduling difficulties. If the caller is having an emergency and identifies it as such when calling, the student is seen the same day. Faculty and staff members should to use good judgment in identifying true emergencies, and in advising students about the same, so that all may benefit from the appropriate scheduling of staff time. It is usually best to have the student call to make appointments themselves, if possible. To do so, they should call the Counseling Center at 8-8404 between the hours of 8:30 a.m. and 5 p.m.

Confidentiality
All Counseling Center staff members treat their contacts with students confidentially and in accord with Maryland state law. This means that the center cannot release information about counseling sessions unless the student signs a specific release of information form authorizing the center to do so. Often, if faculty and staff members are working cooperatively with students to help support their academic success, they are willing to do so. If not, the center can only release information without a student's written consent in response to imminent danger to the student or to others, or to a duly-issued subpoena. Such occasions are rare. Recognizing Students in Distress. It is not unusual for a person to feel depressed, confused, or upset occasionally. When these feelings persist, however, it is an indication that the person may be dealing with more than the normal variations of life. Listed below are some common signs of psychological distress that may benefit from some form of intervention or assistance. This list serves only as a basic reference point, not to diagnose a student's problem. If faculty and staff members suspect that a student requires such professional help, they should refer them to the Counseling Center or call the Counseling Center for help.

Signs of Distress:

• Extremely poor academic performance or a significant change from good to poor performance.
• Unusual or noticeably changed interaction patterns in the classroom.
• Depressed or apathetic mood, excessive activity or talkativeness, evidence of crying, noticeable change in appearance and hygiene, alcohol on the breath, missed tests, or repeated inability to remain awake.
• Repeated attempts to obtain deadline extensions or postpone tests.
• Inappropriate or exaggerated emotional reactions to situations, including a lack of emotional response to stressful events.
• Obvious loss of contact with reality, such as rambling speech, grandiose beliefs, disorganized thoughts, and seeing, hearing, and feeling things not apparent to others.
• Suicidal or other self-destructive thoughts or actions, such as, "I wish I wasn't here" or "I'd be better off dead." Actions that may suggest this include giving away valued possessions and putting legal, financial, and university affairs in order. (Please note: any such signs should be taken seriously and evaluated by a professional. Do not attempt to decide the risk of suicide yourself.)
• Disruptive, violent, or homicidal threats or actions.

Guidlelines for Dealing with Distressed Students
There are no absolutely correct procedures for dealing with distressed students. Everyone has their own style of approaching and responding to others. However, listed below are some suggestions that faculty and staff members may find useful:

Know Their Personal Limits as a Helper: Faculty and staff members may not feel comfortable trying to help students with their problem for various reasons: they sense that the student is in need of much more time than they can give, the problem needs much deeper exploration than they are prepared to offer, or it would violate a boundary in their relationship. In these instances, it is usually best to help students get the assistance or support they need in the appropriate place.

To do so, they can:

• Reinforce students for confiding in them and acknowledge their difficulties
• Be accepting and nonjudgmental
• Indicate in a gentle but a direct manner that obtaining professional assistance is a positive step, that their decisions to seek professional help is looked upon favorably ( and not as a sign of weakness), and that they can help students connect with competent professionals
• Remind students of the Counseling Center's policy of strict confidentiality
• Remind students that services are available at no cost
  Point out that the Counseling Center is for all kinds of problems, small and large, and that a situation does not have to reach crisis proportions for a person to benefit from professional help
• Emphasize that, although some people feel that seeking counseling is an admission of weakness or failure, it takes considerable strength and integrity to face oneself and work on self-development
• Offer to accompany students to the Counseling Center or help them set up an appointment
• Know What to Do in an Emergency: If faculty and staff members are concerned about a student's potential for suicide, they should refer him or her to the Counseling Center. While they should not attempt to evaluate this potential themselves, it is helpful to let the student know of their concern. They can probably get some indication about how quickly the student needs help by keeping in mind that professionals assess suicide potential, in part, by asking:
• What the plan for suicide is--exactly what do they intend to do?
• When and where they would carry out the plan.
• Do they currently have the means to carry out the plan?
• Have they ever attempted suicide before?

