Recognizing Distress Signals in our Students

1. Recognizing Distress Signals in our Students Campus Assessment, Response, and Evaluation (CARE) Team Professional Development Day October 18, 2013

2. Campus Assessment, Response and Evaluation (CARE) Team • What we do: • The mission of the Campus Assessment, Response and Evaluation (CARE) Team is to promote student success and enhance campus-wide communication regarding specific behavioral problems that may involve threats to the safety and well-being of the campus community.  • 299-TALK • care@mclennan.edu • Who we are • Dr. Drew Canham • Phyllis Blackwood • Paul Gonzales • Claudette Jackson • Larry Radke • Joshua Rieff • Shelly Rogers-Sharer • Jessica Shelton

3. Students in Distress • Campus crime and violence statistics are relatively stable • Awareness has increased greatly • There have been reported increases in students with psychological issues and students on psychotropic medication • Students in distress are at risk for developing: • Academic and social difficulties • Family and vocational struggles • Depression and anxiety • Violence against others • Suicidal ideation • Most of our research for this presentation focuses on suicidal students, but many of the warning signs are the same • Bottom line-if you notice changes in a student or have a “gut feeling” that something isn’t right, seek help • Most campus violence is planned and there are warning signs-not “they just snapped”

4. Suicide Statistics

5. Facts About Suicide • Suicide is the 11th leading cause of death in the U.S. (roughly 32,000 each year) • Females attempt suicide more than males, while more males complete the act than females • The rate of suicide attempts for females is 3 times that of males • The rate of suicide completion for males is 4 times that of women • This is due to the fact that males use more lethal means (guns, hanging, etc.) than women (overdosing, suffocation, etc.)

6. Suicide Among Our Youth • Suicide is the third leading cause of death for people ages 15-24 • There are 11.5 youth suicides every day • Someone under the age of 24 completes suicide every two hours and five minutes in our country • 18-24 year-olds attempt suicide more frequently than people in any other age group • The rate of youth suicide increased more than 200% from the 1950’s to the late 1970’s, where it has remained

7. Suicide Among College Students • There are roughly 1,000 suicides on college campuses each year • After accidents, suicide is the leading cause of death for college students (7.5 per 100,000) • 1 in 10 college students has seriously considered suicide • Of these, 95% reported feeling so sad that they couldn’t function during at least one point in the last year • 94% reported feelings of hopelessness • 1 in 12 students has planned how they would attempt suicide • 2000 survey of 1,600 college students: • 1.5% had made a previous suicide attempt • 50% reported feeling “very sad” in the last year, 33% said they had been “hopeless,” and 22% said they had been so depressed they couldn’t function • Only 6% of males and 13% of females had been diagnosed with depression

8. Mental Health on College Campuses

9. Why are college students at risk? • Students are facing normal developmental milestones at this age (individuation, independence, identity formation, etc.) • They also face financial stress, academic and social competition, and the pressure to succeed • Students have to adjust to the differences between high school and college • Students face these challenges on an unfamiliar campus, perhaps away from their regular support network • Improvements in psychotropic medication make it possible for people with a severe mental illness to attend college • More students can attend college now versus 20 years ago because of increases in financial aid availability

10. Special Populations Issues • Non-traditional students face the added stress of having jobs and/or family, plus the feeling of “not fitting in” • Returning to school is also considered a major life stressor • International students may experience increased stress because of cultural differences between themselves and their classmates, as well as financial difficulties • Lack of familial support exacerbates the problem • LGBTQ students tend to experience increased depression and isolation • Students with a pre-existing mental health condition, or those who develop a mental health condition while on campus, are at an increased risk of developing suicidal ideation • Among these, males, students under 21, and Asian and Hispanic students face a higher risk

11. Support on Campus • Community and 2-year colleges traditionally have fewer support services available • Only 20% of college students surveyed said they would seek help at their college’s Counseling Center • Faculty and staff typically have the most regular contact with students, and certain assignments may provide faculty with insights into a student’s way of thinking • This means college employees need to know when to refer a student for help, and to whom they should refer them

12. Signs & Symptoms of Distressed Students

13. Helping Someone in Crisis • Suicide IS preventable • ALL threats of suicide must be taken seriously • Most students who are suicidal demonstrate warning signs • We need to know what to look for and how to respond • Most suicidal individuals want to live but are unable to see how their current situation can improve • TALKING TO SOMEONE ABOUT SUICIDE DOES NOT CAUSE THEM TO BECOME SUICIDAL

14. What to Look For: • *Many of these symptoms can also apply to students who are not suicidal but still need to be referred for assistance • Lack of future goals • Giving away possessions • Sadness, hopelessness, stress • Depression • Sleep disturbance (too much sleep or too little), fatigue • Appetite change (eating too much or too little) • Extreme or prolonged sadness • Lack of pleasure in things that used to please them • Feelings of worthlessness • Poor concentration and decision-making • Previous diagnoses (especially Borderline Personality Disorder, Major Depressive Disorder, or Dysthymic Disorder)