The more specific and lethal the plan, the more recent a previous attempt, and the greater the ability to carry out the plan, the higher the risk for a successful suicide. Asking these kinds of questions will not furnish the person with new ideas, but may reassure the distraught person when someone cares enough to ask about his or her welfare.

If faculty and staff members believe someone is so severely depressed or actively suicidal that they would feel uncomfortable if the student simply walked out of their office, they can do the following:

Between 8:30 a.m. and 5 p.m.: Call the Counseling Center at 8-8404. Ask to speak with Carrie Burmaster, LCSW-C; or, if she is not available, another counselor. Identify the situation as an emergency, and consult with the counselor about their immediate concerns.

After office hours or on weekends: If students agree, faculty and staff members may escort them to the emergency room. If students show behavior that is imminently dangerous or unpredictable, faculty and staff members may call Campus Police at 711. They will respond to the scene and accompany the student to the emergency room. Off campus, refer students to a local emergency room, or if the danger is immediate, by calling 911.

Guidelines for Dealing With Students Who May Be Potentially Dangerous to Others:
Situations may sometimes arise when faculty and staff members develop concerns that students may be dangerous to others. This concern may follow observation or report of the following:

• Physically violent behavior
• Verbally threatening or too aggressive behavior
• Threatening e-mail or letters
• Threatening or violent material on academic papers or exams
• Harassment, including sexual harassment and stalking
• Possession of a weapon, particularly a firearm

Sometimes these behaviors are the result of or are exacerbated by mental illness. The first thing faculty and staff members need to do is take appropriate action to protect both potential victims and potentially dangerous students. If danger appears imminent, they should call Campus Police immediately at 711. If uncertain about the situation, it is recommended that they call any or all of the following for consultation and assistance:

• The Counseling Center at 8-8404
• Campus Police at 711
• Their School's Student Affairs Professional
• Their Dean or Department Chair
• The Vice President for Academic Affairs at 6-1850

The Counseling Center, Campus Police, Academic Affairs, Student Affairs, and University Counsel often work together to advise, investigate, and consult in these situations. These offices can be helpful in assessing the dangerousness of a student, helping to design preventive interventions, and outlining options of appropriate courses of action.

Emergency Resources
The Counseling Center, Campus Police, Academic Affairs, Student Affairs, and University Counsel often work together to advise, investigate, and consult in these situations. These offices can be helpful in assessing the dangerousness of a student, helping to design preventive interventions, and outlining options of appropriate courses of action.

On Campus:

• Counseling Center: 8-8404 (8:30 a.m. to 5 p.m. Monday through Friday)
• Campus Police: 711 (24 hours)
• Vice President for Academic Affairs: 6-1850 (8:30 a.m. to 5 p.m. Monday through Friday)
• Student and Employee Health: 8-8792 (8:30 a.m. to 7 p.m. Monday through Thursday, 8:30 a.m. to 4:30 p.m. Friday, 9 a.m. to noon Saturday)
• Department of Psychiatry Urgent Care: 8-1219 (8:30 a.m. to 6 p.m. Monday through Friday)

Off-Campus Crisis Lines, Information, and Referral Services:

• Baltimore Crisis Response: 410-752-2272 (Twenty-four hour crisis help line and information and referral service.)
• Grassroots Crisis Intervention: 410-531-6677 (Twenty-four hour hotline and crisis intervention service, including walk-in service at their Columbia office for people experiencing emotional distress. Also, provides extensive information and referral.)
• First Call for Help: 410-685-0525 (Twenty-four hour information and referral service in Baltimore.)

© Student Affairs at the University of Maryland. All rights reserved.
Updated: Nov. 22, 2002