15. What to Look For continued: • Indirect verbal cues such as “It won’t matter,” or “No one cares.” • Disheveled appearance • Rage or anger that is inappropriate or irrational • Sudden change in attendance, class participation, or quality of work • Withdrawing from normal activities or social interactions • Changes in their usual behavior • Causing disruptions in the living or learning environment • Talking or writing about suicide • Directly threatening suicide

16. Responding Effectively

17. How to Respond to the Student • Stay calm and slow down the process • Maintain personal space and use caution in touching them • Maintain intermittent eye contact • Avoid excessive familiarity • Minimize distractions • Pay attention to their nonverbal communication • Listen, even to speech that might make you uncomfortable • Be direct and talk openly • Be respectful and non-judgmental

18. How to Respond to the Student • Give firm, clear directions and set reasonable limits • Give limited choices • Focus on problem-solving • Offer empathy instead of sympathy • Be truthful • Try not to show your shock or upset feelings • Tell them that help is available and alternatives exist • Remove means to attempt suicide if possible • Engage the person in future talk (looking forward to positive things in that person’s future) • Offer to be another source of support and encouragement-express concern • Encourage the student to exercise, eat right, sleep 7-8 hours daily, and follow any advice given by their doctor or therapist

19. DO NOT: • leave them alone, even to call us • refer to their family as motivation to stay alive • dare them to do it • make decisions for them • encourage “venting” or disordered thinking • ask why • debate values • promise to keep the conversation a secret • overreact • make accusations • be hostile or threatening • get into a power struggle

20. Who to Notify or Call For Help • If the situation is urgent, call 8911 to alert Campus Security • If you are not comfortable calling security, call us; we can call for you • If you suspect a student is suicidal, get help • You are NOT responsible for diagnosing or treating the student, just ensuring that someone who can help is aware of the situation • Refer to Counseling Services (see Campus Response Guide) • Encourage them to come see us • We can come to your location if the student won’t agree to come to us

21. What about confidentiality? • FERPA allows disclosure of information in emergency situations when the information is necessary to protect the health or safety of some person • Additionally, FERPA applies to records…not your observations about a student or a conversation the student has with you • You are not bound by confidentiality in the same way a licensed mental health professional would be • At the end of the day, are you more comfortable with keeping the student happy, or keeping the student safe (even if they’re angry with you)

24. Decision Tree for Students in Distress Counseling Services Wellness and Fitness Building Room 101 299-8210 • Students with general counseling concerns after hours can call Counseling Services and leave a voicemail • If there is an urgent counseling need that occurs during work hours and Counseling Services is closed or unreachable, call Student Development at 8614 • If there is an urgent counseling need after 6pm, call 8911 • Be sure to document what the student said, how you intervened, and where you referred them

25. Culture of Reporting • Let go of any hesitancy – It’s not “pressing charges” • The key concept is “data collection” • A relatively manageable problem in your class may play a role in a larger issue • If you have a question about it, just file a report. We pledge to be diligent in sorting them out. • “If you see something, say something.”

26. www.mclennan.edu/reportit

27. Following-Up • Don’t assume that just because you gave a student our number, that they called • Accompany the student to our office, if possible • Follow up with the student and ask them how they are doing • Be sure you do this privately • We won’t be able to provide confidential information to you unless the student approves • Document what happened and how you responded by filling out a CARE Team report at mclennan.edu/reportit • Take care of yourself • During your interactions with the student, monitor your own reactions and stress levels • Be prepared to feel mentally and physically exhausted • Talk with someone if you need to process what happened

28. Scenarios • Jack is a student in your class. He emails you at 2am to apologize in advance for missing tomorrow’s test. He says he’s been “dealing with a lot of stuff” and “took a few too many pills, if you know what I mean.” What do you do? • Jill is a student you’ve advised. She emails you that she’s thinking about dropping out of school. She says she is thinking about “ending it all.” You reply to her email but haven’t heard back in several hours. What do you do?

29. REMEMBER… • Unless you are a licensed mental health professional, it is not your responsibility to make a clinical suicide assessment • These tips are to help you recognize possible distressed students in order to get them to someone who can help • We are here to answer any questions, hear your concerns, or guide you in how to respond to students you are concerned about • REPORT IT!!!!!!

30. References • Understanding and helping the suicidal individual. (2009). Retrieved June 22, 2009, from http://www.suicidology.org • Youth suicide fact sheet. (2009). Retrieved June 22, 2009, from http://www.suicidology.org • Suicide in the U.S.A based on current (2006) statistics. (2009). Retrieved June 22, 2009, from http://www.suicidology.org • Deisinger, G., Randazzo, M., O’Neill, D., & Savage, J. (2008). The handbook for campus threat assessment & management teams. Stoneham, MA: Applied Risk Management.

31. References, continued • La Di Da by Asher Roth. (2009). Retrieved June 22, 2009, from http://www.halfofus.com • Kadison. R., & DiGeronimo, T. F. (2004). College of the overwhelmed: The campus mental health crisis and what to do about it. San Francisco: Jossey-Bass. • Mattas-Curry, L. (2000). Eight factors found in assessing suicide risk. Monitor on Psychology, 31 No. 2. • Roy, L. (2009). No right to remain silent: The tragedy at Virginia Tech. New York: Harmony Books.